New Office Manager for KHCA

The KHCA Office would like to introduce our new Office Manager, Karla Werth to our Association staff.  Karla replaces Kelly Schreiner as the KHCA Office Manager.  Karla served as the Director of Constituent Services / Office Coordinator for Congressman Jerry Moran for 3 years and Governor Bill Graves for 3 years.  She most recently came from the Kansas Gas Service Customer Service area where she worked for 3 years.  Karla's email is kwerth@khca.org.

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  Proposed Pass-Through Reimbursement for Durable Medical Equipment

KHCA representatives met with the KDOA Reimbursement Advisory Group in April to discuss how the state will implement the changes to the DME program with the 7/1/08 Medicaid rates.  With the 7/1/08 Medicaid rates DME suppliers will no longer be allowed to bill the Kansas Medicaid Assistance Program directly.  NF providers will be expected to supply the DME for their Medicaid residents.   

Below is an overview from the State of the changes to the DME program and their proposed methodology that allows for a pass-through reimbursement for DME to providers. 

Overview by the State 

On July 1, 2008, durable medical equipment suppliers will no longer be allowed to bill the Kansas Medical Assistance Program directly for DME items.  These items will become content of service for the nursing facility program and each nursing home provider will be expected to supply the DME their Medicaid residents require.  Because these costs have not been incurred by the nursing homes in the past, the cost report data used to determine nursing home rates does not reflect expenses for DME.  On July 1, 2008, KDOA will implement a per diem pass-through provision as part of the Medicaid reimbursement rates to address this issue.   

The methodology for calculating the per diem pass-through will be as follows.  The total oxygen expense reported on line 507 and any adjustments related to that amount will be inflated to the midpoint of the rate setting period and combined with expenses reported for other cost report years included in the base period.  This total will be divided by the total non-Medicaid resident day total for the cost report period.  The non-Medicaid resident day total will be determined by subtracting the total Medicaid days (line 48a) from the total resident days reported (line 48). 

An example: For a provider with total inflated costs of $6,000 for oxygen based on line 507, and 36,000 total resident days based on line 48, and 24,000 Medicaid days based on line 48a, the calculations would be as follows.  $6,000 / (36,000-24,000) = $6,000/12,000 = $0.50
This provider would receive a pass-through per diem add-on of $0.50. 
 
The overwhelming majority of the DME payments made for nursing home residents are for oxygen and oxygen related expenses.  This expense is not reported on the Medicaid nursing facility cost reports because DME providers bill KMAP directly for their services.  However, the cost report does include oxygen expenses for non-Medicaid residents.  This is reported on line 507.  KDOA will use the expense reported on line 507 of the cost report to determine a per diem pass-through amount that will be added to the Medicaid rate.

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  Dealing with Gum Disease

“A Life Threatening Health Risk”

Nearly 75 percent of American adults suffer from various forms of periodontal (gum) disease and don’t know it. Though reversible in its initial stages, mounting evidence of the relationship between oral bacteria and life-threatening diseases such as oral cancer; heart disease; diabetes, and respiratory ailments makes it critical that the condition be prevented or treated aggressively.

Heart Disease—The number one killer among men and women. Claiming more victims than all forms of cancer and AIDS combined; the disease affects more than 58 million Americans each year, killing almost a million. Numerous research studies have shown a link between cardiovascular disease and key bacterium in periodontal disease. While research continues to explore the link, it is important to treat periodontal disease aggressively so its impact on heart disease can be reduced or eliminated.

Diabetes—A chronic disease with no cure, diabetes is the fourth leading cause of death among Americans and will result in more than 169,000 deaths this year alone. It
is estimated that nearly 16 million people in the U.S. have the disease, yet as many as half of those who do are unaware of their condition. Approximately, 95 percent of Americans with diabetes also have periodontal disease, due impart to an increased susceptibility to infections. Research has shown that people with periodontal disease have more difficulty controlling their blood sugar levels while periodontal disease can increase the risk of developing diabetes.

Respiratory Ailments—Respiratory conditions can be aggravated when bacteria from periodontal disease travels from the mouth to the lungs and lower respiratory system. Conversely, patients who have other diseases are at an increased risk of developing breathing problems.

This fact sheet is brought to you by the American Dental Hygienists’ Association.

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  MY Innerview

“All In” on Satisfaction Assessment in 2008

Kansas Health Care Association/Kansas Center for Assisted Living, AHCA and My InnerView (MIV) will team up in 2008 to showcase the value and benefits of satisfaction surveys for customers (residents/families) and employees in a series of free Webinars for all AHCA members to begin on April 23 and April 30 at 1 p.m. Eastern Time (ET). To register and receive the Passcode, you must sign up at www.myinnerview.com. With over 4,500 AHCA members using My InnerView’s survey tools, you could say the MIV assessment system is “provider-proven” to be reliable, efficient and extremely affordable. The system is turnkey -- MIV does the administrative work, all analysis and provides a user-friendly report that identifies and prioritizes “next steps.” So make this the year you get an edge in your operations by listening -- in an organized way -- to the voices of your customers and employees.

Excellent Resources from the Advancing Excellence Campaign

Advancing Excellence Webinars have drawn a large call-in volume with total participation ranging up to 8,000 per call. Now you can replay the Webinar on pressure ulcers or have staff who did not see the original program watch it when it is convenient for the facility’s schedule. View the PowerPoint (or PDF), audio, and fact sheet for consumers from the Advancing Excellence Webinar/Teleconference on Reducing Pressure Ulcers in Nursing Homes. Providers and staff would also benefit from Advancing Excellence’s e-newsletter which you can subscribe to. Read the latest news in The Campaign Advance e-newsletter

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  CMS Revisit Fees

Reminder on CMS Revisit Fees:

If you had a health survey revisit between October 19, 2007 and December 25, 2007 CMS will be invoicing you for the revisit fee. 

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  National Center for Assisted Living Award Time!

Nomination forms for NCAL’s 2008 awards are now available.  Last year’s award winners set a high standard, and we are very much looking forward to continuing the tradition. Nominations for the Noble Caregiver in Assisted Living Award, NCAL Administrator of the Year, National Assisted Living Week Programming Award must be submitted through the state affiliates - not individual facilities. The deadline for nominations is Friday, June 6, 2008.

The materials for the following awards are now available:
* NCAL’s Noble Caregiver in Assisted Living Award
* NCAL’s Administrator of the Year Award
* National Assisted Living Week Best Programming Award 

Click here for more information : http://www.ahca.org/members/assisted/ncal_awards/index.cfm. 

Please forward your nominations to Cindy at the KHCA/KCAL office to be submitted. 
Questions?  cluxem@khca.org

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  Tamper-resistant Pad Requirement Takes Effect

After a six-month reprieve granted Congress, the Centers for Medicare & Medicaid Services (CMS) implemented new rules on April 1 requiring that, for Medicaid outpatient drugs to be reimbursable by the federal government, all written, non-electronic prescriptions must be executed on tamper-resistant pads. While prescriptions provided by nursing facilities are generally exempted from this new requirement, prescriptions forwarded by assisted living facilities are not.

Staff at assisted living facilities have several ways to comply with the new rules, according to CMS. The tamper-proof pad requirements do not apply when a prescription is transmitted to a pharmacy electronically, by fax, or verbally, or when a managed care entity pays for a prescription.  Therefore, assisted living facilities that transmit prescriptions in such fashion would be in compliance. Furthermore, if someone goes to the pharmacy with a prescription on non-tamper proof paper and the physician phones the pharmacy to confirm, then it is considered to be tamper proof. A prescription would be considered tamper proof if a physician phoned it in to a nurse at a facility who included it in an order sheet (noting the doctor’s order) that is sent to a pharmacy, if the order sheet is never in the control of the beneficiary, according to CMS. Prescriptions dispensed under Medicare Part D are exempt from the new requirements.

The tamper-proof pad requirements were included in appropriations legislation passed by Congress last year and originally scheduled for implementation on Oct. 1, 2007.  For more information click here.

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  Top Ten Deficiencies for Kansas Assisted Living- 2007

Number 10    K3156-- Health Care Services

Number 9       K3081--Functional Capacity Screen

Number 8       K3092--Negotiated Service Agreement

Number 7       K3155--Health Care Services

Number 6        K3310--Infection Control

Number 5        K3200--Facility Management of Meds

Number 4        K3025--Staff Treatment of Residents

Number 3        K3261--Resident Record

Number 2        K3245--Staff Qualifications

And the Number 1 most written deficiency...K3085--Negotiated Service Agreement

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  KDOA, KHPA and LCE UPDATES

NF/MH Health Surveys

The Commissioner of Licensure, Certification and Evaluation recently informed KHCA and Nursing Facility for Mental Health Administrators that they are moving forward with a reorganization of survey functions for NF-MH's.  Going forward these facilities will be surveyed by the regional office teams.  This change will mean the most effective use of LCE resources.  The facilities will still be surveyed using the same regulations as before.  Click here to view the letter sent to the NF/MH’s.

KANSAS MEDICAID’S ADVANCED ID CARD

The Kansas Health Policy Authority (KHPA) will provide a durable medical ID card for Medicaid beneficiaries. The advanced ID card will take the place of the Medicaid paper cards that are currently issued every month to over 275,000 Kansas Medicaid beneficiaries. The card will be issued annually and will be linked to an electronic database that provides current information about the beneficiary’s Medicaid eligibility status. The advanced ID card will eliminate the need for Medicaid providers to photocopy the cards each month. It will also provide the ability to instantly determine whether a beneficiary qualifies for Medicaid and will reduce the number of rejected claims due to operator error when recording patient identification information. The front of the advanced ID card will contain the beneficiary name, beneficiary ID number, and date of birth. The back of the advanced ID card will contain plan contact information for providers and plan contact information for beneficiaries.

Provider notification and training begins on April 9, 2008. Beneficiary notification and training begins on May 1, 2008 followed by notices in May, June, and July beneficiary mailings. Provider bulletins will be mailed on July 15, 2008. Delivery of advanced ID cards to beneficiaries begins on August 23, 2008. Beneficiaries will begin presenting advanced ID cards to providers on September 1, 2008.

For more information on the advanced ID card initiative, please contact: Travis Haas, Project Manager, at Travis.Haas@khpa.ks.gov , 785-296-1871. Click here to view the entire KHPA document.

FY 2009 Rate Setting Dates

April 18, 2008
Distribute Minimum Wage Pass-Through Application Forms

April 24, 2008
Proposed Methodology Published in Kansas Register
Public Comment Period Begins

May 23, 2008
Public Comment Period Ends
Deadline for Submitting Minimum Wage Pass-Through Applications

June 19, 2008
Final Methodology Published in Kansas Register

June 20, 2008
First Quarter FY 2009 Rate Schedules Mailed to Providers

According to KDOA, the 7/1/08 proposed NF rates reflect a 5.5% increase,the 7/1/08 NF-MH rates reflect at 4.4% increase and the average increase for all homes is 5.3%.

KHPA Memo Re: Availability of Non-Assignable Annuities

Click here to view the entire KHPA Memo re: availability of non-assignable annuities.  The purpose of this memo is to provide guidance on the treatment of non-assignable annuities which were purchased by or on behalf of an institutionalized individual or their spouse with a lump sum payment in exchange for an immediate income stream.  These provisions are effective with all decisions made on or after the issuance date of this memo.

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  Fire Marshal Updates

Click here for the new Plans Submittal Checklist from the Kansas State Fire Marshal’s Office. Always check the KHCA website Fire Marshal page for the latest updates.

Does Your Facility Post the Code to Exit at a Keypad Door?

Has Your Facility recently been cited for exits not being accessible at all times?
One of KHCA nursing facility providers had a recent Life Safety Code survey and the fire inspector cited them for not posting the code at the exit of a keypad door.  The fire inspector said when you walk up to an exit door and it is secure and you have to ask someone the code to get out, that is now a deficiency. The inspector said that they were told by CMS to cite this. This is a recent directive from CMS to our state Fire Marshal’s office according to the inspector.  The inspector cited them at an “F” level.  The Inspector cited the tag on the door locks because there was no information posted as to how to get out/passed the secure door.  He said if he walked up to the door and no staff were around, how could he get out of the door.  He used the main entry as the example because he came in the building and forgot something in his vehicle, and when he went up to the door, he could not get out as there were no instructions on how to release the secure door.

Brenda McNorton of the Fire Marshal’s office looked into the issue for KHCA.  The KSMO response is below:

Recently there has been discussion regarding magnetic locking devices and whether doors in a nursing home can routinely be locked. CMS has reviewed the Life Safety Code requirements and discussed the issue with our Central Office.
 
At issue is NFPA 101 Life Safety Code, 2000 Edition, Sections 19.2.2.2.4 and 18.2.2.2.4, which states:  “Doors within a required means of egress shall not be equipped with a latch or lock that requires the use of a tool or key from the egress side.”  There is an exception (Exception No. 1) that indicates that “Door-locking arrangements without delayed egress shall be permitted in health care occupancies, or portions of health care occupancies, where the clinical needs of the patients require specialized security measures for their safety, provided that staff can readily unlock such doors at all times.”
 
The nursing home environment is considered to be a home and residents have the right to come and go freely. CMS does not believe all nursing home residents have clinical needs regarding their safety, particularly that would justify restrictions on their egress from various locations of the facility. CMS requires a comprehensive and individualized assessment of each resident’s needs to determine what care and services are necessary to meet his/her highest practicable well-being. It would be a rare occasion to have an entire patient population with clinical needs requiring locked means of egress, since one approach is usually not the right course of action for all residents.
 
The NFPA 101 Life Safety Code, 2000 Edition, Sections 19.2.2.2.4 and 18.2.2.2.4 did not change the determination of clinical need under exception 1. Rather, the language was updated in an effort to broaden the use of the code, not to become more restrictive. It is CMS’s expectation, that during a Life Safety Code survey, K38 will be cited if egress doors on a floor are locked and there is evidence that all cognitively aware residents, staff and visitors do not have access to the method of opening the doors. If staff is not aware of how to open the doors or are unable do so, it is very likely an immediate jeopardy situation. In cases where a health and Life Safety Code survey are done at the same time, we would expect health surveyors to investigate and cite this issue, under resident rights or another appropriate regulation, unless there is evidence that it is not a deficient practice. 

While the KSFMO was reviewing the issue, this provider applied for a waiver and received notice denying the waiver with the following KSFMO response:
 
“K38 Annual waiver denied. Exits must be accessible at all times.  You must provide a method to ensure that all cognitively aware residents, staff,   AND visitors have the ability to exit without having to ask for help.  Please address how your facility will correct the deficiency. “

The Association forwarded this to Tom Jaeger for review.  His response:

“CMS is now making the locking of doors a patient/visitor rights issue, which has nothing to do with Life Safety Code requirements.  We have addressed this with CMS Baltimore and they have suggested that AHCA and AASHA meet with the patient rights groups, the ombudsmen and the Alzheimer Association to see if we can reach a common ground position and then come back to CMS.  We intend to address both the clinical needs of residents and the safety of residents.  Safety being the locking of doors to stairs.  States other than Kansas have had several incidents where cognitively aware residents have died while trying to go down stairs in a wheelchair.
 
We know there is a need to put out an AHCA Life Safety Update on this issue, but are waiting to obtain resolution on patient rights and safety issues.  We also want to resolve the issue, which some states are pushing, this being that in order to lock doors in a nursing unit, all residents in the unit must have clinical needs requiring the locking of doors, i.e., special units.  We do not agree with this because this is dictating the facility's and residents' program of care.  Programs of care should not be dictated by the Life Safety Code or locks on doors.
 
What is being recommended for now, in order to avoid deficiencies and immediate jeopardy situations are:
1. We agree that not all residents in a locked area have clinical needs requiring the locking of doors.
2. We agree that all cognitively aware residents should be allowed to travel horizontally in a building and through doors in the means of egress without the assistance of staff.  
3. The following applies to doors locked other than with delayed egress locks:
 
                For cognitively aware patients:
* you can give them the combination to the keypads and document in writing when you did this;
* you could post the combination next to the keypad and put the numbers in reverse order and inform the cognitively aware residents;
 
                For visitors:
* you could post the combination where visitors sign in and out;                     
* you can provide each visitor with a copy of the combination although most visitors probably know why doors may be locked for the safety of residents, you may want to include a short statement as to why doors are locked.
 
               For staff:
* all staff assigned to an area where doors are locked and all staff required to report to these areas during an emergency should be given the combination.
                       
4. All the items in #3 above should be included in written emergency plans and facility operational plans.
 
5. Doors locked with delayed egress locks require no other special actions other than what is in the Life Safety Code in Section 7.2.1.6.1.  Please note that a sign is required to be posted next to each door locked with a delayed egress lock in the means of egress.  The sign tells the person pushing on the door that it will open in "x" seconds.  Therefore it takes no special knowledge or staff to unlock the door.  Therefore, all the special issues addressed in #3 above are not required.”
 
Tom Jaeger hopes to have a better Central CMS policy in the near future.  KHCA will be meeting with the KSFMO, Kansas Department on Aging, and the Ombudsman to discuss this further.

To view this and other LSC Updates please go to the KHCA website at www.khca.org and click on the Fire Marshal page.  Please contact Nancy at npierce@khca.org with any questions.

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  CMS Update on DMEPOS Competitive Bidding Information!

Now Available!  The Medicare Learning Network (MLN) Matters Special Edition Article # SE0805 entitled ~ “Overview of New Medicare Competitive Bidding Program for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) – The first in a series of articles on the implementation of this program.” ~ is now posted on the CMS Website at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0805.pdf.
 
This is the first in a series of educational articles that will assist you in understanding this new DMEPOS program and help you interact with your patients.  The new program begins July 1, 2008 and additional educational materials will be made available to you as we approach this date.
 
This article will be of particular interest to any provider that that may order, refer, or supply durable medical equipment to a Medicare beneficiary affected by the new Medicare DMEPOS Competitive Bidding Program. 
 
The Centers for Medicare and Medicaid Services (CMS) has developed a fact sheet that explains the program for Medicare beneficiaries. This fact sheet, entitled, “What You Should Know if You Need Medicare-covered Equipment or Supplies” is available at, http://www.medicare.gov/Publications/Pubs/pdf/11307.pdf. You may want to provide this fact sheet to your Medicare patients.

If you have questions about this information, please contact Jacqui Stanard of my staff at either 816-426-6405 or Jacquelyn.Stanard@cms.hhs.gov.

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  DMEPOS Update

The Centers for Medicare & Medicaid Services (CMS) has completed the bid evaluation process and on March 20, 2008 announced the single payment amounts for the first round of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program.  AHCA put the following summary together.

Key Points:

* Under the program, the single payment amount will become the Medicare allowed payment amount for the competitive bidding items for beneficiaries who reside in the competitive bidding areas (CBAs).
* Consistent with current CMS practice, Medicare will pay contract suppliers 80 percent of the single payment amount for each competitively bid item.  
* The beneficiaries will be responsible for the remaining 20 percent of the single payment amount.
* As a result of the competitive bidding process, the amounts that Medicare will pay for the ten product categories included in round one of the DMEPOS Competitive Bidding Program overall average 26 percent less than Medicare’s previous payment amounts.

Click here for more information.

CMS will host an audio conference/Q&A session regarding Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) supplier accreditation on April 17, 2008, from 12:00 – 1:30PM CDT.

This audio conference is the second in a series of four designed to provide guidance to DMEPOS suppliers regarding accreditation. We will be discussing compliance with the DMEPOS Quality Standards and the accreditation process, and will provide ample time to answer questions from the supplier audience. To view the presentation materials, please click on the following link:
http://www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/DMEPOSAccreditationPresentation.pdf

For those of you who will be unable to attend, a replay option will be available shortly following the end of the call.  This replay will be accessible from 2:30 p.m. EDT 4/17/2008 until 11:59 p.m. EDT 4/24/2008.  The call in data for the replay is (800) 642-1687 and the passcode is 39283514.

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  CMS Final Rule on E- Prescribing for Medicare's Prescription Drug Program

People who are eligible to enroll in Medicare’s prescription drug program are expected to experience greater safety, increased use of lower-cost generic equivalents, and more efficient communication between their doctor and pharmacy as a result of a new regulation issued today by the Centers for Medicare & Medicaid Services (CMS). The final rule establishes Part D eprescribing standards for four types of information: formulary and benefits, medication history, fill status notification, and identification of individual health care providers.

The standards adopted under the rule will apply to all Part D sponsors, as well as to prescribers and dispensers that electronically transmit prescriptions and prescription-related information about Part D covered drugs prescribed for Part D eligible individuals.  Part D sponsors include freestanding Prescription Drug Plan sponsors, Medicare Advantage-Prescription Drug Plans, and other Part D sponsors.  The new e-prescribing requirements will be effective on April 1, 2009.

This final rule on Part D eprescribing standards (CMS-0016-F/CMS-0018-F) and the earlier final rule establishing eprescribing foundation standards (CMS-0011-F) are available online at http://www.cms.hhs.gov/EPrescribing/

To read the CMS Press release click here:   http://www.cms.hhs.gov/apps/media/press_releases.asp

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  New AHCA Project Database

One of the most important functions that AHCA can do to serve its members and assist state affiliates is the coordination and dissemination of current information on long term care program activity across states.  Information about state Medicaid programs is particularly key, not only because Medicaid is a major payer for nursing home care but also because state Medicaid payment programs play a significant role in determining the nature and character of the operating environment in each state.  While State programs vary considerably across states, tracking and monitoring those differences is important as a means to understand the implications of potential developments in the states.

In our continuing efforts to serve our members and be a central resource of current and comprehensive state-level information, AHCA is undertaking a project to update the Medicaid Payment System Clearinghouse.  The Clearinghouse is a database that compiles key information about ongoing and emerging Medicaid long term care payment system characteristics across states.  For example, the Clearinghouse includes information on payment methodology, bed hold policies, co-pay situations, provider taxes and incentives, CONs, and various aspects of the payment structures.

Once the information is collected, it will be compiled into a database and made available to members on the AHCA Clearinghouse website.  In addition, the website will have written summaries available for each state.  This website will truly make Medicaid payment related information available at your fingertips, and it will be continually updated. 

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  Important Information for Medicare FFS Providers and NPI

The NPI is here.  The NPI is now.  Are you using it?  As of May 23, 2008, the NPI will be required for all HIPAA standard transactions.  This means:

– For all primary and secondary provider fields, only the NPI will be accepted and sent on all HIPAA electronic transactions (837I, 837P, NCPDP, DDE, 276/277, 270/271 and 835), paper claims (UB-04 and CMS-1500) and SPR remittance advice.  

–     The reporting of Medicare legacy identifiers in any primary or secondary provider fields will result in the rejection of the transaction. 

REMINDER: May 23rd is Only Two Months Away, Be Prepared! 
 TEST NPI-only NOW

Now that the NPI is required on all Medicare claims in the primary provider fields, if your claims are being successfully processed with NPI/legacy pairs (and most are) now is the time to begin testing claims using the NPI alone.  If the Medicare NPI Crosswalk cannot match your NPI to your Medicare legacy number, the claim with an NPI-only will reject. You can and should do this test now!  If the claim is processed and you are paid, continue to increase the volume of claims sent with only your NPI.  If the claims reject, go into your NPPES record and validate that the information you are sending on the claim is consistent with the information in NPPES.  If it is different, make the updates in NPPES and resend a small batch of claims 3-4 days later.  If your claims are still rejecting, you may need to update your Medicare enrollment information to correct this problem.  Call the Customer Service Representative at your Medicare carrier, FI, or A/B MAC enrollment staff or your DME MAC to discuss your situation and, if necessary, have it investigated. Have a copy of your NPPES record or your NPI Registry record available.  The contractor telephone numbers are likely to be quite busy, so don't wait.
 
Doing this testing now will allow time for any needed corrections prior to May 23, 2008, the date when only the NPI will be accepted in all provider fields.

Need More Information?

Still not sure what an NPI is and how you can get it, share it and use it?  As always, more information and education on the NPI can be found through the CMS NPI page www.cms.hhs.gov/NationalProvIdentStand on the CMS website.  Providers can apply for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to request a paper application at 1-800-465-3203.  Having trouble viewing any of the URLs in this message?  If so, try to cut and paste any URL in this message into your web browser to view the intended information. 

Note: All current and past CMS NPI communications are available by clicking "CMS Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand CMS webpage.

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  LT Care Solutions

Retiring Talk Show Host Reminds Us: Not Only Elders Need Long-Term Care

Montel Williams was diagnosed with Multiple Sclerosis in 1999. Earlier this year, CBS reported that this season of his daytime talk show, the 17th, will be the last. The reason is the declining health of the host.

His story is a teachable moment for long-term care planning. The lesson is this: none of us knows when our health will change, and we don't tend to get healthier as we age. Mr. Williams is 51 now, which would mean he was only 42 years old when he was diagnosed. A diagnosis of MS makes it next to impossible to get long-term care insurance (some workplace policies may offer some coverage to employees who are actively at work during a specific enrollment time, even if they are otherwise uninsurable).

Like another famous entertainer, Christopher Reeve, Mr. Williams' health changed for the worse at an age that he had no reason to expect that it would. By all appearances, Williams was someone who was fit, healthy, and physically active. He is a veteran and a graduate from the United States Naval Academy.

Christopher Reeve needed many years of long-term care before he died. While no one can know the future, it is likely that Montel Williams will also need extended long-term care. MS, in William's own words, "(means) excruciating pain and that eventually I could lose control of my body. " MS is a potentially debilitating autoimmune disease that affects the brain and spinal cord.

Although celebrities may have the resources to weather the financial consequences of extended long- term care, most Americans find the financial implications can be devastating.

As Reeve's story and Williams' situation demonstrate to us, our best intentions to buy long-term care insurance in the future may be derailed by a health change at a relatively young age. There are many Americans who will need long-term care well before age 65, and even before age 50. The causes are many, from brain tumors to car accidents to debilitating illnesses such as MS and early Alzheimer's.

Since illness or injury can strike at any age, purchasing long-term care insurance by age 50 or even age 40 may be a very smart financial decision.

LT Care Solutions, Inc. specializes in LTC planning for both group programs for companies and for individuals since 1992. For more information contact David Landwehr CLTC at 316-945-2011

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  Out of Sight, Out of Mind-The Hidden Culture
an exhibit at the Topeka and Shawnee County Library

Out of Sight-Out of Mind, The Hidden Culture

A must see for everyone in the long term care world is the exhibit currently at the Topeka and Shawnee County Public Library, Sabatini Gallery.  The exhibit titled Out of Sight-Out of Mind, the Hidden Culture, is series of paintings and poetry by a two women whose mother resides in a nursing home.  The exhibit is open daily and is located at 1515 SW 10th Ave.  You can check out the exhibit online at www.tscpl.org.  If you have any questions, please let Cindy know at cluxem@khca.org .

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  Resident Satisfaction Committee Links

Please click here for an updated version of the Nursing Home Web Resource Guide.

Advancing Excellence is a new coalition based, two-year campaign that launched in September 2006. The campaign is reinvigorating efforts to improve the quality of care and quality of life for those living or recuperating in America's nursing homes.
http://www.nhqualitycampaign.org/.

My InnerView’s  Quality ProfileTM tool assists leaders in monitoring pressure ulcers and physical restraints within their nursing homes as well as sets organizational targets for clinical quality improvement. Our Satisfaction Surveys allow facilities to measure resident, family and staff satisfaction.
http://www.myinnerview.com/

Kansas Culture Change Coalition is a group that provides support to long-term care organizations striving to develop systems that value the dignity of each individual who lives and works within their setting.  It is an organization of diverse interest groups that combine their talents to effect change that is hard to do as individuals.  The Kansas Culture Change Coalition maintains the vision of the Pioneer Network that supports a culture of aging that is life affirming, satisfying, humane, and meaningful.  Culture Change can transform a "facility" into a "home, a "patient/resident" into a "person", and a "schedule" into a "choice".
http://www.kansasculturechangecoalition.org/.

KFMC’s work with KS nursing homes assists nursing home staff with improving care processes on the clinical quality measures. Nursing homes who have committed to working with KFMC over the past five years have made significant progress in reducing quality measure rates.
http://www.kfmc.org/.

QIS Updates- click on tab 9 to access the Critical Element Pathways at
http://www.aging.state.ks.us/Manuals/QIS/TabIndex.html.  Click here for the Resident Interview and Resident Observation forms. http://www.aging.state.ks.us/Manuals/QIS/Tab05/CMS-20050_Resident_Interview_and_Observation.pdf. 

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