FAHSA Innovation Exchange Corner Feature "The Adaptive Olympics" - On the first Thursday of every month, we will highlight one of the innovations posted on FAHSA's Innovation Exchange. Through the LINK, we hope to acquaint more members with this exciting program. This week the spotlight is on "The Adaptive Olympics," submitted by John Knox Village of Florida in Pompano Beach.

National Commission Issues Recommendations - The National Commission for Quality Long-Term Care (NCQLTC), a non-partisan body charged with improving long-term care, released its final report, "From Isolation to Integration: Recommendations to Improve Quality in Long-Term Care", on December 3, 2007.  A press conference was held on Monday which focused on the entire continuum of care and the different roles for quality improvement.  One of the commissioners, Dr. Judy Salerno, National Institutes of Health, acknowledged that we need to move from a system of punishment to a system of continuous quality improvement.

The final report focuses on quality, work force, technology and financing, and features many references to the work of AAHSA's Center for Aging Services Technologies (CAST), Institute for the Future of Aging Services (IFAS) and Quality First.  The report also features principles for reforming long-term care finance advanced by the Leadership Council of Aging Organizations.  The final report is available for download by clicking HERE.

In addition, the NCQLTC issued two reports that will be the foundation for reforms over the next twelve months.  The first report, Long-Term Care Today: A System in Need of Change, looks at the challenges that all of the stakeholders in the current system face.  The second report, A Roadmap for Reform, describes six key areas that the Commission will address.

Upcoming Membership Events:

• December 11, 2007 - FAHSA District 5 Meeting, Sheraton Orlando Downtown, Orlando
• December 12, 2007 - FAHSA District 10 Meeting, Plymouth Harbor, Sarasota
• January 8 & 9, 2008 - FAHSA Board of Trustees Meeting, Boca Raton Resort & Club, Boca Raton
• April 14, 2008 - FAHSA Board of Trustees Meeting, Wingate Inn, Tallahassee

Start Your New Year Off Right -Make a resolution to attend FAHSA's 5^th Annual Dynamic Directions Advanced Nurse Leadership Workshop on January 15-16, 2008 at the Safety Harbor Resort & Spa.  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, Electronic Data Systems Corporation (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, including a long-term care 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 with EDS Webinar will feature Jeff Jacobs, EDS' Deputy Account Manager, 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. 

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

FAHSA Calendar of Events

Florida Senior Care is ALIVE! - FAHSA's COO, Dr. Erwin Bodo, attended two public forums regarding Florida Senior Care (FSC) on November 29, 2007.  The first forum was seeking public comments about FSC in general.  The FAHSA issue brief (available on the FAHSA Members Only Web page) on this topic was transmitted to Agency for Health Care Administration (AHCA) and Dept. of Elder Affairs (DOEA) officials, and its salient points were discussed in the Thursday meeting.  With the most recent legislative changes, FSC is expected to come online in the Orlando area in November 2008, with the Miami area following in about six months.  The most significant FSC changes that resulted from the last Legislative Session include the change of pilot locations, 100% voluntary participation, and the inclusion of all dually-eligible individuals over the age of 18.

The afternoon meeting focused on the legislatively-mandated evaluation of Florida Senior Care.  In addition to the usual Office of Program Policy Analysis and Government Accountability review, the Legislature also requires an independent evaluation.  AHCA asked Erwin Bodo and three other provider group representatives to serve as a panel of experts during this meeting.  The pros and cons of various approaches were discussed and Dr. Bodo requested that AHCA involve all relevant provider groups by establishing an Evaluation Advisory Group.  This advisory group would serve as a sounding board to the company hired to perform the evaluation.

Emergency Meeting "Run" on Local Government Investment Pool - In an emergency meeting last week, the State Board of Administration (SBA, made up of Governor Charlie Crist, Chief Financial Officer Alex Sink and Attorney General Bill McCollum) voted to freeze the Local Government Investment Pool. Local governments cannot withdraw funds until the freeze is lifted.  This move was precipitated by recent withdrawals of $10 billion from the pool by local governments.  The pool's balance now stands at approximately $15 billion.

The withdrawals were caused by local governments' concerns about the pool's stability and the fear that its investments were backed by subprime mortgages.  While the pool does not have direct exposure to subprime mortgages, it does hold mortgage-backed securities that have been hit with credit downgrades. Recently, $2.2 billion of its portfolio had been downgraded to below investment grade, and another $3.6 billion was on credit watch.  Historically, the pool has a good track record of solid returns, but its continued performance is currently much less certain. An extended freeze on the pool could create some financial difficulties for local governments that depend on the pool to meet payroll and other expenses. This is yet another indication of financial challenges for the state.

Source: Florida TaxWatch, a statewide, nonprofit, nonpartisan research institute that is widely recognized as the watchdog of citizens' hard-earned tax dollars.

Orange County Circuit Court Declares Medical Malpractice Caps on Damages Unconstitutional - In an order issued on October 30, 2007, Ninth Judicial Circuit Judge John H. Adams, Sr., held that the medical malpractice damage caps for hospitals that appear in s. 766.118, F.S., are contrary to the plain language of Article I, Section 26, Florida Constitution, a.k.a. Amendment 3, "Claimant's Right to Fair Compensation". The court held that Article I, Section 26 clearly states that victims may recover certain percentages of "all damages", and this means "all of the damages that a jury could potentially award". The court reasoned that because the constitution allows claimants to collect "all" damages, the legislative attempt to "cap" those damages is, therefore, not permitted. The decision is a setback to providers that have statutory caps on damages and those that hope to pursue them in the future.

Free Home Safety Seminar for Caregivers - The Byrd Alzheimer's Institute, in partnership with the Hillsborough County Department of Aging Services and the Hillsborough County Sheriff's Office, is hosting the second annual home safety seminar for caregivers.

The seminar will take place Saturday, December 8, at the Ruskin Senior Center (901 6th St. S.E., Ruskin, FL) from 10:30 a.m. to 1:00 p.m.  Respite daycare will be provided at no cost for loved ones during the workshop and an RSVP is required.

Special guest speaker Dr. Ann Louise Barrick, a Clinical Professor at the University of North Carolina-Chapel Hill, Department of Psychology and Director of Psychology at John Umstead Hospital, will talk about the difficulty of bathing persons with dementia and tips on caregiver safety.  Barrick has helped produce two training films on methods for bathing.  The training video will be a part of the seminar.

Representatives from Arden Courts assisted living facility will speak on their Montessori program and how to incorporate it into the home.  Hillsborough County Sheriff's Office will discuss tips on keeping the home safe and caring for loved ones with disabilities and other challenges including Alzheimer's and dementia during the holidays. 

Attendees must call to reserve a seat at: (813)319-4115.

Senior Call-in Day for Housing -- Congress has yet to finalize the housing budget for fiscal year 2008. To ensure maximum funding, AAHSA designated December 6, 2007 as a call-in day. They ask providers to encourage their senior residents to call their Representative and Senators to let them know that any cuts in the Section 202 and project-based Section 8 renewal budgets would be devastating. AAHSA has prepared a flyer to post on bulletin boards or to serve as the basis for calling a meeting of your residents. The flyer includes a toll-free number and talking points that residents can use to call Capitol Hill. Just fill in the names of the legislators serving your community. It's important to let your members of Congress know how critical this funding is to seniors. Click on Call for Funding Flyer.

Hospices Refund Millions in Medicare Payments - Longer life spans of hospice patients with Alzheimer's disease and other forms of dementia have forced hundreds of hospice providers to refund millions of dollars in excessive Medicare payments, according to a report in the New York Times. One federal panel estimated 1 in 13 providers were subject to refund demands for 2005.

Originally, the Medicare hospice program was created for people with a terminal illness and who were certified by doctors as having less than six months to live. Many of the patients had cancer, which runs a somewhat predictable course once curative treatments are stopped.

An Alzheimer's patient's average length of stay is 86 days, while the average is 44 days for lung cancer patients, according to the Medicare Payment Advisory Commission. Complicating providers' plight is 1998's Congressional action that removed length-of-stay limits but kept aggregate reimbursement caps in place. One federal health official, however, intimated that poor management might be more responsible for hospices' financial troubles than insufficient government reimbursements.

Home Health Prospective Payment System (HH PPS) Refinement & Rate Update for Calendar Year 2008 - Correction Notice (CMS-1541-CN2) -- Since the publication of the HH PPS Final Rule "Home Health Prospective Payment System Refinement & Rate Update for Calendar Year 2008" (CMS-1541-FC) dated August 29, 2007, technical errors have been identified.  CMS had previously posted draft descriptions of those errors and advised the public to refer to the published correction notice, in the Federal Register, as official notification and publication of the errors and corrections.  "Home Health Prospective Payment System Refinement and Rate Update for Calendar Year 2008; Corrections" was published on November 30, 2007.  Read the Correction Notice.  Read the Final Rule (CMS-1541-FC).

FAHSA Members Testify Before Duval and Lee County Legislative Delegations -- Last Wednesday, Joshua Ashby and John Meserve (Fleet Landing), Martin Goetz (River Garden Hebrew Home/Wolfson Health & Aging Center), and Mary Alice Phelan (St. Catherine Laboure) testified before the Duval County Legislative Delegation.  John presented both as Mayor of Atlantic Beach and CEO of a continuing care retirement community.  He spoke about an important water management issue that affects his constituency and the proposed repeal of sales tax exemptions and exclusions and the economic impact it will have on continuing care residents.  Josh, Marty and Mary Alice touched on a number of other issues including Medicaid reimbursement, Medicaid Reform and possible ALF and nursing home regulatory changes related to background screening of contractors and residents.  They urged the legislature to proceed with caution when responding to highly-publicized individual incidents of regulatory problems because of the consequences it will have on good providers.

On the same day, Peter Dys (Shell Point Retirement Community) testified before the Lee County Legislative Delegation.  Peter touched on the same topics.  For a copy of the testimony, please go to FAHSA's Legislative Issues Web Page and click on Shell Point Testimony.

Appearances at delegation meetings make a difference. Lawmakers were interested and asked questions when members testified last week.  Please volunteer to do the same in your area. FAHSA staff will help with testimony. 

FAHSA Staff Attends Medicaid Billing System Seminar - FAHSA's COO, Dr. Erwin Bodo, attended a three hour seminar on the billing system changes that will be implemented when the new Medicaid Fiscal Agent, EDS takes over the Medicaid claims payment responsibility on March 1, 2008.  The current turnaround documents, forms, and related billing software will become obsolete on February 29.  In their place providers will have to use the UB-04 to bill Medicaid for nursing home services.  Read more on this issue and those listed below in the latest Nursing Home Alert, NH 07-34. 

Other Nursing Home Issues:

·         National List of 'Worst' Nursing Homes Released

·         FDA Warns Consumers: Vail Enclosed Bed System Poses Risks

·         Save the Date:  2007-2008 LTC Joint Training Meetings Scheduled

·         CNA License Renewal Reminder

·         Survey Question:  Is a physician's order necessary to serve a resident a nutritional shake?

·         MDS Coding Corner:  Pressure Ulcers

·         Preventing Adverse Drug Events

Greystone Financial Group

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

FAHSA is pleased to tell you about the FAHSA Group Purchasing Organization (GPO).  The GPO program further enhances the value you receive from your membership and is required for us to be in compliance with Medicare Safe Harbor requirements The FAHSA GPO program, in conjunction with the AAHSA, Care Purchasing (CPSI), and FMS Purchasing and Services (FMS) GPOs offer you the opportunity to save daily purchases from over 200 vendor partners.  To view these vendor partners please click on the Preferred Business Associated Guide and go to pages 22-25.

FAHSA members participating in these programs are saving from seven to 50% off list prices.  In addition to these savings, your participation allows FAHSA to receive non-dues revenue based on your purchases.  This revenue assists FAHSA to provide the educational programs and advocacy you expect while keeping membership dues' to a minimum.

There is no obligation or commitment on your part to participate in the FAHSA GPO programs. This is simply a value added member benefit. Our program is also not exclusive; you can belong to one or all three GPOs.  We simply ask that you look at all of the FAHSA programs and decide the best savings for you. 

We have three (3) Enrollment Agreements and ask that you complete one or all and fax the completed enrollment to the GPO at the number listed on the form. Click below to obtain the enrollment form. 

1. AAHSA Enrollment Form
2. Care Purchasing Enrollment Form
3. FMS Purchasing & Services Enrollment Form

If you are already enrolled in one of the GPOs, you are still required to complete a new enrollment form in order to have the FAHSA GPO covered under the Medicare Safe Harbor Laws.

If you have any questions, please call Julie Copeland, Vendor Relations Coordinator or Janegale Boyd, President/CEO (850) 671-3700.  Thank you for your continued support of FAHSA.

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: