FAHSA Weighs in on ALF Regulation -- A few weeks ago, the Senate Children, Families and Elder Affairs Committee dedicated most of a three- hour meeting to hear from regulatory agencies involved with the care and oversight of an assisted living resident with facial cancer that was not properly treated. The unfortunate situation has since captured the attention of a Tampa Bay television station and has state agencies scurrying to address concerns raised by the Committee and the media. (Please refer to the Action Alert to ALFs on the Web site for more details.)

Last week, FAHSA sent a letter to Senate Children, Families and Elder Affairs Committee Chair Senator Ronda Storms (R-Brandon) urging her not to respond hastily to this unusual case. The letter pointed out that the ALF resident was atypical in that he could not speak or communicate and had no family or health care surrogate or guardian to advocate for him. We reminded the committee that Florida led the way in passing stringent ALF regulation in l980 that gives regulatory agencies broad authority to use a wide range of sanctions to deal with problem providers. Current law takes into account the diversity of ALFs both in size and the scope and duration of care and services they provide. One bad outcome does not necessarily justify changes that could result in a more regulated institutional model of ALF care -- exactly what elder consumers do not want.

FAHSA staff will be monitoring proposed legislation and regulatory changes that emanate from this case. We will oppose questionable policy revisions that increase operational costs or detract from what consumers like most about ALFs -- a homelike setting. VIEW THE LETTER sent to Senator Storms and other members of the Senate Children, Families and Elder Affairs Committee.

FAHSA Staff Addresses FLiCRA Members at Annual Meeting -- This week, over 100 Florida Life Care Resident Association (FliCRA) members from chapters around the state are convening for their annual meeting. Freedom Plaza, a Brookdale community located in Sun City Center, is hosting the event. On October 25th Mary Ellen Early (FAHSA's Senior Vice President of Public Policy) and FLiCRA CEO Bennett Napier did a PowerPoint presentation on Florida demographics, trends and opportunities for CCRCs, preliminary public policy topics for the 2008 Legislative Session, and grassroots advocacy.

For more than a decade, FAHSA and FLiCRA have been partners in pursing legislation and regulatory changes that are mutually beneficial to residents and providers. This meeting is another example of our efforts to work together.

District Ten Meeting a Success - Dorothy Barichak, FAHSA District Ten Chair, held a meeting on October 17, 2007 at Kobernick House in Sarasota. Eighteen representatives from five member communities and two companies that are business associates attended the meeting. Ms. Barichak and Diane Marcello, FAHSA's Nursing Home Chair, provided an update on the issues raised at the October Public Policy meeting and an overview on the new nursing home quality indicator survey. Attendees had the opportunity to participate in a discussion about tax concerns, and learn more about culture change. The members also heard about the FAHSA's Group Purchasing Organization (GPO) program and Preferred Business Associates. Thanks and congratulations to Dorothy for an interesting and successful meeting. District Chairs who are interested in learning more about the topics presented at the meeting and replicating the program locally should contact their FAHSA staff liaison.

Protect Your Tax-Exempt Status - The Internal Revenue Service's Exempt Organizations division is offering one-day workshops in three regions of the country for small and mid-sized section 501(c)(3) organizations. The workshops will focus on what an organization must do to keep tax-exempt status and comply with tax obligations. Preregistration is required. The workshops will be held in mid- November and December, but additional dates and venues are planned for 2008. Contact Jennifer Hilliard, AAHSA at jhilliard@aahsa.org or (202) 508-9444, or regi ster online.

What Story Does Your 990 Tell? -- IRS Form 990 is more of an information return than a tax return. Failure to answer all questions can trigger an audit. Use the form to elaborate on your mission and why your organization is worthy of tax exempt status. It's not enough to say, "We provide outstanding services to the elderly."

The public can obtain information on non-profit entities through GuideStar.org -- an Internet site accessed by close to 8 million people this past year. Approximately 3.1 million Form 990 images are posted on GuideStar. You might want to check out the Web site to verify that the information on your organization is accurate. You can also compare your responses to those of other entities providing similar services.

Don't Miss the Final Opportunity to Participate in the Last of a Series of FAHSA Workshops on the New Quality Indicator Survey (QIS) - 6 contact hours - The final FAHSA training opportunity on the new Quality Indicator Survey (QIS) is scheduled for November 7 in Bradenton. Don't assume that your staff can prepare for the QIS in a couple of weeks. It will take time to make the transition. NOW is the time to train your nurse leaders and MDS coordinators so they can begin the process. Attendees will learn how the new survey process relates to residents, family, and staff, resident observations, record reviews, and the Minimum Data Set (MDS) data. They will also learn about the survey pathways that address assessment, care planning, care provision and reassessment.

During the training, Cindy Pearse, Nursing Home Quality Accredited QIS Instructor; Carmen Shell, VP of Nursing, Morse Geriatric; and several FAHSA members who participated in training at the Agency for Health Care Administration will present the latest information and resources available on the QIS. Our trainers will provide tools to prepare for the new survey process including the protocols, the forms and the applications. This training is a must for Administrators, Assistant Administrators, DONs, ADONs, Risk Managers, MDS Coordinators, and Staff Development Directors. Please visit the Calendar of Events page of FAHSA Web site to download a registration form or register online.

CNA Train the Trainer Program to be Held in Bradenton - November 8 - This course, generously written and developed by Westminster Services, Inc., will provide your RNs with the required education and training necessary to teach the CNA course and to prepare your nursing assistant students to challenge and pass the CNA exam. Please visit the FAHSA Calendar of Events to view the brochure or register online.

Please Join Us for FAHSA's 14th Annual Maintenance Workshop - November 14 & 15 in Orlando - This popular and highly interactive workshop will provide Maintenance Directors, Staff and Administrators of retirement communities, nursing homes, assisted living and high-rise independent living facilities with the most up-to-date information on 'hot' Maintenance topics such as Plumbing, Heat, Electrical, Bid Specs, Air Handling, Refrigeration, Safety Regulations, and Building Maintenance. Attendees will have opportunities to hear the latest information from experts, view the latest products and services from exhibitors, and network with other maintenance directors and staff. Early Bird Registration Deadline is November 1, 2007. Please visit the FAHSA Calendar of Events to view the brochure or register online.

Upcoming Events:

• October 31 - FAHSA District 6 Meeting, Indian River Estates East, Vero Beach
• November 7 - QIS Training, Westminster Bradenton Shores, Bradenton
• November 8 - CNA Train the Trainer, Westminster Bradenton Towers, Bradenton
• November 14-15 - FAHSA's Maintenance Workshop, Holiday Inn, Orlando
• November 27 - MDS Coding and Care Planning Webinar
• January 15-16 -- FAHSA's Dynamic Directions Advanced Nurse Leadership Workshop including QIS Training, Safety Harbor

Don't Forget to Prepare for Pandemic Prevention - The Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) have developed checklists to assist home health providers, clinics, long-term care and other residential facilities in assessing and improving their preparedness for responding to pandemic influenza. To access the appropriate checklist for your organization, please visit the Pandemic Flu Web site.

Proper Hygiene Prevents MRSA Spread - The Florida Department of Health (DOH) reminds Floridians of the importance of proper hygiene to prevent the spread of MRSA (methicillin-resistant Staphylococcus aureus), the common cold, influenza and a number of other infections. Research published last week in the Journal of the American Medical Association (JAMA) estimates that there are more than 94,000 MRSA infections and 18,000 deaths in the USA each year. MRSA no longer appears solely in health care settings, it is becoming more common in the community since its appearance in the 1960's.

MRSA is a type of Staphylococcus (staph) resistant to some antibiotics. While 25% to 30% of the population is a carrier of staph, approximately 1% is afflicted with MRSA. Most staph and MRSA infections are treatable with antibiotics. Staph infections, including MRSA, occur most frequently among persons in hospitals and health care facilities (such as nursing homes and dialysis centers) who have weakened immune systems. These health care- associated staph infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia. In the community, MRSA is most often associated with skin infections but may also include more serious and life threatening infections.

Any disease outbreak or cluster in a community is considered reportable and the Department of Health has established a surveillance program aimed at MRSA in the community. The Department of Health is currently developing further surveillance to look for severe cases of MRSA infection in the community.

The Florida Department of Health highlights the following Centers for Disease Control and Prevention (CDC) recommended precautions:

• Keep your hands clean by washing thoroughly with soap and water or using an alcohol-based hand sanitizer.
• Keep cuts and scrapes clean and covered with a bandage until healed.
• Avoid contact with other people's wounds or bandages.
• Avoid sharing personal items such as towels or razors.

Property Insurance Becomes a National Issue - Two south Florida Congressmen (Reps. Ron Klein, D-Boca Raton, and Tim Mahoney, D-Palm Beach Gardens) recently filed a bill to create a national catastrophic insurance plan that relies on government-issued bonds to pay claims after mega- catastrophes. It did not take long to find out that property insurance isn't just a Florida problem. The New York Times reported recently that Long Island homeowners are losing their coverage because of what companies perceive as newly discovered hurricane risk. Last month, before the House Financial Services Committee, on which Reps. Klein and Mahoney serve, Rep. Matthew Patrick from Massachusetts noted that almost half of the homes on Cape Cod and other nearby coastal areas get coverage from that state's insurer of last resort. Because of the growing recognition that insurance is a nationwide problem, the Klein-Mahoney bill passed the financial services committee and may have a chance of a full House vote this year. U.S. Senators Mel Martinez, a Florida republican, and Bill Nelson, a Florida democrat, are working on the Senate version of the bill.

Special Session on Property Tax Reform Hits a Snag - The House and Senate were scheduled to return to Tallahassee today to continue their work on property tax reform. However, early Wednesday morning, Senate President Ken Pruitt sent a memorandum to his members informing them they would not be returning this week. The memorandum even hinted that the Senate may not be coming back at all; but if they did it would not be any earlier than Monday, October 29.

Speaker Marco Rubio followed later in the day with a similar letter to all state representatives. He also told his members that they would not return until Monday.

Governor Charlie Crist stated that a deal needs to be made by October 29 if the proposed constitutional amendment is to make its way onto the January 29, 2008 ballot. The Governor is still optimistic that the House and Senate will meet the deadline.

CMS Responds to QIS Questions from Provider Training -- During the September Agency for Health Care Administration Quality Indicator Survey (QIS) provider training, questions were asked by providers and forwarded by AHCA to the Centers for Medicare and Medicaid Services (CMS) for a response. See the responses in the latest Nursing Home Alert, NH 07-29.

Other Nursing Home News:

• FAHSA Member Request for Guidance on Bed Rails
• MQA Proposed Rule on CNA Certification Renewal/ FAHSA Offers Clarification on In-service Requirements
• FAHSA Works to Make HIV/AIDS Continuing Education Requirements Consistent
• Proposed Nursing Home Administrator Rule Changes on CEs
• Clarification on Self-submittal of NHA CE Credits into CE Broker Electronic Tracking System
• MedWatch Alerts and Warnings
• Medicare Project Shows Bed Sores Can Be Stopped With Proper Care

You Be the Judge - Can an Employer Use Surveillance to Disprove Disability without Violating ERISA?
John Denham worked for Sunoco, Inc., since December 1976. On May 25, 2000, Mr. Denham began a medical leave of absence due to neck, left shoulder, and back ailments and began receiving short-term disability payments under Sunoco's disability income plan. As required by company policy, Mr. Denham periodically reported his medical condition to his supervisor and to Sunoco's company doctor. Mr. Denham also gave consent for his medical records to be shared with Sunoco. To read the entire article please click HERE.

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