State News for August 2014

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Kansas Health Care Association Executive Director Cindy Luxem
Kansas Health Care Association Executive Director Cindy Luxem

MIDWEST

LTC survey results to be withheld

KANSAS — The state no longer will publicly release survey results for nursing homes going through the informal dispute resolution process, the Department for Aging and Disability Services (KDADS) recently announced. Long-term care associations and consumer advocacy groups have protested the new system, the Kansas Health Institute News Service reported.

The change will apply only to the small number of nursing homes that appeal survey findings, and it will ensure that the public sees only final survey reports, KDADS spokeswoman Angela de Rocha said. The state will be able to immediately post survey results for nursing homes that seem to be abusing the appeals process, de Rocha told the KHI News Service.

However, long-term care trade associations also will not see survey results while appeals are pending. This could hinder efforts at improving care quality, said Cindy Luxem, executive director of the Kansas Health Care Association. 

The longer wait time is not ideal, but knowing that all published survey results are final could be a positive change, LeadingAge Kansas Chief Executive Officer Debra Zehr told KHI News Service.

Consumers now will only be able to see “whitewashed” survey reports and will not know which facilities had Immediate Jeopardy and other serious deficiencies “somehow” dismissed, countered Mitzi McFatrich, executive director of Kansas Advocates for Better Care.

Providers win on CONs

MISSOURI — The state will not change its certificate of need program thanks to a recent state health planning board vote.

Currently, a nine-person committee determines whether the need for a new nursing facility exists in a particular location; under the proposed change, certificate of need applications first would have had to pass through a three-member subcommittee.

Opponents, notably
LeadingAge Missouri, say that this would have made it easy for applicants to make campaign donations to the legislators on the subcommittee, further politicizing the CON process, according to the St. Louis Post-Dispatch.

Sen. Mike Parson (R-Bolivar) said that the full committee still would have had ultimate authority, and the subcommittee would simply have done prescreening to make certificate of need consideration more efficient, the Post-Dispatch reported. 

Opponents said that the written version of the proposal did not match Parson's description.

NORTHEAST

Euthanasia bill advances

NEW JERSEY — Terminally ill individuals would be able to obtain drugs to end their lives under a bill recently advanced by a state Assembly committee. 

Nursing homes and other healthcare providers would not be required to participate in the administration of the prescriptions, according to The Associated Press

The “Aid in Dying for the Terminally Ill” measure passed out of committee on a 7-4 vote, the AP reported. It would allow people expected to die within six months to get life-ending medications. 

SOUTHEAST

Peacocks ‘fowl' grounds

FLORIDA — A nursing home in Volusia County has asked Florida Fish and Wildlife to remove a family of troublesome peacocks from the grounds, according to local reports.

The birds have lived near the Ridgecrest Nursing and Rehabilitation Center for months, local ABC affiliate WFTV reported. They are posing a problem because they become territorial, and may peck at cars when they see their own reflection, wildlife officials said.

State to facilities: Pay up

GEORGIA — Nursing homes that owe money to the state have 30 days to pay, or they will face termination from Medicaid under a policy that took effect July 1.

The issue mainly is delinquent provider fees, also known as “bed taxes,” according to Georgia Health News. The controversial fees are a mechanism for the state to gain more federal Medicaid dollars, which are meant to flow back to providers. 

If facilities owe more money than “can be collected from 12 months of the provider's claims payments,” they now are required to pay a certain amount within 15 days or face suspension from the Medicaid program, the new policy states. Termination proceedings begin if a payment is not received within 30 days.

The Department of Community Health recently sent past due notices to 33 nursing homes, GHN reported. The new termination policy has not necessarily been “triggered” for all these facilities, the Department of Community Health noted.

More prisoners in SNFs?

KENTUCKY — The state legislature has approved a pilot program to transfer prisoners to private nursing homes. The goal is to reduce state expenditures on care for geriatric prisoners, which currently run to $4.4 million annually, according to The Associated Press.

Medical parole already exists, but the program would require the parole board to approve more prisoners for release to nursing facilities, the AP reported. Death row inmates and sex offenders would be ineligible.

Prisoners who are placed in private SNFs can qualify for Medicaid, shifting some of their care costs to the federal level. 

The pilot program has sparked concern among long-term care providers.

Caring for convicts is not part of the mission of private facilities, and Bluegrass State nursing homes already have high liability costs compared with most other states, Kentucky Association of Health Care Facilities Communications Director Steve McClain told the AP.

“[Our members] are not going to take this without a lot of thought and discussion,” McClain said.

SOUTHWEST

Survey reveals transfer woes

NEW MEXICO — Hospital-to-nursing-home transfers could be improved through better communication and more comprehensive documentation, according to a survey of skilled nursing facility medical directors in the state.

Three-quarters of respondents said that hospital patients often arrive at the SNF without a discharge summary and with care orders that the nursing home staff use more as a “guide” than a “definitive prescription for care,” stated a study abstract from the University of New Mexico. 

In addition, 88% said the discharging hospital should include a direct contact number. All agreed that a medication list, code status and functional capacity at discharge should be communicated to the receiving skilled nursing facility.

WEST

Lawsuit slaps duals demo

CALIFORNIA — The state's efforts to improve care coordination for dual-eligibles have encountered a potential roadblock: a lawsuit filed by three independent living operators and other organizations, including the Los Angeles County Medical Association.

Cal MediConnect is a joint state and federal demonstration program. It aims to move a large number of people eligible for both Medicare and Medicaid into managed care plans, to enhance coordination of medical, behavioral and long-term care, according to the Los Angeles Daily News.

Eligible beneficiaries are automatically enrolled unless they take steps to opt out. The opt-out process has created “vast confusion” for duals, who often are frail seniors, the lawsuit contends.

The suit filed in July requests a preliminary injunction to stop passive enrollment and delay the overall program. 

Duals are not being well-served by the status quo, in which care is “very fragmented,” Department of Health Services spokesman Norman Williams asserted in a statement. 

Surveys delayed, funding risk

HAWAII — State inspectors have not been keeping up with nursing home surveys, which could result in a loss of federal dollars, according to local reports.

Budget cuts last year are to blame for the delayed inspections, a health department official told the Honolulu Star-Advertiser in June. Federal law requires an inspection every 15 months, but a Star-Advertiser investigation found that 17 facilities had gone an average of 20 months without an inspection.

Fifteen of those nursing homes were to have been surveyed by the end of July, according to the health department.

If all the federal inspection requirements are not met by September, the state reportedly could lose up to $121,000 in funding. 

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