RIPPED FROM THE HEADLINES

Health Spending Plans Aid Nursing Homes, Drug Importation

House and Senate budget writers have rolled out health care spending plans for the coming year that would set aside money in key areas such as nursing homes and drug importation but still have wide differences.

It’s early in the annual Legislative Session, with plenty of time to work out deals, but the initial budget proposals included a spending gap between the House and Senate.

Senate Health and Human Services Appropriations Chairman Aaron Bean, a Fernandina Beach Republican, unveiled a proposed $39.4 billion spending plan in his committee Wednesday, topping the $38.7 billion plan that House Health Care Appropriations Chairwoman MaryLynn Magar, a Tequesta Republican, recommended Tuesday.

While he boasted that he was “proud” of the budget, Bean said it still wasn’t enough to fully fund the six health care-related agencies that serve Florida’s poor, elderly, disabled and veteran populations. The current-year budget for the agencies is $37.6 billion.

“There’s not enough money in health care to cover every need or want,” Bean said. Read More...

Source: News Service of Florida

Fourth Time Could Be A Charm For Florida Bill Creating Elder Abuse Fatality Review Teams

Senate Minority Leader Sen. Audrey Gibson, D-Jacksonville, has filed bills seeking to create “elder abuse fatality review teams” for the last four sessions.

The first three versions all failed, but Gibson’s 2020 iteration already has passed three committee hearings unanimously and is poised for chamber adoption. In addition, a House companion bill has secured two committee approvals with one panel hearing to go before it is introduced onto the House floor.

The Senate Appropriations Committee endorsed Gibson’s bill Thursday with little comment in a resounding 18-0 tally, its last stop before full Senate votes. Senate Bill 400 was swiftly presented and passed with two supporters deferring comment because time was running out on the two-hour committee session after a 90-minute presentation of Gov. Ron DeSantis’ proposed $91.4 billion fiscal 2021 budget request.

SB 400 authorizes, but does not require, the state attorney in each of Florida’s 20 judicial circuits to create an elder abuse fatality review team, composed of volunteer members. Team volunteers would come from law enforcement agencies, medical examiner’s offices, area agencies on aging, the state’s Long-Term Care Ombudsman program and the Florida Agency for Health Care Administration (AHCA), among other agencies and advocates.

More than 6.6 million of Florida’s 21 million residents are at least 60 years old, the highest percent of senior citizens of any state in the nation. Read More...

Source: John Haughey / The Center Square

ADVOCACY

2020 Legislative Days: Advocacy in Action a Success With High Attendance

This week LeadingAge Florida held its annual Legislative Days: Advocacy in Action (AIA) event, where members and business partners had the opportunity to meet with their state legislators and advocate for the issues that matter most to Florida’s seniors.

Joel Anderson, LeadingAge Florida Board of Trustees Chair and President/CEO, Village On The Isle, opened the program with remarks about the creation of LeadingAge Florida’s Political Committee. The LeadingAge Florida Political committee will be a critical component of the association’s advocacy efforts and will help us support lawmakers who have demonstrated a commitment to, and understanding of, issues important to older Floridians, their caregivers, and the communities that serve them. Following Joel, Vice President of Advocacy Susan Langston and LeadingAge Florida lobbyist Hayden Dempsey provided attendees with an overview of the legislative landscape and a detailed briefing on several important legislative issues. Members and business partners spent the rest of the afternoon at the Capitol, where they had more than 30 successful meetings with key legislators to discuss priorities that included assisted living legislation, affordable housing for seniors, nursing home funding and more.

A legislative reception was held Wednesday evening and well-attended by many legislators. It was a great opportunity to network, build relationships and further educate key decision makers on how their legislation affects member communities and the quality care provided for residents. The event was a success and a great start to a legislative session that will have many accomplishments. Thank you to all of those who attended.

We want to continue the momentum we created this week. The best way to do that is to continue communication and relationship building with your legislators. Write them, call them, attend one of their local town hall meetings or invite them to your facility. By inviting them and giving them a tour, legislators will have the opportunity to see how laws are affecting seniors across the state. The most effective lobbyist is always a constituent. As a provider, your credibility makes you the perfect expert advocate for your community and the elders you serve.

For an overview of LeadingAge Florida’s 2020 legislative priorities, click here.

Regulatory Update: Nursing Home and Assisted Living

This is the first regulatory update for the new year and it starts with an interesting development in the ongoing activity of the state agencies that draft rules governing our facility operations. As you know, the rulemaking process can drag on for several years and encompasses salient activity as well as the mundane. Read below and you decide:

AL Rule Challenge - The rule revisions to Rule Chapter 58A-5, F.A.C., that were adopted by the Department of Elder Affairs on May 10, 2018, were challenged as not being within the range of legal rule writing authority (since the challenge, the rules were moved to AHCA as Rule Chapter 59A-36). The administrative law judge agreed that seven of the challenged rules were adopted by the executive branch agency without the proper delegation of authority from the legislature and the rules were thereby void.

The state appealed that decision and the 1st District Court of Appeal finally issued its opinion this week, and it was not good for AL providers. The court reversed the lower tribunal’s decision and ruled that broad language contained in the statute was nevertheless specific enough to confer rule writing authority on the subject matter. More legal activity on the case may be taken in the form of a request for a rehearing or a request for Florida Supreme Court jurisdiction, or the decision could be left to stand.

What does the decision mean for AL operations? Unfortunately not much. Since the challenged rules are existing rules that are already in effect, all AL providers have been operating under these rules since May 10, 2018. The court’s decision right now is only of interest to administrative law scholars. If further legal action is taken, we will keep you informed. Read the court’s opinion here.

NH and AL Adverse Incident Reporting – LeadingAge Florida attended a second rule hearing yesterday, January 30, 2020, on Rule 59A-35.110, F.A.C. AHCA held this second hearing in response to comments we provided at the first hearing in October and the agency incorporated our suggestion. In this rule involving adverse incident reporting, AHCA is proposing to adopt a scheme that would encourage timely incident reporting within statutory deadlines by establishing an incremental fine process for late filings. Basically, a fine of $50 will be imposed for each day a filing is late, but the fine will not exceed $500. It is hard to write that fines are “good”, but in this case, the agency is being very reasonable in trying to encourage prompt adverse incident filing while not being overly punitive. We will let you know when this rule is final and in effect.

If you have any questions or would like more information, please contact Susan Anderson, Director of Assisted Living Public Policy via email or by phone at (850) 702-0306.

REGULATORY

Top 10 Deficiencies
Week 4: F684 - Communicating Resident’s Care Needs and Ensuring Implementation

This week’s deficiency is F684 - Provide appropriate treatment and care according to orders, resident’s preference and goals. The deficiencies cited relate to failure to implement the approaches and interventions identified on the care plan.

My recommendation to avoid this citation is to review the system you have in place to communicate to the caregiver nurse and/or CNA the approaches and interventions they should follow based on the care plan. Nurses and CNAs need to know what they need to do for each resident in their care. Are you using CNA Kardexes, printed CNA care plans, etc.? Are the interventions that nurses are to follow documented on the medication or treatment records?

You also need to review the system you have in place to ensure that care needs are being met on a consistent basis. This can be accomplished through daily rounding by administrative nurses, asking residents and family members if their care needs are being met, and by reviewing documentation to ensure care directives are carried out.

Ensuring care needs are met is more important than avoiding a deficiency. It goes to the heart of the mission of our members - to provide the highest quality care and treatment to the residents you serve.

I am available to help you if needed. You can reach me via email or by phone at (678) 778-0561.

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.

MEMBER SPOTLIGHT

Penney Retirement Center Earns Another Gold Seal

Pavilion for Health Care honored for excellence in long-term care

The Pavilion for Health Care at the Penney Retirement Community has done it again. By receiving yet another Gold Seal skilled nursing home award, it continued to reaffirm its excellence in the field of long-term care of the elderly.

During the 35-minute ceremony last Friday, representatives from the state capitol, the president of the Clay County Chamber of Commerce Wendell Chindra, Green Cove Springs Vice Mayor Van Royal, council member Connie Butler, senior residents of the facility and about 100 others were on hand for the award.

The award was presented by Elliot Palevsky, CEO Emeritus of River Garden Senior Services in Jacksonville. He is a Gold Seal Panelist and was instrumental in its creation.

“Penney is excellent not because you follow the regulations,” Palevsky said, “excellent because you nurture a culture of care and mutual respect and mutual giving. Excellence that is ongoing and evolving. My father used to say, ‘there is no such thing as good; it’s only a byproduct of trying to get better.’ That has been the motto of Penney and this pavilion. Gold Seals come and go. There are almost 700 nursing homes in the state of Florida. Maybe 40 of them have ever had the Gold Seal. Maybe 20 some-odd have one right now, and only two have had the Gold Seal each time it was available. Penney is one.”

“I am just so proud of the work that my field nurses and CNAs (Certified Nursing Assistants) and the great support from the chain of command,” said Ariel Aranzaso, R.N., head of nursing. This award is the first Gold Seal under his watch. “They’ve always been supportive of me and of the work that I do here.” Read More...

Source: Bruce Hope / Clay Today

Cypress Cove Announces Plans For Luxury Villa/Apartment Expansion

Plans for construction of a $60 million dollar 12-acre luxury villa and apartment expansion to the South Fort Myers life plan community of Cypress Cove were announced Wednesday at the community’s newly opened sales office.

The Oaks at Cypress Cove, an 82-luxury villa and apartment complex is to be located on a tract of land at the southwest corner of Bass Road and Summerlin Road within HealthPark Florida’s 400-acre campus. “Construction,” says Cypress Living President and CEO Troy Churchill, “which will not begin immediately, is being preceded by pre-marketing and sales efforts. We are extremely encouraged by the initial interest.”

Churchill explains that development of The Oaks is “a direct response to the overall ‘Cypress’ brands repositioning plan. By embracing current trends and incorporating many innovative technologies, this housing project provides a great opportunity for our organization to once again set a high bar in Southwest Florida older adult living.”

The Oaks will include three high-rise luxury apartments, each housing 24 large open-concept apartments with scenic multi-view lanais, and 10 elegant villas, ranging from 2,230 to 2,396 square feet, with lakeside views. Each five-story high-rise features a first-floor under-building parking garage. Innovative smart home technology is to be built into each housing unit. Read More...

Source: Ed Stransenback, Cypress Cove Media & Public Relations Coordinator

HOUSING

FL House Budget Plan Shifts $240 Million In Affordable Housing Funds To Other Spending Needs

The Florida House plans another raid on state affordable housing funds in its budget proposal for 2020-21.

In a plan released by the House Transportation and Tourism Appropriations subcommittee on Tuesday, the House wants to shift some $240 million out of the housing programs to use in other areas of the budget.

It would leave $147 million to be spent on affordable housing programs, including $73.2 million for the State Housing Initiatives Partnership (SHIP). SHIP distributes money to cities and counties to help low- and moderate-income Floridians obtain housing through new construction, down-payment assistance, home repairs, and other programs.

The House would spend another $48.8 million on a program to help build more affordable apartment units in the state. And the proposal includes $25 million for affordable housing programs in hurricane-damaged counties.

However, the House decision to use another $240 million in housing funds in other areas of the budget stands in contrast to the Florida Senate and Gov. Ron DeSantis – both support plans to fully fund the affordable-housing programs. Read More...

Source: Lloyd Dunkelberger / Florida Phoenix

New HUD Guidance on Reasonable Accommodations / Assistance Animals

HUD issued new guidance, FHEO-2020-1, to clarify “how housing providers can comply with the Fair Housing Act when assessing a person’s request to have an animal in housing to provide assistance because of a disability.”

The guidance, from HUD’s Office of Fair Housing and Equal Opportunity, is immediately effective (January 28, 2020) and addresses, in part, the fact that Fair Housing Act “complaints concerning denial of reasonable accommodations and disability access comprise almost 60% of all [Fair Housing Act] complaints and those involving requests for reasonable accommodations for assistance animals are significantly increasing.” The guidance goes on to say that most HUD charges of discrimination against a housing provider involve the denial of a reasonable accommodation to a person who has a physical or mental disability that the housing provider cannot readily observe.

From the preface, the guidance “provides housing providers with a set of best practices for complying with the [Fair Housing Act] when assessing requests for reasonable accommodations to keep animals in housing, including the information that a housing provider may need to know from a health care professional about an individual’s need for an assistance animal in housing. This guidance replaces HUD’s prior guidance, FHEO-2013-01, on housing providers’ obligations regarding service animals and assistance animals. In particular, this guidance provides a set of best practices regarding the type and amount of documentation a housing provider may ask an individual with a disability to provide in support of an accommodation request for a support animal, including documentation of a disability (that is, physical or mental impairments that substantially limit at least one major life activity) or a disability-related need for a support animal when the disability or disability-related need for the animal is non-obvious and not known to the housing provider.”

The 19-page guidance, which should be very helpful to housing providers, includes two sections. The first is about accessing a person’s request to have an animal as a reasonable accommodation under the Fair Housing Act. The second section provides guidance on information that an individual seeking a reasonable accommodation for an assistance animal may need to provide to a housing provider about their disability-related need for the requested accommodation, including supporting information from a health care professional.

Source: LeadingAge

Medicaid Block Grant Proposal Likely Has Little Impact In Florida

A Trump administration proposal that would allow states to apply for Medicaid block grants likely won’t have much of an impact on Florida’s program, unless the state decides to expand Medicaid.

The Centers for Medicare and Medicaid Services announced the plan, called the Healthy Adult Opportunity, on Thursday. It’s an optional program that would allow states to receive part of their Medicaid funding in one lump sum. Unlike the current system where the federal contribution increases as a state’s health care costs go up, funding under the block grants would be capped.

The grants would be limited to healthy adults under 65. States could not use them to cover care for children, pregnant women, nursing home residents or disabled people.

Since Florida didn’t expand Medicaid under the Affordable Care Act, it would have very few, if any, people within the eligible demographic. The state’s Agency for Health Care Administration was still evaluating the new plan and could not comment, a spokesman said.

It's unclear whether the announcement would make Medicaid expansion more palatable for Florida legislators. State leaders have previously supported block grants. In 2017, the Agency for Health Care Administration formally requested a waiver that would allow all of its Medicaid funding to flow to the state in one lump sum. Read More...

Source: Julio Ochoa / Health News Florida

 VALUE FIRST

 Your Value First Program

When it comes to balancing resident satisfaction and foodservice costs, you face many challenges. As specialists working with senior living and long-term care communities, we can help you provide your residents with nutritious and satisfying meals that fit your budget. However, our support goes far beyond helping you reduce food costs. Our tools and resources can support your entire operation by reducing costs and improving efficiencies at every step of your supply chain.

It all starts with a cost study where we’ll work with your purchasing team to analyze your current expenses and give you line item comparisons on exactly how we can help you save. As the New Year started we have already seen successes in a number of food cost studies.

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

If you are currently using CINTAS but not through our program, please take a look at this flyer. CINTAS and Value First, in partnership with Vizient, are offering members incredible savings. Contact me for information on how to enroll.

This week I want to thank The Mayflower, Apostle Village and The Arlington of Naples for their time and allowing me to discuss how Value First can help them save.

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 Value First vendor 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

NEW BUSINESS MEMBERS

Please join us in welcoming our three newest business members - Centers Business Office, Hylant and Resource One, Inc. Be sure to visit their website to learn more about the services they offer to senior living providers.

• Centers Business Office - Centers Business Office is a full service consultancy that has been helping nursing home owners maximize profitability and efficiency for more than ten years. Whether you need help in one area or many, a call to Centers Business Office is the only one you need to make. A/R management, billing and collections, consulting, complete business office solutions – A/R, A/P, finance, payroll and accounting.
  
  
• Hylant - Hylant is one of the largest privately held insurance brokerages in the United States. Founded in 1935 and headquartered in Toledo, Ohio, we offer complete risk management services, employee benefits brokerage and consultation, loss control, healthcare management and insurance solutions for businesses and individuals locally, nationally and internationally.
  
  
• Resource One, Inc. - Whether you are looking to buy janitorial supplies online, shop for cleaning products at one of our fully stocked showrooms, or have one of our knowledgeable representatives visit your Florida business and assess your cleaning supply needs, you have come to the right place. In addition to Janitorial supplies, cleaning chemicals, and floor care products, we also offer: floor care equipment sales and service; commercial laundry chemicals, dispensers, and service; commercial warewashing machines, chemicals, and service. We supply cleaning supplies and janitorial supplies to all areas of Florida including Sarasota, Ocala, Tampa, St Petersburg, Orlando, Miami, Naples, Ft Myers, Jacksonville, Tallahassee, St Augustine, Clearwater, Panama City and Gainesville. Contact us today to find out how we can supply you with the right cleaning products at the right price. Like us on Facebook for special offers.
  
  

The goal at LeadingAge Florida is to deliver the highest quality of service to our members. We strive to increase the value of, and return on, investment of your community's membership. As such, LeadingAge Florida works to connect our business members with your communities and facilities to help you secure the best possible services for your residents and benefits for your staff.

If you have any questions or if you know of a business that we should contact, please let Business Development Manager Julie Copeland know by calling her at (850) 702-0317.

Senate Weighs Medicaid Retroactivity Issue

A Senate panel has twice delayed considering legislation that would make permanent a move to eliminate a 90-day period in which people could retroactively apply for Medicaid coverage.

Federal law directs state Medicaid programs to provide 90 days of retroactive coverage to give people time to apply for Medicaid following traumatic incidents or diagnosis of illnesses. That way, people can gather needed information, such as proof of age, citizenship, sources of income and assets.

At the urging of former Gov. Rick Scott, state lawmakers in 2018 agreed to change Florida’s policy. Instead of the three-month time span, the new policy requires people to apply for the Medicaid program in the same month they seek health care.

Lawmakers excluded pregnant women and people under age 21, which means the policy change impacts elderly and disabled Medicaid beneficiaries.

Lawmakers in 2019 extended the policy through July 1, 2020, and directed the state Agency for Health Care Administration to analyze the policy change and submit a report on the total number of non-pregnant adults who applied for Medicaid while in hospitals or nursing homes between Feb. 1, 2019 and Dec. 6, 2019, and the number of applications that were approved and denied. But AHCA couldn’t collect the information the Legislature requested. Read More...

Source: News Service of Florida

COMING ATTRACTIONS

JANUARY

WEBINAR 6 WEEK SERIES: MDS PDPM Assessment, Coding & Systems Orientation & Proficiency Series
Thursday, January 16, 2020 - every Thursday for 6 weeks
Webinars will begin at 2:00 pm ET
This 6-week, 6-session webinar series provides MDS section-by-section coding guidance under PDPM and insights for optimal data collection, supportive documentation, and consistent coding accuracy. Live sessions are completed weekly over 6 weeks and review key MDS sections under PDPM. Recordings are provided with full-series purchase for ongoing on-demand access for new hire orientation and as a staff development resource. Reduce the learning curve for clinical reimbursement staff and drive PDPM coding accuracy and compliance with this MDS series taught by Proactive’s expert instructors.

FEBRUARY

Eldergrow Webinar
2/6/2020 @ 11 AM ET and 3 PM ET
In the next few months, we are going to apply for CMP Funds to implement Eldergrow into interested nursing homes. This will be a fully-funded and staffed grant. Learn more by joining the webinar! Eldergrow™ offers residents a therapeutic connection to nature through innovative gardening products & services. The mobile, sensory garden brings nature inside 12 months a year. Eldergrow educators teach evidence-based, therapeutic horticulture classes that improve life for our growing community of elders living in residential and nursing care.
To register for the 11 AM session, click here.
To register for the 3 PM session, click here.

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.