Transportation Survey

Over the past year KHCA and KAHSA has been participating in the Money Follows the Person Project Statewide Steering Committee. As part of our work, we are trying to address barriers for persons who wish to receive services in their own homes. One of the most significant barriers is lack of transportation.

KHCA and KAHSA would like to learn about our members' current transportation services for community-dwelling individuals, and about interest in and perceived barriers to providing community transportation.

Please fill out the survey listed below to help gather information.

http://www.surveymonkey.com/s.aspx?sm=2LzW1dHNHhwEyyBoqx4EKQ_3d_3d

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  KHCA/KCAL Nurse Conference

 KHCA/KCAL Nurse Conference happening this month.  Click here for a copy of the brochure.

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  Kansas Nurse Preceptor Academy

This one-day, intensive training academy prepares bedside nurses to be preceptors for new nurse hires; equipping the preceptors with knowledge and skills, strategies to improve retention of newly hired nurses, and tools to use with preceptees. New and experienced preceptors will receive a manual of robust resource tools, professional personality profile, lapel pin, two-year subscription to the New Preceptor Newsletter and access to quarterly nurse preceptor continuing education Webinars.

Register to attend one of the four pilots: Topeka April 27th, Colby May 5th, Wichita May 22nd or Garden City June 2nd. The four spring pilots are supported in part by a grant from the Kansas Hospital Education and Research Foundation and the United Methodist Health Ministries Fund.  

Follow this direct link to the registration brochure or access it on the KHA Education Events page. Be sure to check out the Frequently Asked Questions. Contact Cara Greve (cgreve@kha-net.org) or Christie Carney (ccarney@kha-net.org) at (785) 233-7436 with any additional questions.

Please pass this information on to others who may be interested in attending the program.

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  Kansas Budget Looks Aweful!

The article below is review of the latest budget information for the state of Kansas.  The legislators have all returned home and will return to Topeka at the end of April for the veto session.  This will also be the time that the remaining budget details are completed.  The nursing home rebasing still remains frozen for FY 2010 but the legislators will review during the veto session.  With the state budget numbers looking so dismal, we are concerned that the rate freeze at this time would be better than cuts but will try to convince the lawmakers to use the federal stimulus dollars towards commitments made when they passed and the Governor signed our annual rebasing, looking at the three previous years.

March revenues plummet

Tax-only revenues were $57 million less in March than projections, paring not only revenues for the current fiscal year but for Fiscal Year 2010 as well.

The revenue numbers released this afternoon by the Kansas Department of Revenue add to a four-month drop in receipts, and March was the biggest drop since the Nov. 4 Consensus Revenue Estimate.

Fiscal year-to-date, receipts are off $135 million from the gloomy estimate made by the Nov. 4 estimate, and are part of the information that the Consensus Revenue Estimating Group will consider in its mid-April computation of likely revenues.

For March, the most dramatic drop was in individual income taxes, off $48.2 million from the $190 million estimate, a 25% shortfall. This year’s individual income taxes were $47 million, or 25%, less than March’s take in 2008.

Sales taxes were off $5.6 million from the estimate of $135 million, or 4.2%. Sales tax revenues were 4.5% less than in March of 2008.

The year-to-date numbers put revenues $135 million or 3.5% below estimates that are based on already pared-down in November estimates.

On the July 1 through today basis, corporate income taxes are off $58 million, or 28% below estimates. So far this fiscal year, Kansas has taken in $107 million less in corporate income taxes, or 41.8%, than it did in 2008.

Individual income taxes for the fiscal year are off $59 million at $1.8 billion, which is $30 million less than for the same period last year.

Here’s the shorthand:
* For March, actual tax-only revenues were $344.5 million, $57 million or 14% below projections of $401.5 million. We’re $64.5 million, or 15.8%, below the same month last year.

* Year-to-date, actual tax-only revenues are $3.742 billion, $135 million or 3.5% less than the reduced-in-November estimate of $3.877 billion. For the year, we’re $185 million less than the similar period last year, which is a 4.7% falloff.

***
What’s it mean?
The chain of computations of ending balances is badly damaged. The Fiscal Year 2009 rescission bill which appeared to have a $167 million ending balance on June 30 now produces an ending balance of $110 million with three months of the fiscal year left. It means that lawmakers may well have to retouch the FY ’09 budget should revenues continue to diminish.

For FY ’10, that shortfall rolls forward, cutting the beginning balance and paring the optimistic $172 million ending balance to a little over $115 million.
***
Look for the Omnibus appropriations bill which will be considered at the veto session to become another rescission bill, as balances drop and further cuts become likely in the current fiscal year and likely more cuts in FY ‘10.

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  Schedule for FY 2010 rates

We will all be watching this process very carefully.  The information below is from the Kansas Department on Aging and their schedule for FY 2010 rates.

4th quarter rates mailed out March 20th

4/16  proposed rates
4/23  proposed public notice published/comment period begins
5/22  comment period ends
6/9  rates finalized
6/11  final public notice
6/18  final publication

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  Five Star Quality

Bruce Yarwood recently sent the following memo to members about the Five Star Rating System-

The unintended consequences resulting from CMS’ Five Star Rating System continue to  mount, including:
1) A few state governments are evaluating the use of Five Star in their Medicaid pay-for-performance initiatives;

2) HUD has issued a directive related to Five Star that we anticipate will impact FHA lenders, mortgage holders, and facilities; and

3) increased media focus on Five Star. 

During its last meeting, the Board of Governors approved a revised approach to address the shortfalls with Five Star.  We will proceed as follows:

* Continue to work with CMS to adjust Five Star and elevate our concerns to the new CMS Administrator as soon as an appointment is made.

* Meet informally with the Department of Health and Human Services’ (HHS’) Office of the General Counsel to express concern about implementation of Five Star, citing discussion points made in the legal analysis that was completed by ReedSmith. Note: This is not a threat of litigation; we are simply informing the General Counsel’s Office of our concerns in an effort to advance internal action at HHS/CMS to address the problems with Five Star.

* Leverage the efforts of AHCA members who are already reaching out to their Members of Congress by following through with a selective grassroots effort to encourage Congressional champions to pressure CMS into making changes to Five Star.

* Collect information from our members that clearly illustrate the unintended consequences that have resulted from Five Star.

* Reach out to other stakeholders who either share our concerns or who may inform our efforts to seek additional options to Five Star.

If you have questions, please contact Lyn Bentley at lbentley@ahca.org

More Five-Star Rating
 
The Technical Manual for the Five-Star Rating system has been revised slightly. The cut-point tables have been removed from the manual and are now a stand alone document so that information about the cut points can be changed without having to reissue the whole manual. There are a few other changes as well. Ellen Greif of Region V provided the following links:

http://www.cms.hhs.gov/CertificationandComplianc/Downloads/summaryupdatestug.pdf  (One page summary of updates)

http://www.cms.hhs.gov/CertificationandComplianc/Downloads/usersguide.pdf  (Technical Users Guide revised 3/25/09)

http://www.cms.hhs.gov/CertificationandComplianc/Downloads/cutpointstable.pdf  (Cut-Points Tables revised 3/25/09)
 

As a reminder the phone number to call if you would like to dispute any of your numbers is 1-800-839-9290.

AHCA letter to Thomas Hamilton about Five Star Quality

AHCA letter to Thomas Hamilton, CMS, concerning issues around Five Star Quality Rating System

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  AHCA/NCAL Need You in Washington, DC in June!

AHCA/NCAL is proud to bring you a great line up of speakers for this year's Congressional Briefing June 3-4, in Washington, DC. Among them is Howard Fineman, NBC News Analyst and Newsweek's senior Washington Correspondent, who will provide an insider's view on the Obama Administration and new Congress. Fineman will be available to sign copies of his book.

Congressional Briefing is your unique opportunity to meet face-to face with Members of Congress and their staffs to discuss long term care legislative issues at the federal level. Share with top policy leaders and decision-makers how their legislation affects your facility and how you conduct quality care for the frail elderly and disabled. You will also gain a comprehensive understanding of Congress and the AHCA/NCAL legislative goals for 2009. AHCA/NCAL lobbyists will present talking points and lobbying tips for conducting Capitol Hill visits. Register today!

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  Nursing Home Salary and Benefit Survey Underway

The Association office receives phones call periodically asking for survey information.  The opportunity below, supported by AHCA, is a chance to participate in a survey. 

The Hospital & Healthcare Compensation Service (HCS) is now conducting their 2009-2010 Nursing Home Salary and Benefits Report survey. 

Supported by AHCA, the study provides nursing home salary and benefits information for most types of nursing home staff in markets across the nation. Participating facilities may purchase a copy of the report at the significantly reduced rate of $135.

The survey can be downloaded directly by clicking here or requested by calling HCS at (201) 405-0075. 

Please submit the completed questionnaire to HCS by April 10, 2009. For more information contact Peter Gruhn, pgruhn@ahca.org  or HCS directly by clicking here.

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  The Time To Prepare For RACs Is Now

Plan Now To Participate In Informative Webinars

The recovery audit contractor demonstration project (RACs) will be expanded to all 50 states by no later than 2010. By 2010, CMS plans to have 4 regional RACs in place - each responsible for identifying overpayment and underpayments in approximately one fourth of the country. To plan for this, AHCA is hosting 4 webinars, one for each of the 4 RAC regions. The tentative dates are:

* Region A  -  June 2
* Region B -  May 27
* Region C -  June 1
* Region D  -  June 2

CMS is hosting a Special Open Door Forum for Part A provider RACs on April 8, 2009, from 2 - 3:30 pm, ET. This forum will introduce providers to the new contractors and provide more information about the RAC program. To dial in, please call 1-800-837-1935 and use reference conference ID 92490299. An audio recording and transcript of this Special Open Door Forum will be posted here beginning Thursday, April 16 and available for 30 days.

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  Kansas Department on Aging Information

Click here to read the latest in the sunflower connection. 

Many of our members were attended and participated in the hearings on the regulation changes. 

We have included a letter from Greg Reser outlining some concerns from the testimony heard and we sent this response.

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