Members Focus on Potential Legislative and Regulatory Changes Affecting ALF Providers - Members of FAHSA's ALF/Home and Community- Based Services Public Policy Committee and the ALF Task Force made up of members of the CCRC / Retirement Community and Nursing Home Public Policy Committees met by conference call Tuesday, November 13th, to discuss potential changes to laws and regulations affecting ALF providers expected to be proposed by lawmakers in the 2008 legislative session. Seven FAHSA-member communities were represented on the call.

Among the proposals discussed by the group was expected legislation that would require background screening for all employees and contractors working on an ALF campus, including those providing time- limited services that do not involve interaction with residents. This requirement, if adopted, might be extended to apply to nursing homes as well. A small subgroup will meet again when we know more specifically what is being proposed to work on FAHSA's response. Other potential legislation discussed by the group included proposals to consolidate specialty licenses, Limited Nursing Services and Extended Congregate Care (ECC), to require increased regulatory oversight for poor- performing ALFs, and to enhance staffing requirements and regulatory standards for ALFs serving residents who have been diverted from nursing homes or are served by a state waiver program. The committee and task force will continue to monitor and discuss these issues and others expected to arise in the coming months in response to increased allegations of resident neglect in Florida ALFs.

Draft Rule Published on Waivers of ALF Regulations - A draft rule was published in the November 2, 2007 Florida Administrative Weekly outlining the process and criteria for petitioning the Agency for Health Care Administration for a waiver of ALF rules as authorized in s.429.41 (4), F.S. The law authorizes AHCA to grant waivers for innovative or cost- effective proposals that enable residents to age in place. The draft rule can be viewed online at the FAW Web site.

Annual Membership Survey Coming Your Way - Please watch your e-mail in-box for the annual membership survey. This survey will help us to serve you better in the coming year.

Florida Lutheran Celebrates 50 Years of Service - This week, more than 300 residents and friends of Florida Luther Retirement Community gathered to celebrate 50 years of "Living the Legacy of a Faith-based Community." The outdoor festivities began with a presentation from noted Deland historian Bill Dreggors. Mayor Bob Apgar presented administrator Jenny George with a proclamation commending Florida Lutheran and the Good Samaritan Society for their contributions to the community. The keynote address was given by President & CEO of the Evangelical Lutheran Good Samaritan Society David Horazdovsky, who provided a history of the Society, currently the nation's largest faith-based senior housing and long-term care provider. One of the original founders of Florida Lutheran, the Rev. Gerald Daniels (now a resident), also spoke. He described how the community developed and grew to become one of Deland's most recognized landmarks. The event concluded with lunch and music. Congratulations to the staff of Florida Lutheran and those who preceded them for a job well done.

College Arms Towers Opens Time Capsule - Recently, workers found a time capsule when they cut into drywall at College Arms Towers, an affordable senior housing community in DeLand. The protected box was hidden behind the cornerstone of the building, which was dedicated in 1970. The capsule was opened after the October board meeting, when one of the original board members, Colonel Carl Ward, now retired, was honored. An article covering the event in the DeLand Beacon noted that the 16- story building, the tallest in the city, was built for just over $2.6 million with initial rents as low as $72 a month. Other memorabilia will be added to the box before it is put back in place, perhaps to be reopened in another 35 to 40 years.

River Garden Holds 15th Annual Gala - On November 10, River Garden Hebrew Home and Wolfson Health and Aging Center hosted its 15th annual fundraising gala. The sold out event was attended by 478 supporters who were treated to a wonderful evening of entertainment and dining in an elegant setting decorated like a cruise ship. Each place setting included a short bio of one of the River Garden residents - a poignant reminder of what the evening was all about. The event was planned almost entirely by volunteers.

Upcoming Membership Events:

• November 28 -- FAHSA District 3 Meeting, Terry Conference Center, DePaul Building, St. Vincent's Campus, Jacksonville
• December 5 -- FAHSA District 7 Meeting, Kramer Training Room, The Tradition of the Palm Beaches, West Palm Beach
• December 11 -- FAHSA District 5 Meeting, Sheraton Orlando Downtown, 60 South Ivanhoe Blvd., Orlando
• January 8-9, 2008 - FAHSA Board of Trustees Meeting, Boca Raton Resort & Club, Boca Raton
• January 15-16 -- FAHSA's Dynamic Directions Advanced Nurse Leadership Workshop including QIS Training, Safety Harbor, FL
• April 14 -- FAHSA Board of Trustees Meeting, Wingate Inn, Tallahassee

CORRECTION - FAHSA's 2008 Legislative Workshop April 15-16 - Please note that FAHSA's Legislative Workshop will be held on April 15 and 16, 2008. The Save the Date postcards received by members last week incorrectly indicated that the workshop would begin on April 14. The FAHSA Board of Trustees Meeting will be held on April 14 in Tallahassee. Please update your calendars with the correct dates.

Use FAHSA's Self-Study Training Modules to Meet Regulatory Requirements - If your community is looking for an efficient and cost-effective way to ensure that new and existing staff meet mandatory educational training requirements, consider purchasing one or more of FAHSA's training Videos/DVDs:

• HIV/AIDS Prevention & Treatment
• Domestic Violence
• Medical Errors
• OSHA Universal Precautions & Infection Control
• Resident Abuse Prevention Program

The advantage of using the training series is that individuals can work at their own pace and complete the training on their own or as part of a group. For new hires, this option in invaluable. It not only saves time, it saves money in regulatory problems!

See a list of programs at: http ://www.fahsa.org/documentsvideos.htm -- Click on the FAHSA Training Courses and Products Brochure.

END OF YEAR SPECIAL -- There is a 10 percent discount if you order by 12/31/07!

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.

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.

Upcoming Educational Events:

• November 27 - MDS Coding and Care Planning Webinar
• January 15-16 -- FAHSA's Dynamic Directions Advanced Nurse Leadership Workshop including QIS Training, Safety Harbor
• April 15-16 -- FAHSA's Legislative Workshop, Leon County Civic Center, Tallahassee

Millage-Based Dues Structure Adopted by FAHSA Board - The FAHSA Board of Trustees voted to change FAHSA's dues structure from a unit- based system to a millage-based system that reflects community revenue. The change will take effect with the 2008-09 fiscal years, which will start on December 1, 2008.

In the coming months, the Link will contain a number of brief articles about the reasons for the change, pros and cons for various dues structures, examples of the new system, and general questions and answers. In the interim, if you already have a question, please contact Erwin Bodo, FAHSA's COO, at 850/671-3700 or ebodo@fahsa.org

The first article will discuss the reasons for switching from a unit-based system to one based on millage.

IRS Releases Compliance Guide for Tax-Exempt Charitable Organizations - On Oct. 19, the Internal Revenue Service (IRS) released a compliance guide for 501(c)(3) charitable organizations. The guide covers activities that may jeopardize an organization's tax-exempt status, including federal information returns, recordkeeping and more. Please contact Jennifer Hilliard at jhilliard@aahsa.org or 202/508-9444 for more information.

Florida Budget Woes Continue: Impact Could be Far-Reaching - This week, state economists reduced estimated revenues for Fiscal Year 2007-08 by $1.033 billion (3.9%) and for Fiscal Year 2008-09 by $1.441 billion (5.2%) from earlier projections. This sets up another round of budget cuts just two months after the Legislature cut $1 billion. The state now faces a $1.1 billion recurring general revenue shortfall in the current budget year. Current reserves total $1.9 billion, but historically lawmakers have been reluctant to use them for recurring expenses. This does not bode well for state-funded programs.

If the estimates prove correct, FY 2007-08 will be the second consecutive year that revenue collections will have decreased from the previous year. Once again, the reductions can be attributed to the downturn in Florida's housing market and the subprime lending crisis. Slowed population growth and record energy prices were also cited as negatively impacting state revenue collections. More normal growth rates are expected to resume in FY 2008-09.

While the estimates for almost all tax sources were reduced, the big losers were again the sales tax, doc stamp and intangibles taxes and the corporate income tax. In addition to reductions in the exaggerated level of sales tax collections Florida had previously enjoyed due to record home construction, a reduction in consumer spending on items such as furniture, appliances and automobiles has also cut into the state's revenue.

Governor Signs Gaming Compact with Seminole Tribe of Florida - Yesterday, Governor Charlie Crist signed a twenty-five year gaming compact with the Seminole Tribe of Florida. In exchange for significant revenue sharing of profits, the agreement gives the tribe the exclusive right to operate slot machines and card games in the seven existing facilities on tribal lands. The agreement comes on the eve of the federal government's approval of a request from the Seminole Tribe of Florida to allow slot machines on tribal lands absent any revenue sharing with the state.

The tribe will pay the State of Florida $50 million upon the federal government's approval of the compact. Guaranteed annual minimum payments to the State of Florida will be $100 million. Starting in 2010, the state will receive between 10 and 25 percent of the revenue on a sliding scale, depending on total revenue amounts. The Florida Legislature will appropriate the funds.

Through the compact, Governor Crist recommends that the funds primarily be used to enhance and support Florida's education system. The Governor also recommends that the Legislature designate five percent of the funds to local governments near the tribal lands to assist with increased economic activity, tourism and anticipated ancillary development.

The compact provides a significant disincentive for the future expansion of gambling in Florida since the state will forfeit its share of the tribe's revenue if expansion occurs on non-tribal lands.

New Rules Reduce Access to Medicaid Nursing Home Coverage - Florida has enacted rules that make it more difficult for seniors to receive Medicaid-subsidized nursing home care. The rules, which went into effect Nov. 1, set $500,000, rather than $750,000 as the maximum amount of equity interest applicants are allowed to have in their homes to quality for coverage. Seniors still have time to adapt to a new rule regarding the look-back period. Starting in 2010, the look-back period for financial gift giving will extend to five years from three years.

States are required to use the new Medicaid nursing home eligibility rules under a provision in the 2005 Deficit Reduction Act, which went into effect last year. So far, 37 states have done so, according to federal officials.

CMS Rule Would Slash Physician Payments in 2008 - The Centers for Medicare & Medicaid Services released a final rule that would cut Medicare physician reimbursements by 10.1% on Jan. 1. While seemingly unrelated, the move could negatively affect long-term care providers.

Unless Congress acts to reverse the reductions, Medicare will pay $58.9 billion to about 900,000 physicians next year. Nursing home providers fear that, to lessen the harshness of the doctor payment cuts, lawmakers could trim their payments to give physicians more. The final physician fee schedule rule is expected to be published in the Nov. 27 Federal Register.

CMS also recently disclosed a final rule that would increase Medicare outpatient hospital care reimbursements by 3.8% in 2008. However, overall Medicare expenditures for outpatient hospital care will increase by 10% in 2008, to $36 billion. Read the Rule

FREE REPORT - NURSING TRENDS 2007 -- As you may know, Johnson & Johnson continues to fund major initiatives to promote the profession of nursing in the U.S. They have recently funded research on the topic of current and projected nursing workforce trends.

WorldWide HealthStaff Associates Ltd would like to provide you with a complimentary copy of Nursing Trends 2007, a report authored by some of the leading academic researchers in the country on nursing workforce trends.

If you are struggling with nursing shortages now or if you are unsure of the recruitment opportunities and challenges you will face in the future, this report is what you are looking for.

Not only does this report provide the latest research findings on the effectiveness of past efforts to address the urgent need for nurses, it paints a clear picture of what the issues are that employers will face in the short, medium and longer term.

Here are just a few of the new findings published in Nursing Trends 2007:

• The nursing shortage in 2007 is less severe than predicted five years ago
• 12,000 nursing faculty will retire in the next five years
• In less than five years, there will be more nurses in their fifties than in any other age group

Changing Trends for Lending in Senior Living - Tax-exempt bond volume in the nonprofit senior living sector was up 41 percent during 2006, to almost $6 billion. Much of this growing stream of capital funded new construction and substantial rehabilitation projects, further upgrading and expanding the country's senior living stock, which now totals an estimated 57,840 facilities. Over the past few months, however, senior living stakeholders have been forced to re-examine the sector's future growth prospects as the economy digests the current subprime mortgage meltdown. Is the current housing slump going to affect senior housing development? To read the complete article, provided by Lancaster Pollard, a FAHSA Preferred Business Associate, please click HERE.

Enjoy Retirement -- There may be some glorious days ahead - the days of your retirement. No longer confined to the rigors of the workday world, you can spend your time doing what you want to do. However, don't expect everything to fall magically into place. Like most things in life, you'll get the most from retirement by planning. To read the entire article, provided by FAHSA Preferred Business Associate Hunt Insurance Group, please click HERE.

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