RIPPED FROM THE HEADLINES

CMS May Move To Reduce ‘Burdensome’ Requirements For Nursing Homes Next Year

A proposed rule to reduce “burdensome” requirements for providers could be finalized next year, according to the Centers for Medicare & Medicaid Services.

The agency discussed this action in its Fiscal Year 2020 Mission & Priority memo released last week. The annual document is based on regulatory changes, budget allocation adjustments and new initiatives. It is used to guide the work of CMS’ regional offices, state survey agencies and the Quality, Safety & Oversight Group.

“The MPD discusses survey and certification functions as well as the Medicare funding allocation process for states, which directly impacts the work prioritization and planning for the required survey workload in the fiscal year the MPD is issued,” CMS wrote.

Among the actions CMS could take next year, according to the memo, are finalizing a rule that reduces “burdensome” requirements for providers. Under the proposed “Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency” rule, requirements for participation that have been identified as unnecessary, obsolete or excessively burdensome to nursing homes would be removed. CMS believes the rule, if finalized, could save $616 million annually for providers. Read More...

Source: Danielle Brown / McKnight's Long-Term Care News

Plan to Import Cheaper Canadian Drugs Advances Under Trump

A plan to import drugs from Canada and other countries continues to move forward. On Wednesday, Gov. Ron DeSantis and U.S. Health and Human Services Secretary Alex Azar announced that plans are moving forward, for Florida and other states, to import pharmaceuticals.

HHS released a “notice of proposed rulemaking,” a necessary precursor to a process that could take months if not years. The rulemaking allows 60 days for comments, and an additional 75 days for review.

Azar, DeSantis and other state officials extolled the move in statements at the Capitol Wednesday, memorialized in a media release from the Governor’s Office.

“The high costs of prescription drugs have plagued Floridians for too long, and today’s announcement is a historic step towards a solution,” said DeSantis.

“I want to thank President Trump for his steadfast support of our efforts to bring this issue to the forefront as well as Secretary Azar for realizing the benefits this plan will have not only on Florida, but Americans in other states across the country. With the support of the Florida Legislature, I will continue to work to identify innovative ways to reduce health care costs for Floridians,” DeSantis added. Read More...

Source: A.G. Gancarskion / Florida Politics

HAPPY HOLIDAYS FROM LEADINGAGE FLORIDA!

As we prepare for the upcoming holidays, LeadingAge Florida’s office will be closed Tuesday, December 24 and Wednesday, December 25 in observance of Christmas. Our office will also be closed the following Tuesday, December 31 and Wednesday, January 1 for the New Year’s Day holiday.

Thank you to all our members and partners for making this another successful year. You are critical to our success and continued growth. From all of us here at LeadingAge Florida we wish everyone a wonderful and peaceful holiday season and we look forward to serving you in the New Year.

ADVOCACY

Don't Miss This Opportunity to Earn CE Credits!

Advocacy In Action: Legislative Days | January 28 - 30 | Register Today!

From increasing Medicaid funding for nursing homes and reducing home and community based services waiting lists, to modernizing assisted living regulation and protecting Sadowski funding, let your voice be heard and help support effective senior living policy.

This year attendees have the opportunity to earn 6 CE’s! LeadingAge Florida provides up to 6 contact hours of credit for nursing home administrators, nurses, assisted living administrators, and social workers licensed in Florida.

Make your hotel reservations today. LeadingAge Florida has a block of rooms reserved at the Doubletree by Hilton Hotel Tallahassee at a special rate of $239/night until January 3, 2020. Rooms are almost sold out! To reserve your room, please click here to make your reservation online or contact the DoubleTree at (877) 800-2652. Reference LAD or LeadingAge Florida Legislative Days to receive the group rate. If the DoubleTree sells out, we will have overflow hotel options and rates available soon.

Make your plans now to attend the 2020 Legislative Days: Advocacy in Action. This is a one-of-a-kind advocacy opportunity you will not want to miss.

Registration is FREE to all Community/Provider Members! Please complete the registration process.

Scholarships Available
The Scott Boord Career Development Scholarship Program gives members an opportunity to attend aging services programs and education events for those that otherwise would be unable to participate because of financial limitations. Scholarships are awarded to members who meet certain criteria. To access the application, please click here.

REGULATORY

Have Administrative Staff Read Citations

All of the deficiencies we have published this week were cited at a scope/severity level of Immediate Jeopardy. My recommendation this week is to have your administrative team read all of these citations asking this question for each one: “Could this happen at our facility?”

• Do all your staff know not to let anyone follow them off a secure unit?
• Do all nurses know how to determine a resident’s code status?
• Do you have a sexuality policy for residents with dementia? Do all staff know and follow this policy?
• Do all your nurses know and follow proper infection control procedures for cleaning and disinfecting the blood glucometers?

It only takes one instance of a staff member failing to follow your facility's policies and procedures to be cited for an Immediate Jeopardy. There are more IJs being cited than in the past. Every facility is at risk.

If I can help in any way please contact me. 

Connie Cheren, RN, MSW, LeadingAge Florida's Clinical and Compliance Specialist, can be reached via email or phone at (678) 778-0561 to help answer questions before, during and after your surveys. As a value-added service provided by LeadingAge Florida, Connie can help nursing home and assisted living facility members improve regulatory compliance and clinical outcomes, in addition to offering suggestions about corrective plans of action to improve your surveys.

AGENCY FOR HEALTHCARE ADMINISTRATION

Update from AHCA on Medicaid Long-Term Care Claims Denials Related to Eligibility

AHCA has provided an update regarding the denied Medicaid LTC claims due to the apparent loss of Medicaid LTC eligibility status. For the last several months, AHCA and the Department of Children and Families (DCF) have collaborated to determine how and why some recipients eligible for Medicaid LTC had their status changed from LTC to MMA. This status change was mostly for a one-month period that resulted in the nursing home or ALF claims being denied.

DCF has implemented some solutions within their system to stop the cause of the one-month loss of eligibility. It appears these system repairs are having positive results. Feedback received from FAHA H&S members indicate they are seeing a slowing of claims denials related to eligibility issues. Additionally, DCF has reinstated the full Medicaid LTC status for all recipients for the one-month period loss of eligibility and/or shift to MMA status for the period of 12/1/18 – 11/30/19.

On December 6, AHCA informed the Statewide Medicaid Managed Care (SMMC) health plans of this eligibility reinstatement status and the requirement of the health plans to adjudicate these claims to the providers. The explanation included they are to receive a list from AHCA of these reinstated members to identify the previously denied claims. The purpose of this list is so nursing home and ALF providers will not be required to resubmit the previously denied claim for adjudication.

On December 12th AHCA emailed the SMMC health plans the list of their members whose one-month eligibility had been reinstated. Based on the feedback from AHCA, the health plans will receive payment (capitation) for these members at the end of December. The health plans were not paid previously for these members due to the one-month loss of eligibility. Based on this feedback, and because of the capitation being received at the end of the month, it is likely these claims will be paid in January and potentially February. Read More in the FAHA H&S Newsletter...

Florida Medicaid Health Care Alert - Home and Community-Based Settings Rule | Provider Type(s): 67

This alert is to advise of the Home and Community-Based Settings (HCBS) Rule as specified in 42 CFR 441.301(c)4 and AHCA’s plan to ensure the state’s compliance including upcoming on-site assessments.

In January 2014, the Centers for Medicare and Medicaid Services (CMS) published rule CMS-2249-F (CMS-2296-F), requiring all Home and Community-Based Services waivers to be in compliance with HCBS setting requirements specified in 42 CFR 441.301(c)4. The rule directed all states to evaluate their current HCBS settings for compliance with the requirements outlined in the rule. The regulations enhance the quality of HCBS and provide additional protections to individuals that receive services under these Medicaid authorities.

AHCA will work with providers and managed care plans to ensure that all HCBS settings comply with the rule.

Within the coming weeks, the following Long Term Care Program providers types can expect to be assessed for compliance with this rule:

• Assisted Living Facilities
• Adult Family Care Homes
• Adult Day Care Centers

To determine compliance, a tool will be used to evaluate specific areas. Each provider will be assessed by one of the managed care plans they contract with using this tool. For more information regarding the tool, click here.

For additional information, click here.

MEMBER SPOTLIGHT

Cypress Cove Donates One-Half Ton of Hams

Cypress Cove donated one-half ton of hams Thursday to The Heights Foundation/ The Heights Center (The Heights) for its annual Christmas give away to needy families in the Harlem Heights community. Since Thanksgiving, the Life Plan community of Cypress Cove has donated nearly 1,800 pounds of food to The Heights! Delivering hams to community Director of Arts and Community Programs Melissa Barlow (right) are Cypress Cove representative, from left, Richard Morales, Mike Simmonds, Facilities Director Peter Haight, Cypress Living Vice President of Human Resources Drummond Camel, and Resident Services Director Mary Franklin. (Photo provided by Cypress Cove)

50-Year-Old Holiday Display Brightens Up Local Senior Living Community

This December, residents, team members and guests at Village on the Green senior living community are being treated to a special holiday exhibit that has been five decades in the making. The one-of-a-kind display, featuring an elaborate snow village, is the brainchild of resident Carolyn Bourland, a former Rockette with an affinity for spreading some holiday cheer.

Carolyn began collecting pieces for the display 50 years ago while working at a friend’s design store, and the rest is history. Virtually everything in a typical neighborhood can be found at her snow village. This includes figurines, homes, businesses and community centers, from a courthouse to a barbershop. Many of the display items are no longer in circulation and can fetch anywhere between $500 to $1,000 on the secondhand market.

Setting up the exhibit was a cherished family tradition before Carolyn moved to Village on the Green, and she loves that the community allows her to carry on with it. Her fellow residents are in awe of the details and her longtime dedication.

Would you like to meet Carolyn to learn more about her one-of-a-kind holiday display? Contact Mike Achoki at machoki@glynndevins.com or 913-317-2268. 

HOUSING

Agency Moving Forward with Housing Assistance Pilot Program

Agency for Health Care Administration (AHCA) Secretary Mary Mayhew announced new details regarding the Housing Assistance Pilot Program. The pilot program will operate in Pinellas, Pasco, Seminole, Orange, Osceola, and Brevard counties and began operations earlier this month. AHCA's goal with the housing assistance pilot is to facilitate housing stability and improve health outcomes for the up to 4,000 Medicaid recipients that can be served annually.

In April, the Agency announced that federal approval had been granted to allow AHCA to create a Housing Assistance Pilot Program as part of the Florida Medicaid program.

Secretary Mayhew said, “On behalf of Governor DeSantis, I am excited to announce a bold new direction for Florida’s Medicaid program as we work to support individuals with serious mental illness (SMI) and substance use disorders (SUD) with supportive housing services. In partnership with community providers, our Agency through selected managed care plans, will address a major social determinant of health for individuals with mental illness or substance use disorder by focusing on efforts to support stable housing to improve their health outcomes and reduce preventable hospitalizations” Read More...

Florida Housing Partnership with Governor DeSantis Produces Housing Wins

The Florida Housing Finance Corporation (Florida Housing) is proud to announce numerous housing accomplishments in the first year of Governor Ron DeSantis taking office. “Florida Housing greatly appreciates the support and leadership that Governor Ron DeSantis has provided - from full funding statewide in both of his proposed budgets for housing, to hurricane recovery housing for affected families,” said Florida Housing Executive Director Trey Price. “As the state’s housing finance agency, Florida Housing works every day to help Florida families attain housing options that are affordable to them. With the resources that are entrusted to us, Florida Housing can continue to provide assistance for Florida’s growing and diverse needs.” Read More...

Welcome to Silver Business Partner Clancy & Theys Construction Company!
Thank you For Your Extraordinary Commitment to Our Members

Clancy & Theys Construction Company is a second-generation, family-owned corporation that was founded in Raleigh, North Carolina, in 1949 and has been in continuous operation for the past 70 years.

During our 70-year history, Clancy & Theys has built a legacy by forming long-lasting partnerships with the clients, partners, and communities in which we serve. These relationships are forged by professionals who reflect the company’s mission of acting with fairness, integrity, respect, and collaboration.

During the 1980s and 1990s, Clancy & Theys expanded to serve clients throughout the Southeast United States by opening regional offices located throughout Virginia, North Carolina, and Florida. The Florida Division of Clancy & Theys was founded and registered as a Florida Corporation in 1991 and has been in continuous operation for the past 28 years maintaining vast staff resources throughout the Southeast.

Today, Clancy & Theys employs more than 340 people, including project managers, superintendents, field engineers, carpenters, masons, concrete finishers, equipment operators, warehousemen, truck drivers, mechanics, laborers, and office support personnel in management, accounting, payroll, marketing and estimating. Guided by a powerful motivation to make the construction experience satisfying for our clients, our teams construct the highest quality buildings systematically by utilizing leading-edge technology and common sense to turn complexity into carefully orchestrated simplicity.

Currently, the Clancy & Theys Florida Division is providing construction management services for the expansion of Westminster Baldwin Park in Orlando, Florida. The new 181,310 square foot Westminster Baldwin Park Phase II is a challenging addition to a thriving and active Senior Living Community.

Each senior living community is unique, and it is our goal to fully understand the particular needs of each project, partner, and stakeholder to ensure that all expectations are exceeded. We believe that our culture of quality allows us to fulfill these commitments while remaining consistent with our mission — that’s the Clancy way.

Clancy & Theys Construction Company
Jeff Mock, Vice President
1401 Beulah Rd Ste 124, Winter Garden, Florida 34787
Work Phone: 407 578-1449
E-mail: jeffmock@clancytheys.com
Web Site: http://www.clancytheys.com

VALUE FIRST

Value First is proud to announce our continued success nationally in winning cost study reports using our two vendor partners, US Foods and Sysco.

Value First and our national partner Vizient are ready to provide you a free cost study. All that is required is one month of data, and you are under no obligation to commit. The cost study will provide you:

• A comparative analysis and contract utilization
• Visibility to line-item prices and rebate value
• Access to propriety procurement services
• A product attribute tool to aid in decision making

Please take a advantage of this. It only takes a few minutes of your time, and we do all the leg work.

Let’s end the year strong with a food cost study!!!!

Please contact me, Bobby Bernal, at (850) 509-8112 or email me at rbernal@leadingageflorida.org or Rbernal@valuefirstonline.com

I will walk you through the few easy steps.

Please click here for the NEW Updated Dec 2019 Value First contract catalog.

Thank you again. All the best, and see you on the road!

Robert "Bobby" Bernal, Value First Regional Southeast Manager

C: (850) 509-8112 | Email

COMING ATTRACTIONS

JANUARY

Fundamentals of Pain Management Webinar
1/9/2020 @ 11:00 AM ET
This webinar will review the development of a pain management program, including identification and treatment of a resident’s pain and evaluating the effectiveness of interventions.

Survey Trends Conference Call
1/10/2020 @ 10:30 AM ET
LeadingAge Florida members have been experiencing issues with increased scrutiny in the CMS nursing home survey process. To help our members prepare and deal with the new survey process, LeadingAge Florida hosts this conference call to provide you with critical information on survey changes.

There is no charge for LeadingAge Florida community members participating on this call. Please go through the registration process so we are able to email you the webinar information.

Legislative Days: Advocacy in Action
January 28 - 30, 2020
Doubletree by Hilton | Tallahassee, FL

There is no charge for LeadingAge Florida community members participating at this event. Please go through the registration process so we are able to email you the webinar information.

FEBRUARY

Freedom from Abuse Webinar
2/19/2020 @ 2:00 PM ET
This webinar will apply the principles of the abuse regulation to all aspects of care being provided.