Fred Benjamin, serving as the Chief Operating Officer with Medicalodges, Inc. based in Coffeyville, Kansas, has been selected to the AHCA/NCAL 2011-2012 Future Leader’s program.

Since 2004 the American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL) have hosted Long Term Care (LTC) professionals in an annual Future Leaders program.  The year-long program kicks off with a two-day symposium “Future Leaders of Long Term Care in America” held each July in Washington, DC. Selected participants have demonstrated leadership potential and an interest in representing the interests of LTC providers at the state and national levels. The program covers the latest theories and practical applications in quality management, customer satisfaction, and leadership.

Although Benjamin brings more than 30 years’ experience to the program, he says he is always willing to learn and find better ways of doing business.

The program's goals, as stated by AHCA/NCAL, are that by participating in this program, members of each Future Leaders class will be better prepared to serve in vital roles within AHCA/NCAL and on behalf of the entire profession. By honing their knowledge and leadership skills, these future leaders will help to advance quality and promote the profession’s mission of providing the highest quality resident-centered care for frail, elderly, and disabled Americans.

Those selected to participate in Future Leaders agree to:

•Attend a three-day training session in Washington, DC;
•In collaboration with your State Executive, complete personal and organizational strategic goals and plans;
•Read four to five books over the year; and,
•Participate in quarterly conference calls.

Candidates are nominated through  the KHCA/kcal office on recommendations from the KHCA/kcal Board.

The Centers for Medicare & Medicaid Services (CMS) issued its Skilled Nursing Facility Prospective Payment System (SNF PPS) Final Rule for FY 2012 this afternoon. We are conducting an in-depth analysis of the final rule, but AHCA’s initial review shows cause for concern and extreme disappointment. The rule ignores a unified message from members, caregivers, lawmakers and stakeholders to find a responsible solution to Medicare payments.

Similar to what was first proposed by CMS in late April, the agency will cut Medicare payments by 11.1 percent starting October 1, totaling $3.87 billion. As you know, these reductions are an attempt to return the Medicare system back to budget neutrality for CMS after implementing RUG-IV and MDS 3.0.

CMS also implemented modifications to group therapy, Change of Therapy (COT), End of Therapy (EOT), and other Medicare Required Assessments (OMRAs), virtually without any modification from the proposed rule.

Unfortunately, CMS has disregarded AHCA’s sound and reasonable approach to implement modest reductions to SNF payments over multiple years. Our Association’s proposal would have protected long term care for seniors, while also achieving the government’s goal of a budget-neutral payment system. CMS’ action also failed to acknowledge the tens of thousands of letters, emails, and phone calls all of you made to let the agency know how damaging such a drastic proposal would be to the profession and the economy.

These are only the initial findings, and the AHCA team is combing through the 300 plus page final rule, which you can read in its entirety. But we have already issued a strongly-worded statement demonstrating our disappointment with CMS for issuing such irresponsible public policy. In the coming days, we will provide an overview and let you know what this means for the Association and the profession. But one thing is certain – AHCA will continue to work with CMS and lawmakers on Capitol Hill to implement regulations and policies that are fair to all involved.

“The CMS rule makes reductions beyond what is necessary for budget neutrality. This will threaten our ability to provide quality care to America’s seniors. Coupled with changes in group therapy definitions, this drastic reduction will be especially challenging for skilled nursing facilities to manage.

“At such a critical time, while we already face drastic cuts to Medicaid at the state level and a fragile economic recovery, this was unnecessary. AHCA put forth a more balanced approach that would have met the goal of budget neutrality while protecting the critical role nursing facilities play, which the agency unfortunately disregarded. Their immediate reduction to skilled nursing facilities now puts more than 100,000 health care jobs at risk, as well as our ability to provide quality care to our nation’s seniors.

Governor Mark Parkinson, President & CEO of the American Health Care Association (AHCA), issued the following statement in response to the release of the Skilled Nursing Facility Prospective Payment System final rule for FY 2012 by the Centers for Medicare & Medicaid Services (CMS):

“This final rule only emphasizes the importance of preventing any additional cuts to skilled nursing for the foreseeable future. AHCA will continue to work with CMS and lawmakers to implement policies that preserve the level of care seniors deserve.”

 He also released the following message to AHCA members: 

Friday’s news of the final PPS rule dealt us a severe and unnecessary blow.  Severe because of the impact it will have on our members, their employees and most importantly, our residents. Unnecessary because AHCA put forth a solution that would have satisfied the goals of the government without threatening our profession.

How could this happen? Here is the CMS line of thinking: CMS intended to spend $31 billion on post-acute care in Fiscal Year 2011; CMS now believes it will end up spending $35 billion in FY 2011. So, for FY 2012, it is reducing spending back to $31 billion.  Further, CMS claims that a large part, if not all, of the reason for the $4 billion overpayment was the profession’s behavior.  CMS thinks we up coded, gamed the system, or whatever you want to call it.  As a result, CMS just doesn’t see the big deal about immediately reducing payments by nearly $4 billion.

Of course, it is a big deal.  Most of us find it insulting that SNFs are accused of incorrectly providing inappropriate care.  Many of you have not experienced an increase of the magnitude claimed by CMS.  We are all concerned that the CMS rule will over-correct for a flawed payment system and result in the government actually spending less than $31 billion in the sector next year.  And none of this accounts for the challenges we face with increased costs, drastic Medicaid cuts and the looming threats of additional cuts.

Despite Friday’s result, we must fight on.  We cannot allow the impact of this blow to stop us. Our need to work hard, strategically and as a united front has never been greater.

I have directed AHCA staff to take all possible steps to minimize the impact of the rule. Every idea is on the table, and we will thoroughly examine each option, including our legal and legislative options.

Further, we must make certain that this is the last hit that we take this year.  Unfortunately, there are still three serious risks that we face.  They are:

1.      Attempts on the Hill to claw back any unintended payments we received this year.

2.      Specific attempts to cut skilled Medicare rates because of persistent arguments that our margins are too high.

3.      General cuts to both Medicaid and Medicare that would impact the sector, like cuts in provider taxes and the blended Medicaid rate proposal.

As we develop specific strategies, we will share more information with the membership.  At the time, there are at least two ways that you can help us accomplish our goals.  First, please continue your political support and activity.  Over the last 60 days, our members’ response to our requests for involvement has been stunning.  You have sent over 100,000 emails and letters.  We have lobbied virtually every Congressional office.  This culminated in significant bipartisan support for our balanced approach on the Hill. 

The need to exert our political pressure has not diminished just because the final rule has been announced. We need political pressure now, more than ever.

Second, we need examples from members of the economic impact of this rule.  CMS states in its rule that it does not believe we will lay people off, freeze wages, stop construction of new buildings or renovations of older ones.  We need real world examples of what you have to do to absorb these drastic cuts.  Please send those examples to Julie Painter in AHCA Member Services so that we can ensure policy makers understand the effect of this action.

If we let this rule deflate us, it will have beaten us twice.  We can’t let that happen. We can’t give up.

It has been said that adversity doesn't build character, it reveals it. How will we react in the face of adversity? Will we give up, walk away and sulk?  Or will we channel our disappointment and frustration into an energy to rise up and fight on? 

AHCA is ready to rise to the occasion, and with your help, I have no doubt that we can succeed.

 Please keep watch for more detailed information very soon. If you have any questions, please contact Elise Smith, mailto:esmith@ahca.org, or Bill Hartung, mailto:whartung@ahca.org.

I am writing to introduce, and in some cases reintroduce, myself and our program.   The Office of the State Long-Term Care Ombudsman is a state agency with the mission to advocate for the well-being, safety, and rights of residents in long-term care communities.  Our office assists residents in attaining the highest possible quality of life.  The Ombudsman program is an advocacy program, not a regulatory program.  The purpose of the program is to investigate and resolve complaints made by or on behalf of residents relating to action, inaction or decisions of long-term care communities.

I have recently noticed a pattern and would like to make sure that our office is a resource to you and your community. First and foremost, we are resident advocates, but this does not mean that we take an adversarial role.  Our goal is to work with you to help residents attain the highest possible quality of life.  This brings me to the specific purpose for this letter, which is involuntary discharge. 

When issuing a notice of involuntary discharge, please make sure you are listing at least our state office information, which is 900 SW Jackson, Suite 1041, Topeka, KS 66612, (785) 296-3017.  It would also be helpful to list the Regional Ombudsman’s name, address and phone number (contact map is enclosed).  When you issue a notice, if you would please send us a copy, we would greatly appreciate it. 

Please do not hesitate to contact the Regional Ombudsman, or myself, if you have questions or need assistance.

Thank you for all that you do for long-term care residents!

Sincerely,

Belinda Vierthaler

Denim, diamonds, and more bling that you can imagine waits for you at the KHCA/kcal Convention October 13 & 14, 2011 in Wichita, Kansas. This year’s program features a full line-up of top-notch clinical and regulatory programs. Also featured is the always sold out tradeshow and fantastic evening entertainment. A very special breakout track for line staff will include KDOA’s Audrey Sunderraj reviewing their role in the QIS survey process and a private session with former Ritz Carlton exec and customer service expert Brian Williams. Administrators will be treated to insightful training from former AHCA chair Mary Ousley leading the discussion on health care reform, AANAC master trainer Becky LaBarge with what Administrators must know about the MDS 3.0, and incoming AHCA/NCAL Chair Neal Pruitt with a glimpse into the crystal ball of the future of health care. KCAL members will be treated to the always popular NCAL staffer Shelley Sabo. Joining Shelley from the Iowa Center for Assisted Living is Pat Giorgio. Together, they will help KCAL members understand their important role in the national arena. KCAL members will also have a full track of breakout programs from managing insulin to the future of HCBS in state-licensed only. Comedian Jack McCall will headline the evening Denim and Diamond’s Gala. This event is included in your convention package. Wait, there’s more, but you’ll have to see the next KHCA newsletter for registration information and other exciting program events.

A New Survey and Certification Memo has been released dealing with the use
of Video Cameras in Common Areas in Intermediate Care Facilities for the Mentally Retarded (ICFs/MR) (7/29/11)

To ensure that clients’ rights are protected, the use of video cameras in the ICF/MR must be reviewed, approved and monitored by the Specially Constituted Committee (SCC) of the facility as constituted per 42 CFR 483.440(f)(3)(i-iii).  If approved by the SCC, written informed consent must be obtained from every affected client or designated guardian prior to the implementation of video cameras.  Video cameras may be used in common areas within the ICF/MR facility.  Video cameras may never be used for any reason in areas where there are the highest expectations of privacy such as bathrooms, areas for private visitation or areas for private phone calls. Video cameras may not be used as a substitute for or supplement to adequate staffing or supervision protocols.  The cost of the video cameras must be incurred by the facility and not the clients.Click here for the full memo. 

The U.S. Food and Drug Administration has approved the influenza vaccine formulation for the 2011-2012 vaccine.  The three virus strains included in the formulation are the ones that surveillance has indicated will be the most common for the upcoming flu season; these are the same strains used for the 2010-2011 influenza season.  The strains selected are A/California/7/09 (H1N1)-like virus (pandemic (H1N1) 2009 influenza virus),
A/Perth /16/2009 (H3N2)-like virus, and B/Brisbane/60/2008-like virus.
 
"Vaccines to prevent seasonal influenza have a long and successful track record of safety and effectiveness in the United States," said Dr. Karen Midthun, director of FDA's Center for Biologics Evaluation and Research. 

"It is important to get vaccinated every year, even if the strains in the vaccine do not change, because the protection received the previous year will diminish over time and may be too low to provide protection into the
next year." - FDA Website, 7/18/2011

Employees who are 16 or 17 years old are once again allowed to operate and assist with lifts used to move patients in healthcare facilities as long as they are properly trained, according to the Department of Labor.

In 2010, the department changed a section of child labor law, resulting in those under 18 being prohibited from operating electric and air-operated hoists that exceeded a 2,000-pound capacity. This decision sparked a backlash from healthcare providers and lawmakers.

After commissioning a study by the National Institute for Occupational Safety and Health to study the matter, the department concluded it would not assert child labor violations for 16- and 17-year-old workers assisting a trained adult worker in using lifts. These teenagers must have completed 75 clock hours of nurse's aide training; help only a properly trained employee who is at least 18 years old, and must not engage in “hands on” contact with the resident. Additionally, the teenagers cannot work with lifts or hoists if they are injured, and their employer must give them a hard copy of the rules.

This compromise will allow the “Department of Labor's stated goal of balancing the potential benefits of transitional, staged employment opportunities for children with the necessary protections for their education, health and safety,” Labor Acting Administrator Nancy J. Leppink wrote in a July 13 memo to regional administrators and district directors.  

Reprinted from McKnight's Long Term Care News