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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State Legislators Prepare for Special Session on
Budget Cuts -- This week, legislators were in Tallahassee
to prepare for the upcoming special session on the state
budget and automobile insurance that begins on September 17.
Committee meetings were held on Monday and Tuesday to give
legislators an overview of the projected budget deficit and of
proposals by each state agency to reduce spending by 10
percent for fiscal year 2007-08. The 10 percent was part of an
exercise requested by Governor Crist to begin a dialogue.
Legislators will now formulate their own recommendations.
Based on preliminary comments by individual legislators, the
Senate appears to be leaning more toward an across- the-board
cut while the House seems to favor a more discriminate process
that takes into account the importance of each program or
service. Every special interest group affected by the proposed
cuts will be making its case for special treatment.
A 10 percent budget reduction is particularly problematic
for nursing home providers, since they depend more heavily
than other health care providers on government funding. If the
Agency for Health Care Administration's proposed cut for
nursing homes ($231 million) was adopted by the Legislature,
reimbursement rates would be rolled back to what they were on
July 1, 2006 - - a loss of at least 18 months of cost of
living increases as well as an elimination of the July 1, 2007
rebasing (rate adjustment to more accurately reflect actual
cost). The proposed cuts would result in an additional average
loss per day of $14.40 per Medicaid resident in addition to
the nearly $7 per day loss per resident that is already
occurring.
ACTION REQUIRED: It is important that every FAHSA member
nursing home contact their legislators immediately to ask them
to oppose a reimbursement cut and educate them about the
implications of AHCA's proposal on their organizations and the
quality of care and services they render to nursing home
residents. Earlier this week, a Call to Action was E-mailed to
each FAHSA nursing home member with an Issue Brief and
instructions on how to proceed. If you did not receive the
E-mail, please contact Bonnie Sniffen
immediately at 850/671-3700.
Spotlight on Nursing Homes - In the last edition
of the FAHSA LINK, we highlighted the role of assisted living
facilities within the continuum of long- term care. This week,
the focus is on "nursing homes", commonly referred to as
"health care centers".
Approximately 71,500 individuals reside in Florida
Nursing Homes. Of the 656 licensed homes in the state, 644
participate in Medicaid. The current statewide occupancy rate
is 89 percent. Most care is paid for by Medicaid (63 percent)
and Medicare (19 percent). FAHSA serves 110 nursing home
members, all but a few of which are nonprofit providers. Most
are a part of a continuum of care; 31 are freestanding
facilities.
Among health care providers, nursing homes are the most
heavily regulated. They are subject to both state and federal
regulation. The Florida legislature has adopted the highest
staffing standards in the nation for nursing homes. No other
health care provider in Florida has mandatory minimum staffing
requirements.
The Agency for Health Care Administration (AHCA) is
responsible for nursing home inspections and the investigation
of consumer complaints. AHCA posts a nursing home consumer
guide on its Web site for use when trying to select a home for
a family member or friend. The Nursing Home Guide, available
at http://a
hcaxnet.fdhc.state.fl.us/nhcguide/ , ranks nursing homes
based on inspection results over a period of 30 months. Most
FAHSA members are 4 or 5 star rated. Ten of the 13 Gold Seal
nursing homes are FAHSA members.
Florida has the lowest number of nursing home beds per 1000
residents age 65 and older in the United States. This trend is
likely to continue because of a moratorium on new community
beds, which has been in effect since 2001. Dependence on
nursing homes will also continue to decrease because of the
emphasis by the Florida legislature on Nursing Home Diversion,
a Medicaid waiver program that seeks to reduce spending on
nursing home-eligible Medicaid recipients by contracting with
a care management organization to deliver resources that allow
seniors to receive care in at an existing place of residence,
be it a private home, a government-subsidized affordable
housing community, or an assisted living facility.
FAHSA has the distinction of having a highly regarded
reimbursement expert, Dr. Erwin Bodo, serving as COO of our
association. Thanks in large part to Dr. Bodo's expertise;
FAHSA is invited to have a seat at the table whenever Medicaid
funding is discussed. Dr. Bodo understands the needs of FAHSA
member communities, which makes him extraordinarily capable of
advocating for a positive reimbursement policy on behalf of
FAHSA member nursing homes.
Over the years, FAHSA has had many legislative victories
that have benefited nursing homes, including tort reform in
2001, small but important flexibility from zero tolerance
compliance with minimum staffing requirements, the creation of
AHCA nurse monitors, and relaxed regulatory standards that
allow residents to position their beds against the wall to
make room for a chair or computer.
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| ALF News |
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Are You on A Culture Change Journey? - If
you're not sure what "culture change" means or you don't
know how to evaluate if your organization is doing it,
you may want to use the "Artifacts
of Culture Change" document developed by CMS to find
out. The Artifacts of Culture Change worksheet (included
within the document) contains 11 pages of care,
workplace and leadership practices that lead to culture
change. By using the worksheet, a nursing home or
assisted living facility can score itself and identify
its strengths and weaknesses. CMS' 63-page report
explains the worksheet and how it can be used by homes
aspiring to improve staff satisfaction and expand
resident choices and opportunities to direct their own
care.
For more on this and the issues listed below, please
go to the Nursing Home Alert page.
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| CCRC / Retirement Community
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FAHSA Preparation for
Disasters: Florida Power and Light Customer
Identification - Florida Power and Light Company
(FPL) has agreed to work with FAHSA to identify FAHSA
Nursing Homes and CCRCs who are FPL customers. We have
asked that they identify FAHSA members who are their
customers so that they will prioritize restoration of
electricity as soon as possible-especially in cases of
long-term outages due to a disaster such as a hurricane
or flood.
If you are a FPL customer and you are willing to
provide your FPL bill account number to FAHSA, please
E-mail your account number with identifying information
to Carol A. Berkowitz, Esq., Sr. Director of Regulations
and Compliance at cberkowitz@fahs a.org
This will assist FAHSA efforts to ensure that the FPL
will have the correct account number and contact to
prioritize power restoration in your community during a
disaster.
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| District/Membership News
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FAHSA Member Publishes
Article - Kevin Meyer, Vice President, Director of
Operations, Care Purchasing Services recent article,
"What to Expect from a Group Purchasing Organization?"
was published in the August edition of Nursing Homes:
Long Term Care Management Magazine. To read the article,
please click here.
News from FAHSA's District 10 -- District 10
held a district meeting on August 22, 2007, at Sunnyside
Village, with 18 attending. The agenda included an
update on the proposed budget cuts. Diane Marcello,
FAHSA's Nursing Home Chair and Administrator, Sunnyside
Nursing Home, gave an update on FAHSA's response and a
report on the upcoming QIS Surveyor Training. The guest
speaker was Teresa Lim, Combined Worksite Solutions, who
presented information on the AAHSA Benefit Communication
Program.
The next meeting has been scheduled for Wednesday,
October 10, 2007, at Kobernick House, and the last
meeting of 2007 will be held at Plymouth Harbor on
Wednesday, December 12, 2007. Please mark your calendars
and plan to attend.
Nominations sought for the 2007 Injury Prevention
Award - The Florida Injury Prevention Advisory
Council (FIPAC), in conjunction with Office of Injury
Prevention, plan to honor an individual with the 2007
Injury Prevention Award. The award will be presented
during the FIPAC meeting October 16-17, 2007 in Tampa.
FIPAC is seeking nominations for the award. A nomination
application, which must be completed in order to
nominate someone for this award, can be obtained by
contacting Travis Freida at Freida_Tr
avis@doh.state.fl.us . In order to receive
consideration, all award nomination applications and
supporting materials must be received by October 1,
2007.
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| Education News |
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Dynamic Directions Nurse Leadership Workshop -
January 15-16, 2008 - FAHSA's Dynamic Directions
Workshop: Advanced Leadership for Nurse Leaders, has
been rescheduled for January 15-16, 2008. The two-day
workshop, which is specifically designed for nurse
leaders in long-term care and includes QIS training,
will be held at the Safety Harbor Resort and Spa in
Safety Harbor, FL. Nurse leaders wishing to attend the
workshop should watch their mail for further
information. Online registration will be available on
the Calendar of Events page of the FAHSA Web site
beginning next week.
Department of Health & Human Services Presents
Caregiver Satellite Broadcast - Supporting Caregivers
Across the Lifespan - The New Freedom Initiative
(NFI) Subcommittee on Caregiving presents this broadcast
designed to bring awareness to the range of programs and
services the Department of Health and Human Services
offers that support caregivers across the lifespan. NFI
is a government- wide effort to eliminate the barriers
that prevent people with disabilities from participating
in community life. A panel of experts will provide
information about these programs to increase knowledge
of partners and providers, and improve service delivery
for caregivers.
DATE: Wednesday, September 19, 2007
TIME: 1:00 -
3:30 p.m. Eastern Time
For participant registration, please go to: http://www.cms.hhs.gov/apps/events/event.as
p?id=378 Please see the following National Caregiver
Satellite Broadcast page for information on registration
and viewing, and other items: http://www.cms.hhs.gov/Partnershi
ps/20_CaregiverBroadcast.asp . If you have any
questions, please Email at: caregivers@c
ms.hhs.gov or contact: Spencer Schron at (410)
786-1075, Debbi Oxenreider at (202) 205-2118,
or Rick Greene at (202) 357-3586
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, West Palm
Beach or Miami, FL
- October 5 -- QIS Training, Fleet
Landing, Jacksonville, FL
- October 9 & 10 -- Board of Trustees
Meeting, Orlando, FL
- October 11 -- QIS Training, Orlando
Lutheran Towers, Orlando, FL
- November 15 - FAHSA's Maintenance
Workshop, Holiday Inn, Orlando, FL
- January 15 & 16, 2008 -- FAHSA's
Dynamic Directions Advanced Nurse Leadership
Workshop, Safety Harbor
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| General News |
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Excellent Human Resources Information -
See the July/August Issue of Future Age, a publication
provided to FAHSA members in coordination with our
national counterpart, AAHSA, for an excellent article on
Human Resources. The article, entitled "A Human
Resources Review", provides information on creating a
comprehensive employee handbook and managing human
resources. It can be found on page 28 of Future Age
magazine. If you are an employee of a member
organization and are not receiving Future Age, subscribe
for free online at http://www.aahsa.org/pubs_resources/fut
ureage/default.asp .
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| Housing News |
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HUD Could Be In Real Trouble, This Time --
For the past few years, during the end of HUD's fiscal
year, FAHSA members have been worried about receiving
their Housing Assistance Payments (HAP) on time. Last
year, the problem seemed to worsen with some members
going several months without payments. And, this year,
the problem continues. After years of under funding and
requesting less than what they actually needed, HUD is
simply out of money. And they have taken money from the
older contracts that actually had full contract funding
to pay other contracts.
HUD held a conference call with industry
organizations last week to update them on the subsidy
payment problems and what the Department was doing to
resolve the issues. Although HUD recognizes that they do
not have the necessary funding, it is unclear whether
Secretary Jackson will ask Congress to request the
estimated $2 billion more that is needed to meet the
existing contract obligations. To read the entire
article, please click on the Housing News page below.
Other Housing News:
- Helpful Tips When Writing Service Coordinator Job
Descriptions
- TRACS Corrections/Changes Regarding Move-Out Due
to Death
- Can Long-Term Care Insurance Be Counted as an
Expense?
- What is Your Board Makeup?
- Weekend Reading: New American Survey Guide Posted
- New Tamper Resistant Prescription Pad Requirements
Posted
- It's Time to Write a Reasonable Accommodation
Policy For Your Property
- FAHSA's Vacancy Report
- Question of the Week: Child Support Payments? -
Yikes!
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| Home and Community-Based Services
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National Adult Day Services Week September 16- 22
- The theme of this year's Adult Day Services (ADS) Week
is "Tell the Story of Caring." The National Adult Day
Services Association created a guide to help
organizations get involved in ADS Week. The guide, which
includes suggested activities, sample forms, adult day
services facts, and information on how to encourage
participation from state and local officials, can be
accessed online at http://www.nadsa.org/publications/docume
nts/ads-week.pdf .
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| Legislative News
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Provider Group Will Seek Moratorium on Home
Health Agencies - If your organization is
considering creating a home health agency to serve
residents or the community at large, it may need to act
quickly. Associated Home Health Industries of Florida
has announced that their top legislative priority for
2008 is a two-year moratorium on the issuance of new
home health agency licenses. Since there are more than
1,600 agencies statewide, they represent something of a
regulatory challenge that might prompt AHCA to support
such a moratorium. FAHSA will continue to monitor the
development of this legislation and will present the
issue to our public policy committees for input prior to
the 2008 legislative session.
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| Nursing Home News
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Final Copies of Revised Guidance on Paid
Feeding Assistants and Accidents and Supervision Issued
-- The links to the Centers for Medicare &
Medicaid Services (CMS) Transmittals 26 and 27 - the
final copies of the Revised Guidance for Paid Feeding
Assistants (Transmittal 26) and Accident and Supervision
(Transmittal 27) have been issued are listed below. If
you received an advanced copy of the guidance, these
links are identical to the final versions.
Paid
Feeding Assistants - Effective Date August 17, 2007
Accident
and Supervision - Effective Date August 6, 2007
Other Nursing Homes News:
- Deficiencies Cited at Higher Rate in QIS
- NPI Requirements for State Medicaid Agencies
- FAHSA Preparation for Disasters: Florida Power and
Light Customer Identification
- CMS 671 Form for NATCEP Approval
- Reminder: CMS Satellite Broadcast and Webcast--
Physical Restraint Use in Nursing Homes: The Exception
Not the Rule, Part III
- HHS Presents Caregiver Satellite Broadcast -
Supporting Caregivers Across the Lifespan
- Are you on a Culture Change Journey?
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| Preferred Business Associate
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New Guide Published -- AAHSA and Lancaster
Pollard have published a new
guide on refinancing Section 202 affordable senior
housing properties. Please download the useful guide
which includes:
- An overview of the evolution of the Department of
Housing and Urban Development's Section 202 direct
loan program for affordable senior housing.
- Explanation of the various options available to
inject capital into aging properties
- Several case studies illustrating the processes
and outcomes of AAHSA member properties that
refinanced using federal programs, tax credits and
other tools.
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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