Florida Association of Homes and Services for the Aging
December 20, 2007 Vol 15, Issue 3
Hands  FAHSA LINK
 
Welcome to this week's edition of the FAHSA Link.
 

Happy Holidays!  The FAHSA Board of Directors and Staff wish you, your family and staff a safe and healthy New Year! The FAHSA office will be closed from December 25 through January 1, 2008, so the LINK will not be published next week.  Next week, in case of an emergency while the office is closed, please contact Janegale Boyd (850/294-3412) or Gail Matillo (850/294-3415).  

 

First Series of FAHSA Regional Meetings Scheduled:  Mark your calendar now to participate in this exciting value-added service! -- One of the "Big Ideas" adopted by the FAHSA Board is to hold periodic regional meetings throughout the state to give members an opportunity to network and learn while earning continuing education credit.  At each of these meetings, an educational presentation will be featured on a topic that is of interest to all members.  In addition, attendees will have the opportunity to participate in a roundtable discussion for their membership type.  The first group of regional meetings will feature Morrison Senior Dining's "Voice to the Silent Generation".  Please mark your calendar and plan to attend one or all of the meetings at the nearest location.  Watch your e-mail for more information.

 
  • February 27 - Southwest Florida Regional Meeting (Districts 9, 10, 11 and 12)
    11:00 a.m. to 3:15 p.m., Shell Point Retirement Community, Ft. Myers
  • February 28 -  Central Florida Regional Meeting (Districts 4, 5, 6, and 13)
    11:00 a.m. to 3:15 p.m., Village on the Green, Longwood
  • February 29 -  North Florida Regional Meeting (Districts 1, 2, 3, and 14)
    11:00 a.m. to 3:15 p.m., River Garden Hebrew Home for the Aged, Jacksonville
CNA License Renewals Underway -CNAs must renew their licenses by December 31, 2007.  To renew, please send the renewal fee ($50 or $80, depending on whether the renewal is for a two-year or three-year period), and any address changes to the Department of Health, Board of Nursing, 4052 Bald Cypress Way, Bin #C13, Tallahassee, FL 32399-3252.  Click on the following web sites for more information -- Basic Regulatory Information, or Renewal Information.
In This Issue
District and Membership News
Education News
General News
Housing News
Home and Community-Based Services News
Nursing Home News
Sponsor
Preferred Business Associates News
Job-Mart
Group Purchasing Organizations
Join Our Mailing List!
FAHSA Quick Links
District and Membership News

deHoernle Alzheimer's Pavilion Receives Respite Care Grant -- The Community Outreach Committee and the Foundation Board of the Boca Raton Community Hospital Foundation approved a grant of $22,100 to the Count and Countess deHoernle Alzheimer's Pavilion located in Deerfield Beach. The grant will help fund day and overnight respite care for those suffering from Alzheimer's disease in order to ease the strain on their caregivers.

 

Alicia Schindler, the Executive Director of the deHoernle Alzheimer's Pavilion, an affiliate of the Miami Jewish Home and Hospital at Douglas Gardens, said, "We sincerely appreciate the continued support of the Boca Raton Community Hospital Foundation. This grant will allow Palm Beach County's memory impaired residents to receive adult day services and overnight care 365 days a year. It will also provide much-needed support and counseling for their caregivers."

 

Upcoming Membership Events:

  • January 8 & 9 - FAHSA Board of Trustees and Public Policy Committee Meetings, Boca Raton Resort & Club, Boca Raton
  • February 27 - Southwest Florida Regional Meeting (Districts 9, 10, 11 and 12)
    11:00 a.m. to 3:15 p.m., Shell Point Retirement Community, Ft. Myers
  • February 28 -  Central Florida Regional Meeting (Districts 4, 5, 6, and 13)
    11:00 a.m. to 3:15 p.m., Village on the Green, Longwood
  • February 29 -  North Florida Regional Meeting (Districts 1, 2, 3, and 14)
    11:00 a.m. to 3:15 p.m., River Garden Hebrew Home for the Aged, Jacksonville
  • April 14 - FAHSA Board of Trustees Meeting, Wingate Inn, Tallahassee

    FAHSA Calendar of Events

Education News

FAHSA's 5th Annual Dynamic Directions Advanced Nurse Leadership Workshop will be held on January 15 & 16, 2008 at the Safety Harbor Resort & Spa.  Don't miss this opportunity to gain knowledge from the experts.  READ THE BROCURE and REGISTER ONLINE.

 

FAHSA's Next Webinar - Medicaid Billing with Florida's New Fiscal Agent, EDS, takes place on January 22.  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, so it's important to make this training a part of your "To Do" list.  READ THE BROCURE and REGISTER ONLINE.

 

Upcoming Educational Events:

 
  • 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., EST
  • January 29 - Webinar -- FAHSA's CCRC Occupancy Issues, 2:00 p.m., EST
  • April 15 & 16 - FAHSA Legislative Workshop, Leon County Civic Center, Tallahassee

 

FAHSA Calendar of Events
General News

Snipes to Serve as Acting Director of Medicaid - Dyke Snipes has been selected to serve in the role of Acting Director of Medicaid.  Dyke will assume this role effective January 2, 2008.  He will serve in this capacity while the Department conducts a nationwide search to fill the position of Deputy Secretary of Medicaid.

 

Dyke has served as Assistant Deputy Secretary for Medicaid Finance since 2004, and has 29 years experience with the State of Florida. Most of that time was spent working with Medicaid, health care services, and funding issues for health care services through numerous positions at AHCA, the Florida Legislature, and the Florida Department of Health.

 

Minnesota Ruling May Affect Tax Exemptions for Nonprofits - Last week, the Minnesota Supreme Court issued a ruling that could affect the exemption from property taxes for a substantial portion of nonprofit organizations in Minnesota. The case, "Under the Rainbow Child Care Center, Inc. v. County of Goodhue" overturned a decision by the Minnesota Tax Court. The Tax Court had ruled that a nonprofit day care center qualified for the property tax exemption even though it did not meet the third criterion listed in the North Star case, which concerns whether the recipients of the "charity" are required to pay for the assistance received in whole or in part. The Supreme Court ruled the nonprofit cannot qualify as "an institution of purely public charity" without satisfying this criterion.

 

Although the Supreme Court has never ruled that all six factors in the North Star case must be met to qualify for the tax exemption, it stated that some factors are essential. It specifically mentioned, for example, that it could not envision a situation in which the sixth factor--dividends or assets upon dissolution not being available to private interests--could not be met and the organization still qualify as a charitable institution. In this case, the Court ruled that the third factor is also essential. The Court held that the third factor "tests for a value that is fundamental to the concept of charity--that is, whether the organization gives anything away."

 

The Court stated "it is not sufficient that an organization serves a worthwhile purpose, or even that it does so on a nonprofit basis".  An organization must provide its 'charity' to recipients free-of-charge or at considerably reduced rates." The day care center in question actually charged rates higher than its market competition for infants, toddlers, and preschool children. The rates it charged for school age children were between the high and low rates of its competitors.

 

Government programs provided subsidies to families who could not afford to pay the charges of the day care center. The Court's decision indicates that payments from government programs on behalf of individuals who cannot pay are not an indication of a charitable act by the organization. Although the individual does not pay the charges, the organization does get paid, and consequently the fundamental concept of charity has not been realized, even though the government payments may be substantially discounted.

 

Stetson to Offer Seminars for Seniors -- Stetson University College of Law invites local seniors to attend an Elder Law Pro Bono Seminar on January 26, 2008 from 9:00 a.m. to 12:00 noon at the Hamilton Auditorium of Pasadena Community Church, 227 70th Street South in St. Petersburg.  Information will be presented on proper planning for end-of-life issues.  Stetson law students, under the supervision of Mr. Charles R. Gallagher, Esq., will be drafting Florida Bar approved living wills and the designation of health care surrogate documents free of charge for all attendees.  All are encouraged to attend this informative seminar on vital issues affecting seniors.  For more information, or to arrange for a seminar at your facility, please contact Casey Stoutamire, cstoutam@law.stetson.edu.

Housing News

National News -- Project-based Assistance (PBA) renewals will be funded at $6.139 billion, up $163 million from last year. In addition, any amounts recaptured from the prior-year unobligated tenant or project-based rental assistance may be used to renew or amend PBA contracts in FY08. Owners of rental properties with PBA estimate that this year's renewal funding is short by $2 - $2.5 billion.  Section 211 of the bill directs HUD to submit a report to Congress by August 30, 2008 detailing the number of federally-assisted housing units under lease and the per-unit cost of those units.

 

The conferees beefed up some of their bill and report language requiring HUD to account for all outstanding tenant and project-based contracts on a project-by-project basis and their costs and report regularly to the Appropriators. This is in response to the late HAP debacle this year where HUD was behind as much as two months in paying owner / managers of buildings with project-based vouchers in them.

 

An even more specific and hefty requirement requires HUD to report quarterly to the Appropriations Committees on the number of PBA units by HUD region, including the number of opt-outs and an analysis of the number of federally-assisted units being refinanced under the Mark-to-Market program. The bill goes on to state, "The Secretary shall identify in detail and by project all the efforts made by the Department to preserve all Section 8 project-based housing units and all the reasons for any units which opted out or otherwise were lost as Section 8 project-based units. Such analysis shall include a review of the impact of the loss of any subsidized units in that housing marketplace, such as the impact of cost and the loss of available subsidized, low-income housing in areas with scarce housing resources for low-income families."

 

The Appropriators weren't done. Responding to the continuing problem of late HAP payments to landlords and management agents, Section 235 of the bill directs HUD to provide a "complete and accurate accounting for FY07 and FY08 of "actual" PBA renewal costs; revised budget estimates of the cost to renew all PBA contracts expiring in FY07 and FY08 and to identify all sources of funding that HUD will use "to fully fund all 12 months" of PBA contracts expiring in FY07 and 08.  HUD must report this information to Congress within 60 days of enactment of the Omnibus bill. Anytime after that, HUD "may" revise and update its cost estimates if an audit of the project-based program "reveals additional information that may provide Congress a more complete understanding of the Secretary's implementation" of the PBA program.
 
The same section of the bill directs HUD, as part of next year's budget submission, to provide a project-by-project analysis "that verifies that such budget request will fully fund all project-based contracts" in FY09, including expiring contracts.

 

In addition, the Conference Report accompanying the bill further states, "The Appropriations Committees note the Department's inability to identify actual funding needs for Project-based Rental Assistance renewals. The Appropriations Committees also finds that the Department has not been aggressive in reducing the impact that its decisions are having on the affordable housing community. In light of what appears to be a severe funding shortage, the Department has taken the drastic step of abandoning its practice of 12-month contracts and has been sending short-term renewal that impact owners, landlords, financial institutions, and most importantly tenants of Project-based housing."

 

A large part of the problem is that the Administration has not determined if 12-month contracts can be conditioned on the availability of funds, and can be funded incrementally. The Appropriations Committees directs HUD and OMB to make a final determination about whether an Anti-Deficiency Act (ADA) violation would exist under those circumstances by January 15, 2008. If not, a violation would exist, and HUD is then instructed to immediately begin issuing two-month contracts subject to the availability of funds. If a violation would exist or has occurred, the administration must report that violation to the Committees immediately.

 

HUD Translated Materials for Persons With Limited English Proficiency -- The bill increases the Fair Housing account by $380,000 and requires HUD to create and promote translated materials on its programs for people who have limited English proficiency.  HUD has recently required private property owners to bear this cost. This provision had been successfully offered as a floor amendment to the Senate version of HUD appropriations by Senator Bob Menendez (D-NJ).  A word of caution, however, this does not mean that contract funding/payment issues are fully resolved.   Congress did not provide a full 12 months of funds for all contracts, and funds will continue to be placed incrementally onto contracts.  But the mere fact that there is a full appropriation (as part of the omnibus) instead of just another long-term Continuing Resolution (like last year), HUD's financial management team should have a better time of trying to access and release funds.    

 

Once this legislation is signed into law (the President has indicated he will not veto it), and HUD gets its money from the Treasury, we expect to see much larger increments - perhaps enough to carry all existing and renewal contracts through the end of the fiscal year (Sept 30, 2008).    We know that the HUD funding staff wants to get as much attached to individual property contracts as soon as they can. 

 

Your continued advocacy and communication to the FAHSA office on these issues are critical, and we depend on you to let us know when you are having any problems.  Keep those e-mails coming!

 

 

FAHSA Housing Alert Page

Home and Community-Based Services News

Hospice RN Pay Rises 3.4% - The national average hourly pay for registered nurses providing hospice care has risen to $25.86 per hour, according to results of a new national survey. Meanwhile, the national average for licensed practicing nurses in hospices rose 2.8% to $18.51 per hour.  Among other key information in the 2007-2008 Hospice Salary and Benefits Report from Hospital & Healthcare Compensation Service: turnover was 20.4% for RNs and 21.6% for LPNs in hospice settings. Earlier this year, HHCS surveys showed that national average pay rates were $25.00 and $24.48 for RNs serving as staff members and charge staff nurses, respectively, in nursing homes. LPNs in nursing homes, meanwhile, averaged $18.74 and $18.00 for regular staff and charge-nurse designations, respectively.

Nursing Home News

CMS Proposes "The PACT" - CMS is proposing a new pilot study, "The PACT" (Positive Action-Critical Thinking). This is a pilot designed to promote improved resident outcomes for Medicare beneficiaries with pressure sores. The goal is to formulate a PACT between the following key stakeholders in a community:

·         Nursing homes with a high incidence of pressure sores

·         Administrators

·         Corporate Owners

·         Directors of Nursing Services

·         Medical Directors

·         State Survey Agencies

·         Long-Term Care Ombudsman

·         Clinical Nurse Consultants

·         Quality Improvement Organizations

·         CMS Regional Office & Central Office staff

·         Area Hospitals

·         Hospital Associations

·         Home Health Agencies

·         Nursing Home Associations

·         NPUAP

The purpose of forming the collaborative effort is to encourage CMS providers with a high prevalence of pressure sores to (1) improve quality care and services; (2) reduce the prevalence of pressure sores; and (3) foster improved outcomes in clinical settings.  This goal might encompass a long-term care facility, the hospital or a resident's home for community-based care and services, in other words across the full continuum of care.  The goal is Positive Action, Critical Thinking and Success of the Government Performance Results Act (GPRA) goals related to pressure sores.

 

Since FAHSA is on the steering committee and will be providing input into the research, selection, and criteria set forth, members will benefit from timely updates.

 

FDA Cautions Fatal Skin Reactions Due to Carbamazepine Therapy - FDA informed health care professionals that dangerous or even fatal skin reactions (Stevens Johnson syndrome and toxic epidermal necrolysis), that can be caused by carbamazepine therapy, are significantly more common in patients with a particular human leukocyte antigen (HLA) allele, HLA-B*1502. This allele occurs almost exclusively in patients with ancestry across broad areas of Asia, including South Asian Indians. Patients with ancestry from areas in which HLA-B*1502 is present should be screened for the HLA-B*1502 allele before starting treatment with carbamazepine. If these individuals test positive, carbamazepine should not be started unless the expected benefit clearly outweighs the increased risk of serious skin reactions. Patients who have been taking carbamazepine for more than a few months without developing skin reactions are at low risk of these events ever developing from carbamazepine. This is true for patients of any ethnicity or genotype, including patients positive for HLA-B*1502.

 

Read the complete MedWatch 2007 Safety Summary including a link to the FDA Information for Healthcare Professionals Sheet and the Drug Information Page regarding this issue.  

Sponsor
 Lancaster Pollard

    Lancaster Pollard has been providing financial advisory and capital funding services to healthcare providers and senior living communities since 1988. We are, for the most part, three firms in one:

  • Lancaster Pollard & Co. is a registered broker/dealer and recognized as one of the nation's leading underwriters of taxable and tax-exempt debt in addition to providing financial advisory services that include mergers and acquisitions, asset / liability management, debt policies, and interest rate risk management.
  • Lancaster Pollard Mortgage Company is an FHA/GNMA/USDA approved lender that offers mortgage insurance funding options for hospitals, nursing homes, assisted living facilities, and affordable housing projects.
  • Lancaster Pollard Investment Advisory Group is a registered investment advisor providing consulting and management services to non-profit organizations seeking to meet their fiduciary duties while optimizing investment plans and maximizing investment results.

They bring this collective experience - broad perspective and first hand knowledge of many financial products - to every engagement. Contact Jerry Swiacki at (770) 772-4778, ext. 203 or e-mail Jerry at gswiacki@lancasterpollard.com for more information.

Preferred Business Associates News
 

CoupleWithDollarFAHSA'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 or clicking on the FAHSA Preferred Business Associates Page hyperlink. FAHSA members can also use the on-line directory to search for PBAs by specialty.

 
Job-Mart
 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

FAHSA's Group Purchasing Organizations

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.

Save 10%

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!

To order please click HERE for order form.

Offer Expires: December 31, 2007

Copyright 2007 -- Publication of the Florida Association of Homes and Services for the Aging (FAHSA).

  • FAHSA Chair: Alma Ballard
  • FAHSA President/CEO: Janegale Boyd
  • Managing Editor: Gail Matillo
Copyright Information: Copies of the articles and other information in this publication may be noncommercially reproduced for the purpose of educational or scientific advancement. Otherwise, no part of this publication may be reproduced or utilized in any form or by any means, mechanical or electronic, including photocopying, microfilm and recording, or by any information storage and retrieval system, without the written permission of the editor.

Correspondence: Should be addressed to: Editor, 1812 Riggins Road, Tallahassee, FL 32308. For telephone inquiries, call (850) 671-3700. Or E-mail FAHSA at info@fahsa.org. © 2007 FAHSA. All rights reserved.

Disclaimer: The information contained in this correspondence is not intended as a substitute for legal advice. Please discuss any information gathered from this or any other FAHSA publications with your legal counsel in the context of your particular situation before implementing any new policies or procedures.

Florida Association of Homes and Services for the Aging | 1812 Riggins Rd | Tallahassee | FL | 32308