2007 PEAK Award Winners

Congratulations to Medicalodge of Kinsley!!!

Nine Adult Care Homes Receive Awards for Culture Change

The Kansas Department on Aging has recognized nine Kansas adult care homes have for their efforts to transition from the traditional institutional model of care to more person-centered care. Secretary of Aging Kathy Greenlee will present the Promoting Excellent Alternatives in Kansas (PEAK) awards May 3 during the Governor's Conference on Aging Services in Topeka.
The 2007 PEAK winners are:

Bethel Health Care Centre, North Newton, Leigh Peck, Administrator
Brewster Health Center, Topeka, Linda Farrar, Administrator
Greeley County Health Services/Long-Term Care Unit, Tribune
Medicalodge of Kinsley, Janel T. Burr, Administrator
Pleasant View Home, Inman (for an unprecedented fifth straight year
Salina Presbyterian Manor, Salina, Fran Paxton, Administrator
Schowalter Villa, Hesston
Village Manor, Abilene, Amy Hock Altwegg, Administrator
Village Shalom, Overland Park, Mathew Lewis, CEO

 "Facilities that embrace resident-centered care feel different from the moment you walk in the front door," Greenlee said. "The purpose of culture change is to focus as much on quality of life as quality of care.  For residents, this change makes a world of difference."

 KDOA began recognizing adult care homes through the PEAK Awards in 2002. Facilities must submit an application for consideration for the honor. The Secretary will make on-site presentations of the awards later this year.

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  National Nursing Home Week

May 13-19, 2007 is National Nursing Home Week and Mother’s Day is May 13.  Many nursing home residents are the people who planted the seeds that have made our community grow stronger. This week gives us a chance to honor these special residents, as well as the families, staff, volunteers, and community.

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  WHAT’S NEW AT KHCA…

Be sure to keep checking the member’s only section and the education calendar/online registration of the KHCA website at www.khca.org for new information.  New information is being posted weekly. There will also be new information posted to the Fire Marshal page.  Contact Nancy at npierce@khca.org if you need a member’s only password. 

New Information posted to the Members Only section includes:

* The proposed Nursing Facility Medicaid Rates for 7/1/07.  This proposed regulation will appear in the April 26, 2007 Kansas Register.

* A long-term care regulation interpretation from the LCE Commission on wireless resident call systems.

* Legislative Post Audit report on Health Care Related Programs in Kansas: Determining What Funding Kansas Receives and Who Administers it.  The report states that for FY2006 SRS spent $226.1 million for the DD Waiver, HCBS and $85 million for the PD Waiver, HCBS.  The report states that the Kansas Department of Aging spent $318.9 million for Nursing Facilities and $62 million for the FE Waiver, HCBS.  A link to the full report can be found on our website, members only section.

Don’t miss two great chances to showcase your facility. During the month of May, your facility will have the opportunity to nominate a staff nurse who will be recognized at the June 6 & 7, 2007 Resident Care Conference in Junction City. You will also have an opportunity to nominate a distinguished Elder living in long term care. These individuals will become “Ambassadors” for Long Term Care and will be recognized during the September 27 & 28, 2007 KHCA Convention and Trade Show. Look for nomination forms by email and snail mail soon.

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  KDOA Updates

2007 Governor’s Conference on Aging will be held in Topeka on May 2 & 3, 2007.  Click here for the brochure.

Ventilator-Dependent Rates Amended
KDOA reported that they have submitted the state plan amendment for Medicaid Ventilator-Dependent rates.  Those providers now participating in the program will receive a $450 flat reimbursement rate and can continue to bill DME for oxygen and cylinders effective 2/1/07.  Once the state receives notification from CMS that they have approved the rate change KDOA will make a retroactive adjustment to 2/1/07.  Contact Bill McDaniel or Dave Halferty at KDOA for more information.

NPI Implementation Delayed
CMS has delayed implementation of the NPI until May 23, 2008.  KDOA has asked us to remind Providers that they still need to have their NPI by May 23, 2007 or risk a possible fine by CMS.  According to KDOA, all but 25 nursing home providers have their NPI and these 25 are in the process of obtaining theirs.  The state also suggests that providers try out the system over the next year while both systems are running simultaneously.

Occupancy and Staffing Data is Now Online
The Adult Care Home Semi-Annual Report which is prepared for the Kansas Department on Aging by the University of Kansas School of Social Welfare Office of Social Policy Analysis, is now available online through the KDOA website.  Click here to view it. The data is gathered on a calendar year semi-annual basis via questionnaires sent to all Kansas licensed nursing facilities, nursing facilities for mental health, assisted living facilities, and residential health care facilities and include information on occupancy and staffing.

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  The ABCs of Long Term Care Insurance Claims
David Landwehr CSA, CLTC

We all purchase insurance hoping against hope that we never collect. And, in the event that we have a claim, we want no surprises. While the claims decision process for life insurance is crystal clear, the same is not true of most other types of insurance. Will our homeowners policy pay for the flooding of our basement - or is that only covered by the National Flood Insurance Program? It depends on the cause of the flooding. Will a parking lot accident resulting in a bumper dent be covered by our car insurance? Only to the extent that the repair cost exceeds the deductible. Will the insurance company give me money to replace the diamond that fell out of my engagement ring? Only if the ring was a scheduled item, and then the insurer will replace the stone, not send a check.

Similarly, it is important that long term care policyholders understand how their policy works, and what might impact whether a claim is paid or denied. Since contracts vary, it is important to read your own policy to understand its benefits. This press release is highlighting six areas with which policyholders should be familiar to minimize surprises at claim time.

A - stands for ADLs (Activities of Daily Living). A loss of ADLs is one way that a policyholder triggers (becomes eligible for) benefits. Most policies meet federal tax qualified mandates and require a loss of two ADLs from the list printed in the policy. The ADLs are bathing, eating, transferring, continence, toileting, dressing.

B - stands for Benefit. The Daily Benefit is the maximum amount of money that a policyholder will collect each day from the insurance company for covered services. Reimbursement policies will reimburse the insured for out of pocket spending on covered services up to the daily benefit purchased. Most policies have state licensing requirements for facility care, and may require that home care be through a state licensed agency. A minority of policies (called cash benefit policies) provide a cash payment once the insured is eligible, regardless of the cost or type of care received.

C - stands for Cognitive Impairment. When an insured suffers from "severe cognitive impairment" he or she is eligible for benefits from virtually any long term care insurance policy. This cognitive impairment trigger is a way for insureds who do not require ADL assistance to collect benefits. Examples of conditions causing cognitive impairment include Alzheimer's disease and dementia caused by drug interactions.
C also stands for Certification. Most modern long term care insurance policies follow federal government mandates and require that care be needed for at least ninety days in order for a claim to be approved.

D- stands for Deductible (called an elimination period in a long term care insurance policy). To satisfy a day of the elimination period, the insured must usually pay out of pocket for covered care. This would mean that a policyholder with a ninety day elimination period policy would need to pay for ninety days of care to be eligible to receive benefits. Some policies have relaxed rules for satisfying the elimination period on home-based claims. For example, the policy may credit seven days against the elimination period if one day of professional care is received that week.

To understand the landscape of a typical long term care insurance claim, answer these questions.
Does the insured suffer either a loss of ADLs or a loss of cognitive impairment as defined in the policy? For example, just because someone doesn't want to shop or cook anymore doesn't qualify them to move to assisted living and have the insurance company pay a claim, it requires a change of health meeting the ADL requirements.

*  Does the insured suffer either a loss of ADLs or a loss of cognitive impairment as defined in the policy? For example, just because someone doesn't want to shop or cook anymore doesn't qualify them to move to assisted living and have the insurance company pay a claim, it requires a change of health meeting the ADL requirements.
*  Is the professional care being received a covered service according to the policy? Policies might not cover care by unlicensed caregivers, though home care through licensed agencies or facilities will usually be covered.
*  Is the care expected to last at least ninety days? Most LTC insurance policies written since 1997 have this requirement for claims (in order to comply with HIPAA, making the policy premiums eligible for federal tax deductibility and the income received tax free.).
*  Has the deductible (elimination period) been met? No claim will be paid until the elimination period is satisfied.

Long term care insurance is the only insurance designed to protect your retirement lifestyle and nest egg against the high cost of long term care. A change of health requiring long term care is the number one risk we face in retirement. Contact your agent or insurance company to file a claim or to ask questions about your own policy.

LT Care Solutions, Inc. specializes in LTC planning for both companies and individuals since 1992. We believe that dabbling is dangerous and LTC is an important decision best made in consultation with an experienced advisor. Go to www.LTCare Solutions.com for more info.
Website: http://www.LTCareSolutions.com

LT Care Solutions
David Landwehr CSA, CLTC
President
email: dlandwehr@ltcaresolutions.com
phone: 316-945-2011

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  Fire Marshal Updates

Nursing Facility Education
Upcoming Education with the Fire Marshal’s Office will be held on July 18th in Topeka and July 19th in Wichita.  KHCA is hosting this statewide event which will include the Fire Marshal’s office and Tom Jaeger, a National Consultant.  The Fire Marshal’s office will give updates on LSC and all will participate in a panel discussion and a question and answer session.  Watch for the brochure the end of May and sign up online at www.khca.org.

Assisted Living Education
The Fire Marshal’s office will be hosting six educational sessions across the state of Kansas for Assisted Living Facilities and RHHC.  The topic will be the Kansas Building Fire Safety Handbook Training and they will be held in the following areas:

June 26, 2007 in Liberal
June 28, 2007 in Dodge City
July 10, 2007 in Hays
July 12, 2007 in Scott City
July 31, 2007 in Colby
August 8, 2007 in Hill City

Contact Brenda at the Fire Marshal’s Office for more information at 785-296-3401.

Architects and Fire and Building Code Consultants
The Fire Marshal’s Office has shared a list of approved Architects and Fire and Building Code Consultants that they have with the Association.  Please go to the www.khca.org fire marshal page to view the list.

New Postings to our Website
Check the Fire Marshal page at www.khca.org for recent postings from CMS on annunciator panels and permitted gaps in corridors.  Also check www.khca.org for AHCA’s LSC Update Q & A on Permitted Gaps in Corridor Doors.

Reminders From the Fire Marshal’s Office
The Association staff met with the Fire Marshals Office and their representatives who review code footprints for nursing facilities and assisted living and plan of corrections for nursing facilities and assisted living.  The following were tips they would like us to pass along to our membership. 

1. Steven Fenske-Reviews code footprints for nursing facilities statewide for construction and remodels.  Steven would like to remind owners and administrators to call him at 785-296-6472 or email him at fenskes@fm.state.ks.us if you have any questions about compliance with any structural changes prior to starting construction.  He will also review spec sheets of products and will tell you ahead of time if you will be complying with LSC prior to purchasing anything.  Steven is currently developing a checklist for nursing facility providers and their Architects to review prior to submitting code footprints.  The checklist will contain necessary items for your code footprint to be approved.  It will contain reminders for the Architect to stamp, date and sign the document and to list active and passive fire protection systems.
2. Jack Chatmon- Reviews code footprints for assisted living statewide for construction and remodels.  He would like to remind providers to contact KDOA or KDHE 30 days prior to needing a 50% and Final construction inspection.  KDOA and KDHE will then schedule it with the Fire marshal’s office.
3. Amanda Yorkey-Reviews the plan of corrections for assisted living.  She did not report any problems.
4. Barb Sumpter-Reviews plan of corrections for nursing facilities.  She would like us to remind providers to label their attachments with the corresponding K-tag that it pertains to.  Also to remind providers to date and sign the POC.  She would also encourage providers who think they might possibly go over 30 days to submit a waiver.  When completing the POC she suggests that you answer how you will correct the deficiency, how you will monitor it, and actions you will take so it does not reoccur.  She would also like to remind providers who receive letters from KDOA/KDHE for Health deficiencies at a G+ or higher level to read the letters carefully.  If a provider needs to be in compliance with a G+ health deficiency within 45 days, then they will also need to be in compliance within 45 days for any LSC issues or risk being in a denial of payment.
   

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  AHCA Convention

Mark your calendars now for this year’s AHCA/NCAL/MECF 58th Annual Convention & Expo,
October 7-10, 2007 in Boston, Massachusetts.

Online Attendee Registration and Housing Now Open!

Register online, and make your housing reservations for the
AHCA/NCAL/MECF 58th Annual Convention and Expo in Boston, MA.

* Learn about issues facing providers in the long term care profession.
* Hear dynamic keynote speakers, James Carville, Mary Matalin, and Michael Durant.
* Learn about innovative programs and state of the art technology in long term care in our expanded expo halls.
* Enjoy our featured Gala including spectacular performances by Mary Wilson of the Supremes followed by the legendary Four Tops.
* Tours have been arranged for you to discover the colonial charm and urban sophistication of Boston.
* Network with colleagues.
* Receive up to 17 CEU’s.

Visit our convention website at www.AHCAconvention.org to get up to date convention information.

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  AHCA Asks For Your Support

Study Deadline Now April 27 - Independent & Regional Facilities Urged To Participate

Protecting critical Medicare and Medicaid funding for long term care is a top priority for AHCA—and we need your help.  AHCA has retained the Lewin Group to update our nursing facility "hydraulic" study, which examines reimbursement and costs for providing long term care services.  Your participation in this important study will assure that we have the best, most accurate data as we inform and educate policymakers about the complex payer funding relationships for our profession.

The corporate offices of large chain facilities are submitting data already; so, we are urging Independent Owners and small-medium regional multi facilities that have been underrepresented in past studies to participate today.  To learn more about this study, please Peter Gruhn at AHCA.

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  Upcoming CMS Webcasts

Please click here for the upcoming CMS webcast on Nursing Home Improvement.

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  AHCA Has Scored A Big Win With CMS

AHCA has scored a big win with CMS --- they have (finally) issued an S&C memorandum clarifying door gap allowances and debunking the use of a “light test” by surveyors.  It is important to note that much of the body of the S&C memorandum was actually drafted by Tom Jaeger.   Click here to view AHCA’s Q & A on the topic.

Any questions, please contact Lyn Bentley at AHCA at 202-898-6304.

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