Rule Development Workshop on ALF Core Training Requirements, Provider Requirements, and Waivers of ALF Regulations -- On Wednesday, November 28th, FAHSA staff Carol Berkowitz, Esq., Senior Director of Regulation and Compliance, and Gail Matillo, Director of Housing and Program Development, attended a Department of Elder Affairs Rulemaking Workshop on the Assisted Living Core Training Provider Requirements and the Minimum Curriculum. On behalf of FAHSA, Ms. Berkowitz recommended that the Department should consider adding an educational component on guardianship to either one of the six Core Training modules or as a continuing education requirement. As proposed, the guardianship module would not be an in-depth module; but one that would provide an overview of guardianship issues so administrators and staff can become familiar with available resources and contact information to inquire about guardianship when there are no family members or friends, and no durable power of attorney and the resident is unable to communicate. This issue was recommended during a November 13th conference call with FAHSA's ALF/Home and Community-Based Services Public Policy Committee and members of the ALF task force appointed from the Nursing Home and CCRC/Retirement Community Public Policy Committees. Based on the number of comments received by the December 5, 2007, deadline the department will either plan another rule development workshop or move forward with the rule making process.

In addition, DOEA issued a draft rule outlining the process and criteria for petitioning the Agency for Health Care Administration (AHCA) 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 would allow residents to age in place. The draft rule was published on November 2 and may be viewed online at the FAW Web site.

High-Profile Regulatory Problems Could Influence Survey Process - Because of recent high-profile regulatory problems in several nursing homes and assisted living facilities, be prepared for greater than usual scrutiny during surveys and follow-up visits. Most surveyors are very dedicated and committed to their work. When a regulatory problem becomes a public issue and they are unfairly criticized, it's only natural that surveyors would be more cautious when exercising judgment about a potential deficiency.

Members Considering Opening a Home Health Agency Should Begin Process NOW - Last week, we reported that an Interim Project in the Florida Senate will study the proliferation of new home health agencies and review licensure requirements and regulatory standards prior to the 2008 legislative session. Meanwhile, AHCA has effectively halted new Medicare/Medicaid Certification Activity for home health agencies, citing a CMS directive that places new certification surveys at the bottom of the survey priority list. This week, FAHSA staff spoke with Associated Home Health Industries of Florida (AHHIF). Despite the AHCA priority directive, AHHIF clarified that a moratorium on new licensure for home health agencies in Florida remains its top priority for the 2008 legislative session. The group hopes that the interim project will boost its arguments for the moratorium. If legislation to that effect is introduced and passed in the 2008 legislative session, the moratorium will likely go into effect in May or July 2008. If your organization is considering opening a home health agency, the process should be initiated as soon as possible. Home health agencies seeking Medicare/Medicaid certification may seek accreditation along with deemed status from one of three national accreditation programs: Community Health Accreditation Program, Joint Commission on Accreditation of Health Care Agencies, or Accreditation Commission for Health Care. Be aware that certification can take four months or longer and can be very expensive.

Mark Your Calendar and Plan to Attend FAHSA's Regional Meetings - During FAHSA's Board meetings in May and October, the Board designated four geographic regions in Florida to conduct regional meetings. The meetings will include roundtable discussions, an educational presentation with continuing education credits, and networking opportunities during lunch. FAHSA has scheduled the first set of regional meetings in Jacksonville, Orlando, Ft. Myers and Ft. Lauderdale during the week of February 26, 2008. Please watch your E-mail for more information.

Upcoming Membership Events:

• December 5, 2007 -- FAHSA District 7 Meeting, Kramer Training Room, The Tradition of the Palm Beaches, West Palm Beach
• December 11, 2007 -- 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, 2008 -- FAHSA's Dynamic Directions Advanced Nurse Leadership Workshop including QIS Training, Safety Harbor, FL
• April 14, 2008 -- FAHSA Board of Trustees Meeting, Wingate Inn, Tallahassee

Start Your New Year Off Right - Make a resolution to attend FAHSA's 5th Annual Dynamic Directions Advanced Nurse Leadership Workshop on January 15-16, 2008 at the Safety Harbor Resort. Don't miss this opportunity to hear the latest information from featured presenters including Alfreda Walker, MSN, RN, CMS Branch Manager, CMS/DSC Region IV Atlanta Survey and Certification; Pat Boyer, MSM, RN, NHA, President, Boyer and Associates; Cynthia Pearse, LCSW, NHA, LHRM, Social Work Consultants and Florida's Nursing Home Quality Representative; Joyce Ann Gilbert, Ph.D., RD, LD/N, President, JA Gilbert Associates; Leslie Gibson, RN, BSN, the Hospice of the Florida Suncoast; Cheryl Boldt, RN, LNHA; and a distinguished panel of FAHSA members.

Watch Your E-mail for Information on FAHSA's Next Webinar - FAHSA's Medicaid Billing with Florida's New Fiscal Agent -- EDS -- The current Medicaid fiscal agent contract with ACS will end on February 29, 2008. The new fiscal agent, EDS, will begin claims processing on March 1, 2008. The new system brings a number of changes and enhancements to today's processing, such as interactive web services for Medicaid providers which includes an LTC Billing feature enabling online processing as an option to replace paper Turn Around Documents (TADs) and WINASAP PC-based software. Both the 021 claim form and WINASAP software will be discontinued effective with the transition to EDS. Additionally, PC-based software called Provider Electronic Solutions (PES) will be available as an option for claim submission.

It is imperative that your staff understand these changes and become thoroughly familiar with the new billing options and procedures. FAHSA's Medicaid Billing Under EDS Webinar will feature Jeff Jacobs, Deputy Account Manager with EDS, who will focus on areas of change that impact Long-Term Care providers. The training will include a detailed walk through of the LTC Billing on the web and other changes.

End of Year Special on FAHSA's Self-Study Training Modules - Order by the end of the year to save 10% on the following regulatory courses:

• 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 is 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.

Upcoming Educational Events:

• January 15-16, 2008-- FAHSA's Dynamic Directions Advanced Nurse Leadership Workshop including QIS Training, Safety Harbor
• January 22, 2008-- FAHSA's Medicaid Billing with Florida's New Fiscal Agent -- EDS Webinar, 2:00 p.m.
• January 29, 2008 -- FAHSA's CCRC Occupancy Issues Webinar, 2:00 p.m.
• April 15-16, 2008 -- FAHSA's Legislative Workshop, Leon County Civic Center, Tallahassee

Many Elevator Licenses Past Due - The Department of Business and Professional Regulation estimates that about 13 percent of the state's 48,000 elevators are delinquent in their licensing, but some of that is just paperwork. As of mid-April, there were 4,343 elevators in "delinquency" for licensing. More than half had permits that expired July 31, 2006, but the numbers will decline as fees and inspection documents are processed. Be sure to verify that all of your elevators are properly licensed.

Court Must Reconsider Arbitration Provision Agreement - Battles among family members and providers over the validity of arbitration agreements continue to flare around the country. One Tennessee case this month, for example, was tossed back to the trial court to reexamine whether a resident's health care power of attorney truly empowered his spouse to sign an arbitration agreement.

The Tennessee Court of Appeals wrote that a state trial court viewed Thomas Cabany, Junior's signed power of attorney too narrowly. That means that it might have, in fact, empowered Cabany's wife to validly sign the arbitration agreement. That would waive the family's right to pursue claims against Mayfield Rehabilitation and Special Care Center and NHC Healthcare of Murfreesboro, TN. Cabany died in 2004.

The recent court order can be found as Cabany v. Mayfield Rehabilitation and Special Care Center, Tenn. Ct. App., No. M2006-00594-COA-R3-CV, 11/15/07. READ THE COURT'S DECISION

IRS Announces 2008 Standard Mileage Rate - This week, the Internal Revenue Service issued the 2008 optional standard mileage rates used to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes.

Beginning Jan. 1, 2008, the standard mileage rates for the use of a car (including vans, pickups or panel trucks) will be:

• 50.5 cents per mile for business miles driven;
• 19 cents per mile driven for medical or moving purposes; and
• 14 cents per mile driven in service of charitable organizations.

The new rate for business miles compares to a rate of 48.5 cents per mile for 2007. The new rate for medical and moving purposes compares to 20 cents in 2007. The rate for miles driven in service of charitable organizations has remained the same.

Grants Available for Innovations in Senior Transportation -- The National Center on Senior Transportation (NCST) is soliciting proposals from aging/human service agencies, tribal organizations, faith-based organizations, units of state and local government, public and private transportation providers and other entities interested in developing and implementing innovative approaches to increasing senior transportation options and improving older adult mobility. Successful projects will be collaborative, replicable, and consistent with senior transportation-related goals of the national United We Ride initiative of the Federal Transit Administration. Proposals are due by 11:59 p.m. EST on Monday, Dec. 17, 2007. For more information, please review the following Web site.

Affordable Workforce Housing Ordinance Upheld -- The 2nd Judicial Circuit Court has upheld a controversial Tallahassee ordinance that requires housing developments of a certain size to include units that are considered affordable. Organizations composed of home builders and property owners had challenged Tallahassee's workforce-housing ordinance. The city received confirmation Monday of Judge John Cooper's judgment, which was issued last week, City Attorney Jim English said. 'We were comfortable that (the ordinance) was constitutional, and now we have a judicial statement to that effect,' he said. The Florida Home Builders Association, one of the plaintiffs, is evaluating the decision before deciding on a next step. The Association supports affordable housing but opposes mandatory measures.

The City Commission adopted the ordinance in 2005. It designates certain areas of Tallahassee as Inclusionary Zones, where new developments of more than 50 units must make 10 percent of the units affordable to families earning between 70 and 100 percent of the median family income (up to $57,600 for a family of four). The goal is to encourage developers to build homes near the city center that are affordable to workers such as teachers, police officers and nurses.

Q & A on Hospice Claims Services - Additional questions and answers regarding CR 5567 - "Reporting of Additional Data to Describe Services on Hospice Claims" (re-issued November 2, 2007) are now available on the CMS Web site. The implementation date for reporting is optional for January 1, 2008. The mandatory date for reporting is July 1, 2008. For access to CR 5567 and both sets of Questions and Answers, see the Spotlight section of the Ho spice Center page.

Medicare Demand Billing Article on FAHSA Web site - The Centers for Medicaid and Medicare Services ("CMS") issued Transmittal 930 to create a single, consistent billing policy for skilled nursing facilities as it relates to residents who have exhausted their 100 covered days (benefits exhaust) and when a resident no longer requires skilled services (no-pay). Prior to October 31, 2006, the implementation date of Transmittal 930, fiscal intermediaries (FI) were inconsistent in treatment for such bills. Transmittal 930 only applies to residents who are newly admitted or in Part A stays on or after October 1, 2006. Basically, with the bill, a skilled nursing facility is required to submit a bill for a Medicare beneficiary that has started a qualified Part A benefit stay for every month of the related stay even though no benefits may be payable. Laura L. Wilson, CPA, MBA, Moore Stephens Lovelace, PA, and Karen Henderson, Moore Stephens Lovelace Broussard Clinical Consulting, LLC, have written an article for FAHSA members explaining the new process for Medicare Demand Billing for skilled nursing facilities. To read the article, please visit the " Members Only" page of the FAHSA Web site.

Other Nursing Home News:

• AHCA Secretary Commitment to More Open Dialogue with Nursing Home Providers
• CMS Rule on Waiver of Disapproval of Nurse Aide Training Program in Certain Cases and Nurse Aide Petition for Removal of Information for Single Finding of Neglect
• Advancing Excellence in America's Nursing Homes Campaign Needs Assessment Request
• Guidance on Compliance Plans for Allegations of Fraud by Employees
• LTC Open Door Forum Changed from Dec. 6 to Dec. 13
• Legislation Opposes Medicare Reductions
• Study Touts Benefits of Inpatient Service over SNFs for Therapy
• New CMS Resources from the Medicare Learning Network
• Household Design for Nursing Homes Showcased at Annual AHCA Meeting on Plans & Construction

Play it Safe this Holiday at the ATM -- As holiday shopping season gets under way, you may find yourself in need of extra cash. ATMs can be an easy target for criminals. Click HERE to read these safety tips the next time you visit the ATM for some quick cash. This article was provided by Lancaster Pollard, one of FAHSA Preferred Business Associates.

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