Pulse June/July 2006 - Florida Health Care Association

Transcription

Pulse
FHCA
JUNE/JULY 2006
FLORIDA HEALTH CARE ASSOCIATION
Update
A Long Term Care Monitor of Nursing Home and Assisted Living Issues
Bush-whacked:
Sylvester is
‘future leader’
$91 million in nursing
home funding vetoed
F
HCA Senior Vice
President David
Sylvester is one of
only 21 people in the
nation selected to
participate in the American Health
Care Association’s 2006-07 Future
Leaders of LTC in America symposium
July 17-18th in Washington, DC.
Future Leaders is a twelve-month
training program that familiarizes
participants with key long term care
issues and helps them develop better
leadership skills.
Levine, Francois
confirmed
A
gency for Health Care Administration Sec. Alan Levine was
confirmed by the
Florida Senate during
the last week of the
60-day 2006 legislative
session.The vote allows
Levine to remain at AHCA until at
least 2007, when Gov. Jeb Bush leaves
office.Also confirmed was
Department of Health
Sec. Dr. Rony Francois,
who was appointed in
September 2005.
Mega Pulse
I
n addition to a complete update
on important legislative, regulatory,
quality improvement and reimbursement issues, this month’s super-sized
32-page FHCA Pulse also contains
valuable information about goods
and services on display at the FHCA–
FCAL 2006 Annual Conference
trade show. The regular monthly
production schedule resumes with
the August 2006 issue.
Inside
A Day in the Life of an NHA. . . . . . . . . . . 8
CMS Sit-Down . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Dining Forum . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
LTC Business News . . . . . . . . . . . . . . . . . . . . 26
2006
FHCA-FCAL
Annual Conference
headed to Kissimmee
Dynamic keynoters;
huge trade show;
24 hours of CE; Rain
plays at finale banquet
Cuts threaten quality improvement
and financial stability; access to
nursing homes imperiled
I
n a sudden and unexpected move described as
“baffling” by FHCA Executive Director Bill
Phelan, on May 25th Gov. Jeb Bush vetoed
some $91 million in Medicaid nursing home
funding, including $65.5 million targeted at those
facilities that had been most seriously impacted by previous
cuts. The governor also cancelled the restoration of $25.6
million in funding cut last year.The vetoes dealt serious blows
to the financial stability of the state’s 700 nursing homes.
“By cutting our lifeblood, Governor Bush has dealt a blow
to the steady improvement in quality of care we have seen since
CONTINUED ON PAGE 5
T
he elegant Gaylord Palms
Resort & Spa in Kissimmee
is the site for the FHCA-FCAL
2006 Annual Conference, the
largest event of its kind in
Florida. This year’s theme is
“The New Age of Old Age…
Let the Revolution Begin!”
FHCA members and other
attendees will be able to choose
from 41 continuing education
seminars with the potential for 24
contact hours in both nursing
home- and ALF-specific topics.
Full registrants will also receive
four free correspondence courses
in HIV, End-of-Life / Palliative
Care, Medical Errors and Domestic
Violence, a $125 value.
CONTINUED ON PAGE 3
Florida Health Care Association
P.O. Box 1459
Tallahassee, FL
32302-1459
Real Royalty:
Thelma Ardery, right, was among
many who chatted and posed for
pictures with Miss USA 2005,
Chelsea Cooley, during a recent
lunchtime visit to The Haven of
Our Lady of Peace in Pensacola.
Below right, Alma Bell of Sandy Ridge
Care Center in Milton was crowned
Ms. Northwest Florida Senior during
the sixth annual FHCA District XII
(Pensacola) Ms. Northwest Florida
Senior Pageant. For more, see “News
from Across Florida,” page 23.
A Treasured Elder:
Still Punching Strong
See Page 10
PRSRT STD
U.S. Postage
PAID
Tallahassee, FL
Permit No. 1007
FROM the
PRESIDENT’S
DESK
by Dion Sena
FHCA President
Our next FHCA
President will have
a great challenge
Florida
Health Care
Association
Dion Sena,
President
Bill Phelan,
Executive Director
David Sylvester,
Senior Vice President
Deborah Franklin,
Secretary
Nina Willingham, Treasurer
FHCA Pulse
JUNE/JULY 2006
FHCA Pulse is produced monthly for the
Florida Health Care Association, P.O. Box
1459, Tallahassee, FL 32302-1459, by Ed
Towey & Associates, Inc.
Editorial – To submit information, guest
articles, press releases, etc., contact Ed
Towey at (850) 224-6242 or via e-mail at
[email protected]. Fax information to
(850) 224-9823 and include your name,
telephone number and e-mail address.
To contact FHCA, call (850) 224-3907.
Advertising – For information on Pulse advertising rates and availabilities, contact Ian
Cordes at Corecare Associates at (561) 6595581 or via e-mail at [email protected].
All articles and advertising are subject to
editorial review.
2 FHCA JUNE/JULY 2006 Pulse
Am-Bushed by ‘Veto Corleone’
W
hat was he thinking? I simply can’t fathom Governor Bush eliminating $91 million in critical
nursing home funding, which was about 20 percent of the total $449 million he line-item vetoed.
A St. Petersburg Times editorial stated the governor says he “hunts down legislators” pet projects, particularly those that don’t serve a statewide purpose or are not vetted by a government agency, and strips
them from the budget on principle. By what standard, then, does he veto the elderly in nursing homes?
It might have been different were our state in dire financial straits, but this year there was a surplus
of at least four and as much as six billion dollars.The governor said this surplus was for a “rainy day.”
Governor, I hesitate to say this so directly, but in the lives of the elders for whom we care, a hard rain
is falling down right now and you just took away their umbrella.
Florida’s nursing homes should never be expected to continue to take these funding hits. In axing
the Medicaid funding we had so diligently worked to obtain in the Senate and House, Gov. Bush
threatens the very quality improvements he had long championed. I believe his vetoes will also put at risk
his own plans for Medicaid managed long term care. So, until we all can work together in developing
a new program, our society has the moral obligation to preserve the current Medicaid program as a
safety net for those who truly need it. FHCA and its allies will not shy away from this basic, fundamental public policy objective and social responsibility.
This will be one of the greatest challenges for our next FHCA President.Which brings me, however
indirectly, to my next point.
Memorable moments
As I conclude my term as FHCA President, I note that several people have asked me what my most
memorable moment was. There have been several, but the most memorable were the hurricanes of
2004 and 2005. This is what really tests your mettle. We again showed what we were made of and why
we are the pride of our profession.
My most memorable trip (and there were many trips) was in March 2005, when my wife Cathy and
I, FHCA Senior Vice President David Sylvester and Executive Director Bill Phelan visited the White
House.We ate breakfast in the West Wing in what FHCA lobbyist Bob Asztalos calls the “Navy Mess.”
Our host was Director of the White House Office of Faith-Based and Community Initiatives Jim
Towey, the former legal counsel to Mother Teresa and the brother of FHCA media/public relations
consultant Ed Towey. Later, we all were seated in the front row at a White House event at which
President Bush himself spoke and greeted us.
Thank you
I am greatly encouraged to see the slate of FHCA officers for next year. Member talent and commitment is a wonderful thing, something we’ve always been fortunate to enjoy and benefit from
throughout FHCA’s 52-year existence. History, leadership and strong roots are what have kept us
together, and I must personally thank FHCA past presidents Bobby Rosenthal (1998-2000) and Tom
Kelly (1994-96) for their constant support.Thanks also to all our associate members who came through
during the hurricanes and continue with strong commitment in service. I have always had a great
respect and appreciation for our dedicated staff at FHCA, but having worked even closer with each of
them over the past two years makes you understand even more why we are the envy of all the state
organizations. Bill, Cathy, Dawn, Debbie, Erica, Judi, Kelli, Koko, Lee Ann, LuMarie, Peggy, Rita,
Susan, Teresa, Tony, Venetia — you are the All-Star team.
A personal thank-you
I must also thank our partners at Allied Mobile X-Ray, Eric and Aaron, for their generous support
of me and FHCA.You always hear about the bad partnerships, well, I am blessed. Okay, how blessed am
I? Anyone who really knows me knows my wife. You also know her constant support, understanding
and shared commitment to FHCA and caring for and Treasuring Our Elders. Without her support I
could not have run for this office. Her belief in me strengthens me everyday. Saying “thank you” to my
wife Cathy is not enough and saying that I am a blessed man would be an understatement. The Beatles
song “Here, There and Everywhere” opens with this line: To lead a better life I need my love to be here.
Know me, know my wife. Know our Annual Conference chair.
Never can say goodbye
And in the spirit of our 2006 FHCA-FCAL Annual Conference theme,“The New Age of Old Age...
Let the Revolution Begin,” I say (and I quote the Beatles one more time)You say goodbye and I say hello.
I can’t wait to see you and say hello to you at conference.
It is unity — not necessarily unanimity — that is important for us to write the future.
One mission. One voice.
2006 FHCA-FCAL Annual Conference headed to Kissimmee
CONTINUED FROM PAGE 1
“We always want to combine equal
amounts of education and fun,” FHCA
Annual Conference Committee chair Cathy
Sena said.“This is our chance to get together and support one another.”
Highlights
In addition to two outstanding keynote
speakers, the 2006 FHCA Nursing Home
Administrator of the Year will be named, along
with other awards that recognize outstanding legislators, members, volunteers, individual patients and residents, associate members
and those who excel in community outreach activities. FHCA’s highest honor, the
Walter M. Johnson, Jr. Circle of Excellence
Award, will also be given at the end of the
annual banquet. The Circle of Excellence
recipient is chosen by previous years’ honorees and nobody, including the honoree
him or herself, knows who the winner is
until it is announced by FHCA Secretary
Deborah Franklin, the 2005 honoree.
A 275-booth trade show will feature the
latest and best goods and services available
to long term care professionals, and at the
Impressive
Line-Up:
Left to right,
keynote
speaker U.S.
Navy Capt.
J. Charles
Plumb, Retired, will discuss overcoming
adversity in his talk, “Who Packs Your
Parachute?”; second-day keynoter Patrick
Brannelly’s topic is “Breakthroughs in
Brain Science: Transforming the Way We
Age”; Beatles tribute band Rain entertains
at the annual banquet, the highlight of
this year’s conference.
two general membership sessions, candidates
for FHCA office will be elected to serve
one-year terms, changes in bylaws will be
voted on and a set of officers for the newlyreconstituted Florida Center for Assisted
Living will be elected.
Event organizers chose a 1960s-era “new
age” theme, so “flower power” and hippie
imagery from the era will be omnipresent,
particularly at the trade show. “It will be
reminiscent of Woodstock. Come prepared
to let your mind wander — only with all
new cutting-edge information on aging and
long term care delivery systems,” Sena said.
FHCA JUNE/JULY 2006 Pulse
3
LTC LEGAL ISSUES and TRENDS
by Karen Goldsmith
Light at the end of the tunnel?
Goldsmith, Grout
& Lewis
FHCA Legal Consultant
W
ith the government denying more
and more Medicaid applicants after
they have already been admitted to long
term care facilities, providers have been
searching for means to collect for services
rendered. This problem is not unique to
Florida. In fact, it is a universal issue, given
the limited ability to transfer or discharge a
patient for non-payment.
approved for Medicaid in April of that year.
He had less than $2,000 in assets, except
for his residence. Since he indicated an
intent to return to his house, it was treated
as an exempt asset.
Legal standing
Fraudulent conveyance
A facility in Tennessee recently took an
interesting approach, with great results. In
Beverly Healthcare Brandywood v. Gammon, the
court overturned a transfer of property in
favor of a provider.The first hurdle that the
facility had to overcome was the ability to
maintain the action, legally prove standing.
In Gammon the court held that the facility
had standing under the Tennessee fraudulent
transfer statute. Florida has a similar statute,
found in Chapter 726, Florida Statutes. This
statute allows a creditor to sue for a fraudulent conveyance. You may be that creditor.
Next, the court looked at the facts underlying the transfer of the patient’s assets.
In Gammon, the patient was admitted to
the facility on February 28, 1997. He was
His daughter, Betty Gammon, was the
man’s agent under a durable power of attorney. Purportedly, on advice of counsel, she
sold her father’s house and distributed
approximately half of the proceeds to herself
and her two sisters. In addition, she paid
$5,000 to herself and her sisters for a servicefor-life agreement. Some money was left in
the father’s account. He was disqualified for
Medicaid for several months. He apparently
did not pay the nursing home the private
pay rate for those months.
The lower court held that the sisters’ were
liable to the nursing home for the debt,
because under Tennessee statutes in effect at
that time, the patient had knowledge that
his future debts would exceed his ability to
A collections case in
Tennessee might help you
pay. Since he had no life-threatening illness,
he reasonably would expect to stay in the
nursing home for a period of time. Selling
his home gave him a non-exempt asset (the
proceeds) from which to pay the nursing
home. He did not use the money to pay
the nursing home, but rather transferred it
to his daughters.The appellate court upheld
the lower court’s decision.
I cannot tell from the opinion that I read,
whether the man personally was involved
in the transactions or whether only his
daughter, under the power of attorney he
had granted her, made the sale and conveyance of the proceeds to herself and her
sisters. However, I do not believe that the
court decided based upon the actions of
the daughter, since the judgment impacted
all three sisters.
Florida law
Florida has a fraudulent conveyances
statute similar to that of Tennessee. Under
the Florida statute, the creditor need not
hold a debt when the property is transferred.
The creditor’s claim can arise after the transfer
was made if the potential debtor actually
intended to defraud the creditor, was about
to engage in a business transaction for which
the remaining assets of the debtor were too
small to satisfy the debt when it became due
or if the debtor should reasonably believe
that he would have debts beyond his ability
to pay. Given a specific set of facts, any one
of these conditions might apply in a nursing
home lawsuit for payment for services.
While actual intent is often hard to
prove, Chapter 726.105, F.S., sets out certain
factors which the courts may consider,
absent specific evidence of intent. These
include, among other factors, that the person
who received the asset was an insider, that
the transfer was of substantially all of the
debtor’s assets, or that the transfer occurred
shortly before the debt was incurred.
Caveat
In preparing this article, I have not done
extensive research on case law in Florida
under this statute. However, in light of the
reasoning in the Tennessee case, your attorney may want to take a look at the statute
and how our courts have interpreted it.This
may be a fresh approach to collections or it
may be time for our courts to take a new
approach. Perhaps there is light at the end
of the tunnel, if you have the right facts.
Bush-whacked: $91 million in nursing home funding vetoed
approval of his landmark SB 1202 elder care
legislation in 2001,” Phelan said on the day
of the veto.“We are extremely disappointed
in him.”
If only…
Had Gov. Bush not vetoed the $91 million
in funding, the 2006 legislative session might
have been considered one of FHCA’s best
in recent memory:
■ Major nursing home funding increases
were approved with broad support in both
the Senate and House
■ The law protecting the confidentiality
of facility adverse incident reports was
extended
■ Funding was restored for the Medicaid
adult dental, hearing and vision program,
including funding for partial dentures
■ A moratorium on new nursing home
bed construction was extended for another
five years, with certain exceptions to allow
for local need
■ The alternative fee a leased facility must
pay in lieu of obtaining a lease bond was
halved, from two to one percent of three
months-worth of Medicaid payments
■ Minimum CNA staffing was increased
to 2.9 hours per patient per day, but it will
be measured on a weekly, not daily, basis
and it will take effect January 1, 2007
■ Florida Senior Care, the Medicaid
managed care program for the elderly, must
receive final legislative approval before
beginning the pilot programs scheduled
for Orlando-Melbourne and Pensacola
■ The state’s Nursing Home Guide was
streamlined to include more current Watch
List information, and the combined report
will be issued quarterly, not yearly
■ Some $17.6 million in funding was
approved for construction of Florida’s sixth
veteran’s nursing home
“Our disappointment is compounded by
the fact that state law requires us to provide
(nursing) services, but the state won’t pay
us for them,” Phelan pointed out.“This will
likely cause nursing homes everywhere to
shift the cost to their private-pay patients,
in effect imposing a ‘silent tax’ on them.
Nursing homes will also be forced to carefully limit their Medicaid-paid admissions,
which will profoundly affect access to nursing home care by middle-class families
everywhere in the state.”
Phelan noted that nursing homes would
have used some of the additional funding
to offset their losses due to greatly increased
fuel, utility and property/casualty insurance
costs.
“The governor is right to shoot down
budget ‘turkeys,’ but this is money that goes
to pay for the care of Florida’s most frail
citizens,” Phelan said.
Call to action
In response to Gov. Bush’s veto, FHCA
sent letters to all Senate and House members thanking them for their support during
the 2006 session and asking them to contact
their respective leadership to urge restoration of the funding “through whatever
means possible.” FHCA members are also
being encouraged to contact their state
legislators to urge them to do likewise.
“We fought very hard for this funding,”
Phelan said. “We’ll fight very hard to get
it back.”
(Editor’s note: For more on the legislative
session, see “LTC Business News,” page 26.)
FHCA Welcomes
New Members
FCAL - NCAL MEMBERS
Bishop Grady Villas, St. Cloud
Crown Pointe of Spring Hill
The Pavilion at Bayview, St. Augustine
ASSOCIATE MEMBERS
Atlantic Healthcare, Miami
CareerStaff Unlimited, Clearwater
Community Education, LLC,
San Marcos, CA
Druzak Medical, Inc., Aliquippa, PA
James F. Gilroy III, P.A., Tallahassee
Medicom, LLC, Brooklyn, NY
Rehab Care, Winter Haven
Resurgence Holdings, Inc., Tampa
Southern Healthcare Assurance Group,
Orlando
Statewide Disaster Restoration,
Southfield, MI
)
FHCA JUNE/JULY 2006 Pulse
5
Florida Center for Assisted Living
by Lee Ann Griffin
More new rules on the
way for ALFs?
L
ast month, assisted living facilities around
the state received a package of proposed
new rules from the Department of Elder
Affairs.The rules have been developed internally over the last couple of years between
DOEA and the Agency for Health Care
Administration, the primary regulator of
ALFs. Facilities are now getting a look at the
proposed rules for the first time and are considering whether or not the changes reflect
a step toward improved service for their
clients or toward a more expensive and
restrictive health care model.
The Florida Center for Assisted Living
has conducted a regulatory analysis of the
proposed new rules and provided a detailed
report to members in mid-May.The changes
include additional communication, documentation, and organizational requirements,
including:
■ Fire: A copy of the annual fire safety and
sanitation inspections conducted by the
Proposals would increase
communication, documentation and organizational
requirements
state’s local authority are to be sent by the
facility to AHCA within 30 days of the
inspection; provides for new administrative
actions for failure to comply
■ DNRO: A statement of the facility’s policy regarding Do Not Resuscitate Orders be
included in the admission packet
■ Activities: An increase in scheduled
activities from five to six days and from ten
hours per week to 12 hours per week
■ Contact: Facilities would be required to
contact a resident’s health care provider
when observable health care changes occur
that may be due to the person’s medications.
Documentation would follow in the resident’s record
FHCA POLICY & QUALITY
ASSURANCE SPECIALIST
■ Documentation: Any communication a
facility makes to report a resident’s unusual
reactions or significant changes to the resident’s health care provider would have to be
documented in the client’s record
■ Rx labeling: New labeling and packaging requirements for customized resident
medication packaging
■ Rx packaging: New labeling and packaging requirements for sample or complimentary prescription drugs dispensed for
the resident
■ Keys: Facilities would be required to
maintain master or duplicate keys for the
resident’s bedrooms and bathrooms
■ CLSP: ALFs with a Mental Health
Services license would now be required to
include a description of other services they
provide or can arrange as part of the resident’s Community Living Support Plan
■ Moratorium: When notifying an ALF
that a moratorium is being placed on the
facility, the AHCA Area Office would have
to notify the ALF both in writing and via a
telephone call on the same day. Currently,
only a telephone call is required
Forms updated
Additionally, some commonly used forms
for ALFs are being updated. For example,
some changes to the Form 1823, “Resident
Health Assessment for Assisted Living
Facilities,” are being proposed. First, the
form is now produced by AHCA, not
DOEA. Second, additional information will
be asked for regarding the resident’s ability
to perform self-care tasks and their need for
oversight.
We have requested a rule hearing with
DOEA to open these proposals up for discussion.We will continue to work with our
assisted living facility members to bring any
concerns forward at that time.
F HCA
Web site
•
•
•
•
NEWS, BULLETINS
MEMBERSHIP
REGULATORY
REIMBURSEMENT
www.fhca.org
Thoughts from the inside…
A day in the life of a
nursing home administrator
(Editor’s note: John Simmons is FHCA
District IX (Jacksonville) President and the
administrator of 163-bed Jacksonville Nursing
& Rehab Center. As a health care administrator
with more than 30 years experience, he will
conduct a seminar, “Proud Again to be an
Administrator,” during the FHCA – FCAL
2006 Annual Conference. Simmons writes,“I’ve
learned that having a positive attitude is crucial.
Keeping it is the tough part!”)
Monday, 7:20 a.m. Arrived at work and
was soon met in the parking lot by two of
my best CNAs who complained they never
have enough linen to do their rounds properly — that laundry never brings them
enough. Promised them I would look into
it. Stopped at laundry department on the
way to my office. Laundry lady says some of
the CNAs take the linen and hide it in the
patients’ rooms. She says the aides want to
run out of linen so that they do not have to
work. Hmmm. Promised to look into it.
7:35 Started my morning rounds. The
hallway circulation fan is off again. For three
years I have had to turn it on every morning to circulate the air. No one ever seems
to know who turns it off or why after I
leave the night before. Three years! Some-
The daily ups and downs of
health care’s toughest job
day I am going to find this “no one” and
ask why he/she does that!
7:50 Check several rooms and find a ton
of linen stacked in the closets. The linen is
clean, but I toss it into the soiled-laundry
barrel to wash it again.Will talk to night staff
one more time. Maybe it’s time for a 2:00
a.m.“raid” and some write-ups!
8:30 Check e-mail from corporate.
Another conference call for tomorrow.
9:00 Morning meeting. I remember
when these were “stand-up” meetings and
ended quickly. Business office claims nursing
department not turning in slips for billing
in timely manner. Nursing claims they were
turned in on time but someone lost them.
Wonder if “someone”is related to “no one?”
10:00 Medicare RUG meeting. Must
check all Medicare patients to make sure
their RUG level is appropriate.
10:30 Family member in to ask “why in
the hell” we cannot find Mom’s sweater.
Try to explain that Mom wanders the facility all day and thinks all the rooms are her
7:00 a.m. Supervise Rusty’s Tree Service topping of two large trees overhanging
the parking lot
by John Simmons
room. She is often found lying on another
person’s bed and often has removed various
articles of clothing, so the sweater could be
anywhere. (In fact, I’ll bet “no one” gave it
to “someone” and they put it “someplace”
out of the way.) Family member forcefully
explains that Mom would never go into a
room not her own and that I do not really
know my own patients. Promise I will look
into it. Invite family member to come in
for a care plan meeting sometime since she
has missed the last three or four. Family
member explains she simply does not have
the time for that.
11:00 Fire alarm goes off. Maintenance
man said he forgot to tell me he was having
a drill today. Good news: all the staff knew
what to do and did it well. Make a note to
come watch the next one on 11-7 shift to
see if they do as well.
11:35 Nursing agency salesperson comes
in to give me candy and asks for more
business. I tell him yet one more time that
he gets no business from me if he continues
to poach my staff for his agency. Candy is
good, however.
12:05 p.m. Rehab manager comes in
to ask for more money for PRN staff.
Seems rehab folks want to find yet another
entrance into Ft. Knox! Should have gone
to PT school.
12:25 Open mail from attorney’s office
asking for another medical record to be sent
to their office because it seems we are not
treating his client well. The patient’s family
member has shown up from North Carolina
to check on dear old Dad (the first time we
have heard from him in three years), and of
course, his second stop while in town was
to dear old lawyer’s office. Spend 30 minutes
looking at medical record and thanking
God for nurses who know how to document well.
1:15 Check kitchen and grab lunch.
Found dirty can opener. Gave lecture about
food safety and that we must do everything
right all the time.
1:30 A family member stops by to thank
us for doing a good job. That was nice.
But there was a “however.” Seems Mom’s
hearing aid is missing. Aha! When I was in
CONTINUED ON PAGE 13
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Reference Resources For Your Special Needs
The recently updated Geriatric Medication Handbook is now
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Documentation
Reorder From:
© Copyright 2001 MED-PASS, INC.
All rights reserved
A full line of Long-Term Care and ALF-specific documentation solutions,
including forms for assessing, monitoring and risk management, are available
for immediate use.
800-438-8884
Form # AL1020
Rev. 2/05
CARE ALERT
Use this form to report any changes in a resident's condition.
Describe the change in condition below and forward a copy of this
form to the community □ Wellness Director □ Director of Nursing
□ ________________________________
Rm/
Regarding: _______________________ Apt. # ________
(Resident Name)
On _____/_____/_____
The following was
□ Witnessed
□ Noticed
at
_____:_____
AM
PM
□ told by the resident
□ told by another individual
(specify: ______________________)
□ Accident, fall or incident
□ Deterioration in mental status (confusion, delirium, etc.)
□ Chest pain or other pain that is unusual for the resident
□ Abnormal vital signs
□ Persistent vomiting or diarrhea
□ Choking incident or any new onset of respiratory problems
□ Weight variance (change of 5% or more during last seven
days)
□ Change in continence
□ Unusual bleeding or bruising
□ Skin deterioration (decubitus ulcer, significant skin tear,
rash, etc.)
□ Changes in gait (stumbling, shuffling, balance problems,
etc.)
□ Increased assistance needed in ____________________
□ Other _________________________________________
□ Other _________________________________________
Additional Comments: _______________________________
_________________________________________________
INH101101
Employee Signature/Title
White - Appropriate Director
Phone 800-438-8884
Fax 800-230-8687
www.med-pass.com
www.heaton.org
Date
_______________________________________________________
Yellow - Resident Record
A treasured elder...
William David Besmanoff
Former heavyweight prizefighter still going the distance
W
illie Besmanoff busily studies scrapbooks jammed with newspaper clips,
photos and souvenirs of when he was one of
the top heavyweight fighters in the world.
“I was a boxer, not a fighter,” Besmanoff
quickly points out to the Treasure Our
Elders interviewer.True, and in his 73 years,
he was also a professional baker, small businessman, construction worker, civic booster,
husband, father and grandfather. Today he
lives comfortably at the spacious Moultrie
Creek Nursing & Rehab Center in St.
Augustine, his home for the past six years.
A heart condition and recurring balance
problems have slowed him only slightly, and
at 210 lbs., he is but five pounds above his
old fighting weight. His shoulders remain
broad, his fists massive, his eyes piercing and
his smile, ready and gentle.
Between 1952 and 1967, Besmanoff
boxed in 92 professional matches against such
pugilistic legends as Zora Folley, Archie
Moore, Sonny Liston, George Chuvalo and
in 1961, 19-year-old Cassius Clay fighting
in only his tenth professional bout. Clay
(three years later he changed his name to
Muhammad Ali) won by TKO in the seventh, sending Besmanoff to the canvas twice
in that round. “I was knocked down, but
never knocked out,” Besmanoff says with
great pride of all his fights, including 62
amateur contests before he turned pro.
German-American
Besmanoff was born the older of two
children to a German mother and JewishAmerican father, a physician, in Munich,
Germany in 1932. The couple divorced
before Besmanoff was eight years old. His
father returned to the U.S. as World War II
broke out in Europe, and Besmanoff ’s
mother moved the family to Berlin to live
with her parents. His maternal grandfather
was a prominent businessman and tranportation executive who raised young Willie as
his own son and looked out for the family
during the extremely difficult war years.
Besmanoff vividly recalls the constant
Allied bombing raids late in the war, one of
which caused the partial collapse of his
school while he and his classmates were
inside. Trapped for almost two weeks,
Besmanoff was rescued by his grandfather
Tough Guy:
Besmanoff’s scrapbook documents an exciting career and
stirs many memories; at right,
Besmanoff pounds Argentinian
fighter Alex Miteff during a 1958
fight in Seattle;
Besmanoff’s solid
upper body,
lightning left and
keep-coming-atyou style made
him a fearsome
and formidable
opponent.
who had organized a digging party to help
get them out. “I remember sitting down on
what I thought was a log, but it was a badly
burned, dead body.”
Budding boxer
Boxing for Besmanoff began after the
war, when at age 13, he joined an athletic
club organized by American GIs in occupied Berlin. Within four years he was its
undisputed champ and became something
of a hometown celebrity. By early 1952,
Besmanoff held the German lightweight
title and was named to the first West
German Olympics boxing team even
though, technically, he was considered an
American.
While still a teenager, Besmanoff was
approached by managers and trainers who
urged him to turn pro, which he did on
August 15, 1952, against Hans Schreiber.
Besmanoff lost in the fourth round, but
would fight 14 bouts after that before seeing
his second loss. His American debut came
February 25, 1957, at the famous St.
Nicholas Arena in New York City. The
half-German half-American was an instant
crowd favorite, as much for his charisma
as his impressive 34-5-7 record at that point.
It was while he was in America that
Besmanoff ’s manager, Lou Burston,
arranged a reunion between Besmanoff and
his estranged father whom he had not
seen or heard from in 16 years.“He told me
he wanted my mother back, but she said
she wouldn’t leave Germany. That was it.”
On the road
Besmanoff relocated to Milwaukee,
Wisconsin — a city with a large GermanAmerican population — and spent the next
ten years touring the U.S., fighting seven
or more times a year and building a name
for himself. He fought with great intensity
inside the ring, but carried no personal
animosity toward any of his opponents
outside the ring. He stayed in touch with
many of them over the years, including
Muhammad Ali.
Flipping through his scrapbook some
more, Besmanoff pauses at a yellowed
newspaper clip from 1960, describing the
“American Heavyweight Title” fight
between Besmanoff and Archie Moore.
“There’s ‘Old Baggy Pants,’” Besmanoff
says, pointing to a photo of Moore. “We
went at it for ten rounds in Indianapolis
until he hit me right square on the nose and
I started bleeding pretty bad. I think I would
have bled to death if the referee hadn’t
stopped the fight.” Besmanoff boasts of
having never sustained any serious injury in
over 150 fights and never seriously injuring
any boxer. “I was lucky. I was very lucky.”
Bowing out
By the late 1960s, the ring losses started
to outnumber the wins, and at age 34,
Besmanoff sensed it was time to call it
a career and return to being a full-time
baker, a trade he learned while a young man
in Germany. He used his boxing winnings to
open a bakery in Melbourne Beach, and
later, another in nearby Satellite Beach.
Still another newspaper clipping (Once
Punching for Dough, Now Punching the
Dough) described how people loved to
Nice Guy:
Besmanoff towers
over his then fouryear-old daughter
Barbara in a prefight photo taken
circa 1964. At
right, Dad and
daughter today.
come to the famous ex-prizefighter’s bakery
for a loaf of his signature bread and to hear
some great boxing stories. Besmanoff later
went to work for Publix and moved his
family from city to city in Florida as he
helped get their in-store bakeries up and
running. Eventually, he settled down in St.
Augustine, where two of his three daughters
live with their families.
Fond memories
Was he ever scared in the
Besmanoff insists he never was, even
things were not going well for
Moultrie Creek administrator
ring?
when
him.
Brian
Ferguson agrees and recalls locating a Sports
Illustrated video of one of Besmanoff ’s old
fights and sitting down with him to watch
it. “He lost that particular fight, but he was
fearless all the way through.” Ferguson says
at the end of the fight the two sat in silence
until Besmanoff turned to him and said,
“I remember every one of those punches.
Some of them hurt a lot. But I feel good
now and it’s great to have memories to
share with everyone. I’ve had a good life.
I’m a very lucky man.”
FHCA honors William David Besmanoff
and treasures his many contributions to our
state and nation.
FHCA JUNE/JULY 2006 Pulse 11
CMS outlines goals during an
8-state regional sit-down
T
he Centers for Medicare & Medicaid
Services Region IV SNF Provider
Forum was held in Atlanta over two days last
month, with eight southeastern states’ health
care associations represented, including
Florida’s. CMS’ agenda began with a Medicare Part D discussion and its impact on
nursing home patients. One of the major
problems has been with some long term
care pharmacies not contracting with some
plans that had automatic enrollment of dual
eligibles. The ability of dual eligibles to
change their enrollment on a monthly basis
was viewed as a protection for them.
Performance goals
The CMS performance goals include the
decrease in the prevalence of restraints and
pressure ulcers in nursing homes. CMS
noted pressure ulcers can be prevented with
most patients; that there are enhanced
enforcement guidelines for surveyors; that
reduction remains a high priority; and that
consumers view high pressure ulcer rates as
indicative of poor quality of care.
Florida is reporting only a “very slight
decrease” from 9.7 percent in 2003 to 9.5
percent in 2006, with the national average
being 8.5 percent. CMS’ target goal is to
reduce the rate by a least one percent in
2006.
Restraints
CMS further stated that many providers
still “mistakenly hold that restraints are
necessary to prevent injury and they can
cause incontinence, pressure ulcers, loss of
mobility and other morbidities.” Again,
Part D plans, restraints,
pressure ulcers, other
topics on the agenda
Florida has reported only a “slight decrease”
in restraint use, down from 9.3 percent to
9.0 percent since 2003, with the national
average being 6.4 percent.Alabama leads the
region with a 3.4 percent restraint use and
7.3 percent pressure ulcer prevalence rate.
Some of the reported lessons learned
through the interventions of the Quality
Improvement Organizations across the
south included:
■ Extensive education has to be given
to patients, families and staff
■ There are time constraints for monitoring care
■ MDS coding confusion needs to be
addressed
■ More activities are needed for
Alzheimer’s patients and those with related
dementias
■ Ongoing motivation of staff needs to
be recognized
QI pilot
The CMS Quality Indicator Survey pilot
program is being demonstrated in five states
with the plan to roll it out to 25 states in the
next year before national implementation.
The QIS is a revised long term care survey
process with an initial review of larger
samples of patients based on the MDS,
observations, interviews and medical record
reviews.The QIS team members use a tablet
by LuMarie Polivka-West
FHCA QUALITY CREDENTIALING
FOUNDATION SENIOR
DIRECTOR
personal computer throughout the survey to
record findings. The computer synthesizes
and organizes the information for the survey
outcomes. The intent of the revised survey
process is to improve “consistency and
accuracy of quality of care and quality of
life problem identification using a more
structured process” and to “focus survey
resources on facilities with the largest
number of quality concerns.”
IJs
The long term care enforcement discussion focused on Immediate Jeopardy situations. There has been an increase in the IJ
findings across the states.The regional office
imposes a civil monetary penalty of between
$3,050 and $10,000 per day of Immediate
Jeopardy or a per-instance CMP may be
imposed for one or more deficiencies
identified during a survey, not exceeding
$10,000. CMS sends a public notice to
the newspaper near the facility when an IJ
is noticed. In all IJ cases, the provider
agreement must be terminated by CMS
no later than 23 calendar days from the last
day of the survey, if the IJ is not removed.
Immediate Jeopardy removal is based on
the following:
■ The scope of the problem: How many
beneficiaries, staff involved and outcome of
the situation
■ A reasonable, feasible and comprehensive plan of removal
■ Evidence that the plan is being implemented
According to CMS, the basics in avoiding
an Immediate Jeopardy citation are:
■ Assess patients for risk upon admission
and ongoing
■ Have a system in place to prevent
accidents and incidents
■ The system in place must be effective
in solving the problem identified
■ Continuous training and education of
staff regarding the system and policies and
procedures at the facility
Pay-for-performance
Nursing home quality followed with a
discussion of Congress’ pay-for-performCONTINUED ON PAGE 15
A day in the life of a nursing home administrator
the kitchen they found one left on a tray
and I just happened to have brought it to
my office with my lunch. Man, do I look
like a genius today. Once in a while I get
one right.
2:00 Talk with hospital discharge planner.
Family members do not want one of our
patients to return to us, saying they have a
problem with how we care for her (though
they’ve never said anything to me). I wonder
aloud with the DP if it might have something to do with the fact that they are not
following through with the Medicaid application because they want Mom’s check to
pay the mortgage on Mom’s house where
they also just happen to be living. Okay, I
say, tell them politely that we do not want
her back either. I am told “we can’t do that.”
Either way, I can’t win.
2:40 Staff development person comes in
to remind me that I have to meet with the
orientation class in five minutes and talk
about HIPAA and corporate compliance.
2:45 Meet new employees. All of them
have worked at other facilities. I ask if they
10:00 a.m. Review RUG levels with
Irwin Co, RN, Director of MDS
have heard of HIPAA. No one has. How
can that be? After my lecture I check the
files on the new recruits. I decide to call two
facilities and see if they will tell me more
than just their dates of hire, etc. Nope!
But the administrator tells me to “watch out
for that one,” whatever that means.
3:15 Review latest survey material that
the department heads gather monthly.
Overall satisfaction is still running in the
high 90 percent, which makes me feel better. Many of the comments are so positive
that I start to feel better about the day.
After all, that’s why I am in this profession.
3:35 Vendor calls. Seems corporate did
not send them a check. Promise to look into
it. Call corporate and they claim we did not
send the invoice in a timely manner. Check
with the department head involved who
claims he gave it to AR in plenty of time.
Check with AR and she claims she did it
on time. Call corporate person back and ask
for the check to be cut ASAP. I take the
blame. That was a fun 25 minutes!
4:15 Meet with the business office manager to go over AR accounts. The number
is getting better but still way too many families trying to beat the Medicaid system and
not paying the surplus. Not much we can
do but keep making the calls and applying
pressure. Review three cases for greater
CMS outlines goals during an 8-state regional sit-down
ance plans and its three-year demonstration
project in four or five states. Facilities that
achieve either high performance or substantial improvement in quality of care will
be awarded incentive payments. The key
questions for the study are:
How should nursing home quality performance be measured?
■ How should the payment pool be
determined?
■ How should performance be linked to
payment?
■
The core domains for the study will be
staffing, appropriate hospitalizations, MDS
outcomes and survey deficiencies.
No-pay bills
The discussion on “no-pay bills” stressed
the October 1st requirement that a SNF will
be required to bill for a “beneficiary that has
started a spell of illness under the SNF Part
A benefit for every month of the related stay
even though no benefits may be payable.”
Also, both a private pay SNF patient not
on a skilled stay but in a certified bed and
a Medicaid patient in a certified bed, have
to have a “no-pay bill” submitted after discharge or monthly while in the certified
section of the facility.
RUG refinements
There is an ongoing analysis of the
SNF PPS Resource Utilization Group
refinements because the increase from 44
to 53 RUGs has resulted in a 13 percent
increase in payments. The CMS presenter
cautioned providers that if the ADL score
is between four and six, they will not qualify for the new nine RUGs, “even if the
extensive service and rehab criteria are
met.”
Sex offenders
CMS also addressed the problem of
convicted sex offenders residing in nursing
homes with the statement that their
rights have to be respected as others and a
facility cannot transfer/discharge a person
with a history of sex abuse unless he/she
meets one of the five criteria in CFR
483.12. CMS does not have any federal
requirements related to sex offenders in
nursing homes.
Interpretive Guideline Changes
Completed Revisions
F314
Pressure ulcers (11/04)
F315
Incontinence (6/05)
F501
Medical Director (11/05)
F520
Quality Assurance (6/06)
F521
Psychosocial Severity Guidance
(6/06)
Future Issuances
F324/325
Accidents and Supervision
F371/325
Safe Food Handling
F373
Paid Feeding Assistants
(new tag)
F334
Influenza and Pneumonia
(new tag)
F329/425
Pharmacy Services /
Unnecessary Drugs
F309
End of Life / Pain Management
F223-226
Abuse
Advance copies of surveyor guidance
are available at www.cms.hhs.gov/surveycertificationgeninfo/.Click on“Policy and Memos
to States and Regions.”
PREVACID SoluTab and
Nutrition-related
Long Term Care
citations declining . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Three things to watch for
to avoid citations
I
The value of PREVACID SoluTab
in the Long Term Care setting:
=
n general, nutritional issues don’t seem
to be cited by AHCA surveyors as much
as they once were — today, they’re not even
in the Top Ten list of most frequently-cited
tags. However, there are a few things cited
related to table heights and not feeding
people all at the same time, and F371
(safe food handling) is still one of the leading dietary issues, according to AHCA’s
St. Petersburg-based Health Services &
Facilities Consultant Mary C. Maloney.
Here are some others:
Hydration
Hydration appears to be cited more
often than Nutrition. The most-cited
hydration issues have to do with monitoring the fluid restrictions for patients with
end-stage renal disease. Another issue
with ESRD patients, not cited as often,
is obtaining appropriate weights. Nursing
homes do not always ensure that they are
using post-dialysis treatment weights for
patients with ESRD on hemodialysis for
evaluating nutritional status. This is not
always being care planned. The nursing
home may use the weights from the
dialysis center, but often there is a lack of
communication between the two facilities. Effective communication is necessary for the optimal management of the
person with ESRD, particularly for other
nursing issues (vascular access, blood
pressure, etc.).
Diabetic management
Diabetic management in nursing homes
has improved overall, but sometimes the
interdisciplinary team (including the
physician) isn’t aware of the current
diabetic management practice guidelines.
Practice guidelines for glucose control
are not being followed, in terms of
getting biochemical lab tests done, like
A1C. The IDT doesn’t always look at the
fingerstick blood glucose values and sliding
scale insulin coverage of diabetic patients
to evaluate their glucose control. Recently,
Maloney says she has been noticing some
physicians are paying attention to the
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• Adverse events reported most frequently with PREVACID were
diarrhea (3.8%), abdominal pain (2.1%), and nausea (1.3%).
• Symptomatic response to therapy does not preclude the presence
of gastric malignancy. PREVACID is contraindicated in patients with
known hypersensitivity to any component of the formulation. Please
see the brief summary of the complete prescribing information for
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• PREVACID is indicated for the short-term treatment of GERD
(gastroesophageal reflux disease) including erosive esophagitis.
• PREVACID products should not be crushed or chewed.
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and 5.1 mg per 30 mg tablet.
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Printed in U.S.A.
Nutrition-related
citations declining
current guidelines and are lowering the
scale for sliding scale insulin coverage from
200 mg/dl to 150 mg/dl. The nurses are
not picking up on this and are not giving
the insulin to the patient when the blood
sugar is 175 mg/dl, for example. It may
only require, say, two units of regular
insulin, but over time, this could affect
the patient’s blood glucose control.
Tube feedings
Tube feedings are not always being
administered as ordered, so the patient
does not receive all their nutritional
intake.This is not very common, Maloney
says, but sometimes the patient’s tube
feeding is turned off for care, and then
someone forgets to turn the pump back
on.Another issue — equally rare — is changing a tube feeding formula without
conferring with the facility dietician
beforehand. In one case, the changed
feeding formula doubled the calories and
protein with the same volume administered, far exceeding the patient’s requirements. This case of over-feeding had
potential poor outcomes, as the patient
had impaired kidney function.
Advertise in FHCA
Pulse
contact Ian Cordes at Corecare
Associates, exclusive sales agent
ph: (561) 659-5581
fax: (561) 659-1291
e-mail: icordes @ bellsouth.net
F HCA
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NEWS, BULLETINS
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A day in the life
of a nursing home
administrator
Florida’s First and Foremost Licensure Program*
Online Healthcare Risk Management
– Nationally Recognized Faculty Experts –
University of South Florida
Office of Continuing Professional Education
http://www.cme.hsc.usf.edu/hcrm/
Tel: (813) 974-2161
Email: [email protected]
*Meets State of Florida Agency for Health Care Administration 120 Hour
Educational Program Licensure Criteria
pressure and make note that at least two of
them will probably call AHCA as soon as
they get the letter demanding payment.
Call DON and let her know to expect
AHCA in any day next week.
4:45 Make afternoon rounds with DON.
Stop in several rooms to chat with the
patients, several of whom thank us for taking
good care of them. Two even brag about
the food.
5:10 Check outside storage area and
find it unlocked. Call maintenance man and
tell him to come back to the facility and
lock it properly. He is not happy.
5:30 Check kitchen for dirty can opener.
It is clean. Walk through dinning room and
note that staff is serving properly. The
background music is right and the patients
are happy with the food. Head back to
the office feeling good. Will check my calls
before heading home.
6:20 Head for the car, but stop at smoking area to chat with a CNA and several
patients.The aide tells me her vacation days
are not right on her check. Promise to look
into it. Tomorrow.
What would you do if you
discovered the Golden Egg?
Visit the CareerCenters at
www.fadona.org, www.fmda.org, and www.fhcswa.net
These are the official online CareerCenters of the
Florida Association Directors of Nursing Administration,
Florida Medical Directors Association, and
Florida Health Care Social Workers Association.
4:15 p.m. Go over AR accounts with
Business Office Manager Pat Fierst
These CareerCenters are a treasured new online resource designed to
connect long-term care industry employers with the largest, most qualified audience of nurses, nurse administrators, directors of nursing, nurse
practitioners, medical directors, physicians, physician assistants, social workers, social service designees, and directors of social services in Florida.
Job Seekers may post their resume (it’s FREE) — confidentially, if
preferred — so employers can actively search for you.
Let these CareerCenters help you make your next employment connection!
5:40 p.m. Meet with Resident Council
President Peter Meyres
Quality Improvement
Dining forum inspires ‘culture change’
E
ager to improve both the quality of care
and the quality of life in their facilities,
more than 150 nursing home staff members
attended a dining forum held at the Winter
Park Civic Center to learn more about how
to change the traditional dining experience
into one that’s fun and incorporates choice.
Teresa McCann, RN, Regional Director
of Education and Change Management for
the Institute for Caregiver Education, kicked
off the day-long conference, sponsored
by the Teaching Nursing Home, Florida
Pioneer Network, Darden Restaurants and
the Winter Park Health Foundation.
McCann emphasized the importance of
incorporating the food traditions of the
people who live in the nursing home and
celebrating their life histories.
Among many good ideas, McCann suggested:
■ Offering more food choice in the
facility
■ Bringing out food on steam tables so
as to enhance the aroma of the food and
make choosing easier
■ Encouraging staff to dine with the
people they serve as well as their visitors
■ Liberalizing diets
■ Decorating the dining area more like
home (using cloth tablecloths and napkins;
bottles instead of paper condiment packets;
salt and pepper shakers; glassware rather than
plastic; table centerpieces; napkins rather
than bibs)
According to McCann, making meals
and mealtime more enjoyable will increase
appetites, decrease weight loss, dehydration,
medication use and facility-acquired wounds
and improve satisfaction.
During breakout sessions, conference
participants learned about best practices in
dining for people with dementia, how to
ensure regulatory compliance and the
benefit of adding a “wheelchair buffet.”
There was also a firsthand success story told
by Lori Jowett, Administrator and Mike
Miland, RD, Chief Clinical Dietician, of
FHCA member Health Central Park in
Winter Garden.
HCP transformation
Health Central Park began its own
culture change journey slowly in the late
1990s. It really took off about two years ago
Great ideas for making
mealtime more enjoyable
after receiving assistance from the Florida
Pioneer Network and the Teaching Nursing
Home. It has converted all its nursing units
into “neighborhoods,” each with its own
name. Jowett shared how the neighborhoods
use “learning circles,” a high involvement,
relationship-building technique that ensures
all — including staff — stay involved and
participate in the life of the home.
HCP begins the lunchtime meal with
servers dishing up hot soup from a special
cart. The soup is served before the entrée,
which has enticed people to arrive early and
to eat in the dining room instead of their
own rooms. Most dine restaurant-style,
selecting from a menu in the main dining
room.
“We’re doing a lot of things to make the
dining experience fun,” Jowett said.
The Health Central Park dining program
includes many other restaurant features
including linen tablecloths and napkins,
background music, finger towels, a salad bar,
a carving station and a dessert cart. The
elders in the home are actively involved in
all aspects of food planning and preparation
— even pie and jam making.
All departments within the nursing home
are involved in the HCP dining program.
Office workers wheel people to and from
the dining room. Human resources staff
helps serve soup. Activities staff serves the
Pitching In: Health Central Park chef
William Frazier carves and serves fresh
roast turkey restaurant-style to “waiter”
Sharon Caccia, HCP’s Housekeeping
Supervisor. Right, Rubye Waters awaits a
tureen of delicious hot soup, served up by
Terri O’Neal, Human Resources Coordinator.
by Debra Wood, RN
meals and works with the dietary department to plan special events, such as ethnic
days or drive-in movie dates, which features
hamburgers or pizza.
“They love it,” Jowett said. “We’ve had
no complaints from anybody, including
family members, about food. We get high
praise from all corners.”
Eats n’ Treats
Some of the elders at Health Central Park
operate the Eats n’ Treats Country Store,
which sells snacks, beverages and easy-toprepare foods to fellow patients, staff and
even students completing their clinical
rotations in the facility. The proceeds are
donated to the HCP Resident Council to
fund outings and other amenities. The
country store has been so successful that
those involved with Eats n’ Treats were
honored with FHCA’s Group Volunteer of the
Year award in 2004.
The dining forum concluded with an
interactive panel of regulatory, quality
improvement and culture change leaders
responding to questions from participants.
At its conclusion, people left the dining
forum enlightened about the possibilities of
enhancing quality of life and in how doing
so will improve outcomes and overall
quality of care.
(Debra Wood is an Orlando-based Registered
Nurse and professional writer. For more information, contact Cathy Lieblich, coordinator, Florida
Pioneer Network at (407) 228-1815, or via
e-mail at [email protected].)
News from
across
Florida
FHCA Region III Vice President Ben Carotenuto, left, and
District IV (Tampa) President Nancy Thurman, lower row
left, led a delegation of FHCA members who came to
Tallahassee during the legislative session to advocate
for adequate nursing home funding.
Miss USA 2005, Chelsea Cooley,
meets with staff and patients at
The Haven of Our Lady of Peace
in Pensacola; at right, contestants
compete in the sixth annual Ms.
Northwest Florida Senior Pageant
held in Pensacola. Thirteen representatives from area nursing homes
competed, emceed by Jeff Nall of the
Council on Aging. FHCA District XII
(Pensacola) raised over $1,500 in
prize money for the event, donated
by generous community sponsors
including Target Stores, Gulf Power,
Covenant Hospice, Baptist Health
Care, PharMerica, Aegis Therapies,
Life Care Center of Pensacola and
the Heritage of Santa Rosa. Alma
Bell was named this year’s winner.
Patients and residents of Village on the Isle in
Venice donated $32,000, which was divided
into eight $4,000 scholarships and presented
to nursing staff during a special ceremony.
VOTI President/CEO Tom Kelly, at podium,
presented the scholarships on behalf of the
Resident Council.
Administrator Gary West and two staff
members of Valencia Hills Health & Rehab
Center in Lakeland pose in front of FHCA’s
Aging in America art exhibit. The exhibit
was featured at the facility’s first Quality
Fair, in which several local businesses
participated.
FHCA Pulse welcomes news items,
press releases, photos or guest articles of
500 words or less. For information, call
(850) 224-6242. You may fax items to
(850) 224-9823. Information also can
be mailed to: Florida Health Care
Association, P.O. Box 1459, Tallahassee,
FL 32302-1459.
Spring Hill’s Epley wins CNA essay contest
(Editor’s note: Following is the winning entry in FHCA’s annual CNA essay contest, which includes a $500 cash prize.
Ms. Epley is a CNA at Spring Hill Health and Rehab Center in Brooksville, where the administrator is Dennis Dijon.)
“Caring is our business”
by Cheryl Epley
ften, it’s the little things in life that are the most
memorable and meaningful to folks. After all, I still
remember the nicest thing my husband ever said to me.
The conversation took place 14 years ago. He barely
remembers it, but I will never forget it. Those few kind
words meant the world to me that day. Here is that saga.
I was pregnant with our first child and as big as a barn.
I felt just like a big old hippopotamus. I tried on every
stitch of clothing in my closet. Naturally, nothing fit me.
Feeling sorry for my over-sized self, I sat down on the
bed to have a good cry. However, my pity party was cut
short when my husband came into the room and put
his arm around me. He said, “Don’t cry. You’re not fat.
You’re pregnant, and that’s not ugly, it’s beautiful.” Then
he kissed me on the cheek and left the room. At that
moment, the dark storm clouds rolled away and the sun
shone brilliantly in my little corner of the world.
O
Our privilege
As CNAs, we have the privilege of bringing a little
sunshine into our residents’ lives each time we show up
for work. Sometimes all it takes to brighten someone’s
day is a few kind or encouraging words.
When my rehab patients get discouraged, I put my
hand on his or her shoulder or take them by the hand. I
look them in the eye and say,“Don’t give up.You’re going
to make it. Keep trying. Keep doing your therapy.You are
going to get better but it’s going to take longer than you
want it to. It’s going to be okay.You are going to be okay.”
We caregivers must remember that it is an uphill
battle for our residents. Many of them have just been
through major surgery, serious injuries, or both. Many
are dealing with life threatening illnesses. They have lost
their independence and are no longer in control of
their own lives. They are frightened, in pain and at the
mercy of the medical professionals.They are facing some
monstrously big problems. They need all the TLC,
encouragement and kindness that we can dish out to
them.We must remember to treat them as we, ourselves,
would like to be treated if we were standing in their
shoes. Who knows, maybe someday we will be.
Honoring requests
A tried and true way to brighten a residents’ day is by
honoring their requests whenever possible, no matter
how odd or quirky their request may sound. For
example, I once took care of a man who wanted to sleep
completely nude with the air conditioner cranked way
up high.This seemed very strange to me, but it made him
feel comfortable and content. His request was grantable
as long as the staff took extra care to make sure all the
curtains were pulled completely around his bed in order
to respect his privacy.
Another offbeat request came from a little old lady
who was deathly afraid of germs. She was thoroughly
convinced that she would become infected by some horrible disease just from sitting on the toilet. Her fears were
easily quelled. Her family gave her a can of disinfectant
spray. She carted it around with her in her wheelchair
wherever she went. Before allowing the staff to help her
onto the toilet, she would hand them the spray can.
She wanted the toilet seat to be quickly sprayed and
wiped. If this was done for her, she was happy and smiley
all shift long. If her request was denied, she would fret
miserably and complain about all those nasty germs
crawling around on her tail end from the dirty old toilet
seat. Her sunshine for the day came out of a spray can.
If you used the spray, you brightened her day.
Spreading sunshine
As CNAs, we can’t do a whole lot about the big problems that our residents must face. However, there are hundreds of little ways to brighten a resident’s day and spread
sunshine. So, if he wants a scoop of strawberry ice cream
instead of vanilla for a bedtime snack, well, sure, why not?
If she needs a hug or a pat on the back to help her make
if through the day, by all means, give her one. If he feels
restless and can’t fall asleep, try giving him a back rub to
help him relax. If she feels sad and droopy and a flower
would cheer her up, just slip outside and pick her one.
These are all just little things but, after all, it’s the little
things that make up life. Quite often it’s the little things
that matter most to folks. It’s the thoughtful and comforting little things that our residents remember the most.
Congratulations to runners-up
2nd place
3rd place
Sonya Powell
Lisa Andrews
Ridgecrest Nursing & Rehab
DeLand
Administrator: Greg Knowles
Ms. Powell wins $300
Bayview Center
Eustis
Administrator: Linda Graver
Ms. Andrews wins $200
LTC
BUSINESS
NEWS
by Steven R. Jones, CPA
and Lorne Simmons
Moore Stephens Lovelace
More funding highlights (and lowlights)
of the 2006
legislative session
A very rude awakening indeed!
A
s we write this, the great relief we felt after
the 2006 legislative session just vanished
with Gov. Jeb Bush’s veto of the $25.6 million
funding restoration and the $65.5 million that
was going to provide long-overdue relief from
provider targets.
Even though his budget as originally proposed
contained a repeal of the 2.9 minimum mandatory CNA staffing increase, Bush could not veto the
staffing increase because doing so would have
caused a reversion to the prior statute, which
required the increase to take effect July 1st of this
year, and would have eliminated some other relief
(see below). Funding of the Medicaid portion of
the cost associated with the increased staffing
standard is still in the budget, which we estimate to
be somewhere between $3.50 and $4.50 per patient
day. Many details remain to be worked out, but we
hope those facilities that will have to hire and train
the additional CNA staff to meet the new standard
will be able to receive automatic rate increases to partially fund their “staffing up” costs in November
and December. Of course, your facility will likely
have to try and increase private-pay rates to pay
for the non-Medicaid share of the cost because
Medicare payment rates won’t change.
On a more positive note, restoration of funding for the Medicaid Adult Dental, Hearing and
Vision program — including funding for partial
dentures — survived and legislators also rebuffed
a proposal to give the Agency for Health Care
Administration a “free pass” on Florida Senior
Care, so the legislature must still approve the plan
if CMS approves it.We understand CMS recently
returned the proposal with questions that indicate
serious concerns with the waiver. If true, that
means the FSC pilot programs will in all likelihood have to wait until at least July 2007 to
begin, because it is extremely unlikely that a
special session of the legislature will be called
anytime before mid-November, and that’s assuming federal waiver permission is obtained.
Leased facilities
Leased facilities will get a break when the new
provisions of Chapter 400.179, Florida Statutes,
related to bond requirements for leased facilities
are implemented. Specifically, the alternative fee
that a leased nursing facility must pay to AHCA
in lieu of obtaining a lease bond was reduced
from two percent to one percent of three
months-worth of Medicaid payments.
Certificate of Need
Some facilities are having difficulty complying
with conditions placed on their certificates when
they were issued, especially those CONs requiring certain levels of Medicaid occupancy. There
is a proposed rule which acknowledges and lists
some mitigating factors that AHCA may use in
reducing or eliminating fines for non-compliance
with these conditions, which should give AHCA
more leeway in waiving fines.Any mitigating factors that AHCA currently accepts would still be
available under the new rule.This is a good thing
because the original proposed rule mandated the
fine but did not have any reference to mitigating
factors. We hope AHCA will not need to revise
the rule if and when Florida Senior Care is
implemented, since this would be an obvious
mitigating factor. Also, language was added to
this session’s CON moratorium bill which will
provide for automatic reductions in CON conditions for Medicaid occupancy in any area where
a nursing home diversion program exists.
Legislation also passed this session allowing
high-occupancy (96% or more) buildings with
excellent survey history, in subdistricts with over
94 percent average occupancy, to add a limited
number of community beds.The four areas mentioned in last fall’s Senate report with occupancy
above that threshold were: Leon County,
Columbia/Hamilton/Suwannee counties, Nassau/
north Duval counties and Seminole County.
Medicaid Low-occupancy
The recent change removes the adjustment
from the patient care component and will limit
the adjustment to no more than 20 percent of the
applicable component’s ceiling. These changes
should become effective July 1st of this year and will
be of significant benefit for those facilities affected.
Medicare cost reporting
At a recent meeting in Baltimore, CMS advised it has changed the effective date for the new
Transmittal 6 version of the form 339 (Provider
Cost Report Reimbursement Questionnaire),
which is essentially a cleaned-up version of the
old form. The effective date has been changed
from reports filed on or after May 1, 2006, to cost
reporting periods ending on or after March 31,
2006. Also effective with reports ending on or
after March 31, 2006, home offices will no longer
need to submit a form 339. CMS also indicated
that if a report has already been filed (for example, a December 31, 2005 YE) with either the
new or old form 339, the Fiscal Intermediary is
to accept it. No reports already filed are to be
rejected because of the new 339 being submitted.
Open Door Forum
CMS advised listeners on the recent Open
Door Forum call of postings to CMS’s SNF Best
Practices Web site, including sample agreements
for arrangements between an SNF and its suppliers, SNF Request for Ambulance Transportation
for a Beneficiary in a Medicare Part A Stay, several Notices to a Physician Treating a Beneficiary
in a Medicare Part A Stay, and a Notice to a
Hospital Treating a Beneficiary in a Medicare Part
A Stay on an Outpatient Basis. To read them, go
to www.cms.hhs.gov/snfpps/08_bestpractices.asp.
Unsprinklered facilities on the
State Fire Marshal’s to-visit list
I
n order to comply with Chapter 633.022,
Florida Statutes, and Rule 69A-3, Florida
Administrative Code, the State Fire Marshal
announced that officials from his office,
representatives from the local fire authority’s
office and a fire safety surveyor from the
Agency for Health Care Administration will
soon be visiting every one of the 30-35
non-sprinklered nursing homes in Florida.
The nursing home and its owner(s) will
be made aware of the state requirements of
having hazardous areas fire sprinklered by
December 31, 2008, and being fully sprinklered no later than December 31, 2010.
The representative from the State Fire
Marshal’s office will also have available
information and applications to participate
in the State Fire Marshal Nursing Home
Loan Guarantee Program, which is intended
to mobilize private funding for the installation of required fire sprinkler systems in
unprotected, eligible nursing homes within
Florida.
AHCA prior approval
In addition to all local permitting and
before the installation of the fire sprinklered
system is undertaken by the nursing home, a
plan review of the sprinkler system will be
required by the Office of Plans and
Construction, Agency for Health Care
Administration. If you have any questions
concerning the submission of plans, please
contact Skip Gregory, Bureau Chief, Office
of Plans and Construction at (850) 922-6469.
The sprinkler plans and installation of the
system will also be required to be reviewed
through the State Fire Marshal’s office as a
part of the loan requirements.
Facilities found to not be fully sprinklered
after the dates listed in this notice may be
subject to administrative sanctions by the
Division of State Fire Marshal, per Chapter
633.022(4)c), F.S.
Deadlines approach
for full facility sprinklering
Will the existing fire alarm panel handle
the additional sprinkler zones?
■ Are all the areas including patient room
closets currently sprinklered?
■ Are the hazardous areas in the nonsprinklered building sprinklered by the
domestic water system, and if so will they
initiate the fire alarm if activated?
■ What is the building type and does it
contain asbestos?
■ What is the cost of the project?
■ How will this affect the patients and
staff during the completion of the project?
■ What is the possibility of getting the
project completed within a reasonable time
frame?
■
Steam tables warning
Several Florida facilities have received
Immediate Jeopardy citations for serving
food off their steam tables in the dining
room. Surveyors reason that patients are
at risk when the steam tables are left unattended and the patient reaches into the
table. Citations were also given because the
tables were not equipped with proper sneeze
guard protection and food serving temperatures were less than what is required.
(Max Hauth is President, Hauth Health Care
Consultants, Lakeland, and a frequent contributor
to FHCA Pulse on life safety issues. Contact
him at (863) 688-0863.)
by Max Hauth
Unsprinklered or PartiallySprinklered Nursing Homes*
Avante at Mount
Mount Dora
Dora
Crestwood Nursing Center,
Center, Palatka
Palatka
IHS at Gainesville
Gainesville
Center, Bradenton
Bradenton
Lakewood Nursing Center,
Nursing Center,
Center, Altoona
Altoona
Lakeview Terrace Nursing
Westminster Care of
of Delaney,
Delaney, Orlando
Orlando
Carnegie Gardens Nursing Center, Melbourne
Edward J. Healey Rehabilitation and Nursing
Center,
West
Palm
Beach
Center,
West
Palm
Beach
Whitehall at Boca
Boca Raton
Raton
Abbiejean Russell Care
Care Center,
Center, Fort
FortPierce
Pierce
Fort Pierce Health
Health Care
Care Center
Center
Lake Worth
Worth Rehabilitation
Rehabilitation
Terraces of Lake
Cathedral Gerontology Center,
Center, Jacksonville
Jacksonville
Daytona Beach Health
Health &
& Rehab
Rehab Center
Center
Eartha M.M. White Nursing Home, Jacksonville
Governor’s Creek Health
Health &
& Rehab,
Rehab,
Green
Cove
Springs
Green
Cove
Springs
Sandal Wood Nursing Center, Daytona Beach
Southwood Nursing Center,
Center, Jacksonville
Jacksonville
St. Augustine Health &
& Rehab
Rehab Center
Center
Palm Terrace of
of St.
St. Petersburg
Petersburg
Heritage Park, Dade
Dade City
City
Laurell Wood Nursing
Nursing Center,
Center, St.
St.Petersburg
Petersburg
Pasadena Manor, South
South Pasadena
Pasadena
Springs at Boca
Boca Ciega
Ciega Bay,
Bay, St.
St.Petersburg
Petersburg
Manor Pines Convalescent
Convalescent Center,
Center,
Lauderdale
FortFort
Lauderdale
Medicana Nursing and
and Rehabilitative,
Rehabilitative,
Lake
Worth
Lake
Worth
Ocala Health &
& Rehab
Rehab Center
Center
Crystal River Health
Health &
& Rehab
Rehab Center
Center
West Melbourne Care
Care Center
Center
Royal Care of
of Avon
Avon Park
Park
Fort Lauderdale Health
Health &
& Rehab
Rehab Center
Center
*Facilities on this list are those identified by
ered
facilities.
AHCA
and FHCA.This listing may not be
inclusive of all unsprinklered facilities.
Items to consider
Items to be considered if the facility is not
sprinklered or not fully sprinklered:
■ Does the engineer or sprinkler company have the engineering capability, professional licenses and experience required for
completing the necessary design work?
■ Is there an adequate supply of water to
the facility to be sprinklered?
LABOR
RELATIONS
COUNSEL
by Mike Miller
Kunkel, Miller & Hament
FHCA Labor Relations
Consultant
Employees’ rights
to speak freely are
not absolute
Celebratory conduct after
supervisor’s sudden death
justified discharge, holds
federal court
In a case involving a Florida health care institution, a federal trial court recently granted summary judgment to the employer in a case involving race and religious discrimination claims after
an employee was fired for celebrating the sudden
death of her supervisor.The black plaintiff in this
case had a “rocky” relationship with her white
supervisor, who had written up the plaintiff and
given her below-average evaluations.The plaintiff
also had accused her supervisor of making a racial
comment. The supervisor had a sudden illness
that resulted in her death and the plaintiff told coworkers that it was “God’s wrath,” that the supervisor had “reaped what she sowed,” and that
“the Lord’s will has been done.” She also made the
statement, “Praise the Lord…God is good…She
constantly mistreated and today she’s in the
Letters from across Florida
Timely attention
“I was talking on the telephone to my daughter in Okeechobee, Florida.When I reached
for my phone I slipped off the bed and couldn’t get back on. I tried all the ways of returning to the bed to finish my call, only I could not get up.Well, I yelled to my daughter that
I could not get up to talk. She called this establishment and in came enough staff to set me
on the moon. It is the only time I have really needed help…Thanks for the good service I
needed.”
— 94-year-old patient Beatrice Abbot, to the staff at
Marianna Health & Rehabilitation Center.
Open arms
“I cannot find the words to express my gratitude to all of you.We were welcomed with
open arms and everyone was so kind to us… If some day, I need to be admitted to a facility such as yours, I would hope that there would be room with you for myself because of
the care I saw that you give to those that are in need. May God bless each and every one
of you is my prayer.”
— Lois S. Tyre, the spouse of a former patient, to the staff at
Bay Pointe Nursing & Rehabilitation Center in Lake City
Kind acts
“We would also like to express our sincere thanks to all of you for the hard work, care,
and attention given to my mother, Marie Williams, during her two years with you.Your
many kind acts and your friendliness are so appreciated.Thanks also, Scott, for coming to the
funeral home. I really appreciate it.”
— Sharon and Steve Miller & all the family of Marie Williams to
administrator Scott Allen and the Palm Garden of Tampa staff
***
Send FHCA Pulse a photocopy of your favorite card or letter from a satisfied
patient or patient’s family member. Send to FHCA, P.O. Box 1459,Tallahassee, FL
32302-1459, or fax to (850) 224-9823.The best will be posted on the FHCA Web
site and excerpted in FHCA Pulse.
judgment.” Some of the plaintiff ’s co-workers
were so troubled by her celebratory conduct that
they could not go back to work. Her remarks
became the “talk of the department” and disrupted productivity. Management fired the plaintiff
after her conduct was reported, and she sued.
On the religious discrimination claim, the court
reasoned that it was not the religious nature of
the plaintiff ’s comments that led to her discharge,
but rather her inappropriate conduct in openly
celebrating the death of a supervisor and the
disruption it led to in the workplace. The lesson
of this case is that employees do not have an open
license to say whatever they want in the private
workplace.
Employer’s failure to hire
evangelical Christian might
constitute religious
discrimination
While an employer ordinarily has substantial
leeway in considering the qualifications of a
prospective employee, another recent federal case
demonstrates the importance of avoiding a decision based on perceptions or stereotypes. This
case involved a religious discrimination claim
brought by an evangelical Christian plaintiff who
was turned down by the employer because it feared
she might try to “speak God” to its clientele.The
plaintiff was qualified for the job (in fact, overqualified according to the employer) and also listed on her résumé that she had spread “the word
of God” to prison inmates and troubled teenage
girls. The employer was a nonprofit organization
whose clientele largely consisted of homeless persons with psychiatric and substance abuse issues.
It had a policy of “consumer choice,” meaning
that clients were free to accept or reject services
that were offered. The employer apparently had
doubts as to whether the plaintiff would proselytize if hired (the plaintiff alleged that she told her
interviewer her religious views would not interfere with work) and decided not to offer her the
position.The EEOC sued on the plaintiff ’s behalf
and the court denied summary judgment to the
employer, finding the facts were disputed as to
whether the employer’s decision was based on a
stereotype that evangelical Christians are compelled to spread the word of God or on legitimate
concerns that the plaintiff ’s hiring necessarily
would conflict with the employer’s “consumer
choice” philosophy. Due to the two different versions of what was discussed during the plaintiff ’s
interview and the implications that might arise
from a review of her résumé, the court ruled that
a jury trial would be needed to determine these
disputed facts.
FHCA congratulates
nurse leaders
Registered Nurse
of the Year
F
HCA presented its Outstanding Nurse Leaders
awards during a luncheon at this year’s Nurse
Leadership Training Program at the Don CeSar
Resort & Spa in St. Pete Beach. The first Treasure
Our Elders award was presented to Carolyn Crisp of
The Heritage of Santa Rosa in Milton. The award
is presented for outstanding service to the elderly.
2006 FHCA
Nurse Leadership
Training Program
Joy Sacayanan
Nurse Administrators of the Year
St. Catherine Labouré Manor,
Jacksonville
with FHCA President Dion Sena
Licensed Practical
Nurse of the Year
Irena Blackburn
Tina Shook
Ron Leitter
Tandem Health Care
of Winter Haven
Sandy Ridge Care Center,
Milton
Miami Jewish Home &
Hospital for the Aged
An impromptu conga line was part of the
fun at this year’s FHCA Nurse Leadership
Training Program held at the Don CeSar
Resort & Spa in St. Pete Beach. Below,
FHCA Treasurer Nina Willingham sang a
tribute to the 200+ nurses gathered at the
awards luncheon. The popular three-day
training helps nurses from FHCA member
facilities develop their professional abilities
and leadership skills.
FHCA SERVICE CORPORATION SAVES YOU MONEY
We are proud to recommend these fine vendors who provide
quality goods and services. They help keep you and FHCA on top!
American Health Care Association and National Center for Assisted Living
AHCA/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.
Entrées to Health
Entrées to Health is Florida’s premiere USDA-approved manufacturer of enhanced protein-based products, gourmet
entrées and complete meals. Our delicious product offerings are uniquely formulated to provide maximum nutritional
benefits for patients suffering from diabetes, renal failure, obesity, heart disease and more. A sister company to
Food With CareTM Inc., Entrées to Health is dedicated to providing the highest quality products with compassion
and integrity. For additional product information please visit us at www.entreestohealth.com, or call us at (407)
936-0340 ext. 12.
FMS Purchasing & Services
FMS has a full line of products and services in its Group Purchasing Program. FMS services member needs by ensuring
maximum savings and service. Five area managers throughout the state assure members an immediate response.
Our services include: audits, a toll-free number, cost analysis, service reports and the Manufacturers Value Incentive
Program. Call (800) 456-2025.
Hamilton Insurance Agency
Hamilton 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].
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 long-term
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. Call (800) 438-8884.
Office Depot
Office 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 any amount
of products (no minimum order); an award-winning Web site which links you to your pricing and into the warehouse and keeps 18 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.
SCI Companies
Staffing Concepts of Florida, Inc. is a professional employer organization which provides a comprehensive solution to
your personnel needs, including: employee benefits; workers compensation and safety programs; human resources
support; and payroll. SCI specializes in helping health care facilities better manage their single largest cost — labor.
Call (800) 932-4610.
Senior Crimestoppers
The Senior Crimestoppers program is a proven, effective, proactive crime prevention system that combines
proven components to help provide safe, crime-free facilities for patients, 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 Donna Derryberry at (800) 529-9096.
FHCA Bulletin Board
(Note all programs preceded by an asterisk (*) have registration brochures available via FHCA Fax-on-Demand at
(850) 894-6299. Some meetings noted herein may also carry CE credits. Additional information can be found at
www.fhca.org. Click on “Seminars/Events.”)
Continuing Education/
Training
Dementia-Specific Training for
PT, OT, ST and the
Interdisciplinary Team
Friday, July 28
Hillcrest Nursing & Rehabilitation Center
4200 Washington Street
Hollywood
Program runs 8:30 a.m. to 5:00 p.m.
Approved for seven contact hours of continuing
education credit for NHAs, nurses, social workers
and physical, occupational and speech therapists
Look for
Legislative insert
Meetings/Events
FHCA– FCAL 2006 Annual
Conference & Trade Show
Wednesday, July 5 through
Saturday, July 8
by Peggy Rigsby
FHCA Government
Services Director
Gaylord Palms Resort & Convention Center
6000 West Osceola Parkway
Kissimmee
Call (407) 586-0000 for directions or general resort
information. The Gaylord Palms is currently at
capacity in our room block, but you can make
reservations at the Orlando World Marriott at (800)
621-0638; the room rate is $149. The Marriott is
located less than a mile from the Gaylord Palms.
Note to FHCA Pulse readers
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.
Pulse
For FHCA members only, Ms.
Rigsby has inserted in this combined June-July issue of FHCA
Pulse a 20-page comprehensive
summary of all long term carerelated legislation that was considered during the 2006 Florida
legislative session. The document
is also available at www.fhca.org
under “Members Only.”
Her regular monthly column
will resume in August.

Pulse June/July 2006 - Florida Health Care Association

Transcription

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