Richard Taylor speaking on Humanizing Dementia Care at the April 29 Assisted Living Symposium

In this Issue

Inside Your Association -- Aging Services of Georgia

General Notes of Interest

Public Policy Update

Business Connection
Updates from Our Associate Members

Institute News

Center News

Organization/Board Development

News Throughout
the Continuum:

Vacancy Report

Career Opportunities

AAHSA Information

GIA Partners

Occupied
Renovations

Moore Stephens Lovelace, P.A.

GIA Supporters

Ziegler Capital
Markets Group

Mauldin & Jenkins

Cornerstone
Senior Living

LW Consulting, Inc.

Guest Services

Pfizer

GIA Friends  

The Law Offices of Williams & Edelstein

Dixon Hughes

GIA Contributors

HVAC Services

Kings Bridge Retirement Center

Canterbury Court

Presbyterian Village

Presbyterian Homes of Georgia

AAHSA
http://www.aahsa.org

Keep Up with the Quality First Program

Aging Services of Georgia 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. The mission of Aging Services of Georgia 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 Your Association -- Aging Services of Georgia

Celebrating Older American’s Month in Georgia

May is Older Americans Month—a tradition dating back to 1963 to honor the legacies and ongoing contributions of older Americans and support them as they enter the next stage in life. Aging Services of Georgia is joining communities nationwide in celebrating this month with special activities and events.

This year’s Older Americans Month theme—Age Strong! Live Long!—recognizes the diversity and vitality of today’s older Americans who span three generations. They have lived through wars and hard times, as well as periods of unprecedented prosperity. They pioneered new technologies in medicine, communications, and industry while spearheading a cultural revolution that won equal rights for minorities, women, and disabled Americans.

These remarkable achievements demonstrate the strength and character of older Americans, and underscore the debt of gratitude we owe to the generations that have given our society so much. But the contributions of older Americans are not only in the past.   Older Americans are living longer and are more active than ever before. And with the aging of the baby boomer generation—the largest in our nation’s history—America’s senior population is expected to number 71.5 million by 2030.

While keeping the growing population of older Americans healthy and active will increase the demand for senior services, what is remarkable is the extent to which older Americans themselves are supporting each other. As the new generations of seniors become better educated and more financially secure than their predecessors, they are spending more time making significant contributions in their communities through civic and volunteer opportunities.

In fact, older Americans are a core component of service delivery to seniors—embodying and modeling the drive to Age Strong! Live Long! They volunteer at group meal sites and deliver food to homebound seniors; they act as escorts and provide transportation for older adults who cannot drive; they help seniors with home repair, shopping and errands; and they provide vital counseling, information and referral services. Their energy and commitment reminds all Americans—not just senior citizens and their caregivers—to do their part to enhance the quality of life for older generations.

Finally, Aging Services of Georgia would like to thank over 4500 staff working at Aging Services of Georgia member organizations throughout Georgia.  Your commitment to quality care provides comfortable, safe homes and services throughout communities that touch over 126,000 older Georgians.

Spring Luncheon, “Making the Right Impression” is Critical to Your Success!

This is an excellent and thought provoking program for all staff in any organization. Learn how to ensure your organization connects positively with customers. Studies have proven that the biggest challenge organizations face is how to manage relationships with customers. This is where most organizations fail. Dr. Cotter will use
a model developed by Jan Carlson, president of Scandinavian Airways. The program is called “Moments of Truth”. Ideally, each time a customer comes into contact with you or your organization, you want them to leave feeling impressed. So, ask yourself, what kind of impressions are we leaving? Join us May 13th to learn how to set a new standard for each customer contact so that a good impression is left, every encounter! Click here for Brochure & Registration

After the Luncheon, the following Forums will meet:

• Activity Professionals
• HUD Administrators
• Maintenance Professionals
• Marketing/Occupancy
• Service Coordinators
• Adult Day Services

New Provider Members

Emma Cares, Inc (Adult Day Service, Lawrenceville)
SarahCare of Warner Robbins (Adult Day Service)
SarahCare at Evans to Locks (Adult Day Service)
Chulio Hills Health & Rehab (Nursing Home, Rome)
Dade Health & Rehab (Nursing Home, Trenton)

New Associate Business Members:

Vintage Constructors
Contact: Lee Noles
770-421-6195

BlueCross BlueShield of Georgia
Leta Gibbs
678-206-8957

Morningside Marketing Group
Contact: Erna Schneiderman
404-840-6663

Calendar Information

To assist you with planning, we are forwarding you information on special holidays and observances for each month 2 months in advance. The December issue of Coffey Break had information for February.

This month, we are sending you information for July, 2010

July is:
National Cullinary Arts Month
National Mobility Month

July 8-14 National Laundry Worker's Week

Sunday, July 4, Independence Day
Tuesday, July 6, Take Your Webmaster to Lunch Day
Friday, July 9, National Sugar Cookie Day
Saturday, July 10, Teddy Bear Picnic Day
Sunday, July 11, World Population Day
Friday, July 23, Gorgeous Grandma Day
Friday, July 30, Father-in-Law Day

General Notes of Interest

SHAREpoint

SHAREpoint is fast becoming the place to go for timely information about the Association. You should have received a username and password by now. If you haven't, please contact Susan Watkins at 404-872-9191 ext. 10 or swatkins@agingservicesga.org.

If you have been unable to get in, you can check with either Susan or Barry Lastinger at 404-872-9191 ext. 14 or blastinger@agingservicesga.org

Half a Million Nonprofits Could Lose Their Tax Exemptions – From GuideStar

In May 2010, half a million nonprofits could find themselves stripped of their exempt status? The IRS estimates that that's the number of smaller organizations that have failed to file a Form 990-N. more

Great news for Georgia Patients!   

This consumer protection legislation is a great “first step” in helping patients advocate for their own health care and empowers them to be informed consumers.

Please click here or click the link below to view press release posted to the GA Senate Press Office website.

CMS Public Website Address Change

CMS has been working with the Department of Health and Human Services to change the address of their public Agency website from www.cms.hhs.gov to www.cms.gov. This will bring the website name in line with those of the other Operating Divisions within HHS (e.g., www.fda.gov, www.cdc.gov). This name change took place the evening of Friday, April 2. This name change will not affect any CMS web addresses other than the main public website URL: http://www.cms.hhs.gov. The name change also will not impact work email addresses; they will remain firstname.lastname@cms.hhs.gov.

Ambulance Fee Schedule Fact Sheet

The revised Ambulance Fee Schedule Fact Sheet (January 2010), which provides general information about the Ambulance Fee Schedule, including how payment rates are set for ground and air ambulance services, is now available in downloadable format from the Centers for Medicare & Medicaid Services, Medicare Learning Network.

Health and Human Services Inspector General Recommends Changes

The Office of the Inspector General of the Department of Health and Human Services released a wide-ranging collection of recommendations, a number of which could impact the senior living sector. The Office of the Inspector General prescribed, among other things, ensuring proper maintenance of nurse aide registries, updating nurse aide training programs and adjusting Medicare payment regulations. Additionally, the Office of the Inspector General suggested alterations to administrative processes surrounding nursing home reimbursement.
Source: (McKnight’s, 3/31)

Filing Requirements for Medicare Fee-For-Service Claims

The PPACA amended the time period for filing Medicare fee-for-service (FFS) claims as one of many provisions aimed at curbing fraud, waste, and abuse in the Medicare program. The PPACA amended the timely filing requirements to reduce the maximum time period for submission of all Medicare FFS claims to one calendar year after the date of service.

Under the new law, claims for services furnished on or after January 1, 2010, must be filed within one calendar year after the date of service. In addition, claims for services furnished before January 1, 2010 must be filed no later than December 31, 2010. The following rules apply to claims with dates of service prior to January 1, 2010. Claims with dates of service before October 1, 2009 must follow the pre-PPACA timely filing rules. Claims with dates of service of October 1, 2009 through December 31, 2009 must be submitted by December 31, 2010.

The PPACA also permits the Secretary of the federal Department of Health and Human Services (DHHS) to make certain exceptions to the one-year filing deadline. At this time, no exceptions have been established. However, proposals for exceptions will be specified in future proposed rulemaking.

Public Policy Update

General Assembly Finally Adjourns

By Tom Bauer

The 2010 Georgia General Assembly began Monday January 11.  Due to Georgia’s significant budget deficit resulting from the continuing recession and the change in House leadership, the pace of the General Assembly was quite deliberate, and the session finally adjourned “sine die” on April 29, concluding one of the longest sessions ever.  In addition to passing a balanced budget, the General Assembly passed new ethics legislation and a bill to allow regions to tax themselves to fund new transportation improvements.
 
While the budget was the major focus of the session, the General Assembly did discuss a few legislative issues of special interest to Aging Services of Georgia.  These are summarized below, including legislation to allow seniors to age in place (creation of a new level of residential care and a bill to allow flexibility in the provision of health maintenance services and updating of the regulation of continuing care retirement communities). 

Legislation

HB 843 (Jacobs)-  As has been reported over the past year, Aging Services has been working to update the regulation of continuing care retirement communities (CCRCs).  HB 843 was introduced late in the 2009 General Assembly, and Aging Services had expected it to be debated this year.  However, at the request of the author Aging Services drafted a “perfected” bill for consideration in the 2011 General Assembly.  It was felt that this year’s session, which featured a new chairman of the House Insurance Committee, new House leadership, and many noted public officials (both he current commissioner of Insurance and legislators aspiring for that office) seeking higher office) might not be the optimum time for a major regulatory bill.

As it currently stands, the major features of HB 843 (which will be re-introduced) are:

• Changing the definition of “continuing care” to require that skilled nursing is a component of such care;
• Allowing those currently licensed providers that provide assisted living but not skilled nursing to call themselves CCRCs; 
• Expanding the disclosure of details to prospective residents; and
• Requiring escrow accounts or operating reserves (in lieu of a bond) to ensure the financial viability of the provider
• Narrowing the enforcement authority of DOI by removing the authority to petition the court for  rehabilitation/liquidation
• Shortening the bill by leaving some detail to rules process

HB 850 (Martin)- Aging Services of Georgia became heavily involved in amending and ultimately seeking passage of HB 850, a bill creating a new level of long-term care between the medical model of skilled nursing and the social model of personal care home.  Both because it was somewhat confusingly drafted and because it was not placed on a committee agenda for a hearing until late in the session, HB 850 was the object of some intense negotiations up until late March as the General Assembly approached “crossover” day, the point at which bills must pass from one chamber to the other.

Combined with the fact that HB 850 is quite complex and controversial and it was not seriously debated until close to crossover day, the legislation did not make it to the House floor.  Nevertheless, HB 850 triggered a lengthy discussion of legislation allowing seniors to age in place in the most appropriate high quality environment.  The Aging Services Assisted Living Task Force will continue to work with interested parties to achieve this goal, and in fact the governor’s health policy advisor has already scheduled a meeting in May to continue discussion of the issue.

This discussion will begin with the contents of HB 850, which now contains all the major points drafted by Aging Services, in  conjunction with the State Long Term Care Ombudsman, Georgia Council on Aging, and the Senior Citizen Advocacy, including:

• Inclusion of minimum and maximum services a resident can appropriately expect from the assisted living community, including a definition of living needs, such as.
• Assistance with activities of dialing living
• Assistance with ambulation
• Twenty-for hour watchful oversight
• Transportation
• Supplemental services, not entailing full-time nursing care
• Requirement that these  minimum services be provided as a condition of licensure
• Admission and re-assessment process of health of the resident
• Consumer Protections, such as:
• Inclusion of criteria and process for transfer of residents
• Provision for applicability of residents’ rights and long-term care ombudsman...  
• Establishment of medical technician program and provisions for administration of medicines.
• Inspection of assisted living communities, investigation of complaints by DCH.

HB 1040 (Pruitt)- This bill is of particular interest to Aging Services since President Walter Coffey was a member of the task force convened by the governor’s health care policy advisor that strived to facilitate ways to allow individuals with disabilities, including seniors, to stay in the community.  The result was HB 1040, introduced by one of the governor’s floor leaders.  The bill allows a physician or other midlevel healthcare provider to sign an order to allow a registered nurse to train a non-licensed caregiver (e.g. a family member or neighbor) to deliver “health maintenance activities” which would allow a person to remain in the community rather than to live in an institution.  After an intensive subcommittee level discussion concerning whether providers would be immune from any liability. HB 1040 passed.

Budget  

The FY ’10 budget had a $2 billion deficit at the start of the legislative session due to a continuing lag in state revenues. This deficit has ‘spilled over” to the FY ’11 budget due both to a continuation in the decline in state revenues and the “borrowing” of federal stimulus funds from the upcoming budget to this year (FY ’11)..  The approval of governor’s proposed “hospital bed tax”, a 1.45% levy on hospital and insurance plan gross revenues allowed the balancing of the FY 11 budget through tie leverage of additional federal dollars for Medicaid. As an offshoot of the negotiations on the tax there will be a phased in exemption from taxation on all passive (retirement) income for seniors.  This change proved controversial as many senior advocates would prefer the “lost” revenue to fund additional services such as the community care services program.  

In the past we have reported that Aging Services of Georgia had supported an effort to appropriate “civil monetary penalty” (CMP) funds to programs supporting Culture Change.  These CMP dollars, which are collected as fines on nursing homes, according to federal law must be spent to benefit residents of nursing homes.  The FY ’11 budget appropriated $1 million to the long term care ombudsman program and $ 600,000 to Adult Protective Services to allay previous reductions in these programs.  The remaining funds were left in alone.  Aging Services will continue working with other rganizations/advocates to submit a plan to DCH on appropriate/effective ways to use CMP to support the culture change work in Georgia.  Other significant restorations were: 

• $1,376,718  for non-Medicaid HCBS respite services
• $225,000 for Alzheimer’s Respite Services

Turnover in Legislators

         As most of our readers aware, this is an election year for the position of governor as well as all other constitutional (statewide) officers. As a result, many legislators are leaving the General Assembly to run for higher office.  There will be a minimum of 27 new representatives and 13 senators.  This will be a good (and necessary) opportunity to educate candidates on issues affecting Aging Services and the seniors whom it serves.   

Business Connection
Updates from our Associate Members

New Web Video -- Medication Switching: What Patients Should Ask Their Pharmacist

With a growing concern about the frequency of therapeutic substitution or prescription medication switching, AfPA has posted on its website a new public service video for physicians to share with patients.  In the video Dr. Mark Alberts reviews critical questions patients should ask their pharmacists when they find their prescription has been switched to a generic or different medicine.

AfPA encourages you to watch the 5 minute video and to share with your colleagues and  patients.  Also, visit  AfPA's website and share your story about medicine switching.  Finally, to help bring an end to switches taking place without physician notification, visit www.InsurePatientAccess.org and sign the on-line petition in support of the National Health Insurer Code of Conduct. 

The Center for Assistive Technology and Environmental Access

Researchers at The Center for Assistive Technology and Environmental Access (CATEA), part of Georgia Tech, are seeking people to participate in a survey.

Participants must:

• Be at least 60 years old
• Live in Georgia (not in assisted living facility or nursing home environment)
• Have lived in their current community for more than 1 year

The survey is about the activities you do in your home environment and your community environment. It will take approximately 20 minutes to complete. The survey is available online.

If you or someone you know would like to participate but are unable to complete an online survey, a written survey is also available. For more information, please contact Claire Yang at 404-385-8589 or

Emergency Preparedness Planning – How to React

You can do all in your power to avoid an emergency or disaster by putting detailed plans in place.  But if and when an emergency does occur, you need to be prepared to react.  Whether the event threatens lives or property or both, the speed and efficiency of how you notify and communicate is what can prevent loss of life and loss of property.

Notification
Whether it is a fire, a tornado, an intruder or a broken heat pump, there are a number of people that need to be aware of what is happening, when it’s happening.  The fire department, the Executive Director, the Facilities Manager, on-site security, etc. needs to be notified simultaneously, so each can react accordingly.  Whether they are on-campus or off-campus, whether they have a cell phone or a pager or a desk phone, notification needs to occur automatically, in real-time.

Communication
Inclement weather, community lock-down, construction warnings or a fire . . . all events in which residents and staff to immediately be made aware of what to do.  The ability to communicate instantly can save lives.  Simultaneous calls to residential phones, cell phones, pagers and/or PA systems are the most effective way to broadcast emergency related instructions.

Preparing on the front end can help you to avoid many emergencies and disasters, but if and when they do indeed occur, having ability to quickly and efficiently notify and communicate important information can save lives.

Because right now matters most, register for the PREPARE webinar series (click the links for Information & Registration).  Also, contact Status Solutions to find out how SARA can be a part of your Emergency Preparedness Plan.
Submitted by:

Stuart Smith, Territory Manager
Status Solutions
434-296-1789 x722
ssmith@statussolutions.com

Georgia Institute on Aging News

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Last Month's Events

Wednesday, April 21
Webinar

Healthy Eating through the Lifespan
presented by Gwenyth Johnson and Laurie Ledford
Recording

Thursday, April 29
Assisted Living Symposium

Vickie Flynn, Director PCH Division, GA Department of Community Health provides an Update on Georgia Assisted Living Regulations

Upcoming Events

Thursday, May 13
Spring Luncheon and Forums
Atlanta Technical College
Information and Registration

Tuesday, May 18
Focus on Quality Seminar
10:00 am - 2:00 pm
Association Offices
Information and Registration

Saturday, May 22
Cabaret and Silent Auction at Theatrical Outfit
Blues in the Night
Off Broadway Musical
Click here for details
Click here for directions to Theatrical Outfit

The Georgia Institute on Aging is the educational arm of Aging Services of Georgia.  As the premier source of quality, affordable training for professionals in the field of Aging, our primary goals is to be the leading provider of timely and informative educational opportunities for our members and the residents they serve, state and local policy makers, other professionals in the field of aging and the community at large.  Supporting the 7th Annual Cabaret Benefit helps to continue the important work of the Institute.  We promote quality care for older adults that respect their dignity and individuality and never compromise their health and safety. 

Event Purpose…
The annual commemoration of Older Americans Month is our opportunity to recognize the contributions of older citizens and join them in providing services and support that empower the elderly. We applaud you for your contributions and invite you to join us in celebration of older Georgians by attending the Cabaret Musical Benefit on May 22, 2010 at Theatrical Outfit and/or by contributing items to the annual Silent Auction.  This is one way you can Pay It Forward and honor our elders of this generation.

Pay it forward…
Proceeds generated from this benefit and silent auction will provide additional educational opportunities via scholarships for paraprofessionals, professionals, and family caregivers who care for older adults.  Your donations show you CARE for older Georgians and are called to ACTION on their behalf.

Emergency Preparedness Webinar Series-- PREPARE
May 11-- Session III: Putting Your Community Back Together
Presented by Mather LifeWays Institute on Aging in Partnership with the Georgia Institute on Aging
Information
Registration

MDS 3.0 Distance Learning Series
May - November, 2010

May 13: Which Assessment and When
May 25: Areas Affecting Overall Function
June 3: Cognition and Psychosocial Function
June 17: Activities of Daily Living
July 8: Bladder and Bowel
July 27: Driving Restorative Programming
August 3: The New Approach to Skin
August 17: Wrapping up the Assessment
September 8: Working the CAAs
September 21: Up to Speed with RUGs IV
November 9: Q&A Catch Up
Registration Form

Culture Change Network

Culture Change Connection™ E-newsletter will be out the middle of each month!  Go to the Culture Change Network of Georgia Web site to sign up and refer to past issues!

SAVE THE DATE!  October 14, 2010 in Atlanta, GA for the
3rd Annual Culture Change Network of Georgia Summit

Center for Positive Aging

Modern World 101

Over the past several years, the United States has seen a drastic increase in the number of grandparents raising grandchildren.  According to a survey by AARP 31% of adults are grandparents.  Of that percentage, 8% are providing day care on a regular basis and 3% are rearing a child.  And in the state of Georgia, this number is equally astounding with 7.6% of children in the state living in grandparent—headed households. 

By taking on this responsibility, these grandparents are faced with a variety of emotional, financial and physical challenges such as :

• Feelings of shock and sadness
• Inability to physically keep up with your grandchildren, particularly if
• they’re very young
• Financial obligation
• Not knowing how to correctly discipline the child/children
• Legal issues
• Parental involvement in the child’s/children’s lives
• Medical care for the child/children
• Loss of personal time
• Social life changes
• Not being familiar with modern technology, terms, pop culture, etc.

The Modern World 101 program will help to educate grandparents on ways of dealing with issues such as these.  Although a large number of grandparents raising grandchildren raised their own children themselves, they may be unfamiliar with the changes that have taken place since their own children were growing up. Therefore, the program will help to familiarize grandparents with discipline practices, strengthening communication skills, etc.  

Today’s Caregivers Are Your Customers of Tomorrow

Among respondents to the 2009 Caregiving in the U.S. study, 78% expressed the need for help or more information in at least one of fourteen topics related to caregiving. Keeping their family members safe at home (37%), managing their own stress (34%), identifying easy activities to do with their loved ones (34%) and finding time for themselves (32%) were the most often identified needs. Caregivers are a diverse group. Their caregiving experiences range from those that are relatively easy to manage, to those that are burdensome.

We know that most caregivers today are able to fulfill this role without experiencing overwhelmingly negative physical, emotional, or financial consequences. On the other hand, caregivers with the heaviest responsibilities are vulnerable to risks such as a decline in health, emotional stress, and economic hardship. As the baby boom generation ages over the next 25 years, the numbers of people needing care will swell. The numbers of younger people available to provide care are likely to dwindle. This suggests that in the future, caregivers will be older, on average, than today's caregivers and may have greater infirmity of their own. In addition, the younger people who step into a caregiving role in the future may perceive they have less choice about becoming a caregiver. A greater share of caregivers may provide care to two or more care recipients.

The future may bring some positive changes as well. In particular, we are likely to see an expansion of the use of technologies that are already available to caregivers and recipients, as well as the development of new technologies. It is important to recognize that the nearly 66 million caregivers are a critical extension of our formal health care system. Without their efforts, there would be a shift of recipients into public programs such as Medicaid, and the quality of life and the health status of many who need care would decline. It is important to do all we can to support caregivers so they can continue in their roles. Specifically, it is important to:

• Identify and help caregivers who are most at risk for deteriorating health, financial security, and quality of life so that they can continue to provide care while maintaining their own well being.
• Identify and advocate for programs that make a real difference in caregivers' well being and in their ability to continue providing care.
• Identify and promote the use of technologies that can facilitate caregiving.
• Extend the reach of caregiver programs to all caregivers regardless of the age of their care recipient.
• Encourage families to plan proactively for aging and potential health/disability issue.

Source: MetLife Mature Market Institute, Caregiving in the U.S.: Executive Summary, National Alliance for
Caregiving in collaboration with AARP, Funded by the MetLife Foundation

News Throughout the Continuum

CCRC's

CCRC's are Expanding their Home and Community-Based Services Offerings

Preliminary findings from the 2010 AAHSA Zeigler 100 show that more than 75 percent of the largest 25 multi-site not-for-profit senior living organizations offer HCBS; in 2009, two of these organizations expanded their services. Of the largest 10 organizations, 80 percent offer HCBS, with one expanding its services. None reduced the services offered. (In last year's publication, more than 70 percent had either kept their HCBS services level or expanded, but 26 percent had reduced their services). See Ziegler's Z-News. Also, read the report of AAHSA's HCBS Cabinet to learn about developing or expanding HCBS in your organization.

GAO To Study CCRC Financing

The Senate Special Committee on Aging has requested a study by the U.S. Government Accountability Office (GAO) of continuing care retirement community (CCRC) practices. In a Feb. 13, 2009, letter, Sen. Herb Kohl (DWisc.), the committee chair, requested that the study focus on three areas:

• Identifying the different ways CCRCs are structured and operate.
• Determining the current nature and adequacy of regulation to ensure the financial solvency of CCRCs.
• Identifying best practices for minimizing the financial risk CCRCs may pose for residents (including best practices for ensuring the financial viability of CCRCs).

A copy of the letter from Sen. Kohl is available here.

AAHSA staff have been in contact with the GAO staff conducting the study and have provided extensive information about CCRCs. They will continue this dialogue to provide accurate and relevant information showing the important role CCRCs play in meeting the needs of seniors across the country and the many safeguards already in place to assure the continued success of CCRCs.

The GAO may also want to tour a few CCRCs and meet with CCRC staff, so AAHSA may be asking for a few of our members to participate and meet with the GAO staff in the future. While the Chairman of the Senate Aging Committee requested the GAO study, the Senate Aging Committee is conducting its own study of CCRCs. The committee recently requested a significant amount of information about the CCRCs owned or operated/managed by Life Care Services and Brookdale Senior Living.

It is likely this will lead to a hearing by the Aging Committee sometime this summer, but no dates have been disclosed. As this study develops, we will continue to provide updates and keep you informed of its status.

Home and Community Based Services
(Adult Day Services, Hospice, Home Health)

Medicare Home Health Rural Add-on

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which creates a 3% add-on to payments made for home health services to patients in rural areas. The add-on applies to episodes ending on or after April 1, 2010, through December 31, 2016. Similar to temporary rural add-on provisions in the past, claims that report a rural state code (code beginning with 999) as the Core Based Statistical Area (CBSA) code for the beneficiary’s residence will receive the additional 3% payment.

The CBSA code is reported associated with value code 61 on home health claims. The Centers for Medicare & Medicaid Services is working to expeditiously implement the home health rural add-on provision, Section 3131(c), of the PPACA. Be on the alert for more information about this provision and its impact on past and future claims.

Accreditation Organization (AO) Deeming Approval for Hospices

The Centers for Medicare & Medicaid Services’ (CMS) released a memo announcing the decision to approve Accreditation Commission for Health Care (ACHC), for recognition as a national accreditation program for hospices seeking to participate in the Medicare or Medicaid programs.

Section 1865(a) of the Social Security Act (the Act) permits providers and suppliers accredited by an approved national accrediting body to be “deemed” to meet Medicare Conditions for Coverage (CfC) or Participation (CoP) To receive approval, an accreditation organization must demonstrate to CMS that their requirements meet or exceed the Medicare conditions.

CMS reviewed ACHC’s application for approval of deeming authority for hospices in accordance with 42 CFR 488.4 and 42 CFR 418. CMS’ review included ACHC’s survey and accrediting process as well as its health and safety standards. CMS’ review found ACHC accreditation program for hospices to meet or exceed the Medicare CoPs.

CMS announced ACHC’s approval as a deemed status accreditation program for hospices in the November 27, 2009, Federal Register. This is an initial 4-year approval effective November 27, 2009 through November 27, 2013. Deeming authority for this program is limited to the Medicare CoPs and does not apply to ownership, enrollment, or other Medicare requirements. This approval provides hospices with another accreditation option in addition to the Joint Commission and the Community Health Accreditation Program.

How Will Healthcare Reform Impact HCBS Providers?

On March 23, President Obama signed the healthcare reform bill into law. This historic moment owes a lot to AAHSA members who have been advocating for its passage for a very long time. AAHSA's Health Reform Hub has been updated and is ready to give you the latest on how healthcare reform will impact you. The site features specifics (on the right-hand side under "Get Smart") on how healthcare reform will impact adult day programs, home health agencies, and hospice programs.

Grants for Social Model Day Programs Available

The Brookdale Foundation will be making grants available to qualified organizations for the development of new dementia-specific, social model day programs. The 2010 RFP for the start-up of social model "Group Respite" or "Early Memory Loss" programs for people with Alzheimer's disease and their family caregivers is now available.

Affordable Housing

Major Changes Coming to HUD Age and Income Waiver Policies

During a March 25, 2010, meeting, Bob Iber, acting director of U.S. Department of Housing and Urban Development (HUD) Multifamily Asset Management, and team members told AAHSA housing staff that a major change to HUD age and income waiver policies and practices is coming shortly. For several years now, certain senior housing providers experiencing occupancy challenges have requested, and fairly routinely received, one-year age and/or income waivers for tenant eligibility in their HUD subsidized senior properties. Many of these have received successive one-year extensions on application. No more. Read entire article.

Assisted Living

ON DEMAND Training NOW Available

The Healthcare Facility Regulation Division (PCH area of DCH) has posted the new PCH rules.  This includes new general rules, memory care services and memory care units/homes rules.  Most members were present when Vickie Flynn made the presentation at the Assisted Living Symposium last week.  There is important information to remember that may include updating some of your policies and procedures and using some of their forms.  Please take time to review your notes AND listen to this again.  

The "New Rules" presentation is posted here. Scroll down to the bottom of the page for registration.  You must complete the "registration form" and submit it, then you will immediately be connected to the page to choose the webinar. 

Assisted Living State Regulatory Review 2010

The National Center for Assisted Living (NCAL) released the Assisted Living State Regulatory Review 2010. The review provides a snapshot of the current state of assisted living regulation in all 50 states and the District of Columbia. The 2010 edition shows that at least eight states made major statutory or regulatory changes or overhauled entire sections of their rules during 2009. In addition, at least 10 states made changes to fire safety, physical safety or disaster/emergency preparedness standards. Click here to see the complete review

Nursing Care

MDS 3.0 is Not Delayed

Since passage of national health care reform, known as the Patient Protection and Affordable Care Act (H.R. 3590) and the Reconciliation Act of 2010 (H.R. 4872), confusion and misconceptions has been rampant regarding implementation of MDS 3.0 – which is not delayed by the legislation! Implementation is scheduled for October 1 - staff need to be trained; interviews practiced; CAAs selected; and, systems and policies developed. What has been delayed is part of RUGs IV; specifically, the bill states that:

• The Secretary of Health and Human Services shall not, prior to October 1, 2011, implement Version 4 of the Resource Utilization Groups.
• Beginning October 1, the Secretary of Health and Human Services shall implement change specific to therapy furnished on a concurrent basis that is a component of RUG-IV and changes to the look back period to ensure that only those services furnished after admission to a skilled nursing facility are used as factors in determining case mix classification under the skilled nursing facility prospective payment system.
• Nothing in this section shall be interpreted as delaying the implementation of Version 3.0 of the Minimum Data Sets (MDS 3.0) beyond the planned implementation date of October 1.

Currently, this leaves providers with RUGs III and the changes to the look back period and concurrent therapy expected with RUGs IV. The majority of long-term care associations and the Centers for Medicare and Medicaid Services (CMS) agree that this is not a practical or “constructive” delay, with many predicting Congress will vote to change the implementation date of RUGs IV. So to be prepared, AAHSA is advising members to plan for implementation of RUGs IV October 1.

DEA Loosens Grip on Nursing Home Pain Medications

The U.S. Drug Enforcement Agency recently issued an interim rule that slightly relaxes its position on pain medications in nursing homes.
The rule comes after a hearing by the Senate Special Committee on Aging, during which nursing home representatives said DEA regulations were too strict and often resulted in long delays for nursing home patients who need pain medication. The requirements regarding e-prescribing for controlled drugs are different from the requirements regarding e-prescribing of non-controlled drugs, according to the American Society of Consultant Pharmacists.

Before a physician or other prescriber is able to e-prescribe for controlled drugs, they will need to obtain a credential from an authorized third party that certifies his or her identity. The DEA also requires verification that each authenticated prescriber has a license and a DEA registration and is therefore authorized to e-prescribe controlled drugs. They then will need to use two means of authentication to sign electronic prescriptions, the society said. Nursing homes will essentially be treated the same as they always have been by the DEA under the new rule, but it could mean nurses will have an easier time accessing pain medication for patients, according to Sen. Herb Kohl, chairman of the Committee on Aging.
Source: McKnight’s Long Term Care News

Latest Edition of the CMS Nursing Home Data Compendium
Available for Free

The Centers for Medicare and Medicaid Services (CMS) recently released its Nursing Home Data Compendium 2009. The compendium contains information on all residents of Medicare- and Medicaid-certified nursing homes in the United States, including data on nursing home residents clinical characteristics and nursing home survey results. The tables and figures were compiled from CMS survey and certification administrative data and nursing home clinical data contained in the Minimum Data Set (MDS). Below is a sampling of MO specific information:

“LIFElines” email publication for Aging Services of Georgia Nursing
Home Members & Nursing Staff

Aging Services of Georgia healthcare/nursing home members remember to access the latest LIFElines publication. This publication is a partnership between Aging Services of Georgia 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 Aging Services of Georgia nursing home members.

All Aging Services of Georgia nursing home members should now be automatically receiving LIFElines. Any other Aging Services of Georgia member is welcomed to receive this publication – just contact swatkins@agingservicesga.org.

Topics in the April 16 Issue are:

The 7 Reasons Why Most F-Tags are Cited (Part V, VI & VII)

AGING SERVICES VACANCY REPORT

Please assist your colleagues by sharing this information when you receive calls from consumers you cannot serve. 

Career Opportunities

GA Division of Aging Services
Health & Welness Coordinator

Brandon Wilde Life Care Community, Evans, GA
Director of Nursing

Vineville Christian Towers, Inc., Macon, GA
Service Coordinator Job Posting

Lenbrook: Atlanta
Senior Sales/Resident Counselor

McIntosh Trail Long-Term Care Ombudsman Program: Meansville, GA
Ombudsman Trainee (Part Time)

Sarah Care Adult Day Care Centers; Suwanee, GA
Activities Coordinator

Bon Air Apartments; Augusta, GA
Service Coordinator Aide

AAHSA Information

AAHSA Analyzing Health Care Reform

With the recent passage of the historic health care reform bill, AAHSA staff have been busy reviewing the details of that legislation, as well as following other important issues that Congress is expected to take up in the next few weeks.

As AAHSA completes their review they will be posting this accurate and reliable information A word of caution -on a recent conference call with AAHSA, Larry Minnix pointed out that there are many entities publishing information about the bill, however some of it is inaccurate and readers don’t know what is or isn’t reliable accurate information. In addition, keep in mind many amendments to the reconciliation bill have been submitted. If any are adopted by the Senate, the bill will have to return to the House for consideration of the Senate changes.

For the latest on the health care reform bill, AAHSA members can access the "Health Care Hub" on the AAHSA web site. The hub currently contains summaries of the health care reform bill, including separate summaries of the technology, employer and HCBS provisions.

As additional information becomes available, it will be posted on the hub, so AAHSA/MoAHA members should plan to check it regularly.

CMS Public Website Address Change

CMS has been working with the Department of Health and Human Services to change the address of their public Agency website from www.cms.hhs.gov to www.cms.gov. This will bring the website name in line with those of the other Operating Divisions within HHS (e.g., www.fda.gov, www.cdc.gov). This name change took place the evening of Friday, April 2. This name change will not affect any CMS web addresses other than the main public website URL:http://www.cms.hhs.gov. The name change also will not impact work email addresses; they willremain firstname.lastname@cms.hhs.gov.

Ambulance Fee Schedule Fact Sheet

The revised Ambulance Fee Schedule Fact Sheet (January 2010), which provides general information about the Ambulance Fee Schedule, including how payment rates are set for ground and air ambulance services, is now available in downloadable format from the Centers for Medicare & Medicaid Services, Medicare Learning Network.