Tips for Reading the FAHSA Link
Welcome to this edition of the FAHSA Link.
Please note that news topics are highlighted in a brief paragraph or
two. To read the complete document related to a specific member
type, click on the link directly following the article (which will
take you to the Alerts Page for ALFs, CCRCs, HUDs, General, or
Nursing Homes) and then click on the latest ALERT. Please remember
that last year, the FAHSA Board of Trustees made the decision that
your membership dues will entitle you to access only those Web pages
that relate to the membership type your dues cover. That is, if you
pay dues for nursing home beds only then will you be able to access
all general membership and nursing home-related Web pages, but you
will be unable to access housing, ALF or CCRC topics. Suggestions/Comments
FAHSA Quick Links
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Spotlight on Assisted Living Facilities - In
previous issues of the LINK, we showcased continuing care and
fee for service retirement communities. This week, the
spotlight is on assisted living facilities.
Assisted living facilities in Florida outnumber nursing
homes four to one, with 2,470 assisted living facilities,
compared to 656 nursing homes. However, ALFs are generally
smaller than nursing homes. Because the vast majority of ALFs
have fewer than 20 beds, assisted living accounts for a total
of only 76,210 licensed beds, compared to 80,286 beds licensed
for nursing home use. As of August, 2007, only 132 of
Florida's assisted living facilities (with a total of 5,037
beds) are managed by not for profit providers. Many ALFs are
small, private facilities located in converted residential
homes.
FAHSA has 96 ALF members, most of which are either part of,
or affiliated with, communities providing a continuum of care.
Almost all of FAHSA's member ALFs have a greater number of
licensed beds than the state average. The average size of a
FAHSA-member ALF is 59 beds.
An assisted living facility is defined as any building
or portion of a building that "provides housing, meals, and
one or more personal service for a period exceeding 24 hours
to one or more adults who are not relatives of the owner or
administrator." In order to operate an ALF, a provider must
obtain a standard license through the Agency for Health Care
Administration. If a provider is interested in offering more
extensive services, he or she must obtain a specialty license.
Specialty licenses include extended congregate care, limited
nursing services and limited mental health. Currently 804 ALFs
are licensed to provide limited nursing services, and another
302 are licensed to provide extended congregate care.
FAHSA had more of an impact on the ALF law and
regulation than any other association. In fact, our founding
members helped write the first law that passed in Florida to
regulate what were then called "adult congregate living
facilities." Some 15 years ago, we were responsible for
changing the definition to include "one or more personal
service". Prior to that time, any provider that offered room,
meals, and housekeeping was required to obtain a license.
Therefore, most independent living units that were part of
retirement communities were licensed as an ALF. The FAHSA
public policy staff and leadership recognized long before the
rest of the country that the definition was much too broad and
created a burdensome regulatory process for providers that
served independent elders who needed a little help but no
supervision. We were also responsible for amending the statute
to allow continuing care communities as well as retirement
communities that consist of homes or apartments and an ALF
facility to provide intermittent in-home services to residents
who live in the homes duplexes or apartments if the residents
do not require staff supervision for that portion of the day
and personal services are not being delivered and the
organization obtains a home health license. In addition, we
have consistently opposed any efforts that would restrict a
provider's right to adopt resident admission and discharge
criteria that are more restrictive than what is authorized in
law. We recognize that ALFs are very diverse and not all have
the desire or capability to serve more impaired
residents.
Property and Casualty Insurance with Wind Coverage at
Last - If you read the papers daily, as we do, it its easy
to be depressed by the many articles indicating that property
and casualty insurance rates are going to increase and/or more
insurance carriers will leave the state. Although many of
these articles refer specifically to homeowner policies, these
trends can have negative affects on business property and
casualty policies as well.
According to Dick Hunt at HRH (an insurance brokerage firm)
the market for windstorm insurance is still very tight and the
cost is quite high. They are finding very few, if any,
admitted carriers who will provide windstorm coverage along
with their property coverage these days, even in non-coastal
areas such as Tallahassee, Ocala, etc.
However, the good news is that a FAHSA member community
located in a very vulnerable coastal area recently reported
that it was finally able to get wind coverage. The Board of
Vicars Landing and Glenmoor had previously made the decision
to go without wind coverage due to the high cost and high
deductible. Ray Johnson, Executive Director, began working
with Sandy Elsass, President/CEO of UniTer and Brian McGuire
of U.S. RE to explore options. After much review and full
disclosure on Mr. Johnson's part due to his position with the
Ponce de Leon RRG, he was able to obtain a product on wind
with a deductible based on damages sustained rather than
property value. According to Mr. Johnson, "This made the
program most attractive and cost effective for us. We had
previously calculated a probable maximum loss due to wind
damage based upon a computer model that insurers utilized.
Given the high cost of property insurance and the difficulty
of even getting a wind insurance quote, I am sleeping much
better at night now." This coverage is underwritten by a
Lloyds of London program developed through U.S. RE, a
reinsurance brokerage firm. Members are only eligible to
purchase this coverage if they also obtain a general liability
policy from Ponce de Leon RRG.
FAHSA has several Preferred Business Associates (PBAs) who
are working hard to provide members with the most
cost-effective products. Please refer to the FAHSA Web site
for a listing of those business associates. These business
members have been very supportive of FAHSA and their
educational events.
Here is a short synopsis of recent articles:
Daytona Beach News Journal, 8/15/07: The Florida
Office of Insurance Regulation denied the rate requests of
three companies this week for not substantially lowering their
property insurance rates in accordance with new state law.
Cypress Property & Casualty, with 63,129 policies
statewide, proposed a 5.4 percent decrease; First Floridian
Auto Home, with 91,295 policies statewide, proposed an 8.3
percent decrease; and Home Travelers Indemnity, with 4,596
policies statewide, proposed an 8.3 percent decrease.
Florida Today, 8/21/07: An outside auditor finds the
state-run Citizens Property Insurance is short almost $300
million in reserves, thanks to the reopening of hundreds of
hurricane claims two years after the fact.
Pensacola News Journal, 8/16/07: The Hartford --
which gets two-thirds of its 97,000 home policies from
referrals through the AARP -- seeks to raise rates an average
31.6 percent. That almost exactly offsets reductions the
company was ordered to make in June as a result of legislative
changes. The bulk of the increase goes for something
regulators can't regulate -- an increasingly dark view of the
hurricane threat to Florida. Aside from questioning the
company's specific rates and new underwriting rules,
regulators hope to lay ground for the next round of property
insurance fixes by the Florida Legislature. January's reforms
were supposed to lower rates an average 24 percent in trade
for consumer backing of $12 billion in potential hurricane
losses.
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| ALF News |
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Resources for Assisted Living Week - September
9-15 - The American Association of Homes and
Services for the Aging has partnered with the National
Center for Assisted Living to create an online planning
guide for this year's National Assisted Living Week, to
be held September 9-15. Resources are available to help
assisted living members develop activities to celebrate
your residents and staff and the valuable role assisted
living plays in the community at large. The guide is
available at www.nalw.org/2007_planning_guide.pdf
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| CCRC / Retirement Community
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Providers Share Ideas During
Retirement Community Roundtable - A retirement
community roundtable was held in conjunction with
FAHSA's 2007 Annual Meeting and Convention.
Approximately 40 people participated. The session, which
was facilitated by John Meserve and Jack Norton, got
rave reviews -- an indication of the importance of
networking and the opportunity to talk about operational
challenges and possible solutions.
For the convenience of FAHSA members that offer a
full continuum of care, a summary of ideas shared during
the roundtable will be mailed this week to all
retirement community members. The document is also
available on the FAHSA Retirement
Community Web Page.
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| District/Membership News
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FAHSA Member Appointed to
DOEA Advisory Board - FAHSA member William "Bill"
Edelstein, Administrator of Memorial Manor in Pembroke
Pines, was appointed to serve on the advisory board of
the Department of Elder Affairs. The appointment gives
Bill the opportunity to share his views as a nursing
home administrator and as a board member of the Area
Agency on Aging.
FAHSA Member Appointed to New DCF Select Advisory
Panel on Adult Protective Services - Gwen
Kaldenberg, M.S.W., Director of the Bresler Alzheimer's
and Related Disorders Program at Menorah Manor, a FAHSA
member community, has been appointed to serve on the
Florida Department of Children and Families'
newly-created Select Advisory Panel on Adult Protective
Services. The Panel will provide advice and counsel to
the Department's leadership on the provision of
services, including guardianship, and on issues relating
to the abuse, neglect, and exploitation of Florida's
adult population, particularly the disabled and elderly.
The Panel will identify statutory, policy, or procedural
barriers to effective response and service provision and
provide recommendations for improvement and facilitate
communication between the Department and the populations
it serves. The Panel will also be charged with
identifying special needs and services that should be
provided by the Department to better accomplish its
mission of service to vulnerable citizens.
FAHSA Members Are Trail Blazers - This year's
annual convention gave FAHSA members an opportunity to
recharge their batteries and learn from others. This
year, through the round tables and best practice "Best
of the Show" session, we heard about the many creative
programs, services and initiatives that separate FAHSA
members from other providers. Please take the time to
tell us what's new with your organization so others can
benefit. Send an e-mail with a paragraph or two for the
LINK to Heather McInnis at hmcinnis@fahsa.o rg
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Check out FAHSA's Innovation Exchange web site at www.fahsa.org/Members
/InnovationExchange/InnovationExchange.htm for
information on more than 25 creative programs. Better
yet, submit one of your own.
River Garden Offers Weekend Day Care - Day
care is available seven days a week at River Garden
Hebrew Home / Wolfson Health and Aging Center in
Jacksonville. The program was recently expanded to
include weekends so that caregivers can attend
synagogue/church services and social events worry free.
Families had been asking for weekend programming for
some time. The moral of the story is that care giving
duties do not end on Friday afternoon.
Salvation Army Mobile Kitchens featured on Food
Network's Dinner: Impossible - Evangeline Booth
Garden Apartments, a member community sponsored by the
Salvation Army, has informed FAHSA that the Salvation
Army's emergency disaster services canteens (mobile
kitchens) and crews will be featured for the next two
weeks on an episode of the Food Network program Dinner:
Impossible. The episode, in which chef Robert Irvine
must feed 1,000 hungry construction workers in six hours
with the use of only two salvation Army canteens,
premiered on Wednesday, August 22, and will be re-aired
at the following times:
- August 26 - 1:30 a.m. ET/PT
- August 27 - 1:00 a.m. ET/PT
- September 2 - 10:30 p.m. ET/PT
Of the nine shows produced so far this season, the
Dinner: Impossible producer has indicated that this is
the best so far! Those who tune in to find out will be
happy to see The Salvation Army's mobile kitchens
starring throughout the show.
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| Education News |
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Survey and Enforcement Webinar Successful
- On Tuesday, FAHSA held a two-hour Webinar
featuring Dr. Susan Acker. During the presentation, Dr.
Acker discussed the new QIS, and explained the new CMS
associated deficiency memo. During the presentation, Dr.
Acker mentioned several web sites where providers could
receive information and watch archived webcasts from
CMS. Many of the web sites have been mentioned in
previous issues of the LINK in conjunction with specific
topics. Nonetheless, we thought it might be helpful to
provide a list for future reference by your nurse
educator.
Upcoming Workshops:
- September 18 & 19 -- FAHSA's Home
and Community-Based Services Workshop, Wyndham
Jacksonville Riverwalk, Jacksonville
- September 19 & 20 -- FAHSA's Annual
HUD and Service Coordinator Workshop, Wyndham
Jacksonville Riverwalk, Jacksonville
- October 2 -- QIS Training, Miami, FL
- October 3 & 4 -- FAHSA's Dynamic
Directions Advanced Nurse Leadership Workshop,
Safety Harbor
- October 5 -- QIS Training,
Jacksonville, FL
- October 9 & 10 -- Board of Trustees
Meeting, Orlando, FL
- October 11 -- QIS Training, Orlando,
FL
- November 15 - FAHSA's Maintenance
Workshop, Holiday Inn, Orlando, FL
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| General News |
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DOEA Offers 2007 Resource Guide for
Consumers - The Department of Elder Affairs has
produced an excellent 2007 Resource Guide for consumers.
Some of the topics that might be helpful for your
residents and their families include:
- Caregiver and Consumer Support
- Housing and Property Rights
- Health Insurance Programs, Including basic
information about Medicaid and Medicare programs
- Elder Rights, Abuse and Fraud
- Safety and Emergency Services
- Life Planning/End of Life
To download the Resource Guide, please go to: http://
elderaffairs.state.fl.us/CRG/TC.html
AAHSA Resources for Staff Recruitment and
Retention - Two new resources in the Human resources
section of the AAHSA Quality First website discuss how
surveying employees can improve motivation and how to
recruit and retain new employees. These tools can be
accesses at www.aahsa.or
g/qualityfirst .
Plan to Participate in National Memory Screening
Day 2007 - The Alzheimer's Foundation of America
will hold its fourth annual National Memory Screening
Day on November 13, 2007. The event marks the focal
point of AFA's national initiative to promote early
detection and intervention for those concerned about
memory loss, as well as to provide education about
successful aging and community resources. This national
program offers an excellent opportunity for FAHSA member
organizations to participate in community outreach,
generate goodwill and social accountability, and help
raise public awareness of Alzheimer's disease while also
educating the community about the services provided by
the organization itself.
Involvement is simple. AFA will provide participating
organizations with all of the necessary marketing,
consent forms, and education and other materials to
seamlessly and effectively conduct memory screenings
within the community and will list your screening site
on its website. Participating organizations are
responsible for selecting a qualified healthcare
professional, such as a nurse, social worker,
psychologist, doctor, etc., to do face-to-face
screenings, setting aside the time and space to conduct
the screenings, and selecting the memory screening tool
(such as the MMSE, clock drawing or other instrument) to
be used. The organization will also be asked to
distribute and collect all required forms, publicize the
event locally, emphasize to participants that the
screenings do not represent a diagnosis, encourage
participants whose screenings indicate impairment to
follow up with a full examination, and provide education
materials and community resources to the public.
Information and materials are available online at www.
nationalmemoryscreening.org . In order to have your
site listed on the website, you must notify AFA by
October 26. Please contact Amanda Edmonds, AFA Event
Coordinator, at 866-AFA-8484 or aedmonds@alzf dn.org
with any questions or to request additional
materials.
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| Housing News |
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Submit Your 2007 FAHSA Service Coordinator
Nomination TODAY! Service Coordinators provide a
vital link between the residents of HUD elderly housing
communities and the services and programs they need to
live full and enriched lives. The FAHSA award recognizes
a Service Coordinator for outstanding commitment to
his/her residents through innovative programming,
creative problem-solving, etc. This award will be
presented at FAHSA's 24th Annual HUD Elderly Housing
& Service Coordinator Workshop, Wyndham Hotel, in
Jacksonville. Download a nomination form at www.fahsa.org/Members/Memb
erNews/2007FAHSA-SERVICE-COORDINATOR.doc .
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| Home and Community-Based Services
News |
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Transportation Toolbox Offers Coordination
Resources - A publication by the Administration on
Aging and United We Ride, entitled "Seniors Benefit from
Transportation Coordination Partnerships - A Toolbox",
describes innovative efforts undertaken by 14
communities to coordinate transportation services for
seniors. Resources include useful practices in
transportation coordination, a hand book for creating
door-through-door transportation programs, a template
that can be used by communities in building their own
transportation resource guide, and a comprehensive
resource list. The report can be found at www.aoa.gov/prof/transportation/transportati
on.asp .
CMS Medical Home Demonstration Project in
Design - The Centers for Medicare and Medicaid
Services is designing a "Medical Home" demonstration
project to explore ways that states can begin to provide
targeted, accessible, continuous and coordinated
family-centered care to Medicare beneficiaries with
multiple chronic or prolonged illnesses. The
demonstration will be implemented in eight states
beginning in September 2008. For more information, visit
www.cms.hhs.gov
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| Legislative News
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MorseLife Hosts Two State Senators - Keith
Myers, CEO of MorseLife, and his staff met with state
Senator Ted Deutch (D-Delray Beach) last week. This
week, state Senator Dave Aronberg (D- Greenacres) paid a
visit to the MorseLife campus. On both occasions, Mr.
Myers discussed the proposed Medicaid cut for nursing
homes and the effect it would have on his organization
and the seniors who depend on MorseLife for long-term
care.
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| Nursing Home News
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Revised Issue Paper on Budget Cuts Available
on FAHSA Website - To view the updated issue paper,
log on to the "Members Only" section of the FAHSA
website at http://www.fahsa.org/Members/memberso.htm
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Survey Results Indicate Structure of Admissions
Offices Vary - Before convention, a nursing home
administrator who is reorganizing her organization's
admissions program asked us to survey FAHSA members to
find out what they are doing. To read the survey
results, please go to the latest Nursing Home Alert, NH
07-23 dated August 23, 2007.
St. Petersburg Times Creates Consumer-
Friendly Website on Nursing Homes - The St.
Petersburg Times has converted AHCA's 5-star rating
system into a nifty interactive map that is posted on
its Web site to assist people looking for a good nursing
home in finding one nearby. The site lists four and
five- star homes, but also includes links to the nursing
home guide and comparison. By zooming in, consumers can
go directly to the location of their homes or other
locations and branch out from there. The newspaper plans
to update the information quarterly. For more
information, visit http://sptimes.com/2007/webspecials07/spe
cial_reports/nursing-homes/
Other Nursing Homes News:
- Quality Indicator Survey TIPS on Resident
Interviews
- US Census Bureau Currently Conducting the American
Community Survey
- New AHCA System Allows Faster Level Background
Screening Results
- New "Tamper-Resistant" Prescription Pad
Requirements Will Have Minimal Effect on Members
- CMS Webcast: From Institutional to Individualized
Care to be Aired September 14
- CMS Paid Feeding Assistant Guidance - New
Effective Date: August 17
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| Preferred Business Associate
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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.
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| JobMart |
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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
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