The KHCA/kcal office will close at noon Friday, December 30, 2011 and reopen Tuesday, January 3, 2012. Wishing you a safe and prosperous New Year from your staff at KHCA/kcal.

Get ready for some first-rate education and legislator conversation at the annual KHCA/Kcal Winter Conference. This year's conference is on January 24-25, 2012 at the Ramada Inn Downtown in Topeka and will focus on Quality.

Rather than going to the state house as a large group, members will have individual appointments to meet with their legislators (you will receive an email with specifics on this). Transportation will be provided to these appointments.

The Tuesday evening Legislative Reception will have a new twist this year as it will be held at the beautiful Kansas State Historical Society & Museum. Fabulous food, music and a host bar will make this "red carpet" event one not to miss. There will again be shuttle buses available between the hotel and the museum. Directions will be available for those who wish to drive themselves.

Scott Brunner from Kansas Health Institute (KHI) will join us Tuesday morning to discuss Medicaid managed care concepts and the nuts and bolts of what managed care is about. BKD partner John Harris will look at the budgeting aspects that QAPI and other quality improvement programs may bring. Attention will also be given to programs that prevent unnecessary re-hospitalizations and the tools that can help track and prevent these occurrences. Former Kansas Governor and now AHCA/NCAL President/CEO Mark Parkinson and KDOA Secretary Shawn Sullivan will join us Wednesday morning at the Leadership Breakfast. This breakfast is open to all conference attendees.

Our valued vendor partners will join us on Wednesday in the atrium of the hotel with displays and information on the newest products and technologies. Lunch includes an excellent presentation by Ted McDonald, an attorney from Kansas City, on Risk Management. We'll end the conference with the inspiring “Lighting Your Candle and Fanning Its Flame” by an old friend of KHCA/Kcal, Ron Willis.

Click HERE for the conference brochure and registration information.

The Office of State Fire Marshal wishes to recognize the following nursing homes for their efforts in providing a fire safe nursing facilities for the year of 2011. During their annual inspection,these facilities received notice of no deficiencies.

Congratulations to those listed below - we do appreciate your hard work and dedication.

Family Health and Rehabilitation-Wichita
Golden Heights Living Center-Garnett
Golden Living Center Chase County-Cottonwood Falls
Golden Living Center –Fredonia
Golden Living Center-Neodesha
Lakepoint Nursing and Rehab. Center-El Dorado
Lakepoint Nursing Center-Augusta
Maple Heights Nursing and Rehab Center-Hiawatha
Moran Manor-Moran
Medicalodges Arkansas City-Arkansas City
Medicalodges of Coffeyville-Coffeyville
Medicalodges Kinsley-Kinsley
Medicalodges Post Acute Care Center-Kansas City
The Centennial Homestead-Washington

Secretary Sullivan would like to invite you to participate in a provider web chat on KanCare Monday, January 9, 2012 at 3 p.m.

Topic: Web Chat with Secretary Sullivan
Date: Monday, January 9, 2012
Time: 3:00 pm, Central Standard Time
Meeting Number: 598 247 299
Meeting Password: (This meeting does not require a password.)
Host Key: 341993

-------------------------------------------------------
To Begin
-------------------------------------------------------
1. Go to https://intercall.webex.com/intercall/j.php?ED=176728922&UID=496921972&RT=MiM3
2. Click Register 
3. Provide Required Information 
4. Follow the instructions that appear on your screen.

-------------------------------------------------------
Teleconference information
-------------------------------------------------------
Provide your phone number when you join the meeting to receive a call back. Alternatively, you can call:
Call-in toll-free number: 1-866-6207326  (US/Canada)
Call-in number: 1-678-9818305  (US/Canada)
Conference Code: 123 227 6937
-------------------------------------------------------
For assistance
-------------------------------------------------------
1. Go to https://intercall.webex.com/intercall/mc
2. On the left navigation bar, click “Support”.
To update this meeting to your calendar program (for example Microsoft Outlook), click this link:
https://intercall.webex.com/intercall/j.php?ED=176728922&UID=496921972&ICS=MIU1&LD=1&RD=2&ST=1&SHA2=v6B3bOwfVZtZjaYBMOOXuxOwfEGb6-GkukS1nYB8kRQ=
 

The American Health Care Association (AHCA) understands that improving quality of long term care depends upon a stable, well-trained workforce. Providing up-to-date, accurate, and consistent data about nursing facility staff to policy makers and public is critical for AHCA’s advocacy efforts around long-term care issues.

AHCA will conduct its seventh nationwide nursing facility staffing survey, which will collect 2011 data that we can use to estimate the retention and turnover rates of nursing facility employees. This survey will be sent to nursing facilities nationwide by the end of January, 2012. Nursing facilities can also participate in this survey by downloading the survey questionnaire from the AHCA website. Results from nursing facility staff survey reports for 2008, 2009 and 2010 can be found at http://www.ahcancal.org/research_data/staffing/Pages/default.aspx.

For more information, please email  or call Bill Hartung (202-898-2841), Jeffrey Liu (202-898-2818) or Lisa Matthews-Martin (202-898-2824).

Thank you in advance for your participation.
 

Earlier this month, an OH provider shared with AHCA that a Medicare Recovery Audit Contractor (RAC) request from Region B (CGI, covering KY, IL, IN, OH, MI, MN and WI) describing OIG’s findings (OEI-02-09-00202, Questionable Billing by SNFS [12/10]) that “errors can be traced to the providers therapy minute records on the MDS not matching the minutes recorded in the medical record and the patient’s care and resource needs;” and stating that an analysis of the provider’s billing data indicates that a potential aberrant billing practice may exist for Ultra-High Therapy RUGs.  The RAC then requested additional documentation on those claims as part of a “test sample.” 

Generally, Medicare RACs can only audit providers on CMS-approved issues; but the recent RAC Statement of Work (SOW) explains that RACs can now request up to 10 test claims to determine if CMS should approve a new issue.  AHCA has confirmed that the OH provider is one of the 10 test cases RAC Region B will use to determine if CMS should approve the Ultra-High RUGs issue.  We are watching this carefully and will notify you if/when this becomes a CMS-approved issue.  Please notify your membership that we expect Ultra-High RUG RAC audits will be coming down the pike for all providers in all RAC Regions.  Members can protect themselves by self-auditing their own claims/data so they can easily defend their actions if they find themselves in the middle of an audit.

The AHCA Legal Committee also has been talking to companies and attorneys currently involved in OIG/DOJ investigations where providers have anywhere from 10-15% of the census in their facility in the Ultra-High RUGs.  OIG/DOJ began looking at providers with ultra high RUGs in 2008; but have used the more recent 2010 OIG report to support its overall conclusions that providers are “gaming the system,” and that:  a) SNFs increasingly are billing for higher paying RUGs, even though beneficiary characteristics remain largely unchanged; b) for-profit SNFs are far more likely than nonprofit or government SNFs to bill for higher paying RUGs; and c) a number of SNFs had questionable billing.  AHCA’s Legal Committee has created a work group and is working with the Research Department to analyze available data on this issue to disprove the government’s position.

AHCA will continue to keep you updated on this issue, as they fully expect  continued Federal government focus on this Ultra-High RUGs. 

Summary reports or Discharge Summaries that follow discharged hospital patients to a nursing home are frequently delayed and sometimes incomplete, according to researchers at the University of Wisconsin School of Medicine and Public Health.

The researchers’ findings, recently published in the Journal of General Internal Medicine, determined that discharge summaries regularly lack necessary information on diet, activity level, therapy and pending laboratory tests of nursing home patients after departure from the hospital.

The study involved 489 Medicare patients treated for strokes and hip fractures. All were sent to nursing homes after discharge from the hospital between 2003 and 2005.

According to a requirement from The Joint Commission, which accredits healthcare facilities, hospitals must submit discharge summaries within 30 days after a patient is discharged. These summaries provide details on the patient’s hospital stay and can be especially important to care delivery during the first few days of a patient’s nursing home stay.

The University of Wisconsin researchers, however, found discharge summaries were often completed many days after the patient had already been discharged to the nursing home, some more than 30 days after discharge. In addition, the longer it took to release a discharge summary, the more imprecise the information within the summaries became—if they weren’t downright incomplete.

This forces nursing home caregivers to spend precious time contacting the hospital to determine how to proceed with patient treatment, researchers said.

They also found that nearly a third of discharge summaries did not include information on the patient’s dietary needs. Instructions on therapy and activity needs were excluded on more than 40 percent of discharge summaries, and less than 10 percent included information on pending studies and laboratory tests.

“Right now, the Joint Commission standard for the creation of discharge summaries within 30 days is outdated, because this standard doesn't optimally support patients who need care right after discharge,” researchers said. “Our study is the first to suggest that the quality of the actual document starts getting worse the longer you wait to create a discharge summary. Important items are omitted, and because of that, patient care may suffer”.

“We know that one in five Medicare patients is re-hospitalized within 30 days of discharge,” they added. “Experts suggest that care during the hospital discharge and early post-hospital period may be critical in preventing at least a portion of these re-hospitalizations.”

The study was funded by the University of Wisconsin Health Innovation Program and the National Institutes of Health.

Reprinted from 12-22-11 Long Term Care Living Magizine

For the fourth year, the National Council of Certified Dementia Practitioners is offering The National Council of Certified Dementia Practitioners Alzheimer’s and Dementia Staff Education Week February 14th to the 21st Tool Kit. The Tool Kit is free and available at www.nccdp.org. The tool kit includes many free Power Point in-services for download beginning November 15th to March 1st.  Each in-service is designed to be taught in 30 minutes to health care professionals, front line staff, volunteers, support groups, congregations, families, state staff with AOA, state surveyors and Ombudsman  staff. One new in-service is on Sexuality, Intimacy and the Dementia Patient.  Simply log on to the web site www.nccdp.org, complete the registration form and begin downloading. 

The Tool Kit and the declaration by the NCCDP Alzheimer's and Dementia Education Week February 14th to the 21st was developed to bring national and international awareness to the importance of providing comprehensive dementia education by means of face to face interactive classroom environment to all healthcare professionals and line staff and to go above and beyond the minimum state requirements regarding dementia education.

Currently there are no national standards or international standards for dementia education. There are new standards coming from CMS regarding mandatory dementia education for CNA’s working in Nursing Homes.  The regulations are different from state to state and industry to industry. The NCCDP recommends at minimum an initial 8 hours of dementia education to all staff. Throughout the year, additional dementia education should be provided that incorporates new advances, culture change and innovative ideas.

In addition to facilitating the Train the Trainer programs, The NCCDP promotes dementia education and certification of all staff who qualify as Certified Dementia Practitioners (CDP®). The NCCDP recommends that at minimum there should be one Certified Dementia Practitioner® per shift. The NCCDP recommends a trained and certified Alzheimer’s and dementia instructor by the NCCDP to utilize up to date NCCDP training materials.

The NCCDP recognizes the importance of educated and certified dementia unit managers and certifying the Dementia Unit Manager as Certified Dementia Care Manager (CDCM®). Dementia Unit Managers report that they have received little training as a Dementia Unit Manager.

Front Line First Responders and Law Enforcement need comprehensive Dementia training and the NCCDP provides Alzheimer’s and Dementia training to First Responder and Law Enforcement educators and certification as Certified First Responder Dementia Trainer®.

The free tool kit and staff in-services includes
• Free Power Point In-services (Many topics) for  staff, volunteers, family & First Responders, clergy and support group attendees. Includes Power Point, pre test, post tests, hand outs, answers, in-service evaluation and in-service certificates.
• Nurse Educator of the Year Nomination Forms
• Nomination Forms for NCCDP Alzheimer’s and Dementia Staff Education Week Contest
• Proclamations for Senators and Mayor 
• Letters to the Editors Promoting Your Program
• 97 Ways to Promote Alzheimer’s and Dementia Staff Education Week 2011 
• Resources and Important Web Sites
• Alzheimer’s Bill of Rights and the Alzheimer’s Pledge
The National Council of Certified Dementia Practitioners®, LLC was formed in 2001 by a group of professionals with varying work and personal experiences in the field of dementia care. The Council was formed to promote standards of excellence in dementia and Alzheimer's education to professionals and other caregivers who provide services to dementia clients. As the number of dementia cases continues to increase nationally and worldwide, there is a great necessity to insure that care givers are well trained to provide appropriate, competent, and sensitive direct care and support for the dementia patient. The goal of the Council is to develop and encourage comprehensive standards of excellence in the health care profession and delivery of dementia care.
NCCDP is endorsed and recognized by many organizations and associations such as Project Lifesaver International, NADONA National Association of Directors of Nursing Administration in Long Term Care,  Dorland Health an Access Intelligence, Professional Patient Advocate Institute, Care2Learn, Life Care Centers of America, Alzheimer’s Care Guide Publication, TJA Protect Systems International, CarePlans.com. 

The BBB is warning the business community to beware of an ongoing malicious e-mail that pretends to be from the BBB about a complaint filed against the company.

Businesses from across the United States have reported receiving suspicious e-mails from a variety of email address, such as risk @bbb.org or  service @bbb.org  with the subject line “Complaint #” followed by an eight to nine-digit number. The emails appear to come from the BBB national office, the Council of Better Business Bureaus in Arlington, VA.

The body of the e-mail states: “The Better Business Bureau has received the above-referenced complaint from one of your customers regarding their dealings with you. Please review this matter and advise us of your position. As a neutral third party, the Better Business Bureau can help to resolve the matter. Often complaints are a result of misunderstandings a company wants to know about and correct.” The email also encourages the recipient to click on a link provided in the email to respond to the complaint. Variations of the email have numerous grammatical errors.

Because the message is fraudulent, the BBB advises any business that receives this e-mail to take the following steps:

Do not click on any links or reply to the message
Forward the message to phishing@cscprotectsbrands.com
Completely delete the message from your inbox
Run a virus scan on your computer if you did click on any links.
Complaints that the Washington DC & Eastern PA BBB email come from only one address: info@mybbb.org.

These types of phishing attacks are not uncommon. The FTC, IRS and UPS have also been subject to similar attacks.
Reprinted from the Senior Medicare Patrol Program - Kansas Department on Aging