Walter's suprise 50th birthday party, complete with lasagne and a German chocolate cake.
In this Issue
Inside gahsa
News from the Staff
Business Connection
Updates from Our Associate Members
News Throughout
the Continuum:
Home & Community Based Services
Continuing Care Retirement Communities
Website Notes, Computer Tips and ListServs
GIA Partners
Ziegler Capital
Markets Group
Occupied
Renovations
Cornerstone
Senior Living
Moore Stephens Lovelace, P.A.
GIA Supporters
Mauldin & Jenkins
LW Consulting, Inc.
GIA Friends
The Law Offices of Williams & Edelstein
Dixon Hughes
Pfizer
GIA Contributors
HVAC Services
Kings Bridge Retirement Center
Seth Strongin
AAHSA
http://www.aahsa.org
Keep Up with the Quality First Program
The Georgia Association of Homes and Services for the Aging (gahsa) is the statewide association of over 150 key not-for-profit and other mission-focused organizations dedicated to providing quality housing, health care, community based and other related services for older Georgians. Gahsa's mission is to represent and promote the common interests of its members through leadership, advocacy, education and other services in order to enhance each member's ability to serve older Georgians
Inside gahsa
News from the Staff
Salary Survey results ready for members to access
We know this new survey was a challenge for some to complete, but THANKS TO GAHSA MEMBERS who took the time to do so – it helps everyone!
Members who completed the survey can access the results on Thursday, August 11, 2008 for FREE by …
1. Logging into https://survey.gahsa.org
2. Click the "Reports" radio button in the center of the Salary Survey website main page.
3. Customize the report by modifying the dropdown box selections.
4. Click the "Generate Report" button to view the report.
Note: The report will open in a popup window. You'll have to disable all popup blocking software in order to see the report window.
Please keep in mind that only those people who completed the surveys will have access to run reports. If a member completed only the Salary Survey, then he/she will only be able to view the salary-related reports. Vice versa, if a member completed only the Benefits Survey, then he/she will only be able to view the benefits-related reports.
Members who did not complete the survey, but wish to have the information, can receive it from the gahsa office. The cost will be $350.
Proposed Name Change
As gahsa members know by now, The Georgia Association of Homes and Services for the Aging is proposing to change its name to Aging Services of Georgia. There are both philosophical and practical reasons for this strategy. Philosophically, the proposed new name represents a more progressive, enduring and broader identity. Practically, the proposed new name is more succinct -- making it more recognizable and memorable among association members and their respective boards of directors and residents; policy shapers; consumers; and media.
Please review additional information at www.gahsa.org and contact us with your responses. If the gahsa Board of Directors approves the task group proposal to change the name on August 7, there will be a called business meeting at 1pm, September 11th, just after the gahsa summer luncheon, Long Term Care Finance Solutions at the Loudermilk Center in Atlanta, to ask for membership approval to change the name. The name change will become a part of celebrating 35 years of serving the key providers of housing and community-based service organizations in Georgia.
GAHSA Night on Monday in AAHSA Conference in Philadelphia
GAHSA NITE at the national aahsa conference will be held Monday evening before the evening events of the conference. The registration form will be posted at www.gahsa.org by August 15th.
National Nursing Home Survey & Certification System Broken and Beyond Repair
The National Task Force through aahsa has published their final report, “Broken and Beyond Repair: Recommendations to Reform The Survey and Certification System. It is posted at www.gahsa.org. Thanks to gahsa member Liza Fritchley, Vice President of Senior Services at West Georgia Health System, for representing Georgia and serving as one of twenty provider representatives on this task group.
The report feature brief summaries of 13 major issues facing nursing home providers as they attempt to navigate the survey, certification and enforcement process. Those issues fall into six general categories. Each issue brief contains one or more Task Force recommendations.
- Improving the Quality and Preparedness of the Survey Team.
- Enhancing Communication between Regulators, Surveyors and Providers.
- Applying Regulations in a Consistent Manner.
- Encouraging and Rewarding Providers That Strive for Excellence.
- Providing Consumers with Meaningful Information.
- Ensuring Fair Enforcement and Dispute Resolution.
Culture Change Network of Georgia
As you know, GAHSA launched the Culture Change Network of Georgia at the GAHSA 2008 annual conference. Kim McRae, our Culture Change Consultant, was introduced and presented an informative workshop with standing room only!
Spearheaded by the Georgia Association of Homes & Services for the Aging (GAHSA) and the Georgia Institute on Aging, The Culture Change Network of Georgia is a group of dedicated supporters and stakeholders working as partners to promote and foster culture change and improve the quality of life for older Georgians in all settings where aging services are delivered. Please visit www.culturechangega.org for lots of great information. Transformations, the first culture change newsletter will be out later this month.
SAVE September 4, 2008 for the First Annual Culture Change of Georgia Summit at the Loudermilk Center. Carmen Bowman will be presenting a comprehensive overview of the Culture Change – focusing on person-centered caregiving throughout the continuum of aging services.
Thanks to the following groups that have been serving as Advisory Partners to get the Georgia Culture Change movement organized:
Atlanta Regional Commission Area Agency on Aging
Alzheimer’s Association - Georgia Chapter
CMS Survey/Cert Review Branch
Emory HealthCare Fugua Center for Late Life Depression
gmcf (Georgia Medical Care Foundation)
Georgia DHR/Office of Regulatory Services
Georgia DHR, Divison of Aging Services
Georgia Council on Aging
Georgia LTC Ombudsman
The Green House Project
International Association of Homes and Services for the Aging
GSU Gerontology Center
Holleran Consulting
IASA, Consumer, International
Institute for the Future of Aging Services
UGA Institute of Gerontology
Rosalynn Carter Institute
The Pioneer Network
GAHSA members representing the full continuum of care serving on the Advisory Group include:
- AG Rhodes (Nursing Homes )
- The Gardens at Calvary (Dementia-Specific Assisted Living – Green House Model)
- Lutheran Towers – Affordable Housing
- Presbyterian Homes of Georgia (Affordable Housing/CCRC)
- Senior Connections (HCBS)
- Visiting Nurse/Hospice Atlanta (HCBS/Hospice)
- Weinstein Adult Day Services (HCBS ; Adult Day Services)
- Wesley Woods Senior Living (Affordable Housing/CCRC)
Events at a Glance
ATTENTION: Significant Events coming up NOT TO MISS
This is a quick overview.
You'll find more information about
each of these events below in GIA News.
Wednesday, August 13
Fund Development Seminar with Benevon
2:00 - 4:00 pm (1:30 registraton)
gahsa Offices
Thursday, August 21
Strategically Positioning Your
Organization for the Future
9 am - 4:30 pm
Bank of America
Conference Center
Monday & Tuesday
August 25-26
Coaching Supervision:Skills for Supervisors in Home & Residential Care
9 am - 4:00 pm --
gahsa Offices
Wednesday & Thursday
August 27-28
Service Coordinator Conference
Wyndham Peachtree Conference Center
Thursday, September 4
Culture Change Summit
Loudermilk Center
Thursday, September 11
gahsa Quarterly Luncheon:
Georgia Forum on Long Term
Care Solutions
Loudermilk Center
Thursday & Friday
September 18-19
Coaching Supervision:Skills for Supervisors in Home & Residential Care
9 am - 4:00 pm
gahsa Offices
Tuesday, September 23
South Georgia Regional Conference
Lake Blackshear Resort
Sunday, September 28
GIA Fundraising Cabaret
Helene Mills Center
Thursday, October 2
Forums Day
Thursday & Friday
November 13-14
Coaching Supervision:Skills for Supervisors in Home & Residential Care
9 am - 4:00 pm
gahsa Offices
General Notes of Interest
IRS Increases Mileage Rates
In recognition of recent gasoline price increases, the IRS announced an increase in the optional standard mileage rates for the final six months of 2008. Taxpayers may use the optional standard rates to calculate the deductible costs of operating an automobile for business, charitable, medical or moving purposes. They are also used on Section 8 properties when determining medical expense deductions (See Exhibit 5-3 of HUD Handbook 4350.3 Revision 1, Change 2). The rate will increase to 58.5 cents a mile for all business miles driven from July 1, 2008, through Dec. 31, 2008. This is an increase of eight (8) cents from the 50.5 cent rate in effect for the first six months of 2008, as set forth in Rev. Proc. 2007-70. The new six-month rate for computing deductible medical or moving expenses will also increase by eight (8) cents to 27 cents a mile, up from 19 cents for the first six months of 2008. The rate for providing services for charitable organizations is set by statute, not the IRS, and remains at 14 cents a mile. The new rates are contained in Announcement 2008-63 on the optional standard mileage rates. Source: Housing Credit College, Elizabeth Moreland
The Panel Releases Principles for Good Governance
Document Actions
The Panel on the Nonprofit Sector has released Principles for Good Governance and Ethical Practice: A Guide for Charities and Foundations. The Guide represents the first time that charities and foundations reflecting a broad cross-section of the American nonprofit community have come together to develop principles of ethical conduct, accountability, and transparency that they aspire to and encourage all organizations to follow.
The Guide outlines 33 practices designed to support board members and staff leaders of every charitable organization as they work to improve their own operations. The Panel encourages these leaders to examine the Principles carefully and determine how best they should be applied to their own operations.
The Panel incorporated a careful review of more than 50 self-regulation systems, counsel from a diverse committee of experts, and significant feedback from the field in the development of these Principles. The Reference Edition of the Principles includes legal background for http://www.nonprofitpanel.org/
Income and Cost of Living in Metro Atlanta
This Regional Snapshot looks at a variety of income data and shows that metropolitan Atlanta has a low cost of living, which helps explain why it has added more new residents than any other metropolitan area in the country since 2000. At the same time, however, metro Atlanta lags behind many of its peers in a couple of key income measures.
Read this month’s Regional Snapshot. (Opens a PDF document – Adobe Acrobat Required)
Visitors from the Netherlands!
On October 4th a group of 5 managers will arrive in Atlanta to start a eldercare study tour with GAHSA members. They all are employed by Foundation Klompé of Groenlo, the Netherlands which operates three skilled nursing communities (482 beds), assisted living communities, day care centers, independent living homes and a Meals on Wheels program. The foundation employs 1,528 with approximately a same number of volunteers. During their three week stay the Dutch managers will ‘shadow’ their American counterparts in various eldercare communities in the Atlanta metropolitan area. A number of GAHSA eldercare communities in metro Atlanta have graciously agreed to host the group while on their study visit and in Spring 2009 a group of care managers from these communities will travel to the Netherlands and will be hosted by Foundation Klompé.
“This management exchange program is truly unique and will offer many learning moments both for the Dutch visitors and their American hosts” noted Eric Lucas, the IAHSA member who is coordinating the exchange together with Jacque Thornton, Senior Vice President of GAHSA and the Georgia Institute on Aging.
- For more information contact Eric Lucas at 404-373-3695 or erlu@mindspring.com
A 60-Minute Guide to Social Accountability Planning for the Busy Aging-Services Organization Manager
Social accountability for not-for-profit aging-services organizations is more important now than ever before-and just as rewarding.
Social accountability is a measure of an organization's commitment to its mission, its stakeholders and society. It is also a process for planning, budgeting, reporting and evaluating these community benefits.
Social accountability programs that identify and alleviate unmet needs in the community are good for the community, good for mission, good for business and good for the people you serve.
Certainly your residents and clients are a huge part of the community you serve. However the services you provide to those outside your organization reinforce that community benefit and provide enhanced evidence of your not-for-profit status. Those in your external communities are the people who champion your work, volunteer for your residents and remember your organization when they need services for themselves or their family members.
Developing a social accountability program requires an investment of resources and time by your organization. However, don't despair about one more thing to do!
Taking the first step to plan your social accountability program doesn't require a huge amount of time. With only 60 minutes of your leadership, the program can get off to a great start.
Here's how you can create a plan for your organization's social accountability program in about an hour.
Public Policy Update
Most of the public policy news this month still relate to continuing care retirement community and adult day services issues.
Continuing Care Retirement Communities (CCRC)
As reported last month, many changes that are a result of new legislation (SB 433), including changes in the certificate of need (CON) process, went into effect July 1, 2008. On July 1, 2009, parts of the Office of Regulatory Services (ORS) will be moved to from the Department of Human Resources (DHR) to the Department of Community Health (DCH), which administers the CON process. Nursing home and personal care home areas will be moved to DCH. Adult Day Care, Community Living Arrangements, Hospice, and several other programs like Dialysis will stay in DHR.
GAHSA worked very hard in the past two years and sessions of the Georgia General Assembly to free the skilled nursing care component of continuing care retirement communities (CCRC) of some of the more onerous provisions of the Certificate of Need (CON) process. To that end, SB 539 was negotiated with the Georgia Health Care Association (GHCA) and authorized a five-year phased, partial relaxation of the sheltered bed concept under which CCRC nursing homes could admit patients directly from the community (outside the CCRC). In the first year of the CCRC’s existence it could use 50% of its beds for direct admissions, and this percentage would decrease by 10% each year thereafter.
The whole CON process was extensively debated over the last two years, and the CCRC portion was a very small part of the discussion. Partially for this reason and partially because the General Assembly tends to become overloaded with bills near the end of the session, the provisions of SB 539 (the GAHSA bill) were included in another piece of legislation, SB 433. This bill originally only dealt with CON exemptions for cancer treatment centers, but it ultimately became an omnibus CON reform bill. This is not an uncommon approach, and it frequently provides the benefit of providing a smooth means for smaller issues to be “rolled into” larger ones.
In this case the absorption of CCRC issues into the “big CON bill” provided the benefit to GAHSA’s CCRC members that other CON requirements that are burdensome to CCRCs (e.g. indigent care requirements, a one-to-five skilled nursing bed to independent living bed ratio, etc.) would also in effect be eliminated by the new law. This was a recommendation of the CON Efficacy Study Commission which met for two years and with which GAHSA interacted extensively.
The inclusion of the GAHSA “direct admission provision compromise” in legislation was an additional positive development, as was language proposed by the Georgia Health Care Association (GHCA) and supported by GAHSA that allowed nursing homes more flexibility in changing locations within a county and/or subdividing beds. Unfortunately, however, the omnibus bill approach can also result in unintended consequences. This became evident last month when the Department of Community Health (DCH) responded to GAHSA and some other CCRCs’ “letters of determination” that DCH solicited to help providers prepare for the implementation of SB 433.
The legislative intent of the parties negotiating the “direct admission” language of the CCRC portions of SB 433 was clearly to allow existing CCRCs that are less than five years old to “plug into” the phase-in process by allowing them a percentage of direct admissions to skilled nursing beds to be determined by whatever year of their operations they are in. However, under current interpretation by DCH of the manner in which the effective date of SB 433 was enacted, there appear to be only two instances in which CCRCs can avail themselves of an exception to the current CON rules (whether dealing with direct admissions or other provisions such as the bed ratio or indigent care):
- New CCRCs applying to begin operation after July 1, 2008, or
- Existing CCRCs which wish to expand the number of skilled nursing beds.
In both instances, the CCRC would not apply for a CON, but would instead submit the “specific and factual determination request” (for a written letter of exception). In the case of excising CCRCs wishing to expand, their percentage of direct admissions would be determined by the facility’s place in its year of operation and would only apply to the new beds.
Unfortunately, it appears that full implementation of the intent of SB 433 (with regard to CCRCs) may well require additional legislation to “grandfather in” CCRCs with newer CONs (less than 5 years old) relating to direct admissions to their nursing home beds.
In addition to reform regarding certificates of need, the GAHSA CCRC Task Force has a second goal: Modernization of the CCRC regulatory process, for which the Georgia Department of Insurance (DOI) has responsibility. In the coming months, utilizing the resources of AAHSA, the Task Force will be working with DOI to identify ways to provide both additional information to consumers and flexibility to ensure the financial viability of CCRCs. Some of these changes may also require legislation.
Adult Day Center Regulation
The licensure process for adult day centers is moving forward slowly, and the department will be training for the new rules/regulations. It was anticipated that the DHR Board would finally approve the rules/regulations the middle of this month and that ORS will begin training related to these new rules in August or September. However, it now appears that the rules will be approved no earlier than the September meeting. The most likely change to the latest draft will be an approximate 50% reduction of proposed application fees of $100 for all centers and license fees of $150 and $300 for social and medical model programs, respectively.
State Budget
The various departments will be submitting their FY ’10 budget requests to the governor by September 1. Governor Perdue has instructed all executive branch agencies (except K-12 public education and the Medicaid programs) to cut their budgets by 3.5% for the current and upcoming fiscal years.
Business Connection
Updates from our Associate Members
More on New IRS Form 990 for Nonprofit Entities
You are probably aware that your organization will be filing a completely redesigned and more complex Form 990 for your 2008 tax year (the tax reporting year that starts in 2008). The new form incorporates the 2005 and 2006 tax law changes and contains the most comprehensive changes to the reporting requirements in almost three decades. This reform is aimed at making sure exempt organizations present a transparent picture of themselves to the public and that they accurately report their operation and claims to minimize their tax filing burden.
The new form requires more information about an entity's governing body, policies, and practices, which may highlight noncompliance risk areas. The IRS also has plans to expand its focus to look more closely at loans and other transactions between nonprofits and their executives, employment tax issues, and joint ventures between not-for-profit and for profit entities.
Your Board of Directors, as well as management and staff, will have to look at the documentation and reporting responsibilities for the Form 990 in a whole new light. The key to being prepared for the upcoming changes is careful coordination between board members, management, and professional advisors.
Source: Moore Stephens Lovelace, P.A.; DeDe G. Nichols, Principal
dnichols@mslcpa.com; http://www.mslcpa.com
Five Tips to Reduce Fuel Costs
Listen to any news coverage these days and you hear grumblings about the high cost of fuel. Although there is no “magic bullet,” a variety of considerations can help you save money in the long haul. Below are five tips to reduce fuel costs.
- Check your tires often. Tire costs are perhaps the second largest expense after fuel costs, so you must pay close attention to “the shoes of the vehicle.” Tires should be of the right type for your vehicle, must have proper tread depth, and be inflated properly. If you operate a bus, are your drivers really checking tires as part of their pre-trip and post-trip inspections? A minor reduction in tire pressure will waste fuel and reduce the life of your tire… and unsafe tires increase the risk of a crash, which will further increase your costs.
- Maintain your equipment. The old adage “you get out of it what you put into it” is certainly valid when it comes to equipment care. Follow manufacturer-recommended maintenance intervals and do not ignore scheduled services under any circumstances. Proper maintenance helps fuel economy as well as preventing costly breakdowns. Proper alignment, clean air and fuel filters, serviced transmissions, and oil changes have a significant effect on your fuel efficiency.
- Minimize engine idling. A bus uses approximately a gallon of fuel per hour when idling. Just an hour of daily idling produces roughly the equivalent engine wear of driving an extra 25,000 miles annually, so you are increasing your maintenance costs while reducing the life of your engine. Consider implementing an idling policy or utilize anti-idle shutoff technology.
- Enhance driving habits. A good portion of fuel costs are determined by truck speed; controlled exclusively by the driver. Drivers should be accelerating slowly until they reach the speed limit. As for braking, by coasting to a stop (in gear, of course), fuel waste can be reduced further.
- Plan efficient trips. This topic is obvious, but never dull. It’s important for dispatchers and drivers to be aware of local construction plans to prepare for anything that may impede on-time deliveries. The shortest and easiest routes should be used whenever possible, and remember to utilize the “right turn only philosophy.” Avoid heavy traffic by traveling at non-peak hours, since sitting in traffic wastes fuel, and the idle time increases your maintenance costs… not to mention labor costs!
Michael Nischan, CDS
The McCart Group
Michael.nischan@mccart.com
GIA News
Upcoming Events
Wednesday,
August 13
Fund Development Seminar with Benevon
1:00 - 430 pm,
gahsa Offices
Learn a tested system to identify and cultivate donors who love your mission—donors who will give for operations, capital, and endowment. Find out how to grow your organization’s visibility in the community and engage your board in the fundraising process without requiring that they ask for money. This entry level workshop is designed for board members, executive directors, CEOs, and fund development professionals. By the end of this seminar you will have the fundamentals to embark on the path to sustainability and grow your major gifts programs year after year.
Thursday, August 21
Strategically Positioning Your
Organization for the Future
9 am - 4:30 pm,
Bank of America
Conference Center in Midtown Allanta
Over the past two years, a collaboration of AAHSA, the Professional Development Network (PDN), a network of AAHSA state educational directors, the University of North Texas, and the Coalition for Leadership in Aging Services (CLAS) has developed a national educational agenda on issues critical to the success of aging services organizations. With GAHSA leading the effort, KAHSA, SCANPHA, and TNAHSA are joining in offering this exciting program. The one-day seminar is designed to help aging services provider focus on strategic positioning by identifying the possible scenarios likely to impact the future and how to pursue strategies that will lead to success under the different scenarios.
Monday & Tuesday, August 25-26
Coaching Supervision:Skills for Supervisors in Home & Residential Care
9 am - 4:00 pm,
gahsa Offices
NOTE: This training will be available for housing providers in 2009
Wednesday & Thursday
August 27-28
Service Coordinator Conference
Creating a Culture of Excellence
Wyndham Peachtree Conference Center
Create a Culture of Excellence -- Come prepared to experience 2 days of exceptional and stimulating professional development programming specifically designed to meet your needs. The conference sessions listed below are just a few that will significantly fulfill your continuing education core requirements for licensure/certification renewal. In addition the workshops will meet the requirements for Service Coordinators’ Grants.
General Sessions: The Elements of Success;
Strategies for Creating Successful Networks;
Caring for the Caregiver in You;
Expanding Your Understanding of Dementia
Breakout Topics:
Updates from our HUD Regional Office: Service Coordination program, reports, & funding;
Culture Change & Affordable Housing;
Transition Planning with Residents and Families;
Clarifying Qualifications of various Programs and Services;
Building networks in metro ATL;
Building networks in rural areas;
Hospice in Affordable Housing;
Tools for Residents in Abusive Situations;
How to create a neighborly culture among your residents ;
Professional Networking
Thursday, September 4
First Annual Culture Change Summit
Many Paths to Person-Centered Care
This summit is geared toward anyone throughout the continuum of aging services providing program and services to seniors.
Loudermilk Center
Thursday, September 11
GAHSA Summer Luncheon
Loudermilk Center
The Long Term Care Solution, The national framework for financing the future of LTC in America will be presented with a panel response – how it relates to Georgia. There has been much discussion at the state and national level about health care reform. But very little time and energy has been devoted to reforming the financing system for long-term care. Yet long-term care costs are a major driver of rising health care costs, impacting the availability of fund for other critical needs including medical care for our nation’s children.
Thursday & Friday
September 18-19
Coaching Supervision:Skills for Supervisors in Home & Residential Care
9 am - 4:00 pm,
gahsa Offices
NOTE: This training will be available for housing providers in 2009
This curriculum is designed specifically
for supervisors of direct-care workers
in both home and residential settings.
The focus of the training is on worker
retention and improvement of work
performance. It is part of the Atlanta Regional
Commission’s Taking Care Initiative, a project funded through a grant from
the Healthcare Georgia Foundation.
Created in 1999 as an independent,
private foundation, the Foundation’s mission
is to advance the health of all Georgians
and to expand access to affordable,
quality healthcare for underserved individuals
Tuesday, September 23
South Georgia Regional Conference
Lake Blackshear Resort
Three tracks are being presented: Track I is Leadership Development Skills for Executive Directors, Administrators, Department Heads and Supervisors. Track II is the OSHA 10-Hour Certification Training for Physical Plant Managers and Maintenance Professionals. Track III is Health Ideas Module to Address Mental Health Issues Among Seniors for Social Workers and Service Coordinators
Sunday, September 28
GIA Fundraising Cabaret
Sponsor Opportunities
Ticket Brochure
Helene Mills Center
This is the 6th Annual Dinner Cabaret Fundraiser. It is a black & white Hollywood affair.
Thursday, October 2
Forums Day
These forums will be meeting: Marketing, Hud Administrators and Maintenance Professionals
Tuesday, October 28
Fair Housing Symposium
Christian City, Union City GA
Tuesday, November 4
Ethics Symposium with Nancy Kriseman
Canterbury Court, Atlanta
Thursday & Friday
November 13-14
Coaching Supervision:Skills for Supervisors in Home & Residential Care
9 am - 4:00 pm,
gahsa Offices
NOTE: This training will be available for housing providers in 2009
LIFElines email publication for GAHSA Nursing Home Members & Nursing Staff
GAHSA healthcare/nursing home members will begin receiving a new publication called LIFElines. This publication is a partnership between GAHSA and our Illinois Association (Life Services Network). LIFElines provides timely information regarding state and federal issues such as survey preparedness, risk management, immediate jeopardy, clinical issues, abuse investigation, recruitment and retention and a host of other vital information for GAHSA nursing home members. All GAHSA nursing home members should now be automatically receiving LIFElines. Any other GAHSA member is welcomed to receive this publication – just contact swatkins@gahsa.org.
June and July topics were:
June 3: F323: Are you in Immediate Jeopardy of a Serious Survey Deficiency? & F315 Compliance Expectations: Survey Deficiencies Continue to be Prevalent! F323: Are you in Immediate Jeopardy of a Serious Survey Deficiency?
June 16: Side Rail Incidents = Tragedies and Fines & When a Dementia Resident Makes an Allegation of Abuse
Side Rail Incidents = Tragedies and Fines
July 14: Side Rails + Low Air Loss Mattresses:
A MUST READ!
News Throughout the Continuum
HUD Affordable Housing
REAC Inspection Preparations and Responses
The San Francisco HUD office has put together a range of resources concerning REAC inspections - some from previously reference items in AAHSA alerts and/or fact sheets; some more recently compiled from their local resources and information. If you're expecting a REAC inspection, the best tool you can have is preparation. Read the latest edition of San Francisco's "Pacific Currents" report; it's packed with REAC information on the HUD website.
HUD User -- General Information
HUD USER has posted a Comprehensive Housing Market Analysis (CHMA) report for the Augusta, Georgia-South
Carolina area. This recent CHMA contains valuable
information for builders, mortgage lenders, borrowers,
local planners, and others who need to keep up with the
area's housing conditions and trends. Prepared by field
economists in HUD's Office of Policy Development and
Research, the report provides data that are useful in
anticipating changes in the demand for new housing. Our
analysis describes the economic, demographic, and
housing inventory characteristics of the Augusta,
Georgia-South Carolina area housing market from 1990 to
2000, from 2000 through December 2007, and makes
projections regarding anticipated market activity during
the period of January 1, 2008 to January 1, 2011.
This CHMA, as well as previous CHMA reports examining
housing markets across the nation, is available here .
All HUD USER CHMA reports are available as free
downloads.
--------------------------------------
Please contact us at:
HUD USER
P.O. Box 23268
Washington, DC 20026-3268
1-800-245-2691
1-800-927-7589 (TDD)
202-708-9981 (fax)
--------------------------------------
The HUD USER News eList keeps busy professionals in the
fields of housing and community development informed of
new research and resources available from the U.S.
Department of Housing and Urban Development's Office of
Policy Development and Research (PD&R). Periodically,
publication announcements and other useful information
will be sent via the eList. The HUD USER and Regulatory
Barriers Clearinghouses value your privacy; we do not
share our mailing lists with other groups, and you can
unsubscribe at any time.
You can search the eList archives here.
To keep up with the latest HUD research and related
resources, you can also sign up for a free subscription
to our ResearchWorks newsletter (in either electronic or
print-based formats) by clicking here.
On-line Reporting and Payment for HUD Section 236 Excess Income
After Aug. 31, 2008, all excess income reporting and any payments for both insured and non-insured mortgages will be required to use Pay.gov. Select sections of the notice indicate: The change is effective for all reporting periods after Aug. 31, 2008. However, owners and agents may elect to begin using Pay.gov immediately.
Where excess income is owed, ALL payments must be made on-line immediately after completing and submitting the Excess Income report. Once the Form HUD-93104 is submitted on-line, the user is taken to a second screen to process the payment electronically.
If immediate payment in full is not made on-line, the previously created form will not be saved and the owner's record will not reflect that a Monthly Report of Excess Income was submitted. The electronic processing of payments requires the submitter to provide the routing number of their financial institution and their account number when making a payment from the project bank account.
As is the case now, owners must provide copies of each Form HUD-93104 to the appropriate HUD field office. These may be printed by the submitter after they file on-line. View more detailed information on the "hud notices" section of the AAHSA.org website.
Hospice
New Rules for Hospice Providers
The Centers for Medicare & Medicaid Services (CMS) has issued a new rule requiring hospice providers to implement a quality assessment and improvement system. The rule, set to take effect in December, mandates that hospices allow patients to help decide on treatment plans and demonstrate improvement in areas where they are found deficient. Medicare spent about $10 billion on hospice care, which it provides to beneficiaries at no cost, in 2007.
Home Care
ABC News Features Gas Prices’ Effects on Home Care
Last night, ABC News featured a story on how higher gas prices are impacting home care. The National Association for Home Care and Hospice released a study that home care nurses traveled 4.8 billion miles in 2006 to be with patients, an amount they say is more than double the 2 billion miles driven by UPS drivers to make deliveries. See story
CCRCs
Resident Contract Types: What's the Trend?
With the economy in a slump, continuing care providers are asking if competitors are modifying the contract type(s) that are offered not only by continuing care but also rental retirement communities. Ziegler Capital Markets' research department completed a report on this very topic. The information that follows was taken from the July 11, 2008 Z-News written by Kathryn Brod, Sr. Vice President, Director of Senior Living Finance Research.
First, a review of the various resident contract types (that differentiate which health care benefits are made available to residents at what cost) may be helpful:
- All-Inclusive ("Type A") Contracts: Residents pay an upfront entry fee at the time of occupancy in an independent living unit with a required monthly fee that remains the same regardless of the resident's level of care (generally with allowances for inflation increases).
- Modified ("Type B") Contracts: Residents pay an upfront entry fee at the time of occupancy in an independent living unit with a required monthly fee that may remain the same regardless of the resident's level of care only for a specified period of time (e.g., 30 days per year with allowances); or the resident's monthly charges may increase as the level of care increases but at a discount from the market rate for such services.
- Fee-For-Service ("Type C") Contracts: Residents pay an upfront entry fee at the time of occupancy in an independent living unit and the monthly fees increase directly with the level of care provided.
- Rental ("Type D") Contracts: Residents do not pay an upfront entry fee at the time of occupancy. The monthly fee is based on a basic set of purchased services. Additional services are bought on an incremental basis or as the level of care increases.
- Ownership ("Type E") Contracts: The independent living unit is purchased, commonly on a fee simple or cooperative ownership basis, by the resident at occupancy. A modest package of services (generally housing related only) is provided for a comparatively low monthly fee.
From Ziegler's New Community Database, we know that the Type A contract is not as prominently offered as in the past. From 1990 through 2000, the Type A contract was chosen by forty percent of new developments, with no other form of contract reaching twenty percent. In the more recent period of 2001 through 2008, however, Type A and B contracts were each offered roughly twenty-five percent of the time, with Type C contracts (at roughly 15%) far less common and Type D contracts relatively rare.
While entrance fee communities may offer multiple refund options, it is less common for new communities to offer multiple resident contract types (as described above) when they open. In 2007, for example, seven of the fourteen new communities financed offered multiple refund options; just two, however, offered multiple resident contract options.
Tracking resident contract types for existing CCRCs is a more challenging exercise. Anecdotally, Ziegler knows that some providers may add resident contract options in order to provide incoming residents with additional options, or perhaps to compete with other senior living products in their marketplace.
Source: Ziegler Capital Markets
Vacancy Report
GAHSA VACANCY REPORT
Please assist your colleagues by sharing this information when you receive calls from consumers you cannot serve.
Facility |
Units |
Cost |
Type of Subsidy/Waiver |
Campbell-Stone Apartments, Buckhead |
2 – Studio |
$650 |
Sec. 8 Sec. 8 |
Lutheran Towers, Midtown |
3 – Effeciency 4 – One Bedroom |
|
Sec. 8 Sec. 8 |
Springfield Gardens, Warner Robbins |
1 – One Bedroom |
$627 |
HUD PRAC |
The Zaban Tower, Atlanta |
5 – Efficiency Personal Care: 1 – Studio 6 – One Bedroom |
$2655 |
HUD PRAC
HUD PRAC |
Career Opportunities
MobilexUSA
A.G. Rhodes Home
Director of Nursing
Admissions Manager
St. George Village
Christian City, Union City, Georgia:
Nursing Home Administrator
Director of Nursing
AAHSA Information
SNF PPS Final – We Won!!!
(exact wording from Barbara Manard, AAHSA VP of Health Strategy)
Medicare Increases Nursing Home Payment Rates,
Recalibration of RUGs to be Studied Further
Medicare payment rates to nursing homes will increase by $780 million next year, the Centers for Medicare & Medicaid Services (CMS) announced last week.
The boost in payments is the result of a 3.4 percent increase in the annual market basket calculation of the cost of goods and services included in a skilled nursing facility stay. The price of the items in the basket is measured every year and Medicare payments are adjusted accordingly.
A recalibration of the payment categories, intended to correct a previous error, that had been proposed for Fiscal Year 2009 has been delayed while CMS continues to evaluate the data. The proposed rule announcing the planned recalibration was published in the Federal Register on May 4, 2008.
“CMS is committed to providing high quality care to those in skilled nursing facilities and to paying those facilities properly for that care,” said Acting Administrator Kerry Weems.
“However, in view of the widespread industry concern that a recalibration could potentially have adverse effects on beneficiaries, clinical staff, and the quality of SNF care, we will continue to evaluate the underlying data carefully as we consider implementing an adjustment in the future,” Weems said.
Medicare pays skilled nursing facilities on a prospective payment system known as the Skilled Nursing Facility (SNF) Prospective Payment System (PPS). The SNF PPS uses a resource classification known as Resource Utilization Groups (RUGs) to help determine a daily payment rate. The RUGs reflect a patient’s severity of illness and the kind of services that a person requires—something known as “case-mix.” Each RUG group is assigned a case-mix weight showing the relative acuity of each RUG group within the overall system.
In 2006, CMS made refinements to the case mix structure to account more accurately for the resources used in the care of medically complex patients. The refinement expanded the case-mix model to add nine new groups for beneficiaries requiring both therapy and extensive medical services, and included an adjustment to account for non-therapy ancillary services. The payment rates were updated using estimated data that have formed the basis of our payments to SNFs since the beginning of 2006.
The expansion of the RUG model was intended to be budget neutral but actually resulted in increased Medicare expenditures. Once actual utilization data under the expanded RUG model became available, CMS found that patients were being classified into one of the newly-created RUG groups more than 30 percent of the time (as compared to CMS’s earlier projection of 19 percent), thus triggering Medicare payments that are far higher than was originally intended.
In the May proposed rule, CMS proposed to make changes in the RUGs to establish payment rates that more accurately reflect the needs of patients. In this final regulation, however, the agency says it will continue to evaluate the data, and determine what action it will take in the future.
A copy of the final rule is available on the CMS website at: http://www.cms.hhs.gov/SNFPPS/LSNFF/list.asp#TopOfPage
AAHSA Member Benefit Spotlight: IFAS
The Institute for the Future of Aging Services (IFAS) is an independent research organization dedicated to bridging the worlds of policy, practice and research to advance the development and diffusion of high-quality aging and long-term care services and supports. IFAS is the applied research arm of AAHSA.
IFAS pursues its mission in close collaboration with AAHSA's members-enabling researchers to work alongside real-world providers to change the landscape of aging services to support older adults' desire to maintain their autonomy and control their own lives as they age. As a member of AAHSA, you can access their publications anytime at www.futureofaging.org.
Melissa Sharp, Vice President, Southeast Region, AAHSA
Please feel free to contact me with your questions or concerns at (202) 508-9456 or by e-mail at msharp@aahsa.org.
Website Notes,
Computer Tips
& ListServs
Whats New
Two new items have been added to the the gahsa.org publications page :
From the AAHSA Task Force on Survey, Certification and Enforcement
National Nursing Home Survey Certification
From the Fuqua Mental Health Project
Evaluation Results
Computer Tips
Using photographs in Excel and Word
In Excel, you can put a picture in either the header or footer. Go to File/Page Setup. When the dialog box opens, select the Header/Footer tab and select whether you want a Custom Header or Footer (see screenshot). Now click on the Insert Picture button (the second button from the right) and a dialog box will open that helps you select the graphic. Once it’s located, click on Insert and the words code &[Picture] will appear in the center section where the graphic will be. Click on OK and OK again. To view the page with the header, return to the worksheet and under File, click on Print Preview (see screenshot).
In Word, you can put a photograph in your document with Insert/Picture/From File. If you want the text to wrap around the picture: Select the picture, right click and select Format Picture. click on the Layout tab and select Tight. Another handy trick: With the picture selected, go to Insert/Text Box. You can now drag the picture anywhere in the document and the text will automatically adjust.