58th Annual KHCA/KCAL Convention & Trade Show--Don't miss it!!

The 58th Annual KHCA/KCAL Convention and Trade Show will be held at the Century II Convention Hall in Wichita on September 25-26, 2008.  Early registration cut-off will be this Friday September 19, 2008.  Click here for a brochure.

It's not too late to sign up for the KHCA/KCAL Golf Classic.  Call Cindy for more information or email cluxem@khca.org.

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  KHCA/KCAL PAC events at the 58th Annual Convention and Trade Show

Photo with Presidential Candidates:  Contributions will be accepted at this fun opportunity to have a photo taken with Presidential Candidates Senator McCain or Senator Obama.  Well, actually they are life-sized cutouts of them…but fun nonetheless!  Just ask Marla Nispel!

Early Presidential Election Poll:  A Presidential Election Poll will be conducted during the Convention and Trade Show.  Participants will be able to vote for their favorite candidate by purchasing jelly beans and placing them in their designated container.  An ‘Undecided’ category will also be available.  We will announce our winner at the end of the conference.

The money collected during these events will be used to further the legislative long term care agenda on behalf of the seniors of Kansas.  Thank you for your participation.

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  KACE Education Event

Kansas Adult Care Executives (KACE) presents The ABC’s of Incontinence Care in LTC: Assessment, Behavior Treatment and Containment. Click here for the information.

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  Fire Marshal Updates

FM Update for Smoking Violations
 
 
The Kansas State Fire Marshal's Office released the following document.

A nursing home in Larimer, PA was accused and punished for “permitting unsafe smoking by patients around oxygen equipment.”  As explained by the Pittsburgh Post-Gazette in a story released on July 30, 2008, Forbes Road Nursing and Rehabilitation Center was placed in immediate jeopardy in May after state inspectors observed a patient using a nasal cannula smoking outside.  After this citation, no new admissions were allowed for two days until state surveyors were convinced that procedures were in place to prevent similar incidents.  The 134-bed facility will continue to have a provisional license through November.
 
The dangerous mix of smoking materials and the use of oxygen have had detrimental effects here in Kansas.  The combination of home oxygen and cigarettes has been a common cause of burn injuries within our state over the past five years.  However, the numbers appear to be decreasing.  During 2006, three injuries were reported involving oxygen and heat sources; 2007 saw this number drop to one injury and to date none have been reported for 2008.  Despite the low numbers of reported incidents, there is still a sobering element to them: because of the nature of the injuries, they are more likely to be fatal.
 
This is why the Pennsylvania state agencies reacted so strongly to what they found during the survey.  The 2000 edition of NFPA 101 includes requirements for smoking regulations, and these are echoed in K-tag K66.  Kansas surveyors will be looking for regulations that include four things, even if your facility maintains a smoke- or tobacco-free campus:
 
1.      Smoking shall be prohibited in any room, ward, or compartment where flammable liquids, combustible gases, or oxygen is used or stored in any other hazardous location, and such area shall be posted with signs that read NO SMOKING or shall be posted with the international symbol for no smoking.
2.      Smoking by patients classified as not responsible shall be prohibited, except when under direct supervision.
3.      Ashtrays of noncombustible material and safe design shall be provided in all areas where smoking is permitted.
4.      Metal containers with self-closing cover devices into which ashtrays can be emptied shall be readily available to all areas where smoking is permitted.
 
CMS requires these policies to be in place.  However, you as the facility are the only one who can enforce this diligently.  It’s not just another requirement and if it isn’t enforced, it might not result in a fire that affects the whole facility.  However, it can make the difference between life and death for a single resident.
 
 

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  Kansas Activity Directors 18th Annual Conference

The Kansas Activity Directors Association (KADA) will hold its 18th Annual Conference "CELEBRATE THE INDIVIDUAL"  Oct. 13 & 14, 2008 at the Holiday Inn Select in Wichita, Kansas.  Sessions included are survey survival, documentation, individualized programming for various levels of elders, stress reduction and humor.
This conference is appropriate for Administrators, Activity Professionals, Activity Assistants and any facility staff involved with activities.  Conference flyers will be out in the next week. 
For more information please contact Susan Hatcher at 316-253-7217 or susan.hatcher@cox.net
 
" Activity Professional of the Year Award"
Do you have a top notch Activity Director?  Does he/she go above and beyond?  Is he/she someone your facility and elders can't do without?
Show them your appreciation and nominate them for the Kansas Activity Directors Association "Activity Professional of the Year" Award. In 250 words or less describe why you feel your A.D. should receive this award.  At least 3 letters of support must accompany the application.  These may be from elders, their families and/or staff.  Please cite examples of how the applicant demonstrates each of the following characteristics:
1. Leadership
2. Creativity
3. Problem Solving
4. Rapport with elders, families and staff
5. Contribution to professional organizations on the local, state and/or national level (KADA, KHCA, KAHSA, NAAP, NCCAP).  This may include serving on committees and/or volunteering.
6.  Support of the Activity Program
 
On a separate sheet of paper, list the following information:
1.  Nominees name, facility name and address, Company name (private ownership or corporation)
2.  Nominees years of experience, certification and title.
3.  Name, title and signature of nominator.
 
~ The nominee must be a current member of KADA or be employed at a facility with a KADA membership. Membership to KADA will be confirmed prior to the acceptance of the nomination~ If you would like to confirm membership please contact Lisa Donahue at 620-382-2191.
Please send completed information to:  KADA Awards Committee, 2461 Clover, Lincolnville, KS, 66858-9826
Applications must be postmarked by Sept. 28.  Any nominations received after this date will not be eligible for the award.  A member of the Awards Committee will notify the winner prior to conference.

Here is a link to KADA's website, which has the award information that can be downloaded.
http://www.geocities.com/kansas_activities/links.html

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  Nursing Facility PASRR Prociess and Medicare Skilled Admissions
By Sue Schuster, LMSW Senior CARE manager, Kansas Department on Aging

Mr. Jensen has admitted to your building with Medicare as his payor source.  He is uncertain whether he will be staying permanently,  but as time goes on he realizes that it would be very difficult for him to return to his home alone.   His family agrees and discussion is had for him to transfer to assisted living after a period of rehabilitation.

Since Mr. Jensen came to you from the hospital with  the 3-day qualifying stay and his physician states he will need a good deal of therapy to regain balance and be safe in independent ambulation you realize he may be using Medicare as a payor source for 30-60 days. 

Toward the end of this time Mr. Jensen’s family explains to you that his finances are such that he can not private pay the total cost of Long Term Care.  Your social services department assists the family to apply for Medicaid.  When a request is made for approval of Medicaid you are told that Medicaid is unable to be approved until a CARE assessment is completed.

Your admissions personnel explain to you:  “But he had Medicare, we didn’t think he needed a CARE assessment;  and the hospital is supposed to do those and we didn’t get  one when he came in…”

You call SRS -and then KDOA- and you are told that you need to contact the Area Agency on Aging in your local area and they will arrange for a CARE assessment to be completed on Mr. Jensen.  Payment for Medicaid can begin – if he qualifies for Medicaid functionally as well as fiscally – at the date on the completed CARE assessment. 

You state,  “But he’s already been here almost 3 months and Medicare ended almost a month ago… the family told us they had applied for Medicaid…  we didn’t know a CARE had not been done;  he moved from the original hall back to our unit and we don’t handle any of that admission process here…”

PLEASE – DO NOT LET THIS SCENERIO HAPPEN IN YOUR BUILDING!!!!

1-EVERY person admitting into a Long-Term Care facility from the COMMUNITY MUST have a CARE assessment or an acceptable out-of-state-PASRR prior to admission into your building:   Only exceptions:
          a-hospice letter excepts the resident from PASRR process
          b-categorical determination letter excepts the resident from PASRR process
          c-the resident will be staying less than 30 days (note from physician accompanies)

In the event of a  short-term 30-day admission, your building needs to contact the Area Agency on Aging by day 20 of the resident stay if it does not appear the resident will be able to discharge within 30 days and request the CARE assessment. 
 
2-A great cross-check to make sure your building can not get caught in this situation is for someone in admissions to be assigned to CONTACT THE LOCAL Area Agency on Aging and CONFIRM that PASRR (CARE assessment) as been addressed on every admission. 

3-The local Area Agency on Aging needs a copy of every CARE assessment done in their area.  Upon admission your staff should be checking to see that the Area Agency has received a copy.  If the resident admits from the hospital make sure the hospital has faxed a copy of the care to the AAA.  Often the hospital will send a copy of the CARE assessment with the resident/family but the Area Agency on Aging did not get it.  Sometimes the resident/ family is very overwhelmed and forget to give you a copy if they have one  with them.

Make this a part of your admissions process and you will never be in the situation of the building in our example.

Your local Area Agency on Aging has been supplied with bright lime green signs with their agency name and number.  These should be posted in your building near the fax/phone in your admissions department.  If you do not have these signs contact your local Area Agency on Aging and they will supply you with the number you need to cover the units in question.

-The resident CAN NOT be charged for lost payment due to not completing the PASRR process timely.

-Your building CAN receive a deficiency for not complying with Federal PASRR law

-SRS can not approve Medicaid payment until the date on the CARE assessment if your building did not follow PASRR regulations.

-The Area Agencies on Aging have 5 working days to complete a CARE assessment from the time they are contacted and the request is made for a CARE.  However, IF your building was not compliant with the PASRR process the Area Agencies on Aging will have to put your request in sequence below those requests for CARE assessments from people who have been compliant with the PASRR process.  

We believe that nursing facilities work hard to give good care and we want you to be paid for the care you provide.   We are sad when our answer to a building is “I’m sorry, we can not approve Medicaid payment until the date on the CARE assessment”   and the resident has been there for several months.  We understand the financial impact you will face as the result of the denial and we do not take this lightly. 

PLEASE – if you have ANY questions regarding your responsibility as a nursing facility for the PASRR process contact our office at 1-785-296-0895.  Our staff will be more than happy to visit with your and answer your questions.   If you would like to send members of your staff to a CARE training to get the latest information contact our office at 1-785-291-3359 for a schedule of new assessor trainings or update trainings.   If you have questions regarding your process with the local Area Agency on Aging please call their CARE coordinator and have that discussion. 

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  Partnership Long-term Care Policies Sweeping Country Including Kansas
David Landwehr

A little-known part of the Deficit Reduction Act of 2005, called Partnership for Long-Term Care, can make a big difference for individuals considering the purchase of long-term care (LTC) insurance. This provision allows each state to implement what is called Partnership for Long-Term Care, a financial incentive for citizens to purchase LTC insurance. The program has become popular with state legislators, who are worried about escalating expenditures on government- funded programs. Forty-nine percent of the country's spending on nursing home care comes from Medicaid. Medicaid is funded by both federal and state taxes. So, it's easy to understand why Kansas and the vast majority of states either have implemented or are in the process of implementing Partnership.

Partnership is not a new concept. What is new is its national expansion. Four states (New York, Connecticut, Indiana and California) have had the program since 1993. After the first four demonstration states, Congress put the brakes on other states adopting Partnership. As of January 2006, the Deficit Reduction Act gave all states the OK to adopt their own Partnership program.

Kansas Partnership long-term care insurance (LTCi) policies are sold by insurance agents, just like traditional LTCi. But, in order for a company's policy to be Kansas Partnership certified, it must meet certain requirements. These requirements include mandatory inflation protection on any policy purchased before age 76, for example.

What's the advantage to the policyholder who has a Kansas Partnership policy? The policyholder knows that, if his or her need for long-term care exceeds the policy benefits, that he or she may apply for Medicaid and be allowed to keep assets that otherwise would need to be spent on care. If, for example, a Kansas Partnership policy pays $100,000 in benefits, an unmarried policyholder could be able to qualify for Medicaid with $102,000 in countable assets, instead of only $2,000. The extra $100,000 has been preserved from Medicaid spend-down. It could be left to family, or a favorite charity. The Kansas Partnership asset protection against Medicaid spend-down is earned as policy benefits are paid.

What's the catch? There is none, as these policies cost no more than policies of identical design. However, many people who purchase LTCi do so to be able to avoid the government Medicaid program. They don't want to rely on Medicaid for many reasons, including the fact that the program usually only pays for nursing homes and rarely covers the kind of care that consumers want in the setting they prefer.

The Kansas Partnership for Long-Term Care is the latest in a growing list of ways that Kansas government is encouraging individuals to do their own personal planning. Kansas Partnership policyholders understand that they can take personal responsibility for how they will pay for future care, while knowing that, should they need the government safety net of Medicaid, they will not be first required to be impoverished.

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  CMS Updates

National Plan and Provider Enumeration System: Keeping It Safe and Keeping it Updated

This message is for health care providers, particularly physicians and other practitioners, who have obtained National Provider Identifiers (NPIs) and have records in the National Plan and Provider Enumeration System (NPPES).  The Centers for Medicare & Medicaid Services (CMS) recommends that each health care provider, including individual physicians and non-physician practitioners:

* Know and maintain their NPPES User Ids and passwords.

* Reset their NPPES passwords at least once a year.  See the NPPES Application Help page regarding the ‘Reset Password’ rules.  Those rules indicate the length, format, content and requirements of NPPES passwords.

* Review their NPPES records in order to ensure that the information reflects current and correct information. 

Maintaining NPPES Account Information for Safety and Accessibility
Health care providers, including physicians and non-physician practitioners, should maintain their own NPPES account information (i.e., User ID, Password, and Secret Question/Answer) for safety and accessibility purposes. 

Viewing NPPES Information
Health care providers, including physicians and non-physician practitioners, can view their NPPES information in one of two ways:

(1) By accessing the NPPES record at:
https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login.  The user will be prompted to enter the User ID and password that he/she previously created. *

* If the health care provider has forgotten the password, enter the User ID and click the “Reset Forgotten Password” button to navigate to the Reset Password Page.  If the health care provider enters an incorrect User ID and Password combination three times, the User ID will be disabled.  Please contact the NPI Enumerator at 1-800-465-3203 if the account is disabled or if the health care provider has forgotten the User ID.

OR

(2) By accessing the NPI Registry at:
https://nppes.cms.hhs.gov/NPPES/NPIRegistryHome.do
The NPI Registry gives the health care provider an online view of Freedom of Information Act (FOIA)-disclosable NPPES data.  The health care provider can search for its information using the name or NPI as the criterion.  

Updating NPPES Information
Health care providers, including physicians and non-physician practitioners, can correct, add, or delete information in their NPPES records by accessing their NPPES records at:
https://nppes.cms.hhs.gov/NPPES/Welcome.do and following the NPI hyperlink and selecting Login. The user will be prompted to enter the User ID and password that he/she previously created.   

Please note: Required information cannot be deleted from an NPPES record; however, required information can be changed/updated to ensure that NPPES captures the correct information.  Certain information is inaccessible via the web, thus requiring the change/update to be made via paper application.  The paper NPI Application/Update Form can be downloaded and printed at:
www.cms.hhs.gov/cmsforms/downloads/CMS10114.pdf

Need More Information?

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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  CMS Caregiver Initiative to Launch on September 18, 2008

The Centers for Medicare & Medicaid Services (CMS) Caregiver Initiative: Ask Medicare will be a webcast on September 18, 2008 at 11:00 a.m. Central Time.  In order to view this webcast please click on the link in the invitation below and register for the launch.  You can watch from your computer.
* Learn about new online resources for caregivers
* Post questions to CMS Acting Administrator Kerry Weems and a panel of experts online
* Sign up for the Ask Medicare bi–monthly e–newsletter
http://webcast.streamlogics.com/custom_projects/medicare/index.asp

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  CMS Survey and Certification Updates

08-34: Compliance With State Fire and Safety Code in Lieu of Life Safety Code
 
The Centers for Medicare & Medicaid Services (CMS) has adopted the 2000 edition of the National Fire Protection Association’s (NFPA) Life Safety Code (LSC) as part of the Medicare health and safety standards for certified providers and suppliers.   It is permissible to use a State fire and safety code (State Code) in lieu of the NFPA 2000 LSC, if CMS finds that the State Code is imposed by State law and that it adequately protects residents or patients.  There are also financial implications for State Survey Agencies (SAs).  Click here for the S&C 8-34 letter.
 
 
E-Prescribing
 
Information on the National E-Prescribing Conference sponsored by CMS.  Click here to view it.

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  AHCA Updates

Senate Committee Passes Two Bills Impacting Long Term Care
Criminal Background Checks & Elder Abuse Addressed

Earlier this week, the Senate Finance Committee reported favorably out of committee two bills that have an impact on long term care providers. The first, the Patient Safety and Abuse Prevention Act of 2007(S. 1577), supported by AHCA/NCAL, would encourage (but not require) every state to perform criminal background checks on nursing home and other long-term-care workers with direct access to patients. It builds on a demonstration project that Congress included in the Medicare Modernization Act of 2003 in which seven states participated.

The second bill - also supported by AHCA/NCAL as a member of the Elder Justice Coalition - is The Elder Justice Act (S. 1070), which would expand the role of the federal government in collecting data on elder abuse and neglect and would dedicate a group of Federal officials to work on issues of elder mistreatment. If passed into law, the EJA would require skilled nursing facilities and nursing facilities to make publicly available the instances of criminal activity that have occurred in the building by facility staff. The prospects for either of these bills becoming law is limited due to timing issues related to the expected adjournment of Congress later this month. For more information on either of these bills, please contact Ken Preede.

Over Half of AHCA's Membership Assessing Customer Satisfaction!

AHCA's Satisfaction Assessment Initiative, with My InnerView as its strategic partner, offers a satisfaction assessment system used by 60 percent of AHCA member nursing facilities, and the cost is much lower than you might expect. To find out how satisfaction assessment can work for you and help you manage better quality results in your facility, sign up for a Webinar at 1 p.m. EDT on Wednesday, September 24, 2008. Participants must log on to My InnerView to register (look for the AHCA logo) and receive log-in and call-in information.

National Adult Immunization Awareness Week is September 21 - 27

Flu season is around the corner and National Adult Immunization Week (NAIW), September 21 - 27, is a good time to promote the importance of the influenza vaccine to your workers. Keeping workers safe from influenza helps to keep vulnerable residents safe. The NAIW campaign kit is available here. Many other tools are available to help promote influenza vaccine. A two-page information kit, Influenza: What you Should Know, is available in English or Spanish. The Centers for Disease Control and Protection (CDC) maintains a flu vaccine site that is a great source of information and The Department of Health and Human Services has a new tool kit to help increase the rate of health care personnel influenza vaccinations. AHCA offers additional information here. Questions? Please contact Janice Zalen.

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  Resident Satisfaction Committee Updates

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. 

Click here for Provider Manual Updates from the KMAP website

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