FHCA - Pulse

1

Update

continued on page 6

FHCAFLORIDA HEALTH CARE ASSOCIATION

SEPTEMBER 2009Florida Health Care AssociationP.O. Box 1459Tallahassee, FL 32302-1459

PRESRT STDU.S. POSTAGE

PAIDTallahassee, FL

Permit No. 1007

A Long Term Care Monitor of Nursing Home and Assisted Living Issues

InsideAbating an Immediate Jeopardy ...... 5

Advancing Excellence and the Medicare/

Medicaid Challenges ......................... 8

Honoring Our Best .......................... 14

New Codes ReflectNew Technology ............................. 18

continued on page 19

Florida to lose almost $80 millionFlorida will experience Medicare cuts of $78.4 million as a result of the Centers for Medicare & Medicaid Services regulatory reduction that was handed down on July 31, 2009. Cuts to Medicare funding total $360 million nationally. Florida is the second most impacted state from these cuts, which are projected to cost $132 million in business activity, $66 million in labor income, and 1,960 in lost jobs. See LTC Business News on page 9.

Assisted Living UpdateThe Florida Center for Assisted Living recently elected its 2009-10 officers, who include Marilyn Jacobs as President, Lavern Brown as Vice President and Rosemary Carbonelli as Secretary and National Center for Assisted Living (NCAL) State Leader.

National Assisted Living Week is September 13-19, 2009, which features the theme “Traditions for the Heart.” NCAL has a number of tools and resources available on its Web site at www.ncal.org. Read more on assisted living issues on page 10.

David Sylvester receives 2009 Johnson Excellence AwardFHCA Past President earns FHCA’s highest honor

Past President David Sylvester (2006-08) was honored during the FHCA Annual Conference in Hollywood with the 2009 Walter M. Johnson, Jr. Circle of Excellence Award. Sylvester was recognized for his leadership and pursuit of advocating for the coexistence of funding, quality and customer satisfaction

as the cornerstone of the long term care profession. The award, which is FHCA’s highest honor, was presented by 2008 Circle of Excellence winner and FHCA Secretary, Scott Bell, who noted Sylvester’s ability to “encourage and inspire others to take action and stand shoulder-to-shoulder with their professional peers to not only react, but also reshape the ever-changing long term care environment.“

Sylvester began his career working on the frontline of health care, serving as a CNA, an ambulance driver and a respiratory therapist. He later became a nursing home administrator, ultimately coming to own

Allen, Jacobs are 2009 top administratorsScott Allen, administrator of Palm Garden of

Tampa, was named the 2009 FHCA Administrator of the Year during the Annual Conference at The Westin Diplomat in Hollywood. Also during the event, Marilyn Jacobs, administrator of Mark Manor – Village on the Isle in Venice, was named the 2009 FCAL Administrator of the Year.

Allen has served as administrator of Palm Garden of Tampa for over seven years, during which time he has transformed the facility into a caring environment, where residents, their loved ones and the staff function as a family. He is known for inspiring his staff to develop and accomplish goals with an end result of providing the highest quality care to the residents. Under his leadership, Palm Garden has been recognized for both quality and satisfaction from the American Health

continued on page 6

FHCA Secretary Scott Bell (left) presents David Sylvester with the Circle of Excellence Award.

2

FHCA September 2009 Pulse 3

FROM the PRESIDENT

by Deborah Franklin

FHCA President

Deborah Franklin,President

J. Emmett Reed, CAE,Executive Director

Nina Willingham,Senior Vice President

Scott Bell,Secretary

Scott Allen, Treasurer

Joe Mitchell, Member At Large

FHCA PulseSeptember 2009

FHCA Pulse is a monthly publication of the Florida Health Care Association, P.O. Box 1459, Tallahassee, FL 32302-1459. To contact FHCA, call (850) 224-3907.Editorial – To submit information, guest articles, press releases, etc., contact Kristen Knapp, APR, Director of Communications, at (850) 224-3907 or via e-mail [email protected]. Fax information to (850) 681-2075 and include your name, telephone number and e-mail address. Advertising – For information on Pulse advertising rates and availabilities, contact Ian Cordes at Corecare Associates at (561) 659-5581 or via e-mail at [email protected] articles and advertising are subject to editorial review.

The Evolution of leadershipMoving forward, thinking strategically

Last month, FHCA hosted a successful Annual Conference, which included an opportunity for the membership to vote on restructuring the FHCA Management Committee to be more representative of the collective efforts that our Association and Our Florida Promise have been working toward over the past two years. The addition of Joe Mitchell as the Member At Large representing Our Florida Promise to the leadership team is another important step towards building that strength and unity which will continue helping us make an impact with legislators as the long term care profession continues to evolve.

That evolution includes so many different factors, from culture change to health care reform to fast-paced technology that has consumers accessing information twenty-four-seven. If we are going to remain the leading advocate for Florida’s long term care profession, we need to be forward thinkers so we can adapt to our needs as professionals, as well as the needs of our residents and staff in this changing environment.

Last month, I referenced the planning session that involved a strategic thinking group who came together to discuss future goals for the Association. They represented past and current leaders in our Association and volunteered two full days of their time, knowledge and expertise to help us assess our strengths and weaknesses and discuss opportunities that will help ensure we are meeting your member needs, as well as thinking strategically about the future of FHCA.

Mission, Vision and ValuesDuring the week we discussed a Mission, Vision and Values statement for FHCA, which we believe

embraces the spirit of who we are and who we strive to be. During the FHCA Membership Meeting in August, I shared these statements with you, in hopes you will see how they pave the way for us to adapt, innovate and lead the long term care profession both in Florida and across the nation.

The proposed Mission statement, which will guide the actions of our Association, spell out our overall goal and provide us with a sense of direction and decision-making, is as follows:

The Florida Health Care Association is an organization proactively advancing the quality, image, professional development and financial stability of its members.

The proposed Vision statement simply answers the question, “Where do we want to go?” This will serve as a guideline for future strategic decisions:

To be recognized as the national leader in shaping health care.And our Core Values, which are a basic framework we can use to understand what this Association

represents and how we put those beliefs into practice:

Membership DrivenProactive AdvocacyContinuous Quality ImprovementEthical PracticesInnovative Leadership

FHCA has much work to do with our Board of Directors and our Bylaws Committee before these statements can be fully considered by the membership. I shared these with our members at Annual Conference last month and am reiterating them now in hopes you will begin thinking about what the Mission, Vision and Values of the Association mean to you as an FHCA member. I believe what we have proposed represents who Florida Health Care Association has always been, as well as who we want to be in the future. I hope you will embrace these ideas as your own and join me in moving forward and thinking strategically about the future of FHCA.

•

•

•••••

FHCA September 2009 Pulse4

legislative process to advocate on behalf of the profession.

Networking Nothing could top this year’s Trade Show.

Buzzing with activity from start to finish, 276 companies were on hand to network with key decision makers over the two-day event. I had the pleasure of meeting with many of the exhibitors to thank them for their support and to solicit ideas on how to make certain that next year’s Conference at the Orlando World Center Marriott is equally as exciting.

Annual Banquet The icing on the cake ended with a

high-class, high-energy Annual Banquet that featured fantastic remarks from FHCA President Deborah Franklin, a moving tribute to Bill Phelan, and the awarding of the Association’s highest honor, the Walter M. Johnson, Jr. Circle of Excellence Award, to FHCA Past President David Sylvester.

While the FHCA Annual Conference & Trade Show is one of the best events with which I have ever been associated, our staff immediately came back to Tallahassee to debrief and find ways to better serve our members at next year’s event.

Special congratulations and thanks to this year’s Conference Chair, Sid Schiff, and all the members of his committee who helped make the event a success, as well as all of our sponsors, exhibitors and volunteers for your tremendous support!

by J. Emmett Reed, CAE

FHCA Executive Director

FROM THE DIRECTOR’S DESK

FHCA Web SiteEmergency Preparedness • Legislative • Membership • Press Center

Quality Improvement • Regulatory • Reimbursement • Seminars/Events

www.fhca.org

This being my first Florida Health Care Association Annual Conference & Trade Show, I really did not know what to expect. I watched our staff and members dedicate their time, talent and experience into all aspects of the planning for the event, but until I traveled to Hollywood for the event, I had know idea of everything that would transpire over the week.

I have had extensive experience with the production of trade shows for the bulk of my 15-years of experience in association management. Suffice it to say, when it comes to conferences and trade shows, I have “been there and done that”…or at least that is what I thought.

FHCA’s Annual Conference has shed new light for me on what an annual conference is all about. And, when I say that Conference exceeded my expectations, I feel as though I am in the running for winning the understatement of the year award.

What was so special about this conference?

LocationThe vistas from The Westin Diplomat are

second to none, and the facilities are top notch. I do hope that you were able to enjoy the beauty and fun that south Florida had to offer.

Education With 43 long term care-related

educational seminars for attendees to choose from, FHCA provided some

Annual Conference a “must see” for health care professionals

incredible learning opportunities for our participants, who were able to earn valuable CEU credits!

Communication Our Membership Meetings provided

unique insight into the direction of the FHCA Board of Directors, as well as showcased the political clout we continue to gain.

Among the lawmakers that came to speak to our members were Senate President Jeff Atwater, Senator Nan Rich and Representatives Kevin Ambler, Kevin Rader and Anitere Flores. What a terrific showing! I am grateful to each of them for taking time to visit with us.

During the FHCA Kickoff Membership Meeting, a new slate of officers were presented, including one newly-added Member At Large position representing Our Florida Promise to the Management Committee. You can read more about this year’s Board of Directors on page 8.

Thursday’s Membership Meeting finished strong with a CEO panel that included Joe Steiers of Signature HealthCARE, LLC, Michael Zomchek of Life Care Centers of America and Michelle Givens of Adventist Care Centers. The panel was moderated by FHCA Secretary Scott Bell, who did an outstanding job leading them through topics that ranged from quality initiatives and culture change to reimbursement and regulatory trends, as well as an important discussion about the need for all long term care providers to become engaged in the


LTC LEGAL ISSUES and TRENDS by Karen Goldsmith

Goldsmith &, Grout, PA

FHCA Legal Consultant

No words bring more terror to the heart of nursing home operators than the surveyor proclaiming an “Immediate Jeopardy (IJ).” The world stops rotating, your head starts to spin and you and everyone else runs for cover.

Once the dust settles, you need to work diligently to get the IJ abated or reduced in severity (and even scope). Once the IJ is abated, the daily fine from the Centers for Medicare & Medicaid Services (CMS) should be reduced and a fast track decertification should be halted. Many times the IJ can be abated before the surveyors leave, but once they are gone, it may be fixed for a day or more before they can return, possibly causing a delay in the abatement.

Plan of actionFirst and foremost, remove the danger. If

the issue is a non-functioning alarm system, for example, begin fire watches immediately - the closer together the better. After all, you are trying to establish that you have removed the IJ. Overkill in remedying the situation is usually imperative.

Secondly, develop a comprehensive plan. At this stage, all of the details may not have been determined, but the general parameters should be. This is the time that you start communicating with the survey team and keep the lines of communication open. Without a clear understanding of what the surveyors believe you did wrong, you cannot prepare an appropriate response and may waste valuable time.

Delegate portions to various people, with one person coordinating

Bring in the troops, but not too many. In an effort to quickly reduce the severity and its consequences, facilities typically bring in tons of professionals (not literally, of course) when an IJ is called. This can be counterproductive, depending on the nature of the deficiency. Carefully choose

the personnel you bring in based on the ability that each one can contribute to the overall correction.

Be creative. In one recent case, a pharmacist was called in on an infection control issue. The operator was inventive and found that a part of the deficiency could be resolved with a pharmaceutical approach. Who better than the consultant pharmacist to perform this function?

Remember that the surveyors may be looking at other non-IJ issues and residents still need care, so don’t remove too many people from day-to-day operation. This could create problems for your residents and you in the survey process.

Also remember that a ship full of captains will likely sink. You need clear delegation of managerial responsibility. While two or three nurses may meet to develop a new policy or procedure, only one should have the authority to finalize it and make changes when appropriate. We have seen several instances where one professional put a new procedure in place and another nurse, presuming she had the authority, completely changed it. Staff will be confused and will be inconsistent in their application of the process. It is a good idea to have a formal chart of authority, and make it clear when staff can deviate from the proposed procedure and when they cannot.

Clear direction as to each person’s role in the solution is critical so that no step is left undone. Again, a written plan is imperative. If a staff member is not participating in carrying out their duties to the group, you may want to consider sending that staff member home. While you do not want to be an ogre, staff needs to know that deviations without a legitimate purpose will not be tolerated. For example, if the issue involves not practicing proper infection control techniques with an HIV-positive resident, there would be no reason that proper precautions, as established in your abatement game plan, was not followed. If a supervisor notices a CNA not following those precautions, she should act swiftly to

remedy the situation.

While supervisory authority to carry out the plan is critical, all staff should understand that they are part of the solution and the role they play. While designating various employees to carry out functions must be done, all staff should understand that they are responsible for lending a hand when appropriate. In addition, all staff must be the eyes and ears of management. Frequent communication between the supervisors and direct line staff must occur.

If you believe that a staff person has created or significantly contributed to the problem, you may wish to remove that person from the premises. Give them a paid suspension or simply ask them to take a few days off while you investigate the situation and determine that person’s role. Having them still on site can be disruptive to the correction process.

Long-term solution planningThe most difficult part of correcting an

IJ is putting into place a long-term solution. The State can revoke a facility’s license for having two unrelated Class I deficiencies in a 30-month period, and IJ deficiencies often translate to Class I deficiencies. If a survey team finds on a subsequent survey that the plan you put into place only cured the problem for a short period of time, you may find yourself with another IJ or Class I. I have no doubt the State would argue that, even though the deficiency is similar to the previous IJ, it is not related. Would they win? Of course, that would depend on the circumstances. Even if you do not get another Class I deficiency, your facility will have lost credibility with the local office, Tallahassee and, perhaps, CMS. The price is too high.

Yet even though this seems obvious, many times providers bring in the troops to fix a problem and then leave the people who caused it in the first place to police the continuing compliance.

Next time: Helpful hints to stay in compliance after the IJ is removed.

Abating an Immediate JeopardyDeveloping a game plan for correction


Care Association and My InnerView, they have been named Florida’s first green facility and were recently recognized by Cypress Healthcare Management as the facility of the year.

Allen also gets top honors for advocacy

During Annual Conference, Allen was also recognized with the Arthur H. Harris Government Services Award, which is presented to an FHCA member for outstanding legislative support and advocacy. Allen is know for his tremendous advocacy for long term care, actively participating in legislative affairs at both the state and federal level, hosting legislative candidates in his facility and encouraging his staff to become engaged in grassroots activities, as well. Allen currently serves as the FHCA Legislative Chair. The award was presented by Joe Mitchell, 2008 Arthur Harris Award winner (top right).

Jacobs active locally, statewideMarilyn Jacobs has been administrator for Mark

Manor at Village on the Isle for nine years, where she successfully runs an affordable ALF unit, without government funds, maintaining a ninety-six percent occupancy level. Currently, Jacobs is serving her second term as President of the Florida Center for Assisted Living. She is also active in the Venice community, helping numerous not-for-profits with their fundraising efforts.

Allen and Jacobs top administrators,continued from page 1

several facilities in the New England area. His facility in Maine was the first-ever recipient of the American Health Care Association’s Quality Award, and his experience enabled him to rise to the top of the Maine Health Care Association before coming to Florida, where he shared that same vision of quality care with FHCA.

Today, he is senior vice president of Health Central in Ocoee, one of central Florida’s most progressive healthcare providers with services including a short and long term care skilled nursing facility, a special care/dementia wing and a cutting-edge rehabilitation center. He was a member of FHCA’s Management Committee from 2000 through 2008 and currently serves as president of the FHCA Quality Credentialing Foundation, where he continues to challenge his professional peers to embrace quality improvement as a continual process.

David Sylvester receives 2009 Johnson Excellence Award,continued from page 1

Marilyn Jacobs with Village on the Isle administrator Tom Kelly.


by Peggy Rigsby

FHCA Director of Government Services

As summer winds down and fall draws near, many of your children, friends and family members will head back to school. At the same time, your FHCA staff and lobbyists will be heading back to the Capitol. Legislative committee meetings start in October, which is our chance to dialogue with key legislators and staff regarding priority issues for the 2010 Legislative Session.

It appears pretty certain that there will be no special session before the regular session begins in March, as the budget situation is not in crisis mode. Although the budget is still not good, it is not yet in crisis. For FHCA, however, reimbursement continues to remain a key priority identified by the Association’s Legislative Committee, which met this summer. While the state economy plays a big role in determining what legislators will have to do, the termination of federal stimulus money after December 2010 and the outcome of federal Medicare and Medicaid legislative proposals will all

Back in actionKeep the ball rolling and do your part

FHCA Florida LeadersGraduates recognized, future applicants wanted

come together to create a challenge for this next session.

Reimbursement is not the only priority on which we will focus, though. The Committee also voted to push ahead on the regulatory reduction items from last year, adding a few new ones as well. Therefore, we will continue discussion with the Agency for Health Care Administration and those advocating on behalf of long term care and its residents to reduce the regulatory burdens that will allow staff more time with residents versus behind a desk bogged down in paperwork.

I have said it before, and FHCA Legislative Committee Chair, Scott Allen, and Vice Chair, John Mangine, want to remind us all again that now is the time to invite legislators and candidates into your building. Do it now before they get too busy with meetings and Tallahassee visits. Do it now while they can spend time with residents, families and staff and discuss issues important to long term care providers. Do

it now while campaigns are beginning and you can offer your help to local candidates with tasks such as mailings or distributing signs. You may have noticed that legislators are starting to recognize the role that we play in the health care system and the more you continue your “grassroots” work, the more effective your team can be in Tallahassee.

So the ball is in your court. Take it and run!

Regulatory updateThe Board of Pharmacy has filed the final

version of Rule 64B16-28.301, Destruction of Controlled Substances. The new rule was effective July 21, 2009, and states that the “administrator designee may include a licensed physician, pharmacist, mid-level practitioner, or nurse” as part of the team, who along with the consultant pharmacist and director of nursing, are witnessing the destruction of controlled substances. For more information, visit www.flrules.org.

During the FHCA 2009 Annual Conference in Hollywood, Past President David Sylvester recognized 27 members of the 2009 graduating class of the Association’s Florida Leaders program. These individuals, who represented the inaugural class of this innovative leadership program, took part in personal and professional leadership development activities throughout the year that included hands-on training, quarterly readings and an opportunity to advocate on behalf of the profession during the legislative session as part of FHCA’s Lobby Wednesdays.

“These individuals are an excellent example of leadership within the long term care profession,” said David Sylvester, FHCA Past President and one of the program’s facilitators. “We are excited for what they

have accomplished this past year and look forward to their involvement to help this program grow and continue building future leaders within the Association.”

FHCA is currently accepting applications for the 2010 Florida Leaders Program, which will kick off November 5-6, 2009. Applicants should be actively involved at the FHCA district, region or state level and show an interest in giving back to the Association and the profession through volunteer service and legislative advocacy. Program activities include hands-on training, quarterly leadership readings and conference call

meetings. More information about FHCA’s Florida Leaders, including applications for the 2010 program, is available on the FHCA Web site at www.fhca.org. The deadline to submit an application or nominate an individual for the 2010 program is September 25, 2009.


by LuMarie Polivka-West

FHCA Senior Vice President of Policy

The Medicare reductions handed down in July from the Centers for Medicare & Medicaid Services (CMS) and the continuing Medicaid funding challenges may cause long term care providers to question why even consider a quality focus in the coming months. The quest for quality improvement and customer satisfaction does not have to be viewed in a vacuum, separate and apart from bottom line budget decisions to be made to accommodate public funding reductions. Given the public reporting on quality outcomes through the CMS Nursing Home Compare and the Five Star Rating System, the public is increasingly informed of a nursing home’s survey history, quality measures and staffing.

It is very important that facility staff understand the different ratings and be able to explain how their facility is dedicated to quality. Family members and friends of residents do not always take their questions to the administrator or director of nursing. The same follows with surveyors and the Quality Indicator Survey (QIS), where the process is designed to query the direct caregivers on care being provided.

Participation in Advancing Excellence is a campaign that facilitates the explanation of the CMS Five Star Rating System to staff, residents, families and friends, long term care ombudsman and the general public. Advancing Excellence includes performance improvement with selected quality measures, staffing and customer satisfaction. The national Web site, which can be found at www.nhqualitycampaign.org, provides many tools for the performance improvement journey. These include promotional examples that can be inserted with employee paychecks and successful practices, such as “stand up meeting” schedules for employee teams around the targeted goals.

Reimbursement – Quality connection

There are links between reimbursement and quality, despite the impression that public funding decisions are made in a silo separate from the regulatory and policy CMS oversight entities. The CMS Five Star Rating System aligns expected staffing by Registered Nurses (RN) with the specific Resource Utilization Groups (RUG) categories reported by the individual facilities. The CMS assumption is that if Medicare is billed and the facility is reimbursed for specific RUG categories, then the facility should staff with the requisite RN hours and the other licensed and certified nursing staff as well. The facilities with a higher acuity of residents and with more Medicare Part A billings will be expected to staff with more RN hours.

Florida averages three stars in staffing because the state’s focus has been on increasing the Certified Nursing Assistant (CNA) hours per patient day. There has been a slight reduction in the state’s RN hours, according to the University of South Florida Policy Center on Aging study results for the 1999-2007 data. The Ch. 400 Florida Statutes minimum staffing requirements for licensed and certified nurses equals only half of the CMS Five Star staffing formula, which gives half of their weight to the RN hours. The CMS Five Star rating outcome is an example of how Medicare and Medicaid come together at the facility level in a manner that is too complex for the public to clearly understand. Funding and state laws do influence staffing patterns and decisions have to be made based on the resident mix of acuities and payment source.

Advancing Excellence and the Medicare/Medicaid challenges

FHCA new, returning leadersAt the FHCA Membership Meeting in Hollywood, FHCA members voted to amend the Bylaws to rename the offices of Chair and Vice Chair to President and Senior Vice President, as well as include a Member At Large on the FHCA Management Committee.

Below from left to right, Deborah Franklin, FHCA President; Nina Willingham, Senior Vice President; Scott Bell, Secretary; Scott Allen, Treasurer; and Joe Mitchell, Member At Large, were elected to one-year terms along with regional vice presidents Marco Carrasco (I), Lori Jowett (II), Elaine Boyer (III) and John Simmons (IV). Marilyn Wood, Sid Schiff and Connie O’Donnell were elected to Multifacility, Independent Owner and Non-Proprietary Vice Presidents, respectively.

Understanding performance measures can help when advocating for adequate funding

Franklin BellWillingham

MitchellAllen Carrasco

Jowett Boyer Simmons

Schiff O’DonnellWood


LTCBUSINESS

NEWS

by Steven R. Jones, CPA and Lorne Simmons

Moore Stephens Lovelace

Move over MEDPACAnd sorry CMS...here comes IMAC

The Obama Administration released a draft version of the Independent Medicare Advisory Council (IMAC) Act of 2009 in July. The Act would establish a five-member council appointed by the President with the consent of the Senate. The members would hold five-year terms and have the authority to recommend to the President two packages of annual payment update rates for certain Medicare payment systems.

The IMAC would be required to provide the President with an annual package of recommendations for calendar year payment systems and one package for fiscal year systems. For skilled nursing facilities, the package of recommendations would replace the annual market basket updates. The President would approve or disapprove each report as a package. If the President approves, Congress would have 30 days to authorize the Department of Health and Human Services to implement the recommendations. If the President disapproves a package of recommendations or Congress passes a joint resolution disapproving a package of recommendations, current law would remain in effect.

The Act would prohibit the annual updates from increasing the aggregate level of net Medicare payments over a 10-year period (despite the huge increase in boomers utilizing Medicare). It also provides the IMAC with the authority to recommend broader Medicare reforms. However, the Act prohibits reforms involving such things as timing of payments to providers, quality of care requirements, and claims payment and appeal procedures.

Judicial review is also very limited by the Act. Someone who feels they have been adversely affected by the IMAC’s recommendations would need to file an action in the U.S. Court of Appeals for the District of Columbia within 30 days of the President’s approval. However, the scope of the review would be limited to whether the IMAC exceeded their authority for determining annual payment updates or making reforms. No other judicial review would be available.

As drafted, the Act would not allow the IMAC to make an annual payment or reform recommendation until September 15, 2014 or after. Furthermore, the Congressional Budget Office (CBO) recently estimated the act would only save $2 billion over a 10-year period.

CMS Issues Final PPS Rule for FFY 2010In the past, we’ve had the good, the bad and the ugly. This year, it’s all about the bad and the ugly.

The Centers for Medicare & Medicaid Services (CMS) recently issued its Skilled Nursing Facility Prospective Payment System (SNF PPS) Final Rule for FY 2010 that will cut $360 million in Medicare payments for FY 2010, a 1.1% reduction from FY 2009. The impact to Florida Medicare payments has been estimated at $78.4 million, the second highest overall in the nation. Although the rule includes a full Medicare market basket update of 2.2 percent or $690 million for FY 2010, it also includes a reduction of approximately 3.3% or $1.05 billion for the so-called “projection error” adjustment to the RUGs payment rates going back to 2005. CMS blames the projection error on “case-mix creep”, the higher spending levels that occurred due to the expansion of RUGs to 53 categories in 2006.

The rule seeks to account for budget neutrality (again) by “recalibrating” case mix indexes (CMIs) and non-therapy ancillary services. Some estimate the recalibration could result in $12-$18 billion in cuts over the next ten years. Let’s hope Washington is finished recalibrating anything for the foreseeable future.

Also keep in mind, the current House version of the health care reform bill would eliminate the market basket increase after only three months, effectively forcing providers to foot the entire $1 billion decrease.

Retro and Emergency Payment Challenges ContinueWe’ve had several instances where we obtained emergency Medicaid payments because the Agency

for Health Care Administration’s (AHCA) vendor was unable to retro-process claims. In most of those cases, AHCA started large recoupments (the entire monthly payment), despite the fact that the claims were never reprocessed, which would generate the extra funding to allow recoupment without a cash crunch. If you need emergency payments or have received one and the underlying claims are still outstanding, contact Medicaid Contract Management to obtain (or keep) the payments to which you’re entitled.


by Lee Ann Griffin

FHCA Director of Quality and Regulatory Services

The Agency for Health Care Administration has been in discussion with Florida Health Care Association and other interested stakeholders in Tallahassee regarding their interest in consolidating the licensure types for assisted living facilities (ALF). The problems the consolidation would attempt to address relate to appropriateness of resident placement and duplication of overlapping regulatory efforts. Discussions to date revisit questions about Florida’s perspective on assisted living facilities and balancing resident’s preferences within a regulatory environment which focuses on physical status. FHCA will be tapping both our nursing home and ALF members for input and direction as policy develops in this area. However, as of yet there have been no official workshops scheduled to discuss the possible licensure consolidation.

More on Assisted Living

AHCA to take on rule-writingOn another note, the Agency for Health

Care Administration (AHCA) is interested in taking on rule-writing authority for assisted living facilities, a process currently done by the Florida Department of Elder Affairs (DOEA). AHCA has rule-writing authority for nursing homes and, as they also license ALFs, has expressed an interest in moving the ALF rule-writing authority under the AHCA umbrella, as well. We have heard concerns from several assisted living facilities that moving rule-writing authority to AHCA would result in a less home-like and more nursing home-like environment for ALF residents. Currently, AHCA is always present and very active during any ALF rule-writing activity or policy discussions at the DOEA.

Want to stay up-to-date on

FHCA news, events and activities?

Follow FHCA on Twitter at

http://twitter.com/FHCA

or join our Florida Health

Care Association Group

on Facebook at www.

facebook.com.


Ponce de Leon LTC RRG, Inc.

Gulf South Medical Supply

American HealthTechCHEM RxFHCA AMSC Good GuysFMS Purchasing & Services, Inc.Lewis Brisbois Bisgaard & Smith, LLPMcCumber, Daniels, Buntz, Hartig & Puig, PAMoore Stephens Lovelace, PAPonce de Leon LTC RRG, Inc.VITAS Innovative Hospice Care

Allied Mobile X-Ray & UltrasoundClear Choice Health CareGuardian PharmacySenior Care PharmacyVelda Farms

Brown & Brown InsuranceCheney Brothers, Inc.HealthScreen Disease Management, LLCHPSI Purchasing ServicesIntegrity Pharmacy ServicesMedCure, Inc.MobilexUSAOmni Home CarePeoplefirst RehabilitationPsychCare ServicesQUniqueRXPERTS PharmacyThe Compliance Store, LLCUltra Mobile ImagingUnisource

ARKRAY USA, Inc.FHCA District IFHCA District VIFirst Choice Medical SupplyKreg TherapeuticsLaw Offices of Peter A. Lewis, P.L.Moore Stephens Lovelace, P.A.Omnicare of South FloridaResource ServicesSelect Medical Rehabilitation ServicesStar Medical Equipment Rental, Inc.TenetVITAS Healthcare Corp. of FloridaWest Gables Health Care CenterWicker, Smith, O’Hara, McCoy & Ford, P.A.

FHCA 2009 Annual Conference & Trade Show Sponsors

Thank you to all our Sponsors. Your generosity made FHCA’s 2009 Annual Conference a success!

FHCA 2009 ANNUAL CONFERENCE & TRADE SHOW A SUCCESSFUL JOURNEYLeft: FHCA President Deborah Franklin announced the naming of the William J. Phelan Library at the FHCA headquarters in Tallahassee.

Right: FHCA President Deborah Franklin honored past president Bobby Rosenthal with the Historian Award.


FHCA Treasurer Scott Allen (right) with Rep. Kevin Ambler.

FHCA Secretary Scott Bell (left) and Deborah Franklin with Senate President Jeff Atwater (center).

Deborah Franklin and FHCA Member Andrew McCumber with Senator Nan Rich (center).

FHCA President Deborah Franklin (right) and Past President Kelley Rice-Schild with Rep. Anitere Flores (center).

Legislators of the Year FHCA honored four legislators for their ongoing support of our long term care issues during its 2009 Annual Conference. Rep. Anitere Flores (R-114) and Sen. Nan Rich (D-34) each received the 2009 Champion for the Elderly Award, while Senate President Jeff Atwater (R-25) and Rep. Kevin Ambler (R-47) were named the 2009 FHCA Legislators of the Year.

Above, Joe Mitchell, FHCA Member At Large (right) and Rich Kase, Florida’s American Health Care Association Board of Governor’s Representative (left), with Rich Miller of the American Health Care Association.



RESIDENT OF THE YEAR AWARDEstella Bryant first arrived at Palm Garden without the ability to walk or talk, but her courage and conviction helped her overcome adversity and regain these abilities. Bryant is one of Palm Garden’s most active residents, volunteering her time for a number of causes, including Breast Cancer and Black History Awareness, the Masons and other community activities. She

serves as their Resident Council President, makes the morning announcements for the facility, sharing inspirational messages as she keeps everyone informed about the day-to-day events. She plays a vital role in assisting Palm Garden with its culture change movement and is known by everyone for her wonderful sense of humor and her unselfish acts of kindness.

WILLIS J. GREGSON ASSOCIATE MEMBER OF THE YEAR AWARD

Stanley “Sandy” Swindling Jr has been providing invaluable information, advice and representation on financial reporting, reimbursement and compliance issues to FHCA members for over thirty years. A director of Moore Stephens Lovelace’s health care team, Sandy

has spent the better part of his career championing the cause of equitable reimbursement for long term care providers. He was instrumental in working with the state to develop the interim Medicare reimbursement process currently used during state emergencies which allows operators to continue providing (and being reimbursed for) the care needed for residents during and post disasters. He has been a frequent presenter at Annual Conference and has always been generous with his time and resources in support of FHCA and its members.

YOUNG ADULT VOLUNTEER OF THE YEAR AWARDDonna Marseco began volunteering with Palm Garden of Ocala at the age of 16, when she needed fulfill a school requirement. Two years later she continues to serve the facility each week, helping in housekeeping and managing the ice cream parlor.

While Donna has a quiet nature, her personality shines brightly. She encourages residents to come out of their room to enjoy hand-dipped ice cream, sharing conversations with them about their past life and her future plans.

HONORING OUR BESTFHCA gives accolades for contributions to the Association – long term care

MEDIA & COMMUNITY INVOLVEMENT AWARDMacclenny Nursing and Rehab Center and adminstrator John Simmons (left) make media relations and community outreach a top priority. From holding evacuation drills to monthly birthday luncheons to letters to the editor about important long term care issues, the staff has found a way to utilize the media to help bring positive awareness to the facility and

the profession. Community events, onsite fundraisers and connections with civic groups are standard procedure at Macclenny and the staff takes pride in being actively engaged with the local community, understanding the role it plays in improving the facility’s quality and satisfaction results.

ADULT VOLUNTEER OF THE YEAR AWARDRonald Strine has been volunteering with Palm Garden of Largo for over five years, where week after week he inspires residents in the therapy department to overcome their adversity with a positive attitude and a belief in themselves. A former therapy patient at Palm Garden himself, Ron

shares his own experiences with residents, many of who are facing a major illness or disability for the first time in their life. Ron gives each of them hope, encouragement and a sense of purpose, and his positive attitude inspires them, as well as the staff at Palm Garden of Largo, on a daily basis.

GROUP VOLUNTEER OF THE YEAR AWARDThe Sarasota County Vocational/Instructional Program at Venice High School has made a significant impact on HarborChase of Venice, helping

residents with education and exercise, running errands or playing cards or just giving great hugs to bring smiles to their faces. These students have a wonderful, youthful outlook and their conversations enrich the lives of residents through their caring attitudes and generous hearts. They also help with serving food, cleaning, folding laundry and lawn maintenance, which not only benefits HarborChase, but also helps them build job skills to better prepare for their future. Their enthusiasm and dedication to the facility is both inspiring and motivating.


Thirty-five FHCA member facilities were recently praised nationally for their extraordinary commitment to quality care for frail elders and people with disabilities. The recognition comes from the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL), which in 2009 will present Quality Awards to nearly 500 long term care facilities across the country.

“Recipients of our Quality Award reflect the long term care profession’s commitment to meeting customers’ needs through a process of continuous quality improvement. Increasingly, through programs such as Advancing Excellence in America’s Nursing Homes campaign, providers recognize how this translates into enhanced quality of care and quality of life for their residents,” said AHCA/NCAL President and CEO Bruce Yarwood. “Recipients of this prestigious award know that the pursuit of excellence is a continuous journey, and that the satisfaction of residents, families and staff makes the journey worthwhile.”

The AHCA/NCAL Quality Awards consist of an entry level, Step I Award, a more rigorous Step II Award, and a final Step III Award that mirrors the Baldrige National Quality Award criteria. The Quality Awards are independently judged by a Board of Overseers, who recently strengthened the program by developing 11 success factors that serve as a valuable framework and tool for facilities that are initiating a systems-based perspective to achieve sustainable levels of performance excellence. Recipient facilities have made quality outcomes and customer satisfaction top priorities.

Florida has 34 Step I award recipients and one Step II award recipient. Step I awardees developed solid vision and mission statements, and an awareness of their environment and customers’ expectations. Recipients at the Step II level addressed their approaches to the core values and concepts of visionary leadership, focus on the future, resident-focused excellence, management by fact, organizational and personal learning, valuing staff and partners, systems perspective and innovation, and focus on results and creating value.

“Florida long term care providers understand that quality is the cornerstone of their profession, and we are pleased that the American Health Care Association is recognizing these facilities and the staff


In addition to all FHCA members and associate members, FHCA Pulse is also mailed to legislators, opinion leaders, reporters and state/federal regulators in Florida. The wider distribution allows others to better understand long term care and the daily challenges faced by the long term care providers we represent.

Note to FHCA Pulse readers

LABOR RELATIONS

COUNSEL

by Mike Miller

Kunkel, Miller & Hament FHCA Labor

Relations Consultant

Court of Appeals refuses to enforce NLRB ruling on e-mail policy

This column reported last year on a case involving an employer’s non-solicitation and e-mail policy and the Union’s allegation that the employer violated the law by disciplining an employee for sending a union-related e-mail. The employer in that case had a policy that, among other things, stated that Company equipment was “not to be used to solicit or proselytize for commercial ventures, religious or political causes, outside organizations, or other non-job-related solicitations.” The Company was aware that employees were using the e-mail system to send and receive personal messages, including baby announcements, party invitations and offers for sports tickets and dog walking services. However, no employee was using the e-mail system to support an outside cause or organization (other than for a United Way campaign, which was sponsored by the employer). The exception was a unit employee (who was a union president) who sent e-mail messages to co-workers about a union rally and asking unit employees to wear green to work to support the union’s negotiating position. The Company disciplined the employee for sending the e-mails because they violated the policy prohibiting “non job-related” solicitations for an outside organization; namely, the union.

The National Labor Relations Board (NLRB) discussed the difficult task of balancing the rights of workers to organize and bargain collectively under the Act against the Company’s right to put limits on the use of its own equipment. The NLRB majority (it was a 3-2 decision) found that employees do not have a Section 7 right to use the employer’s e-mail system, just as it had in the past found that employees do not have a right to use other forms of Company property (e.g., bulletin boards and phones) to further the union cause. However, the employer cannot discriminate in its enforcement of the policy based on content. In this case, the NLRB drew a distinction between “personal” e-mails and e-mails that solicit or support an “outside organization” and found that the e-mails the employee sent fell into the latter category and, therefore, could legitimately be banned by the employer. The correct analysis, held the NLRB, was whether the employer’s policy drew a line between union activity and non-union activity. The U.S. Court of Appeals for the D.C. Circuit took up the case and rejected the NLRB’s conclusion (which is sure to be revisited by the new Board once a full complement of members is added). The Court said the proper characterization was between work-related and non-work-related e-mails. Solicitations for outside organizations was just one form of non-work-related message, as were personal solicitations for parties, sports tickets and dog walking. Thus, an employer cannot allow personal message and discriminate against union solicitations without violating the Act.

In other newsThe federal minimum wage increased as of July 24, 2009 to $7.25 per hour, supplanting the lower

Florida minimum wage of $7.21. Employers must pay the higher of the two rates. This means that all “employers” should be paying a minimum wage of at least $7.25 per hour at this time.

The U.S. Department of Homeland Security (DHS) has announced that employers should continue to use the current form I-9 even though it carries an “expiration” date of June 30. A new form will likely be effective later this year. DHS also advises that the I-9 form should be completed in English in all states, even if English is not the employee’s native or best language. The only exception is Puerto Rico, where the I-9 can be completed in Spanish.


Each quarter, the Centers for Medicare & Medicaid Services (CMS) releases a new database containing Nursing Home Compare data. These data include the Five Star Rating System scores. We analyze these data quarterly to spot trends and to better understand how the system is impacting nursing homes around the country. This brief article reports some of the data that we found interesting.

Total Number of Certified BedsWe were interested in the distribution defining the number of certified beds around the

country.

Number of Certified Beds Percentage of All Homes in CMS database

1-75 Beds 33.4%

76-125 Beds 40.3%

126 & UP Beds 26.3%

Total ResidentsWe also wanted to know the distribution of residents per nursing home. How big do

facilities get?

Number of Residents Percentage of All Homes in CMS database

0-75 Residents 45%

76-125 Residents 37%

126 – 200 Residents 14%

201-1368 Residents 4%

In fact, there are some really large nursing homes across the country. There are three facilities with more than 1,000 residents; nine facilities with between 800 and 999 residents; and there are 63 facilities with between 500 and 799 residents. This made us wonder if there was any relationship between number of residents and the overall Five Star rating.

The table below clearly shows that there is. Using a statistical tool called an analysis of variance and subsequent mean contrasts, we found that smaller nursing homes earned on average more stars.

Number of Residents Mean Star Rating (High 5-Low 1)

0-75 Residents 3.34 Stars


126 & UP 2.44 Stars

Finally, we wanted to drill down to see what specific star ratings explain this overall rating impact. Using the analysis of variance procedure, we found that Health Survey Outcomes explained most of the differences.

Number of Residents Mean Health Survey Star Rating (High 5-Low 1)



126 & UP 2.44 Stars

This suggests that it is more difficult to achieve high star ratings as the number of residents increase.

By Larry R. Vinson, PhD

Moore Stephens Lovelace-Broussard Clinical Consultants

More on Five Star ratings Precious Possessions

By Zula Clark, ResidentParadise Lane

Old people, like old paintings

Are faded here and there

But years have added to their worth

Though the polish isn’t there.

The paintings lose a little gilt

The oldsters lose some hair

That only makes them more precious

To people who really care.

Don’t stack them in a corner

Or in an old back room.

Bring them out and show them off

They’ll be gone all too soon.

Then you’ll realize their worth

Although it is too late.

Heartache, sorrow, and distress

Will always be your fate.

Zula Clark is a resident of Health Central Park in Winter Garden. She is 93 years old, legally blind and still writes poetry by using a telesensory machine to read and see her work.


by Max Hauth

MSW, NHANew codes reflect new technology

The 2009 National Fire Protection Association’s (NFPA) Conference and Expo held at Chicago’s McCormick Place featured over 275 exhibitors and 130 educational seminars. The focus of the NFPA conferences is always the technical meetings during which the codes to be reviewed are presented and voted on by the membership. This year 12 such codes were reviewed.

NFPA 72, formerly known as the National Fire Alarm Code, will now be known as the National Fire Alarm and Signaling Code. The changes in technology allow for mass notification of pending dangers from tornadoes, hurricanes, fire, etc. via cell phones, computers, etc. Because of such technological advances, the mass notification system (MSN) was adopted as a part of NFPA 72.

NFPA 99 Health Care Facilities has undergone a sweeping re-write by the technical committee to reflect how the health care industry provides services. It was to be adopted as an NFPA Code; however, on the voting floor, the membership had some concerns and thus returned the total document back to committee. It remains unclear as to which cycle the document will be placed in and brought back to the membership.

While attending the Agency for Health Care Association’s Life Safety Physical Plant committee meeting and the NFPA conference, it was noted by Jim Merrill, Center for Medicare & Medicaid Services (CMS) life safety consultant, that it appears CMS will attempt to adopt the 2009 Life Safety Code.

CMS’s Look Behind Surveys continue to be issues for a number of facilities in Florida, with sidewalks identified as a particular area of concern. Possible solutions may be a Fire Safety Evaluation System (FSES) survey. Contact the Agency for Health Care Administration Life Safety surveyor or Office of Plans and Construction for more information.

Max Hauth is President, Hauth Health Care Consultants, in Lakeland and a frequent contributor to FHCA Pulse on life safety issues. Contact him at (863) 688-0863.

The Rosie II Automated Vital Signs System increases nursing efficiency by up to 800% by taking BP, Pulse Rate,SpO2 and Temp in 45 seconds. The system ensures recordkeeping accuracy by capturing patient ID, time and datestamp for up to 200 sets of vitals. The first question clientsask is “How much does it cost?” The real question is “Howmuch will it impact your budget?” The answer is, “It won’t!”

www.lifesystemsonline.com

Reason #4 Why you need a Rosie… No Capital Budget Required!

life systems, inc.800.841.1109

Legislators are set to cut millions of dollarsfrom LTC budgets. Are you prepared for budget reductions?

No Budget?No Problem!

Time is running out to review your contact information and submit needed changes for the Florida Health Care Association 2010 Membership

Directory and Buyers’ Guide. You can review your account information on the Members Only section of the FHCA Web site at www.fhca.org and make any necessary edits. If you’d like your listing to be e-mailed to you for review, please contact Deborah Iden of FHCA via e-mail at [email protected].

Attention FHCA Members


Update continued from page 1

Disaster preparednessSeptember is National Preparedness Month and an excellent reminder for FHCA member nursing homes and assisted living facilities (ALF) to take advantage of the resources available on the Emergency Preparedness section of the FHCA Web site. These include the Emergency Management Guide for Nursing Homes, which provides an overview of how to develop a comprehensive emergency plan, create policies and procedures and a template for conducting training based on the Department of Homeland Security Exercise and Evaluation Program. The Guide, along with the accompanying Comprehensive Emergency Management Software Application for Nursing Homes, was developed in partnership with the John A. Hartford Foundation, University of South Florida and the Florida Department of Health. FHCA recently conducted training on these

tools, as well as hazardous materials planning for nursing homes and ALFs, for member facilities of the Utah Health Care Association. More information about these, as well as up-to-date H1N1 resources, can be found on the FHCA Web site at www.fhca.org.

Art from the Heart seeks talented residentsFHCA’s Art from the Heart Program is seeking artwork submissions for the 2010 calendar, which will raise awareness about the long term care profession and raise funds for FHCA’s Quality Credentialing Foundation that endeavors to improve quality of care for those living in Florida’s nursing homes.

In it’s fourth year, the Art from the Heart Calendar will feature artwork created by nursing home and assisted living facility residents from across the state of Florida.

NOTICEABLY DIFFERENT.Knowledgeable, accessible, responsive. You’ll develop a personal connection with our senior living team—people dedicated to using their skills and resources to create a noticeably different client experience.

Audit, accounting, and tax | Reimbursement | Internal auditStrategic capital planning | Feasibility studies Operations and performance improvement | Market researchLong-term care demand analysis

Contact Gregory Hathorne at 407-802-1200

© 2009 LarsonAllen LLP

Calendars are distributed free to FHCA member facilities and are an excellent tool for promoting long term care within the community and enhancing resident and family relations. The Program also gives Activity Professionals a great opportunity to help residents express their own unique talents by encouraging them to submit entries for consideration for the calendar.

A panel of judges from the Tallahassee art community will select the finalists for the 2010 calendar, but all entries will have the opportunity to be featured in museum exhibits and on FHCA promotional materials.

Entries are due to FHCA by September 30, and more information, including criteria and requirements for submitting artwork, can be found on the FHCA Web site at www.fhca.org.



FHCA Welcomes New Associate Members

Accurate Healthcare, Nashville, TNAdvanced Healing Systems, Inc., Bloomington, MN

Approved Nab Ceus.com, Inc., Indian Trail, NCBuckeye International, Inc., Hollywood

Comegys Insurance Corner, St PetersburgCORE Senior Housing, LLC, Sarasota

Fusion Healthcare, St PetersburgKAS Technologies, Inc., Lake City

LarsonAllen, LLP, OrlandoLilly USA, LLC, Indianapolis, IN

Links Medical Products, Inc., Irvine, CAMed Pro Associates, Ellicott City, MDMedicaid Eligibility, Inc., Boca Raton

Meridian Select Insurance, TallahasseeMMI Med Carts, Los Angeles, CAReliant Rehabilitation, Plano, TXRx Care, Inc., Fort Lauderdale

Sarah Marie Harris, PhD, NHA, Winter HavenStar Medical Equipment Rental, Inc., MedleySunshine Visiting Physicians, Pompano Beach

Unisource Worldwide, Inc., Miami

NATIONAL LONG TERM CARE EXECUTIVE LEADERSHIP SYMPOSIUM

Critical Issues and Emerging TrendsDecember 3-4, 2009 • Orlando, FL

Invited Speakers Include:Neil Kurtz, MD, CEO of Golden Living, Inc., leader extraordinaire, who understands the need for strategic planning to ensure principled business practices and quality at the facility and corporate level

Joe Lubarsky, a leading expert in the area of third-party payment system policy and design, who will discuss a range of payment topics

Tony Marshall, Florida’s leading Medicaid rate-setting and budgeting informant

Claudia Reingruber, CPA, on the importance of understanding clinical practices and budgeting

Sandra Fitzler and Lyn Bentley, American Health Care Association staff with CMS working partnerships on the link of MDS 2.0 to 3.0 and a regulatory compliance update

Steve Lytlehale, PointClear, Inc., national expert on the Five Star Rating System

Save the Date


American Health Care Association and National Center for Assisted LivingAHCA/NCAL offer hundreds of long term care professional development resources. Categories include Care Practice, Compliance & Regulation, Staffing & Retention, Consumer Resources, Nurse Aid Training, Assisted Living and many more. Go to www.ahcapublications.org or call (800) 321-0343 Monday - Friday, 9 am - 6 pm to place an order.

Edge Information Management Inc.Since becoming an approved service corporation company for FHCA in 1993, Edge has helped over 250 FHCA members meet their background screening requirements and kept them informed of pertinent legislative issues. Edge offers a variety of background checks including: drug screening, fingerprints, criminal, sexual offender, license verifications and references. Call (800) 725-3343.

FMS Purchasing & ServicesFMS has a full line of products and services in our Group Purchasing Program. Through our six area managers and twenty auditors, we ensure maximum savings, prompt response and unparalleled service throughout the state. In addition to our Group Purchasing Program, we also offer the Manufacturers Value Incentive Program. Contact FMS today to receive a free cost analysis and learn how we can put these powerful programs to work for you. Visit us at www.fmspurchasing.com , or call (800) 456-2025.

Hamilton Insurance AgencyHamilton Insurance Agency has 25 years experience, with an emphasis on the healthcare industry, and is proud to provide the best and most economical services available in the industry to its customers. Offering commercial, health, personal and a variety of specialty services like Risk Management consulting, COBRA and Workers’ Compensation. Contact Geoffrey Shisler at (877) 260-9468 or via e-mail, [email protected].

HealthScreen Disease ManagementHealthScreen Disease Management works with self-insured employers to manage those employees and dependents covered under the employer’s health plan diagnosed with chronic illnesses such as asthma, diabetes, hypertension, etc. The expertise we have developed in working with the chronically ill has allowed us to successfully stabilize the healthcare costs of these individuals, which translates into identifiable direct dollar savings to the employer. Unlike many vendors in this industry, HealthScreen is strictly a Pay for Performance organization. HealthScreen will provide employers with 1,000 or more covered employees a Net Guaranteed Return on Investment (ROI) of 125 percent at the end of the first twenty-four (24) months of the program. HealthScreen will put up to twenty-five (25) percent of fees at risk to support this guarantee. HealthScreen also provides one of the most unique and successful smoking cessation programs available today. For more information contact Mack Bryson at [email protected] or call 877-223-4325. Visit our website at www.ehealthscreen.com

MED-PASS, Inc. (Heaton Resources)MED-PASS is a nationally known company specializing in the research and development of documentation solutions, policy and procedure manuals, regulatory guides and in-service training programs for the longterm care professional. Our manuals and guides are comprehensive, easy-to-use and continuously updated. Our forms and resources offer peace of mind and quality and better than competitive prices. Visit us at www.med-pass.com, or call (800) 438-8884.

Office DepotOffice Depot offers Florida Health Care Association members extra discounts and services due to the cooperative purchasing power of FHCA. We offer a wide variety of benefits, including 50 items which have been reduced based on volume ordering up to 80 percent off the list prices (the “High Use Item List”); next-day delivery on everyday office products; an award-winning Web site which links you to your pricing and into the warehouse and keeps 12 months of tracking information at your fingertips. Call (800) 422-2654 for information or to set up an account; call (800) 386-0226 to place an order.

RXPERTS PharmacyRXPERTS is Florida’s premier pharmacy providing pharmaceuticals and infusion services to nursing homes and assisted living facilities. We are the only pharmacy to print the patient/resident’s digital photo on the Rx label, POS, MAR and all other forms. RXPERTS participates in all third party billing, including all approved Medicare Part D PDPs. Call Jeff Wilkes, Director of Sales and Marketing at (813) 579-7042.

Senior CrimestoppersThe Senior Crimestoppers program is a proven, effective, proactive crime prevention system that combines proven components to help provide safe, crime-free facilities for residents, staff, visitors and vendors. Personal lock boxes for use by residents and/or family members, an around-the-clock, completely anonymous “tip line” call center, cash rewards of up to $1,000 posted on any and all incidents that occur and educational materials for residents, families, management and staff members are a few of the components that make up the program. More details can be found at www.seniorcrimestoppers.org or contact Kay Joest at (800) 529-9096 for more details.

FHCA SERVICE CORPORATION SAVES YOU MONEYWe are proud to recommend these fine vendors who provide quality goods and services.

They help keep you and FHCA on top!


Some meetings noted herein may also carry CE credits. Additional information and registration can be found at www.fhca.org. Click on “Seminars/Events”

Classified Ads“Help wanted” and “situations wanted” classified ads are free to FHCA members. You can also post your ad on the FHCA Web site at www.fhca.org. Click on “Job Board.”

Interim Administrator/Prudent Manager – Available statewide. Successful companies need prudent management in difficult economic times as they strive toward operational effectiveness; namely, focus and accountability. As a seasoned professional who has both management and consulting experience in the operation of health care facilities, you will get both a licensee and an opportunity to “fine tune” your operation. Contact Doug Eitel at (813) 843-6250, or via e-mail, [email protected].

Interim Administrator/Executive Director or RVP – Excellent problem solver and communicator. Knowledgeable on LTC regulations (state and federal). Given excellent evaluations for management and leadership. Licensed in Florida. For your needs, call Fred Taylor at (727) 534-0726, or via e-mail, [email protected].

Continuing Education/Training

FHCA CNA Train-the-Trainer SessionWednesday, September 168:30 a.m. – 12 NoonHawthorne Village of Brandon

Class size is limited to 25 RNS from FHCA/FCAL member facilities only.

FHCA Education Program: Rights and Responsibilities and RatingsTuesday, October 27Ramada Inn North, Tallahassee

Wednesday, October 28Haines City Banquet Hall, Haines City

Thursday, October 29Sheraton Suites Cypress Creek, Ft. Lauderdale

All programs run from 9 a.m. to 4 p.m. and offer 6 hours of continuing education.

2009 Meetings/EventsFHCA New Officer and District Presidents’ Retreat & TrainingThursday, September 24 – Friday, September 25Tallahassee, FLContact Tracy Achey at [email protected] for details

American Health Care Association Quality Plus 2009 Annual Convention & ExpoSunday, October 4 – Wednesday, October 7McCormick PlaceChicago, ILVisit www.ahcancal.org for details

FHCA Board of Directors Meeting & Florida Leaders TrainingThursday, November 5 – Friday, November 6Location TBD

National Long Term Care Executive Leadership SymposiumThursday, December 3-Friday, December 4, 2009Orlando, FLVisit www.fhca.org for details

2010 Meetings/EventsFHCA Annual Conference and Trade ShowTuesday, July 6 – Friday, July 9, 2010Orlando World Center MarriottOrlando, FL

FHCA Nurse Leadership ProgramTuesday, September 7 – Thursday, September 9, 2010Hilton Clearwater Beach ResortClearwater Beach, FL

24

Documents

FHCA - Pulse