KHCA eNews - 01/11/2005 (Plain Text Version)

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KHCA Winter Conference...On the Winds of Change

KHCA's 2005 Winter Conference promises more access and more insight in the Kansas Legislative process. In addition to classes for nursing home professionals, a special track has been developed for Assisted Living professionals and front line caregiving staff.  Participants will have three exclusive "branch" sessions within their discipline before teaming up for the general sessions. Sessions include A Guide to Personal Financial Freedom by Motorcycle Mary McCune, The Role of the Ombudsman in Long Term Care by Kathy Greenlee - Kansas Long Term Care Ombudsman; and An HCBS Outlook for 2005 by Krista Rose, just to name a few. General sessions include a fun filled Kansas Trivial Pursuit Game to be played throughout the Kansas Statehouse, an all new Technology Fair and a powerful wrap-up session, When Life Throws You a Curve by Kevin Brown.

Some additional Highlights are:

Welcome to Topeka Reception - January 18, 2005 KHCA Office 117 SW 6th Ave  Suite 200, 6:00pm – 9:00pm

Legislative Reception - January 19, 2005 at the Capitol Plaza Hotel from 6:30pm to 8:30pm - This event is only for KHCA, KCAL and Sales Associate Members who are registered for Winter conference.

Technology Fair - January 20, 2005 at the Capitol Plaza Hotel outside the Emerald Ballroom

Secretaries Lunch - January 20, 2005 at the Capitol Plaza Hotel, Emerald Ballroom

Make sure you have your registration into the KHCA office by January 14th. Registration forms can be downloaded at www.khca.org or by calling the KHCA office at 785-267-6003.

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National News

Quality First Gold Circle

Quality First Gold Circle

Those states in the Quality First Gold Circle have 80% or more of their members pledged to Quality First.   We all know this is the right thing to accomplish and it will have a big impact on policy makers and regulators.  Please consider helping Kansas achieve 100% and pledge today!

District of Columbia 100%

Georgia 80%

Kansas 92%

Maryland 87%

South Dakota 100%

Last week AHCA passed the 50% mark of our goal and they are gaining momentum!  Adequately funded quality care is our highest priority, and our Quality First program is the centerpiece of the quality movement.  AHCA has set a goal of 80 percent of member facilities signing the Quality First pledge.  Nationally, we're half way there!  Kansas reached the 92% level, but we would like to have 100% signed on to the Quality First pledge. AHCA recognizes the states that have reached or exceeded that goal as a salute to them and an encouragement for others.  Help us meet the goal and take the pledge!

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2005 Congressional Briefing

One Mission! One Voice!

2005 Congressional Briefing: One Mission! One Voice!

Join AHCA March 1-2, at the AHCA/NCAL 2005 Congressional Briefing in the Nation’s Capitol! 

Our Congressional Briefing is a tradition at AHCA/NCAL, and 2005's will be the best ever.  For the future, we plan to dramatically expand this very important effort.  Bringing hundreds of people to Washington to meet with Congress is important and impressive, but bringing thousands is more impressive, and that is our goal. 

Plus, administrators and nurses can earn up to 3 CEUs!

Registration is FREE for AHCA/NCAL members, but register as soon as possible for space is limited to the first 300 applicants. Register at www.ahca.org

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AHCA/NCAL Salutes Long-Term Care Awareness Campaign

On January 3, 2005, the AHCA and NCAL issued a press release praising the federal-state pilot project, "Own Your Future," a novel long-term care awareness campaign aimed at promoting understanding among baby boomers regarding their need to plan ahead for long-term care.  The Department of Health and Human Services (DHHA) has designed a multi-media campaign that will be launched this year in five states:  Arkansas , Idaho, Nevada, New Jersey and Virginia.  The campaign is aligned with longstanding AHCA/NCAL policy positions that advocate increasing public knowledge about the costs of long-term care and the need for advance planning.

Anticipating consumers' needs, AHCA/NCAL created a consumer friendly web site www.longtermcareliving.com that is referenced in the "Decide On Who You Can Count ON" section of the "Own Your Future: Planning Guide for Long-Term Care."  The web site contains helpful suggestions on how to conduct conversations about long-term care with family members and other valuable resources.  [Return to top]

Patient Care Improving: Federal Report Card on Nursing Homes

Health and Human Services (HHS) Secretary Tommy Thompson has stated the two-year evaluation of the federal Nursing Home Quality Initiative (NHQI) shows marked improvements in key indicators of care.

Launched in 2002 as a unique public-private partnership between government and long-term care providers, NHQI was designed to provide consumers with reliable, easy-to-understand, comparative information regarding care quality in nursing homes.

"The data we're releasing ...shows nursing home residents have better care -- I want to repeat that -- they have better care and a better quality of life since we launched this program," said Thompson at a recent HHS press conference. "...Fewer nursing home residents suffer from chronic pain and fewer physical restraints are being used to take care of elderly patients. Even more impressive, the prevalence of chronic pain in nursing homes has gone down in 50 out of 50 states."

Joined by AARP and leading nursing home provider organizations, including the American Health Care Association (AHCA) and the Alliance for Quality Nursing Home Care, Thompson announced that among the top findings were reductions in the number of residents who experienced pain and the number requiring physical restraints. 

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Regulatory News

Take NUBC Survey by February 1, 2004 in Order to Delay UB-04 Implementation until Transition to ICD-10

The Centers for Medicare and Medicaid Services (CMS) is preparing to implement an updated uniform billing form and data set known as the UB-04 for all institutional health care providers. In order to identify any remaining issues relating to implementation and adoption of UB-04, the National Uniform Billing Committee (NUBC) has created a survey to gather information. Responses to this survey will assist NUBC in making recommendations that will impact implementation strategies for UB-04.

The National Uniform Billing Committee (NUBC) is a voluntary

organization founded in 1975. This Committee was formed to develop a single billing form and standard data set that could be used nationwide by institutional providers and payers for handling health care claims. The current UB-92 form was developed by NUBC. A key factor for the development of the UB-04, which contains a number of improvements and enhancements that resulted from nearly four years of research, was the fact that the current UB-92 could not accommodate changes resulting from the implementation of the ICD-10.

The ICD-10 is the US clinical modification of the World Health Organization's International Classification of Diseases, 10th edition. The current coding system, ICD-9-CM, was created in 1979 and is now considered outdated and, despite annual updates, unable to meet health care needs. The problem is that CMS has delayed the adoption of ICD-10; as such, adoption of the UB-04 at this time without conversion to ICD-10 will create the need for a second conversion when replacement of the ICD-9 is effectuated. According to AHCA, which has representation on the NUBC, while the UB-04 is an improvement over the UB-92, replacement of the UB-92 with the UB-04 at this time, without simultaneous conversion to the ICD-10, is a serious waste of resources.

In an attempt to help providers avoid the unnecessary cost of two conversions, AHCA strongly urges all members to complete the NUBC Survey by the February 1, 2005 deadline , and recommend against adoption of the UB-04 until CMS implements the transition to the ICD-10.

To complete the survey online, go to the NUBC web site. Once at the site, scroll down to the web link under How to Complete the Survey on page 4. The user name and password to access the survey is: user name: nubc-ub04; Password: survey. After you complete the survey, click on the “submit” button and your response will be forwarded to the NUBC.

According to AHCA, critical survey questions include Q12 and Q13. Regarding these questions, AHCA believes that the most important change made with respect to the UB-04 was in anticipation of the use of ICD-10; and, in the absence of a mandate to use ICD-10, the Association recommends continued use of the UB-92. Keep in mind that AHCA is not recommending opposition to the eventual adoption of the UB-04. Rather, it is asking that NUBC not cause two extremely expensive conversions instead of one conversion combining migration to the UB-04 and the ICD-10 at the same time.

Questions concerning how to complete the survey should be directed to NUBC. Questions pertaining to AHCA's recommendation should be directed to Elise Smith. The NUBC will review the survey results at its meeting on February 22nd and 23rd, and will deliberate on an implementation schedule for the UB-04.

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CMS Policy Clarification of Reporting Requirements Related to Mistreatment, Neglect and Abuse

On December 16, 2004 the Centers for Medicare & Medicaid Services (CMS) released a memorandum (S&C-05-09) to clarify CMS' policy on Nursing Home Reporting Requirements for Alleged Violations of Mistreatment, Neglect, and Abuse, Including Injuries of Unknown Source and Misappropriation of Resident Property. The memorandum, from CMS' Survey and Certification Group Director Thomas Hamilton to state survey agency directors, reiterates the provisions of 42 CFR 483.13(c)(2) and (4) that require facilities to report alleged violations and the results of investigations to the state survey and certification agency. The memorandum also defines the terms neglect, abuse, injury of unknown source, misappropriation of resident property, immediately and in accordance with State law. CMS states that this memorandum does not contain new policy.

The American Health Care Association (AHCA) provided comments to CMS on a draft version of the memorandum in August 2004 at the agency's request. Click here to view CMS' draft memo and AHCA's comment letter. The final CMS memo does not differ markedly from the draft but shows that CMS accepted some of AHCA's recommendations for clarification.

The December 16th memorandum also addresses reporting to ASPEN Complaints/Incidents Tracking System (ACTS). The memorandum advises states to manage and enter facility self-reported information into ACTS. Currently only self-reported incidents that result in an onsite survey of federal requirements are entered into ACTS. A footnote on the last page of the CMS memorandum states that the agency will be conducting a feasibility analysis to discern the value of requiring the entry of data into ACTS of self-reported incidents to the survey agency and any other incident that leads to an onsite survey of federal requirements or conditions. AHCA recommended in August and continues to urge that CMS hold these data separately and distinguishable from all other complaints/incidents reported to and tracked in ACTS. Combining facility-reported incidents with all other complaints dilutes the value of the data and presents a distorted picture of the facility.

 
State News

IDR Panel Members Still Needed

Informal Dispute Resolution volunteer panel members are still needed by the Kansas Department on Aging.  If you are interested please contact Linda Berndt at lberndt@khca.org.

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State Fire Marshal Waiver Applications

Effective 1/7/05 all nursing facility and hospitals that are surveyed by the State Fire Marshal under CMS guidelines, will be required to submit any waiver application during the first survey.  State Fire Marshal's office will no longer allow facilities to apply for waivers after the first survey; if you have failed to apply for a waiver during that time frame and try to apply during a revisit you will be denied. All pending and future cases of temporary waivers that are not corrected in the time frame specified by the facility in the POC and waiver request with your commitments to make the necessary changes in the agreed upon time-frame. If a revisit verifies that the facility has not timely followed through with its commitment, a recommendation for denial of payment for new admissions will be made to CMS.

If you have applied for a waiver extension effective 1/7/05, State Fire Marshal's office will expect a follow-up letter stating your progress when you have reached the date you applied for on your waiver.  If we receive no up-date concerning your waiver by the date agreed upon by your facility a recommendation for denial of payment for new admissions will be made to CMS.  For questions contact Brenda McNorton, Chief, Fire Prevention Division at 785-296-3401.

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Alcohol Hand Rubs

The regulation concerning alcohol hand rubs did not come out as planned on Dec 23, 2004. It is still under going review and may not be out until spring if all goes well. Facilities are still under the original edition of the 2000 LSC that prohibits flammable liquids in egress corridors. The alcohol hand rubs are allowed in resident/patient rooms under certain conditions. Call Brenda McNorton at 785-296-3401 if you have questions.

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Association News

Please update your Email address

Please make certain that you advise KHCA of any changes to your email address.  Send these changes to pgish@khca.org  [Return to top]

Use KHCA.org web site as your information source

Your staff at Kansas Health Care Association makes certain that the most up to date information regarding fire marshal regulations and other information is as timely as possible.  Please use this web site.  If you are a member and do not know how to reach the Members Only area, do not hesitate to contact the office and we will give you the information.  www.khca.org

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Village Manor- Abilene remodeling- Free equipment available

Administrator, Amy Hoch-Altwegg, contacted the Kansas Health Care Association, to let us know she has manual beds to give away. Village Manor is in the process of re-modeling and therefore has 60 manual beds available free.  The beds will be available for pick up at the end of January.  All you need is make arrangements to pick them up and they are yours free.  Contact Amy at ahochalt@mhsks.org or call 785-263-1431.  What a deal!!  [Return to top]

Upcoming Meetings

Mark your calendar:

KHCA Board of Directors Meeting - January 18, 2005; 2PM

Government Affairs Meeting- February 8, 2005; 10AM

Workers Compensation Trust Meeting- February 9, 2005; 9:30AM

Joint Provider Training- Falls

Wichita- February 22, 2205

Topeka- February 23, 2005

AANAC MDS Courses- March 9, 10, and 11, 2005 - Lawrence

Pat Maben Presents ( A three part RAI series)... March 23, 30 and April 5, 2005

KHCA Spring Conference- April 6 and 7, 2005 - Wichita

More Information Soon!  [Return to top]

 
Assisted Living News

HCBS/FE Waiver: A Five-Year Follow-up

The Office of Aging and Long Term Care (OALTC), is working on as part of our contract with KDOA and SRS.  The project is titled “Assisted Living/Residential Health Care (AL/RHC) Facility Participation with the Medicaid HCBS/FE Waiver: A Five Year Follow-up”. This current study is a follow-up to previous research our office conducted regarding the availability and access of assisted living settings for low-income (Medicaid enrolled) older adults. During FY 2000, OALTC conducted a survey of all licensed AL/RHCs in Kansas. The survey collected data regarding the facility characteristics, e.g. profit status, average cost, level of service, professional staffing and whether they accepted Medicaid-HCBS/FE customers.  During FY 2005, OALTC will re-survey all AL/RHCs in Kansas to update the information and identify changes in the availability and access of AL/RHCs for low-income older adults. We mailed the surveys to all AL/RHCs in Kansas about a week ago. This study will also provide an updated profile of key characteristics including size, cost, and ownership status of Kansas AL/RHCs.   Below is the complete project description for your reference.

KHCA/KCAL encourages all AL/RHC facility administrators to participate in the survey. 

For more information contact: Roxanne Rachlin

Office of Aging and Long Term Care

KU School of Social Welfare

1545 Lilac Lane, #17B

Lawrence, KS 66044

(785) 864-5867

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AHCA Study Sheds Light on Employment in Assisted Living Settings

Recent findings from an American Health Care Association study show that according to estimates developed by the U.S. Bureau of Labor Statistics (BLS), more than 3.85 million workers were employed in the long term care delivery system in 2003. For purposes of this analysis, the long term care delivery system was based on the North American Industry Classification System coding and defined as two primary service categories: facility-based such as nursing facilities and assisted living, and home-based services.

All projections are based on the BLS Occupational Employment Statistics (OES) survey, which is conducted tri-annually and designed to estimate employment and wages for industries and occupations based on a sample of 1.2 million establishments. “Assisted Living Facilities – Community Care Facilities” is a classification that falls under the broader category of Primarily Non-Medical Residential Care Facilities. The category indicates that “typical providers” are assisted living facilities with or without on-site nursing facilities, homes for the elderly without nursing care, and continuing care retirement communities.

In all of long term care, there are approximately 2.2 million direct-care workers, of which 545,690 are professionals (e.g., registered nurses) and 1.65 million are paraprofessionals (e.g., nurse aides or personal care workers). In assisted living, there are approximately 276,000 direct care workers, according to government statistics. (See chart below.)

Professionals Working in AL                                           Paraprofessionals Working in AL

Registered Nurses                    22,010                          Home Health Aides                     72,890

Licensed Practical Nurses         31,040                           Nursing Aides                           112,050

  Subtotal                                  53,050                          Personal & Home Care Aides      38,210

Subtotal                                    223,150

According to BLS estimates, paraprofessional direct care workers in long term care are women with an average age of 39. From 25 to 33 percent of all paraprofessional workers are unmarried and living with children. From 28 percent to 35 percent of long term care paraprofessionals reported at least some college education.

In 2003, the median hourly wages for paraprofessional direct care workers was $9.20, compared with median wages of $13.53 for all U.S. workers. According to the recent report “Nursing Aides, Home Health Aides, and Related Health Care Occupations – National and Local Workforce Shortages and Associated Data Needs” published by the U.S. Bureau of Health Professions, Health Resources and Services Administration, 20 to 30 percent of paraprofessional direct care workers are employed on a part-time basis and 20 percent of all paraprofessional direct care workers earn incomes below the federal poverty level.   

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