Share Your Best Practices on the KHCA Website

The KHCA website  www.khca.org recently set up a blog for members to share their best practices with each other.  To access it please go to the home page of our website and click on the link titled Share Your Best Practices under the Member's Only section.  Once you enter this site there will be a login screen as well as a tutorial for those not familiar with a blog.  The username will always be khca@khca.org and the password will always match the khca members only password.  The password will change monthly and be emailed to the membership.  This month the password is harvest.  Once you logon to the site you will see an example of a comment posted regarding the sprinklering of nursing facilities by 2013.  Please contact Nancy at KHCA with any questions.

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  2nd Quarter 2008 Health Survey Deficiency Summary

Have you seen the 2nd quarter 2008 health survey deficiency report?  If not please click here or view it on the member's only section of www.khca.org.  The Association staff has put together the following chart which lists the top 5 F-tags written in each survey region for A-F and G+ deficiencies.  The tags are listed in order of frequency cited.

Survey Region	Top 5 F-tags A-F	Top 5 F-tags G+
1	425,371,279,312,272	314,323,309,315
2	425,323,314,315,253	314
3	280,253,272,329,309	314,241
4	281,312,315,323,309	325,314,309,323,314
5	157,281,315,278,323	309,314,221,312
6	469,253,279,272,309	314,309,325,315,317

 

Click here for a list of F- tag descriptions.  Contact Nancy with any questions.

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  Notice of Proposed Nursing Facility Disaster Relief Provision

Click here to view the notice of Proposed Nursing Facility Disaster Relief Provision for calculating Medicaid rates as posted in the October 2, 2008 Kansas register.  Members are encouraged to send comments to Dave Halferty by November 7, 2008.

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  Resident Satisfaction Committee Links

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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  Holidays, Bailouts, LTC and Plan B
David Landwehr

According to Chase's Calendar, a reference book found in most libraries, September is Healthy Aging Month. Financial Planning Week starts October 6. Long-Term Care Planning Month is held each October, and Long Term Care Awareness Month is November. And, January is Financial Wellness Month. What these special events all have in common is that they are all a call-to-action for all of us to consider our health, aging, and our finances.

All too often, we put off what doesn't have a set-in- stone deadline. If a birthday wasn't on a particular day, would we ever buy a gift? Like those friends (or even relatives) who buy "sorry I missed your special day" cards year after year, long-term care planning, and the purchase of long-term care (LTC) insurance is often left to a future day. That day may, or may not, come before a change in health makes planning all but impossible.

As this press release is being written, the United States is in the grips of a major financial crisis. Some respected institutions are being sold at fire sale prices. The federal government has made commitments to bailout others, and to shore up investments that were considered failsafe - before the crisis.

During times like these, it's tempting to batten down the hatches and not even consider buying any type of insurance or investment. However, for those who really understand how long-term care planning works, long-term care insurance is needed by smart baby boomers now more than ever.

The current economic pressures will exert an obvious pressure on both state and federal budgets. When these budgets are squeezed, typically Medicaid and the long-term care provider system suffer. It's not that payments are cut off, but they are often slowed. The optional "waiver" programs that include care in settings more desirable than nursing homes can be the first to be cut back or eliminated. Attractive reforms and initiatives are put on indefinite hold.

Meanwhile, some of the best caregivers flee to the more lucrative private markets. Those individuals with either the ability to pay for their care with cash, or those with comprehensive long-term care insurance policies, then have their pick of where they will receive care - and who will be their caregivers. To put it bluntly, cash (and the relative cash equivalent of insurance) trumps government programs as a payment source. Always has. And, dare we say, with government obligations growing even faster than our population ages, always will?

So, more than ever, responsible financial professionals ask: What's your plan B, for LTC?

website: http://www.LTCareSolutions.com
LT Care Solutions
David Landwehr CLTC
President
email: dlandwehr@ltcaresolutions.com
phone: 316-945-2011

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  Clarification on Federal Regulation for LTC and Sprinkler Systems

The Kansas State Fire Marshal’s office provided the following clarifications on the Federal regulation for LTC facilities and automatic sprinkler systems.  Click here to view the entire regulation
http://www.accesskansas.org/firemarshal/Prevention/PrevDoc/E8-18670.pdf
 
The following are the clarifications from the KSFMO.

Does this apply to ICF/MR’s or Hospitals?
This regulation requires all long term care units to be equipped with sprinkler systems by August 13, 2013 (five years from the published date of the regulation).  On pg 47077, middle column, there is a comment regarding the specific facilities that are affected by the regulation.  The second sentence of the response is a key one: “We do not believe it is necessary for us to require sprinkler systems in other facility types, such as intermediate care facilities, adult day care facilities, or critical access hospitals because there is no demonstrated need for such regulation.”  The regulation applies only to long term care units.
 
What if the long term care unit is part of another building or part of a hospital?
On page 47075, third column, it states: “If a long term care facility was part of another building, such as a hospital, then the building would be required to have sprinklers only in the long term care facility section.”  This means that if the LTCU is separated from the hospital with proper building construction (outlined in NFPA 101), only the LTCU needs to be sprinkled.  If there is no separation between the LTCU and the rest of the building, the whole building is considered to be LTCU and would have to be sprinkled.  By separation, the Fire Marshal’s office means the common wall needs to be a two hour fire rated wall.  This same principle applies to nursing facilities with attached assisted living.

Please contact Kenya at the State Fire Marshal’s office with any questions at 785-296-3401.
 
 

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  AHCA Updates

Nursing Home Transparency Act of 2008 Is Introduced in the House

Representatives Pete Stark (D-CA) and Jan Schakowsky (D-IL) have introduced the Nursing Home Transparency Act of 2008 (H.R. 7128), which is similar to legislation authored earlier in the year by Senators Chuck Grassley (R-IA) and Herb Kohl (D-WI). AHCA is currently reviewing the legislation which includes mandatory compliance and ethics programs, increased requirements for public disclosure, additions to the Nursing Home Compare website, and protections for whistleblowers. Earlier this week, AHCA expressed our public opposition to this legislation. As Congress draws to a close this week, we do not expect this legislation to advance during this year, yet we do expect it to be reintroduced in the 111th Congress. For more information please contact David Hebert at AHCA.

OIG issues report: Trends in Nursing Home Deficiencies and Complaints

Earlier this week, the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) issued a final report entitled Trends in Nursing Homes Deficiencies and Complaints, stating that 91 percent of nursing homes surveyed in 2005, 2006, and 2007 were cited for deficiencies. This percentage includes those homes that had just one deficiency and those homes that had multiple deficiencies. On Tuesday, The New York Times published an article using this information in a misleading way. Mary Jane Koren, Chair of the Advancing Excellence in America's Nursing Homes campaign, responded to the article with a letter citing her disappointment on how the statistics were used.

AHCA is concerned that the information contained in the report does not provide useful information for the public and in fact, could lead to additional confusion about the quality of care provided in American's nursing homes. We are actively working to clear up these misperceptions through efforts with Capitol Hill and the media.  For more information, please contact Lyn Bentley at AHCA.

OIG Releases Final Supplemental Compliance Guidance

HHS, Office of Inspector General (OIG) released its final Supplemental Compliance Program Guidance for Nursing Facilities in the Federal Register, the text of which will be added to the original compliance program guidance (CPG) for nursing facilities first published on March 16, 2000. The new supplement takes into account Medicare and Medicaid payment systems and regulations, evolving practices, current enforcement priorities and lessons learned in the area of nursing facility compliance, and lists new and expanded risk areas for potential fraud/abuse in long term care facilities.

In a meeting with AHCA representatives, the OIG agreed to provide technical assistance to AHCA as we develop new educational materials for AHCA/NCAL membership on the necessary steps to design and implement an effective compliance program and reinforce our position that the national quality debate must move away from only regulatory compliance and begin to acknowledge the Association's other quality activities. For more information, please contact Dianne De La Mare at AHCA.

Congress Takes Steps For Disaster Relief

As facilities continue to recover from Hurricanes Gustav and Ike, AHCA/NCAL is pleased to report that Congress has taken steps to change the Stafford Act so that for-profit long term care facilities may access the same federal disaster relief resources as not-for-profits. Representative Ron Paul (R-TX) has introduced the Nursing Home Emergency Assistance Act (H. R. 7054). Representative William Jefferson (D-LA) has drafted the Long-Term Care Providers Disaster Relief Fairness Act of 2008, which may be introduced. AHCA/NCAL will continue our advocacy efforts on this issue as well as for financial relief for the costs incurred by facilities with HHS, FEMA, and Congress throughout the remainder of 2008 and into next year. For more information, contact Francesca Fierro O'Reilly at AHCA.

CMS Releases Medicaid Integrity Auditor Final Rule

CMS has released a final rule in the Federal Register that finalizes eligibility requirements for Medicaid integrity audit contractors that will review providers and claims. CMS will require the audit contractors review the actions of individuals/entities furnishing items or services for payment; audit claims for payment of items or services furnished; identify overpayments to individuals/entities receiving federal funds; and educate providers of services, managed care entities, beneficiaries and others with respect to payment integrity and quality of care. The final rule will provide requirements for an eligible entity to enter into a contract under the Medicaid integrity audit program and will establish the contracting requirements for eligible entities and will be effective October 27, 2008. For more information, please contact Dianne De La Mare.
 

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  CMS Updates Drug Coverage

CMS Reminds Medicare Beneficiaries to Review and Compare Their Current Drug Coverage

The Centers for Medicare & Medicaid Services (CMS) Acting Administrator Kerry Weems announced the 2009 Medicare prescription drug and Medicare Advantage plan options. Approximately 97 percent of beneficiaries enrolled in a stand-alone prescription drug plan (PDP) will have access to Medicare drug and health plans in 2009 whose premiums would be the same or less than their coverage in 2008.

“As we enter the fourth year of the Medicare Part D prescription drug program, we continue to see high satisfaction rates among beneficiaries and high participation among plans,” said Weems.  “However, plans do change their offerings from year to year.  Some beneficiaries may see significant premium increases or changes, such as reduced coverage in the gap, if they stay in the same prescription drug plan in 2009. We encourage individual beneficiaries to review how their plans are changing and what other options are available to them to determine which plan best meets their needs.”                              

Details about the specific plans in each region will be available mid-October at www.medicare.gov and 1-800-MEDICARE. Open enrollment for prescription drug coverage begins November 15 and ends December 31.     
                                   
The list of national stand-alone prescription drug plans and state specific fact sheets can be found at:   http://www.cms.hhs.gov/center/openenrollment.asp

LINKS:
To read the CMS press release issued today (9/25) click here: http://www.cms.hhs.gov/apps/media/press_releases.asp
Specific Plan Enrollment Information:  www.medicare.gov
List of National Plan Sponsors and State Fact Sheets: 
http://www.cms.hhs.gov/center/openenrollment.asp

Landscape Data Available:
http://www.cms.hhs.gov/PrescriptionDrugCovGenIn/

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  Ask the Contractor Teleconference – Ambulance Supplier

Teleconference on Ambulance Services

The National Contractor for the Section 1011 program, TrailBlazer Health Enterprises®, is hosting the third of three Ask the Contractor Teleconferences (ACT) on Thursday, October 30, 2008 from 1-3:00 p.m. (Central Time.

This ACT is designed for Section 1011 ambulance suppliers and will examine a variety of program issues.

Ask the Contractor Teleconference – AMBULANCE Suppliers
Thursday, October 30, 2008
1-3:00 p.m. (CST)

You may register for the event on the calendar of events page of the Section 1011 Web site, www.trailblazerhealth.com/Section1011/Default.aspx

A confirmation e-mail with the dial-in information will be sent to the e-mail address provided when your registration is approved.

A question-and-answer session concludes the teleconference and you may e-mail your questions in advance through the close of business Thursday, October 23, 2008 to section.1011@trailblazerhealth.com with Ask the Contractor in the subject line.

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  CMS Announces Medicare Premiums & Deductibles for 2009

CMS reports the standard Medicare Part B monthly premium will be $96.40 in 2009, the same as the Part B premium for 2008. This is the first year since 2000 that there was no increase in the standard premium over the prior year.

The 2009 Part B premium of $96.40 is the same as the amount projected in the 2008 Medicare Trustees Report issued in March. This monthly premium paid by beneficiaries enrolled in Medicare Part B covers a portion of the cost of physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and other items.
       
By law, the standard premium is set to cover approximately one-fourth of the average cost of Part B services incurred by beneficiaries aged 65 and over.  The remaining Part B costs are financed by Federal general revenues.  The income to the program from premiums and general revenues are paid into the Part B account of the Supplementary Medical Insurance trust fund, and Part B expenditures are drawn from this account.
       
Normally, the Part B premium increases at the same rate as average Part B expenditures from year to year.  A number of factors explain why the premium can be kept level for 2009.

Growth is expected in 2009 for most areas of the Medicare Part B program, including growth in the cost and use of physician and outpatient hospital care, home health services, physician-administered drugs, ambulatory surgical center services, durable medical equipment, independent lab and physician’s office lab services, as well as growth in the Medicare Advantage program. In most years, this would result in the need for an increase in the Part B premium and general revenue financing.

To view this Fact Sheet in its entirety go to:  http://www.cms.hhs.gov/apps/media/fact sheets.asp

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