AAHSA Assisted Living Salary and Benefit Survey Underway - Hospital and Healthcare Compensation Service (HCS) is conducting its tenth annual AAHSA Assisted Living Salary and Benefits Report. The results provide assisted living facilities with the most reliable, comprehensive source of compensation information. Last year's Report contained data from 670+ facilities.

Salaries and bonus payments will be reported according to state, region, revenue size, and unit size. In addition, both for-profit and not-for-profit data will be covered separately in the Report. Information on 23 fringe benefits will be reported according to region. Percent increases planned for 2007 will be reported separately for management, nonmanagement, RNs, LPNs, CNAs, and Resident Assistants.

Completed Assisted Living questionnaires should be sent to HCS by November 30. The Report will be available in January. AAHSA Member Participants may purchase the Report at a reduced rate of 40% off the AAHSA Member nonparticipant price of $225.

DO WNLOAD THE QUESTIONNAIRE, or call HCS at (201) 405-0075.

CCRC Entrance Fees Could Affect Medicaid Eligibility - Recent changes to the SSI-Related Medicaid Resource Eligibility Criteria as part of the Deficit Reduction Act may adversely affect potential beneficiaries having an entrance fee agreement with a continuing care retirement community ("CCRC"). According to the revised Florida Administrative Code 65A-1.712 "an individual entrance fee in a continuing care retirement community shall be considered a resource as set forth in 1917(g) of the Social Security Act...." According to this Act, a resident's CCRC entrance fee would be considered a resource "for the purpose of determining an individual's eligibility for (or amount of), under a State [Medicaid] plan...." To be considered a resource, a CCRC resident contract must meet all of the following criteria:

1. The resident has the ability to use the entrance fee, or the contract provides that the entrance fee may be used, to pay for care should other resources or income of the individual be insufficient for said care.
2. The resident is eligible for a refund of any remaining entrance fee when the individual dies or terminates the resident contract and leaves the community.
3. The entrance fee does not confer an ownership interest in the CCRC.

A representative of the Florida Department of Children and Families, who makes Medicaid eligibility determinations, said the department has historically taken a common sense approach that an asset was countable only if the beneficiary could access it. It is possible that approach may have to be modified going forward, so all Florida CCRC providers should review their resident contract in relation to this revised rule, seek counsel from their legal and financial advisors, and communicate their conclusions to their residents.

Top CCRC Developers Remain Optimistic - The top developers of continuing care retirement communities remain extremely optimistic on growth prospects, despite the subprime mortgage meltdown that has gripped the U.S. housing market, according to results of a new study released last Tuesday at AAHSA's annual meeting.

"They're still feeling very strong. I think a lot of that shows how strong the growth of the largest (providers) is," said Lisa Lehman, managing partner of Holleran Consulting. Holleran conducted telephone interviews between June and September with top officials at 82 of the country's 100 largest eldercare organizations. Most respondents -- including those at the 10 largest organizations -- currently have expansion construction projects underway. In addition, nearly 90% of respondents in the largest 10 organizations said they plan to acquire new communities in the next two years. Half the respondents said their organizations own land on which they plan to build new communities; that includes 54.5% of respondents in the largest 25 and 67% of those in the largest 10. Two-thirds indicated they expected to build new communities within four years.

Among other findings: Neither the age of a provider's organization nor the type of CCRC contracts offered significantly affected resident satisfaction scores.

District 6 Meeting Held at Indian River Estates West - George Bryan, District 6 Chair, hosted the District 6 meeting on October 31, 2007, at Indian River Estates West. A delicious and beautifully prepared complimentary gourmet lunch was presented on behalf of the ACTS Community for the attendees. Six communities and two businesses were represented, including: Indian River Estates East; Indian River Estates West; Gerald Rester, President, Indian River Estates Residents Association; Asbury Arms; Asbury Arms North; Courtenay Springs Village; Florida Baptist Retirement Center; FMS; and Rehab Dynamics.

FAHSA President/CEO Janegale Boyd presented the program on public policy issues and committee recommendations. The new FAHSA benefit program administered by HRH that covers health, life and dental was also discussed. This relationship is unique because "coverage will be based on the association size and not the individual community." Additionally, discussion occurred regarding the FAHSA Preferred Business Associate Program and group purchasing opportunities as a value-added benefit for FAHSA members. Ms. Boyd explained the highlights of FAHSA business plan goals for next year noting every resident council will receive a FAHSA membership courtesy of the community that is a member. Conversation also occurred concerning the regional meeting concept. The next scheduled District 6 meeting is scheduled for January 17 at 11:00 a.m. at Indian River Estates.

Please Join Us for FAHSA's 14th Annual Maintenance Workshop - November 14 & 15 in Orlando - This popular and highly interactive workshop will provide Maintenance Directors, Staff and Administrators of retirement communities, nursing homes, assisted living and high-rise independent living facilities with the most up-to-date information on 'hot' Maintenance topics such as Plumbing, Heat, Electrical, Bid Specs, Air Handling, Refrigeration, Safety Regulations, and Building Maintenance. Attendees will have opportunities to hear the latest information from experts, view the latest products and services from exhibitors, and network with other maintenance directors and staff. Early Bird Registration Deadline is November 1, 2007. Please visit the FAHSA Calendar of Events to view the brochure or register online.

Plan to Attend - We're putting a fresh face on FAHSA's January Dynamic Directions: Advanced Nurse Workshop....just for you! With the help of our dynamic planning team, we're putting together a program that will meet the needs of not only Directors of Nursing, but quality assurance nurses, staff development nurses, charge nurses and CNA instructors. Nurses practicing in nursing homes, and assisted living settings will want to attend. Please visit the FAHSA Calendar of Events to view the brochure or register online.

MDS Coding and Care Planning Webinar -- November 27 at 2:00pm to 4:00pm.

This Webinar will relate to the new QIS process and is specifically designed for MDS Coordinators, RNs, LPNs, DONs, ADONs, administrators and other nursing home direct care staff and administrators.

The Long-Term Care Minimum Data Set (MDS) is the single most important data instrument that can impact resident care, care planning, financial success or failure, legal defense, survey outcomes, quality assurance and communication between facility staff.

Please visit the FAHSA Calendar of Events to view the brochure or register online.

Upcoming Events:

• November 7 - QIS Training, Westminster Bradenton Shores, Bradenton
• November 14-15 - FAHSA's Maintenance Workshop, Holiday Inn, Orlando
• November 27 - MDS Coding and Care Planning Webinar
• January 15-16 -- FAHSA's Dynamic Directions Advanced Nurse Leadership Workshop including QIS Training, Safety Harbor

Federal Rule Concerning Service Animals Under Consideration - Thanks to the eagle eye of Robin Wagoner, Administrator at Asbury Arms and Asbury Arms North in Cocoa, we were alerted to the Oct. 15th Federal Register rule process on service animals. READ THE PROPOSED RULE.

Many of you will remember a bill filed in 2006 concerning the use of service animals. FAHSA worked diligently on this bill. As a result, it was modified to be in compliance with your HUD contract. The modified language noted that the service animal provision had to comply with the HUD contract which allowed for reasonable accommodations for the tenants' or visitors' disability. By having the language read "reasonable accommodation" it has allowed our HUD managers to request certification from a doctor to be assured the animal is necessary and to request certification that the animal has been trained as a service animal. This new language, under consideration at the Federal level, will not allow you to require physician's certification or allow you to ask for documentation that the service animal has been trained as a service animal. Please remember that Federal regulations and rules will supersede state law. This will also force HUD to change the current contracts.

You have until Dec. 14th to submit your comments. Please E-mail your comments to Gail Matillo at gmatillo@fahsa.org . We will encourage you to note that you are supportive of the use of service animals; however, you would like the ability to request the following:

• Verification of the animal's service training;
• That the animal has been trained as a service animal;
• That the animal is current on their immunizations;
• That the tenant needs the use of the service animal for assistance as confirmed by a physician; and
• That the language be retained concerning reasonable accommodation.

FAHSA will submit comments on behalf of the members; however, the more comments submitted the better.

FAHSA Member VOA of Florida Awarded Housing Assistance Grant - Recently, HUD announced the award of more than $643 million for the FY07 Section 202 and Section 811 funding competition. A total of $518.9 million was awarded nationwide to assist very low-income elderly and $124.8 million nationwide to assist very low-income people with disabilities. Congratulations to VOA of Florida, who will use their award to construct 14 units for very low-income persons with physical disabilities. The project, nine one-bedroom units and five two-bedroom units, will enable the residents to live as independently as possible yet have access to the necessary supportive services.

AHCA Halts Medicare/Medicaid Certification Activity for Home Health Agencies - Effective immediately, the Agency for Health Administration will not be processing applications for Medicare or Medicaid certification of home health agencies. In a letter dated October 23, 2007, AHCA Deputy Secretary Elizabeth Dudek stated that "the Centers for Medicare and Medicaid Services (CMS) has established recertification surveys of existing home health agencies as a Tier 1 (top) priority. Complaint investigations and surveys of home health agencies most at risk of providing poor care are also a higher priority than initial surveys. CMS requires all states complete their higher priority work before using any federal some funds for initial surveys. CMS states that the assignment of a lower priority for new home health certification is necessary since federal funds for Medicare and Medicaid survey has decreased. States cannot conduct initial surveys of new providers unless they can ensure that they will be completing all statutorily-required surveys or surveys assessed a higher priority by CMS. Florida will not have federal funds available for initial certification surveys once all of the higher priority work is completed." The change in policy is retroactive and applies to applications for certification that were submitted prior to October 23, 2007.

Home health agencies that are seeking certification have an option. They may seek accreditation along with deemed status from one of three national accreditation programs: Community Health Accreditation of Program, Joint Commission on Accreditation of Health Care Agencies, or Accreditation Commission for Health Care. If you are affected by this policy change, be aware that certification can take four months or longer and can be very expensive.

AHCA Announces Results of Internal Review of Nursing Home Ownership - This week, AHCA released a white paper summarizing the results of an internal review of nursing home ownership structures. The 24-page report provides a comprehensive review of regulatory enforcement authority, major nursing home regulatory requirements, deficiency patterns over the past few years, nursing home compliance ratings as shown in the Nursing Home Consumer Guide, notices of intent to sue, reimbursement increase trends, change of ownership requests and other historical comparisons. For more on this issue and those listed below, please go to the latest Nursing Home Alert, NH 07-30.

Other Nursing Home News:

• AHCA Update on Medicare Crossover, New Claims Processing & Medicaid Rates
• Board of Nursing Home Administrators Meeting Update
• Navigating Quality Indicator Surveys
• Medicare Part B Drug Competitive Acquisition Program (CAP): 2008 Physician Election
• NPI: Important Information for Medicare Providers From CMS
• Corridor Doors and Sprinklers Most Dangerous Physical Plant Issues
• MDS 3.0 Scheduled for Oct. 1, 2009 Implementation
• CMS Urges Nursing Homes to Use Free Pressure Ulcer Tools to Improve Outcomes

FAHSA's Preferred Business Associates Program (PBAs) -- A list of PBAs can be found by on the FAHSA Web site www.fahsa.org and selecting Preferred Business Associates from the left side menu bar. FAHSA members can also use the on- line directory to search for PBAs by specialty.

FAHSA is pleased to provide an opportunity for you to advertise your "position wanted" or "position available" through the FAHSA Link newsletter and on our Web Page.

FAHSA members may use the Job Mart services at no charge. A nominal fee of $25 will be charged to nonmembers.

Your Job Mart advertisement will be displayed on our Web site for approximately three months. The FAHSA Link is published weekly and distributed to our membership which is comprised of nursing homes, CCRCs, HUD housing, assisted living facilities, independent living facilities and companies/firms.

To reserve advertisement space in our Job Mart program, please complete the application and fax it to FAHSA at (850) 671-3790 or E-mail Erin Steele at esteele@fahsa.org