Pulse August 2006 - fhca.org

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

AUGUST 2006

PRSRT STDU.S. Postage

PAIDTallahassee, FLPermit No. 1007

Florida Health Care AssociationP.O. Box 1459Tallahassee, FL32302-1459

InsideConference Highlights . . . . . . . . . . . . . . . . . . 8Quality Forum .. . . . . . . . . . . . . . . . . . . . . . . . . . 10Treasure Our Elders . . . . . . . . . . . . . . . . . . . . 14News from Across Florida . . . . . . . . . . . . 17

FHCAFLORIDA HEALTH CARE ASSOCIATION

Update

Levine out, Calamas inat AHCA

Last month Gov. JebBush appointed

Christa Calamas as theSecretary of the Agencyfor Health Care

Administration. Calamas was previ-ously AHCA General Counsel andreplaces Alan Levine, who resignedto become President/CEO of theNorth Broward Hospital District.

Citizenship proof

In response to requests from FHCAand other elder care advocates, the

Centers for Medicare & MedicaidServices announced its proof-of-citi-zenship documentation requirementsfor determining Medicaid eligibilitywill not apply to Medicare-Medicaiddual eligibles and SSI recipients.Thedecision is a major victory for elderlyFloridians who live in nursing homesand whose citizenship/birth recordswere incomplete or unavailable.FHCA members only will receive adetailed summary of the new require-ments, inserted in this month’s issueof FHCA Pulse.

NHA renewal fee

The fee for renewing a FloridaNursing Home Administrator

license will remain at $255 per bien-nium, according to NHA board chairDuane Gallagher.The board is alsoconsidering further action againstmore than 350 NHA licensees whofailed to pay the $200 per-licenseeassessment due October 2005. Manylicensees thought the assessment didnot apply to them because they choseearlier not to renew their license.However, the state designates suchlicenses as delinquent/inactive, notnull and void, so those who didn’taffirmatively surrender their licensein writing would be liable for payingthe assessment.

FHCA Quality CredentialingFoundation Senior Director

LuMarie Polivka-West wasnamed the recipient of the 2006Walter M. Johnson, Jr. Circle ofExcellence Award, the association’shighest honor. FHCA SeniorVice President and 2005 Circle of Excellence award honoreeDeborah Franklin announcedthis year’s recipient at the 2006FHCA-FCAL Annual Confer-ence banquet.

Polivka-West is “well respectedat the federal and state levels andat all levels of policymaking,”Franklin said in announcing

Sylvester is New FHCA President, Board Members ElectedSee Page 3

Willingham,Craddock are2006 top nursinghome, ALFadministratorsFlorida’s bestreceive praise

Nina Willingham, Senior Exec-utive Director of 120-bed

Life Care Center of Sarasota,was named 2006 FHCA NursingHome Administrator of the Year.Shelly Craddock, administrator ofThe Inn at Freedom Square inSeminole was named 2006 FCALAssisted Living Facility Administratorof the Year.

“Both these women typify the best in the caregiving pro-fession,” FHCA President DavidSylvester said. “They are leadersand standard-setters who make us all proud.”

CONTINUED ON PAGE 19

Solid Support:FHCA members enthusiasti-cally welcomed AttorneyGeneral Charlie Crist, aRepublican candidate forFlorida governor, to the Julygeneral membership meetingin Kissimmee. Crist praisedLTC professionals andpledged fair regulation.“I’ve seen your facilitiesand the care you provideand the hope you instill,”He said.

Excellence Circle: 2005honoree Deborah Franklin,left, congratulates LuMariePolivka-West on being thisyear’s Circle of Excellencerecipient.

Willingham Craddock

2006 Johnson Excellencerecipient: It’s LuMarie!Quality/regulatory guru honored fordevotion and service to FHCA members

(Editor’s note:The following is excerpted from David Sylvester’s inaugural remarks,delivered July 7, 2006.)

Ibelieve three things must co-exist in order for our profession to serve and succeed. Each is importantin its own right, but together they become like the three-legged stool — meaning if any one of the

legs fails, the stability of the whole thing is put at risk. For long term care, the three legs are funding,quality and customer satisfaction.

FundingWithout adequate funding, long term care facilities go out of business because they can’t survive

financially. Without adequate funding, the remaining facilities have to struggle and spread out scarceresources. The Florida legislature recognized the absolute importance of adequate funding for long term care, so this year they restored last year’s cuts and increased Medicaid funding.Then the governorvetoed it. Our first challenge is to get that critical funding restored.

QualityI am extremely proud of how FHCA leads the nation in quality improvement. We are the only

state health care association with a designated Quality Unit. Under the umbrella of our QualityCredentialing Foundation, our efforts have met with remarkable success. I was privileged to be involvedwith the “self-policing task force,” as it was then called. The simple idea of helping each other and holding each other accountable has really taken off. We’ve seen the steady decline in both total and serious deficiencies. We’ve seen the number of facilities on the state Watch List drop like a rock.We’ve seen a decline in adverse incidents that relate to quality of care. In the coming months,we’ll take our pursuit of quality improvement to the next level. We will seek more third-party and foundation grant money to focus on specific areas of quality improvement. Quality improvement isboth a continuing and continuous process.

SatisfactionI hear administrators say all the time that satisfaction is up among the people in their facilities and

their families. The ombudsman volunteers tell us the same thing, but every time we try to quantify “satisfaction” we meet an obstacle. I have a near term goal for our organization, which is to gather andaggregate satisfaction data from all our facilities. This information will allow us to engage in public policy development with empirical, unequivocal satisfaction measures that will prove to all stakehold-ers that our patients and residents are truly satisfied.

By linking these satisfaction results with our quality improvements, we will also have a strong, objec-tive platform from which to advocate before legislators and regulators. I believe having reliable satis-faction data will be of particular value as Florida proceeds down the road toward Medicaid reform.Legislators and others have long talked about patient-centered care. Now we will have a way to know if they are succeeding.

The place to beLong term care — our chosen profession — is the place to be in the next 20 years. I can’t think of

any profession that provides greater challenges and greater personal satisfaction at the end of the day.It will soon be our challenge to care for the first of the Baby Boomers, whose expectations andresources we don’t even know! We will have the task of reshaping the elder care system so that peoplewill always get the right care at the right place at the right time. Doing this will take all of our bestefforts and creativity.

Throughout it all, we must remain of one mission and one voice.We must remain united and standshoulder-to-shoulder as we face the uncertain future of Medicaid reform. I’m convinced that if wedon’t seize the initiative today, our successors 20 years from now will wonder how we ever could havelet the chance slip away when the stakes were so high.

Unity of purpose and unity of action is what our founding members knew was central for us to succeed, and 52 years later, they’re still right.

A final noteThank you for making our 2006 FHCA-FCAL Annual Conference the success it was. Special praise

goes to FHCA Annual Conference Committee chair Cathy Sena for her committee’s great job.

Florida Health CareAssociation

David Sylvester,President

Bill Phelan,Executive Director

Deborah Franklin,Senior Vice President

Nina Willingham,Secretary

Ben Carotenuto, Treasurer

FHCA PulseAUGUST 2006

FHCA Pulse is produced monthly for theFlorida Health Care Association, P.O. Box1459, Tallahassee, FL 32302-1459, by EdTowey & Associates, Inc.

Editorial – To submit information, guestarticles, press releases, etc., contact EdTowey at (850) 224-6242 or via e-mail [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 ad-vertising rates and availabilities, contact IanCordes at Corecare Associates at (561) 659-5581 or via e-mail at [email protected].

All articles and advertising are subject toeditorial review.

FROM thePRESIDENT’S

DESK

by David SylvesterFHCA President

We’ll succeed ifwe stay focusedon the basics

FHCA AUGUST 2006 Pulse2

The three-legged stool we stand on

FHCA AUGUST 2006 Pulse 3

Sylvester takes the helmNew FHCA officers, board members electedAmerican Health Care Association Board of Governors chair Angelo Rotella, left, swearsin FHCA President David Sylvester. Also installed for one-year terms on the FHCA Boardof Directors were Deborah Franklin, Senior Vice President; Nina Willingham, Secretary;Ben Carotenuto, Treasurer; Cindy Palermo, Region I Vice President; Lori Jowett, RegionII Vice President; Nancy Thurman, Region III Vice President; Mark Daniels, Region IVVice President; Patrick Duplantis, Florida Multifacility Vice President; Sid Schiff,Independent Owner Vice President; Nancy Hall, National Multifacility Vice President;and Connie O’Donnell, Non-Proprietary Vice President.

Thanks for 25, Bill!FHCA and FCAL members stood, applauded and cheered FHCA’soutstanding Executive Director, Bill Phelan, for 25 years service tothe association. Phelan remarked that he and Ronald Reaganbegan their terms at just about the same time and that the greaterpart of his adult life had been spent with FHCA. Phelan thanked hiswife, Pat, and family who were on hand to join in the celebration.

Carotenuto Palermo Jowett Thurman Daniels Duplantis

Schiff Hall O’Donnell

WillinghamFranklin

Rotella/Sylvester


In the last couple of months we have seena number of Immediate Jeopardy cita-

tions resulting from facility renovations.FHCA is working with the Agency forHealth Care Administration’s Office of Plans and Construction Bureau Chief SkipGregory’s office to determine the extent hisoffice will be involved in your renovationsand, in some cases, routine maintenance.However, those issues are still being dis-cussed. This article deals with citations forsafety and care.

I have reviewed several of these citations,incurred by both our clients and others, andin most cases do not believe that the citationis proper. In many cases, I suspect that thesurveyor saw something he or she did notlike and found a niche to cite it, whetherthat niche was appropriate or not.

IJ or not?Several of these citations read as if

patients were at risk for serious injury yetthe surveyors did not even bring the specific situation to anyone’s attention untilthe exit conference. This puts the facility at a disadvantage from both a defense as well as a risk management position. If theretruly is a situation which warrants classifica-tion of Immediate Jeopardy, shouldn’t thesurveyor immediately bring it to the attentionof the staff so that appropriate measures can be taken to fix the problem and explore whether it was systemic or isolated?Isn’t that what good risk management isabout?

Steps to takeEven though I do not agree with the

citations in many cases, I am of the philoso-phy that an ounce of prevention is worth apound of cure. I have some suggestions forthings to think about and steps you can taketo satisfy the surveyors. Here goes:

■ Make sure that the construction compa-ny you are using is familiar with health careconstruction and renovation and understandsthe regulatory requirements so that none oftheir employees put you in jeopardy.

■ Where are tools and ladders kept whenthey are not being used?

■ Is your staff reminded to keep a watch-ful eye when the construction crew is on thefloor?

■ Are subs also trained to respect the population in your building?

■ Discharge and transfer has been an issue –are patients who are moved explained aboutthe move and what is going to transpirewhile they are away from their rooms?

■ One citation involved moving a nursinghome patient to an adjacent hospital, one onlyso she could take a nap when she requestedto do so! AHCA treated this as a transfer andrequired that, in those cases, the facility havedoctor’s orders and give notice. (Bet youknow we don’t agree with this one.)

■ How is debris handled? Typical construc-tion methods will not work in a nursinghome

■ If relocation is only for part of a day, arethere appropriate activities for the peoplebeing relocated?

■ Staff may have to be reassigned so thatall patients are watched and accounted for

■ A comprehensive written plan shouldbe prepared and followed for the safety ofpatients during the process

■ Families and others should be advised as to what is going on*

■ When you tell your patients what toexpect, you may have to reiterate what youtell them several times, because they forget.I promise you that the forgetful ones will be the very ones the surveyors talk to!

DocumentationDocumentation is critical to protect

yourself and your facility. Communicationwith the survey team is likewise important.When the surveyors give examples of inci-dents they have “observed,” often they donot identify the patient or the employeeinvolved.Ten days later when you get yourform 2567 and these incidents are includedyou may have no way to follow up to getyour side of the facts. Staff should be alertedto observe the surveyors and make notesabout the situations they seem to be involvedin. If they are watching a hallway or a particular patient for a period of time, it islikely they are suspicious that a deficiencyexists.

While the construction crew does notwork directly for your facility, managementstaff, including unit managers, should beempowered to stop any activity they feelcould present even a slight danger to thepatients until the construction companypersonnel can be contacted and getinvolved.

Your professional colleagues who havehad these citations are unfortunate.We willbe dealing with the issues on a case-by-casebasis. But a word to the wise: Learn fromtheir problems and prevent your own. If you have any questions, I would be happy todiscuss them with you.

*For more on this topic, see “Good disasterplanning can be good PR, too,” page 21.

LTC LEGAL ISSUES and TRENDS by Karen Goldsmith

Goldsmith, Grout& LewisFHCA Legal Consultant

When is it ImmediateJeopardy? When is it not?

Construction woes

Florida’s First and Foremost Licensure Program*

Online Healthcare Risk Management– Nationally Recognized Faculty Experts –

University of South FloridaOffice of Continuing Professional Educationhttp://www.cme.hsc.usf.edu/hcrm/

Tel: (813) 974-2161Email: [email protected]

*Meets State of Florida Agency for Health Care Administration 120 HourEducational Program Licensure Criteria

FHCA Resident of the Year

Ellen HoeltzelEllen Hoeltzel has lived at Palm Garden of Ocala for eight years and is a past president of the facility’sResident Council. She remains active in the community, writes for the monthly newsletter and helps others in the facility adapt to their new surroundings.“We’re all blessed to have wonderful homesto go to,” Hoeltzel said. “Of course, I think Palm Garden is special.”

FHCA Volunteer of the Year

Darrell GardnerDarrell Gardner has logged more than 12,000 hours of volunteer work in behalf of the elderly patients at Health Central Park in Winter Garden. Over the years, he has helped raise thousands of dollars to fund facility purchases. He was instrumental in setting up and running HCP’s Eats n’TreatsCountry Store.

FHCA Group Volunteer of the Year

Ice Cream Volunteers of Palm Garden of OcalaJoan DeCarli accepts the FHCA Group Volunteer of the Year award on behalf of the Ice Cream Volunteers of Palm Garden of Ocala. DeCarli and two other ICVs set up, serve andencourage attendance at the facility’s weekly ice cream socials. They serve more than a hundred people each week, 52 weeks a year. Administrator Jennifer Mikula, left, ActivitiesDirector Alice Constant and FHCA Past President Dion Sena offered congratulations.

Arthur H. Harris Government Services Award

Nancy ThurmanNancy Thurman,Administrator of Whispering Oaks in Tampa, was honored for her many and tirelessefforts during the 2006 legislative session.As FHCA District IV (Tampa) President,Thurman organized“Lobby Wednesday” trips and participated in several others, personally lobbying legislators meeting in Tallahassee for adequate nursing home funding.

FHCA Media & Community Involvement Award

Avante at Mount DoraFHCA Consumer Relations Committee chair Michael Alexander, left, congratulates ChadHurta, administrator of Avante at Mount Dora, and DON Anne Lenington.The 116-bed facil-ity was recognized for several innovative community and media outreach programs and foraiding those displaced by Hurricane Katrina.

Willis J. Gregson Associate Member of the Year AwardRobin Bleier, RB Health PartnersRobin Bleier of RB Health Partners was named 2006 honoree for her invaluable work as chair of the FHCA Disaster Preparedness Committee. Bleier is a nationally-recognized expert on emergencypreparedness and risk management for long term care providers.


Honoring our best in KissimmeeFHCA members and others who made a difference in 2006 receive well-deserved accolades

Ageneral membership meeting of the re-launched Florida Center for Assisted

Living approved bylaws and elected officersduring the 2006 FHCA-FCAL AnnualConference in Kissimmee. FCAL willremain an independent voice for assisted liv-ing providers and will have a seat on theFHCA Board of Directors.

Village on the Isle President/CEO andFHCA Past President (1994-96) Tom Kellywas elected FCAL President. Kelly had beenserving in the position by appointmentwhen FCAL was re-launched in December

FCAL adopts bylaws, elects officers

Florida Center for Assisted Living


Kelly Craddock Jacobs

Coming to Call:

Democratic candidate for CongressChristine Jennings visits with patientsand residents at Village on the Isle in

Venice duringa recentcampaignstop. TheVOTI campushas becomea regularstop for

local, state and federal candidates foroffice. Below, Republican candidate forU.S. Senate Bill McBride visited withindependent livingand assisted livingresidents atHawthorne Villagein Brandon afterbeing briefed byadministratorDeborah Franklin.

National Assisted Living Week isSeptember 10-16th, and this year’stheme, “Hearts in Harmony,” seeks to promote the special bond between residents and the staff who care for them. To get your planning guide, go to www.nalw.org.

2005. He has since become an untiringadvocate for a “seamless” approach to betterelder care that emphasizes closer coopera-tion among all long term care providers.

“We’re all in the same business,” Kellysaid, “We all do our best to serve the needsof Florida’s elderly and we all worry aboutthe same things.” Kelly cautioned ALFproviders that there are definite moves in thedirection of more, not less, state and federalregulation of ALFs, and that providersshould unite now.

Shelly Craddock of The Inn at FreedomSquare in Seminole was elected FCAL VicePresident, and Marilyn Jacobs of MarkManor in Venice was elected Secretary.

G r e a t s p e a k e r s a n d g r e a t f u n a t A n n u a l C o n f e r e n c e

Fun, Frivolity: There was plenty of time for social activities and FHCA-FCAL members took full advantage. The top Beatles tribute band in the nation, Rain, was a huge hit, luv.


‘New age of old age’Top presenters:U.S. Navy Captain Charles Plumb, Ret., held the audience spellboundwith his “Who Packs Your Parachute?” inspirational talk that coveredhis years in a North Vietnamese POW camp; Patrick Brannelly of PositScience Corporation reviewed recent clinical studies of cognitive decline;American Health Care Association Board of Governors chair AngeloRotella detailed national goals for the coming year; AHCA’s MollyMcKinstry explained the new Emergency Status System; NHA boardchair Duane Gallagher discussed enforcement activities; Republicangubernatorial candidate Charlie Crist praised long term caregivers;

Plumb

McKinstry Gallagher CristRotella

Brannelly

in Kissimmee


Hippies Galore:Tie-dye fashion and otherimagery from the 1960s waseverywhere during FHCA’s annualconference and massive tradeshow. A record number of tradeshow vendors reported briskbusiness. To see these photos infull color, go to www.fhca.organd click on“What’s New,”“Hippies Galore.”


An FHCA seminar conducted duringthe Annual Conference, “Focus on

Quality — Highlighting SuccessfulPartnerships and Strategies,”brought togeth-er representatives from the AttorneyGeneral’s office, Adult Protective Services,the Florida Pioneer Network, the Agencyfor Health Care Administration, the LongTerm Care Ombudsman Program, FMQAI— Florida’s Quality ImprovementOrganization, the Florida Medical QualityAssurance Program, the Medicaid Trans-portation Disadvantaged Program, FamilyForum,hospice providers and the Universityof South Florida’s Center on Aging.

With over 250 participants in the audi-ence, the seminar was lively with interactionover tough issues and controversial con-cerns. Presenters were asked to address thefollowing questions in their briefings thatwere followed by a question/answer period:

■ Summary of your program’s strategiesto influence quality outcomes in long termcare

crime.They have investigated approximately700 PANE cases statewide and there areapproximately ten Operation Spot Checkvisits a month statewide.When asked by theaudience why the AG inspectors must carryguns in nursing homes and needlessly fright-en patients and staff, the response was thatthe intent is to get a “cross-pollination ofdifferent agencies” ensuring the safe envi-ronment of a long term care facility. But lessthan a week later, the AG’s office informedFHCA that its Medicaid fraud investigatorswould no longer display their weapons inlong term care facilities.

OmbudsmanThe Long Term Care Ombudsman,

William Teague of Polk County, stressed therecent Florida legislative changes that willmove the ombudsman into more of anadvocacy role from its more traditional,adversarial role of the past. There will bemore activities performed by the staff in the

■ Program data that indicate the success ofyour program in influencing quality of care

■ Systemic recommendations for contin-uous quality improvement in long term carefacilities

Adult Protective Services spokespersonChris Shoemaker explained how theHomeSafeNet abuse reporting system isshared with the Attorney General’s office, sodecisions are made very quickly on whetheror not a joint investigation will be conduct-ed. The AG’s representative, David Lewis,stated that Medicaid fraud is the primaryfocus, but the AG is also charged with theinvestigation of abuse and neglect in boardand care homes. He noted that the majorityof the 85,000 calls to the adult abuse hotlineare unfounded, but the AG’s Project PANE(Patient Abuse, Neglect and Exploitation) isimportant to uncover evidence right after a

Progress on many frontswith more to come

by LuMarie Polivka-WestFHCA QUALITY CREDENTIALINGFOUNDATION SENIORDIRECTOR

Quality forum a quality affairall around


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Quality forum a qualityaffair all aroundCONTINUED FROM PAGE 10

local offices as well and there are plans forincreased training of ombudsman.Mr.Teaguenoted the federal oversight of ombudsmanactivities frowns on their accepting requestsreported by nursing homes on behalf oftheir patients. Participants noted this is aproblem for people without family mem-bers or friends to advocate for them.Several audience members raised concernsabout ombudsman volunteers reviewingmedical records without having adequateprofessional knowledge and trying toduplicate the work of state surveyors.

TransportationThe Medicaid Transportation Disadvan-

taged program manager,Byron Underwood,provided an overview of the problemsthroughout the state with inadequate fund-ing to meet the transportation needs. Asmall percentage of applicants are using upthe statewide funding prior to the end ofthe fiscal year and leaving providers with-out the means to request the transport.Theoverall budget has been reduced and theneeds are much greater. Participantsapplauded the frank portrayal of the prob-lems and offered to help during the legisla-tive session to advocate for increased funds.Underwood advised participants to call theTransportation Disadvantaged Helpline at(800) 983-2435 with questions.

QIO projectLinda Wilkes with FMQAI and Cathy

Lieblich with the Florida Pioneer Networkare partnering with the Teaching NursingHome on a pilot project, “Effects ofSeparate and Combined Implementation ofCulture Change and Quality ImprovementTechnical Assistance on Reducing NursingStaff Turnover.” Facilities are being solicitedto participate in the project over the nextyear. Volunteer homes will be randomlyassigned to either the Culture ChangeTechnical Assistance-only group or thecontrol group and cannot already be partic-ipating with the QIO on the “8th Scope ofWork” project. Please contact CathyLieblich at (407) 228-1815, or via e-mail,[email protected] if you are willing toparticipate or have questions. Both presen-ters challenged Florida’s providers to com-mit to changing the culture within nursinghomes with the necessity for support fromtop management and involvement in deci-sion-making by the front line staff, withexamples of staff scheduling and care planinvolvement.



Quality forum a qualityaffair all aroundCONTINUED FROM PAGE 12

Audience questions were directed toAHCA’s Long Term Care Services BureauChief Molly McKinstry in reference toculture change activities that enhance din-ing choices and access to food. McKinstrysaid AHCA supports efforts to improve thequality of nursing home life, but that regu-latory compliance has to be maintained. Shehighlighted the quality award-winningfacility programs funded through the state’sCivil Money Penalties for the past twoyears.The focus has been on tangible pro-gram outcomes that enhance the cultureand quality of life in selected nursing homes,from a video promoting hospice care innursing homes to improve end-of-life care,to outside gardens and gazebos for encour-aging outside activities, to a focus on “finedining” and increased food access choices.

Aging Studies CenterKathy Hyer, Associate Professor at the

University of South Florida’s AgingStudies Center, provided an overview ofthe partnership activities with FHCA fromthe hurricane-disaster preparedness grant-making opportunities to the first onlinerisk management program with anemphasis on long term care that provides areduced registration fee to FHCA mem-bers. FHCA members Ben Carotenuto,Suyrea Reynolds, Scott Allen, BrianRobare, Nancy Thurman and BrianTenney were recognized for their advisoryrole to the Aging Studies program. TheUSF Aging Studies program has graduatedmany Florida nursing home administrators.

Doug French, the nursing home liaisonwith Florida Power & Light, reviewed the2006 plan for working with FHCA andnursing homes through the hurricane sea-son. FP&L will contact each nursing homeprior to and after a hurricane. There willbe follow-up with each site after a stormpasses in order to understand specific con-cerns. Facilities are requested to enter out-age information into the FP&L restorationsystem for nursing homes out of power.FP&L will be on the daily FHCA confer-ence call to ensure good, ongoing com-munications.There will be follow-up withevery site until full power is restored.French acknowledged the importantworking partnership with FHCA and theproviders to ensure a timely restoration.French was presented with the FHCADistinguished Service Award for his com-mitment to post-hurricane, power restora-tion for facilities caring for Florida’s vul-nerable elders and persons with disabilities.

Thelma Johnson is meticulously dressedand coiffed and seated at the piano in

the spacious dining room at Catalina HealthCare Center in Daytona Beach. Nat KingCole’s “Sweet Lorraine” echoes gentlythrough the halls and it’s Johnson who’splaying it flawlessly from memory. At age 93, she has many memories from a life lived independently — one that sometimesran contrary to what society’s expectationsat the time were for young black women in the south. Her smile and easy friendli-ness immediately puts one at ease. Her elegant manner bespeaks her educatedupbringing.

Georgia rootsJohnson was born the oldest of three

children in Dermont, Arkansas to parentswho both were college graduates. WhenJohnson was only three months old, herfamily returned to their native Georgiawhere her father was a high school princi-pal, university faculty member and Baptistminister in several cities near and outsideAtlanta. Her mother taught school and supplemented the family’s income by giving piano lessons and selling cosmetics.“When I was a little girl, I met Madam C.J. Walker herself when she trained mymother,” Johnson said of the legendary black entrepreneur and philanthropist.Walker and daughter A’Lelia traveled thesouth for years shortly after the turn of the 20th century and set up thousands ofblack women in their own beautician businesses that also sold her company’s scalp- and hair-care products. Aside fromteaching, nursing and domestic work,black women had few options for earning a living independent of men in the JimCrow days of the early 20th century.Walker’s message to black women was ofequality, economic self-empowerment,independence and social and civic influence,something Johnson herself would embodyfor the rest of her life.

Tuskegee InstituteDuring the summers, teenager Johnson

accompanied her father to TuskegeeInstitute, where he taught as a visiting

A treasured elder...Thelma Raiford JohnsonA career businesswoman who still lives life her way


Johnson’s independentspirit was evident atan early age. “When Iwas a teenager I visit-ed a courthouse inWashington, Georgiaand looked for a waterfountain. There weretwo — one for ‘white’and one for ‘colored.’ I was drink-ing fromthe ‘white’fountainwhen apolicemancame up to me andtold me I couldn’t dothat. I just laughedand told him I wantedto find out what‘white’ water tasteslike!”

Always Elegant:Johnson worked hard all her life but always enjoyed the good life, be it in herbackyard patio or while traveling. Today, she still enjoys life and regularly sneaksoutside to smoke cigarettes with “the younger men.” “I’ve always believed I canachieve what I want to achieve, and I have.”


A treasured elder...professor. There she met many members of the TI faculty, including agriculturalchemist/botanist George WashingtonCarver, who was already renowned. “He had a high-pitched voice and on his shelfwere dozens and dozens of little bags of soil that farmers from all over the southwould send him to analyze,” Johnsonrecalled. “They’d put a little cash in on top so he’d look at it right away.”

After graduating from high school,Johnson attended Tuskegee Institute as anundergraduate while working part-time inthe school’s laundry. She was very popularon campus and knew several of the famedTuskegee Airmen personally. As a memberof the school’s 150-member choir, in 1933, she traveled to New York City for a six-week, three-performances-a-dayengagement at the newly-opened RadioCity Music Hall. Johnson never graduated from Tuskegee Institute, but working in her mother’s hair-care business, and later her own, had meant good money — much more than her parents were making as educators.

Johnson operated beauty salons in Miami

and Atlanta before finally settling in Ocala.“I was visiting and they practically beggedme to stay because they had no beauty parlors,” she recalled. Johnson bought a large tract of land and lived there 30 years. Her salon became a town social center and Johnson herself became veryinfluential in the local business community.When her parents eventually retired, theymoved to Ocala to live with her until their deaths.

Love comesAs a spirited — too often, rebellious —

teenager, Johnson had married and divorcedtwice before age 21. She raised two boys to adulthood as a single mother going to school and working long hours in her salons. By middle age, she had becomefinancially independent but had yet toremarry. Johnson moved for a short time to Washington, D.C., to study music atHoward University and work in her sister’sbeauty salon.

One year, both attended the NationalBeauty Culturists League convention at the nearby Roosevelt Hotel.

“The organizers had recruited single men from all over the area to serve as escortsfor the single women who were coming in from all over the country,” Johnson said.“The one who escorted my sister really had his eye on me.”That would be WarrenJohnson, a clerk at the Navy Annex who was also in his mid-fifties but had nevermarried. “He said to me, ‘You’re going to be my wife,’ and he courted me non-stop for three months.”The couple was marriedat midnight in Virginia (“It was the darkestnight I’ve ever seen in my life.”) and spent20 years together until his death. “He was a fine man and the best thing that ever happened to me.”

Looking backJohnson moved into the spotless Catalina

Health Care Center about three years ago.Today, only a son — himself in his late 70sand living in Fort Pierce — survives her.“I’ve had as rich and full a life as anybodycould have.”

FHCA honors Thelma Raiford Johnsonand treasures her many contributions to our state and nation.

Delegating physician tasksby Peggy RigsbyFHCA GOVERNMENT SERVICES DIRECTOR

CMS and state Medicaidclear up the confusionOn November 13, 2003, the Centers

for Medicare & Medicaid Servicespublished S&C-04-08, which clarified thedelegation of physician tasks in skilled nursing facilities and nursing facilities. InFebruary 2006, the state Medicaid officerevised its Medicaid Nursing Facilities Handbookto reflect this federal policy. See pages 1-6 ofthe Handbook, dated July 2004.

Briefly stated, distinctions are made basedon facility type:

■ In a skilled nursing facility, the initialvisit must be made by a physician and then every other visit may be delegated to a licensed non-physician practitioner oper-ating within their protocol

■ In a nursing facility, the initial visit must be made by a physician, and at theoption of the state (and Florida has opted toallow this), any other visit may be delegatedto a licensed non-physician practitioneroperating within their protocol

In a facility where the beds are dually certified, the schedule is determined basedon how the patient’s stay is being paid. For

■ Rule 64B10-15.0021 was revisedMarch 14th to implement a new approvalprocess for continuing education providers

In addition, the NHA board is developingnew rule language related to preceptorrequirements for delinquent and inactivelicensees and a requirement to notify theNHA board of a change in mailing addresswithin 48 hours as currently exists for noti-fication of a change of position as a nursinghome administrator.

I’ve posted the minutes of the NHAboard’s June 17th meeting on the FHCAWeb site. This is the meeting at which theboard discussed compliance with and possibleaction involving the $200 special assessment.Go to www.fhca.org and click on “MembersOnly,” then “Regulatory,” then “Board ofNursing Home Administrators.”

NHA renewal feeAlso, I reported some time ago that the

NHA board had raised the license renewalfee to $325 for the October 1, 2006 renew-al. Due to circumstances within the Depart-ment of Health, this rule change was notdone in time, so the NHA board did nothave authority to ask for the increased fee.There is concern that this will increase theNHA board’s deficit which will have to beaddressed in some way in the future.

LegislativeThe 2006 primary election is set for

September 5th, less than a month from now.We encourage you to get out the vote atyour facility and to help patients, staff andfamilies make their voices heard by going tothe polls.This is an important election year.If you would like to be involved in helpingcandidates or incumbents, please contact me in the FHCA office or send an e-mailmessage to me at [email protected].

patients under Medicare Part A, the SNFrequirements are followed. For Medicaidstays, the NF requirements are followed.

Please refer to the memorandum for fur-ther information, which may be accessed viathe CMS Web site at www.cms.hhs.gov.

NHA rulesHere are some recent changes to the

Board of Nursing Home Administrator rulesas filed in the Florida Administrative Code:

■ Rule 64B10-15.001 was revised May7th to remove the yearly cap of three hoursof continuing education for attending meetings of the Board of Nursing HomeAdministrators

■ Rule 64B10-15.002 was revisedFebruary 23rd to state that continuing education credit will not be granted foreducation dealing with the internal affairs of an organization

F H C A

Web siteWeb site• NEWS, BULLETINS• MEMBERSHIP• REGULATORY• REIMBURSEMENT

www.fhca.org


News from across FloridaNews from across FloridaNews from across Florida

Palm Garden of Tampa administrator Scott Allen, right, accompa-nied a delegation of his facility’s CNAs for a visit with TampaMayor Pam Iorio, center. Mayor Iorio presented the group with anofficial proclamation recognizing Nursing Assistants Week.

Sen. Paula Dockery (R-Lakeland) and Rep. John Stargel (R-Lakeland)were on hand to congratulate Florida Presbyterian Homes in Lakelandfor achieving state Gold Seal status. The award recognizes the 40-bedfacility for excellence in patient care, administration, staffing andfinancial stability. Left to right, Medical Director Dr. Sergio Vallejo;Director of Nursing Maria Rivera; Rep. Stargel; AdministratorKymberly Harris; Executive Director John Hehn; and Sen. Dockery.

FHCA Pulse welcomes news items, press releases, photos or guest articles of500 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 CareAssociation, P.O. Box 1459, Tallahassee, FL 32302-1459.

FHCA PresidentDavid Sylvester andthen Region II VicePresident Jo-AnnGrasso spent anhour with the edito-rial board of theOrlando Sentinelrecently. Gov. Bush’sveto, Medicaid man-aged care reformsand dramatic nurs-ing home qualityimprovement wereamong the topicsdiscussed.


Top Legislator: 2005 FHCA Legislator ofthe Year Rep. Rene Garcia (R-Miami), left,congratulates FHCA’s 2006 Legislator of theYear Rep. Joe Negron (R-Palm City). Negronled the fight in the House for Medicaidnursing home funding increases.

Top Advocates: FHCA President Dion Sena, second left, presented specialappreciation awards to four Florida-based nursing home companies for theirhelp in securing nursing home funding legislation through “grassroots” politicalefforts. Honored were, left to right, Patrick Duplantis, President/CEO of GenoaHealthcare Consulting; Pegi Money-McCabe, accepting for Opis ManagementResources President/CEO Marilyn Wood; Scott Bell, President Delta Health CareGroup; and Joe Mitchell, CEO of Summit Care II.


Health care providers covered by the HealthInsurance Portability and Accountability Act

are nearing crunch time in the way they handlestandard transactions. The Centers for Medicare & Medicaid Services will replace current providernumbers with National Provider Identifier num-bers for the submission of claims on Medicareservices — and there is less than one year forproviders to obtain the new numbers and beginusing them.The NPI number is a ten-digit iden-tifier that does not carry any specific informationtying it to the provider (such as state of practice,provider type, etc.). Health care providers underHIPAA have until May 23, 2007 to register forand begin using the NPI numbers or suffer theconsequences, which could include the rejectionof all claims not submitted under the NPI number.

The implementation of the NPI number willcome in waves. Currently, providers can submitclaims with NPI numbers and their existingprovider number but claims with only the NPInumber are rejected. Beginning October 2nd,CMS will accept claims with either the NPInumber or the old Medicare billing number orboth numbers. Medicare is strongly recommend-ing the use of both numbers on claims during this period.The final wave begins May 23, 2007,during which, claims with only the NPI numberswill be accepted. Small health providers (definedas those with annual receipts of $5 million or less) have an additional year to comply. Receiptsare defined as total income plus cost of goods soldas reported on the federal tax return forms.

Mid-September deadlineAs required by section 5203 of the Deficit

Reduction Act, a brief hold will be placed onMedicare payments for all claims during the lastnine days of this federal fiscal year (September 9-30, 2006). No interest will be accrued and no latepenalties will be paid to an entity or individual by reason of this one-time hold on payments.All claims held during this time will be paid onOctober 2, 2006. This policy only applies toclaims subject to payment. It does not apply tofull denials, no-pay claims and other non-claimpayments such as periodic interim payments,home health requests for anticipated paymentsand cost report settlements. Please note that payments will not be staggered and no advancepayments will be allowed during this nine-dayhold.

HIPAA contingency planEffective October 1, 2006, CMS will send only

HIPAA-compliant Electronic Remittance Advicetransactions (transaction 835, version 004010A1)

to all electronic remittance advice receivers.Medicare has worked aggressively with providersto achieve HIPAA compliance over the past several years. Effective October 16, 2003, CMSimplemented a contingency plan through whichMedicare continued to accept and send bothHIPAA-compliant and non HIPAA-complianttransactions from/to partners. CMS ended thecontingency plan that addressed inbound claimsin October 2005, and at that time began denyingnon-compliant electronic claims. Now, CMS ismoving to end the contingency plan for ERAtransactions. Currently, 99 percent of all ERAreceivers (providers, clearinghouses, billing agencies and others who receive ERAs on behalfof providers) are receiving the HIPAA-compliantERA. The overall compliance rate for all Medi-care providers in May, 2006 was 96 percent. (Therate for professional providers was 97 percent andfor institutional providers, it was 93 percent.)

Disaster preparednessLet’s hope Florida avoids a major disaster this

year. But this is hurricane season, so let’s reviewsome of the more important financial issues indealing with disasters:

■ Cash is king: When a major storm is immi-nent, ensure sufficient cash is on hand with sever-al key staff members or department heads so theycan adequately perform their necessary functions.Credit/debit cards don’t work well in a worldwithout power.

■ Documentation: Make sure your office man-ager keeps an accurate account of expendituresfor hurricane-related costs and tracks all receiptsduring and after the disaster, especially when cashis involved. It’s easy to lose control of cash flowsduring and after a disaster and, unfortunately,people can take advantage of poor oversightwhen they think no one is looking over theirshoulder.

■ Secure your records: In order to preserveimportant financial history and support claims forinsurance, tax and reimbursement claims, consid-er offsite storage of critical records. At a mini-mum, several years of tax returns, financial state-ments and general ledgers should be in a secure,storm- and flood-proof location.

■ Program billing: Placements of 30 days or less are generally considered temporary. If tempo-rary, the transferring facility continues to bill andshould pay for the services rendered by thereceiving facility. If the transfer is permanent,the receiving facility should bill for services.

For additional information, consult the 2005FHCA Disaster Preparedness Manual. Watch forrevisions to the 2005 guide to be released soon.

LTCBUSINESS

NEWS

by Steven R. Jones, CPAand Lorne Simmons

Moore Stephens Lovelace

Less than a yearremains beforethe transition iscomplete

Waves of NPI change

FHCA WelcomesNew Members

)

FCAL-NCAL MEMBERSThe Inn at Freedom Square, Seminole

ASSOCIATE MEMBERSA Fashion Hayvin, Inc., Orlandoa la Smart Foods/TheWornick Company,

Cincinnati, OHAmerican Health Associates, Inc.,

MiramarAnew International, DeBaryBuilding Engines, Inc., Waltham, MACelleration, Eden Prairie, MNEvolution Insurance Brokers, Chicago, ILHaven Hospice, JacksonvilleHaven Hospice, GainesvilleHome Instead Senior Care, Coral SpringsStanley - Senior Technologies,

Lincoln, NETurner Pest Control, Jacksonville


Protecting your property froma disaster in an evacuation

by Max Hauth

If you’re bugging out,do it the right way.The Florida Building Code and Rule

59A-4.133, Florida Administrative Code,are specific as to the requirements that a newnursing home must follow in order to becompliant when built or remodeled. This is a result of lessons learned from prior disasters and continuing concern for safetyof patients and staff.

During the past two years in particular,we have come to appreciate building codechanges and new, stronger materials. Safehaven-patient support area(s) are nowrequired to ensure the health, safety andwell-being of patients and staff during andimmediately following a disaster. Theseareas, determined by the facility, shouldinclude a nursing station, clean and soiledutility rooms, food preparation area andpatient care area (30 square ft. per patient).

While determining the area of safe haven,consideration must be given not only to thefacility’s patients and staff, but also for thosewho may be received from “outside,”or fromother facilities. The ability to protect thisarea through the use of shutters, 5/8-inchplywood, or other accepted materials isimperative to the safety of everybody.

Shutting downMany of Florida’s older nursing homes are

not equipped with generators or shutters,and some were built in areas now consideredflood zones. These buildings almost alwaysevacuate their patients and staff to otherlike-care facilities that can assure them safehaven.The ability to reduce the strain on thereceiving facility and the patients transferredis determined by how quickly any repairscan be made (if necessary) to the evacuatedfacility.Thus, taking specific shutdown stepsbefore you leave your building can save youtime, damage repair costs and worry.

Steps to take whenshutting down

■ Power down the facility. Keep the lifesafety (fire alarm), refrigeration, limited ventilation (exhaust) and air conditioningoperational

■ Turn off all gas appliances.■ Be sure all doors – inside and out – are

closed. Windows are secured and hardened(shutters, plywood)

■ Secure all outside furniture or items thatmay become projectiles

■ Be sure that the community and utilityare ready for your return

■ Power up the facility 24 hours inadvance of the return of the patients and staff

■ Ensure that all systems are up and operational (including phone service)

■ Notify AHCA, vendors and families ofthe scheduled return date and time

Final question: Does your facility disasterplan include a shutdown and return-homechecklist?

(Max Hauth is President,Hauth Health CareConsultants, Lakeland, and a frequent contributorto FHCA Pulse on life safety issues. Contacthim at (863) 688-0863.)

■ Arrange for the transfer of the facility’sphone service to an alternate location

■ Download and transfer computer filesto backup location

■ Notify AHCA, vendors and families of relocation

Before returning to the facility■ Assess the facility for damage. If dam-

aged, notify AHCA, your insurance carrierand your corporate office, if you have one

this year’s recipient. “She is the epitome of a consensus builder, a mediator, a personyou’d want on your side when the surveyorsare on the warpath.”

“Honored, humbled”In her 14 years tenure at FHCA, Polivka-

West has played many key roles in manyFHCA initiatives, including the QualityCredentialing Foundation and program,FHCA’s training and professional develop-ment efforts and in FHCA’s ongoing workto keep the survey process consistent andeven-handed.

“I am honored and humbled to be includ-ed with so many of my mentors over theyears — from Lynne Fagan, Bill Phelan,Bobby Rosenthal, Max Hauth and EdFortune who encouraged me to join FHCA14 years ago to the extraordinary leaders oftoday,” Polivka-West said after her briefacceptance speech. Paraphrasing humoristGarrison Keillor, she noted, “All the WalterM. Johnson women are strong and all themen are good looking.”

Tradition of excellenceThe prestigious Circle of Excellence Award

is presented annually to a member of FHCAwho has made significant contributions inthe past year, and who has worked for thegrowth and development of FHCA throughthe years. The award was initiated in 1972 in honor of the man who was one of thesignificant forces in the establishment of

FHCA. Mr. Johnson served as FHCAPresident between 1969 and 1971, andthroughout his career was known for hiscommitment to professional excellence, atradition honored in the annual presentation.

This year’s honoree, as in the past, waschosen by the previous years’ Circle ofExcellence Award winners.The identity of thehonoree is always a carefully guarded secret.No one knows the identity of the year’srecipient — including the recipient — untilit is announced.

2006 Johnson Excellence Recipient: It’s LuMarie!CONTINUED FROM PAGE 1

LABORRELATIONS

COUNSEL

by Mike MillerKunkel, Miller & Hament

FHCA Labor RelationsConsultant

U.S. Supreme Court clarifiesretaliation standard

Title VII of the 1964 Civil Rights Act prohibitsretaliation against any individual for opposing dis-criminatory employment practices or participat-ing in an agency investigation of such practices. Inpast decisions, appellate courts have disagreed asto which types of employer actions can be retal-iatory. Some held that an employer’s action had to affect a tangible term or condition of employ-ment, such as a discharge, demotion, or reductionin pay or benefits. Others held that the employer’saction only had to be sufficiently adverse that it would dissuade an employee who otherwisemight complain. Still others had fashioned a mid-dle position. In the case before the U.S. SupremeCourt, the employee was reassigned from a fork-lift job to laborer’s work and she was suspendedfor 37 days without pay, although she was rein-stated with full back pay once the allegations that she had been insubordinate were found to be incorrect. The Supreme Court held that both actions could constitute retaliation by theemployer (for example, many employees wouldfind it a hardship to go without income for overa month, even if they subsequently might bereimbursed) and it adopted the broader reading of the retaliation provision. The new standard isthat an employer’s action is retaliatory when anobjective reasonable person would find it materially adverse so that it would likely dissuadean employee from making or supporting a com-plaint. One example the Court provided was thata schedule change for a young mother with schoolage children might be found to be retaliatory afterlooking at all the circumstances. The court didnote that “petty slights, minor annoyances andsimple lack of good manners” were not sufficientto implicate the protection of the statute.

Employer may have discriminatedon basis of national origin byrequiring additional documenta-tion, refusing to accept natural-ization certificate and firingMexican-American worker

The Immigration Reform and Control Actrequires that an employer confirm that each newemployee is authorized to work in the UnitedStates. However, as the holding of a recent feder-al court of appeals case demonstrates, an employ-er must avoid being too overzealous in its effortsto comply with IRCA because such action maylead to liability for national origin discrimination.The plaintiff in the case was a Mexican-Americanworker who had been working for the companyfor several months when the employer received atip that INS was going to inspect its facility to

determine compliance with IRCA.The employ-er had hired 300 people the prior year in responseto a strike and feared that some of them may nothave been legal. The company hired an outsidecontractor to check the Social Security numbersof all of its employees,which investigation revealedthat the plaintiff ’s Social Security number hadbeen used by someone else in another state dur-ing prior years. Six months later, the company’sHR director brought the discrepancies to theplaintiff ’s attention and told him he had ten daysto supply additional documentation to prove hewas work-authorized.The plaintiff was suspendedwhen he failed to do so, but he then provided hisnaturalization certificate and an earnings reportfrom the Social Security Administration. Thisdocument, however, contained a different date ofbirth, raising the company’s suspicions. The HRdirector told the plaintiff he would have to obtain“Social Security papers” or a new Social Securitynumber in order to return to work. When theplaintiff produced his Social Security card, theHR director suggested that the number had beenstolen from someone else.The plaintiff thereafterdid provide a Social Security document with anoffice stamp, which was verified with the SocialSecurity Administration and he was called toreturn to work.The plaintiff insisted that he wouldnot return to work without an apology and anexplanation as to why he was suspended. The HR director refused, grabbed the letter from theplaintiff and told him to “just get the hell out.”

The district court granted summary judgmentfor the company, reasoning that it had no obliga-tion to apologize and was attempting to complywith IRCA.The Court of Appeals reversed, send-ing the case back for a jury trial.While the com-pany’s explanation may have been plausible, thecourt held that a jury also could have reasonablyfound that the actions of the HR director wentbeyond compliance and demonstrated a biastoward this plaintiff based on his national origin.The sequence of events led the court to believethat the HR director acted improperly. Heignored the original documents that the plaintiffhad submitted at the time of hire; waited sixmonths before demanding additional documentswith a mere ten days notice to produce them;refused to accept the naturalization certificate(which was facially valid); failed to consider thepossibility that the plaintiff may have been a vic-tim of the misuse of his Social Security numberrather than the perpetrator of a fraud; suspendedthe plaintiff and ultimately terminated hisemployment; and grabbed the valid SocialSecurity document from him and told him to“just get the hell out.” The clear message of the case is that an employer should not jump toconclusions and that it should proceed with caution when faced with apparent contradictionsin the evidence.


Adopts a “reasonableperson” standard todetermine materiallyadverse actions


By now, nobody disputes the absolutelycritical value of good disaster planning.

Having and following your own plan is allbut certain to guarantee a good outcomeduring and after whatever disaster or emer-gency may befall your facility. I may bebiased, but I believe the FHCA DisasterPreparedness Manual is still the single bestand most informative source for preparingand updating your own disaster plan. It’ssince become a national model in partbecause it contemplates many different sce-narios and helps you plan your response.

Often overlooked, however, is anotherpotentially valuable side benefit of good dis-aster planning: good public relations for youand your facility. By sharing aspects of yourfacility’s plan with staff, current and prospec-tive patients and their family members, youreduce anxiety and insecurity about theunknown and you simultaneously send avery powerful message about how seriouslyyou regard the safety of every single soul inyour facility. Making that very point canbring you valuable support when the windstarts blowing and the rain starts falling.

How much to tell?The tricky part of sharing your disaster

plan with the above-mentioned groups is inknowing how much information to discloseand what not to disclose.What level of detailis sufficient to accomplish your mission andwhen is too much too much? What’s legallyprotected? One wants to inform but not toover-stimulate sometimes easily-excitablepatients and their families.

A good rule of thumb is to ask yourselfwhat you would want to know if you werestanding in their shoes. For example:

■ When we evacuate: What is the facility’sevacuation zone? What is the facility’s histo-ry of evacuation? If your facility has recent-ly evacuated, describe how it was undertak-en and how it went.

■ How we decide: What is the process thefacility follows in making its determinationof whether to evacuate or stay? Whodecides? When is the decision made? Whichpatients go first?

■ Transportation options: By what meanswill patients and staff be evacuated and bywhom? When will it occur? Where are theyto be sent? How long will it take to getthere? What staff will accompany them?What about personal belongings and meds?

■ Contacting the receiving facility: How dofamily members and others know the evacu-ation has been successful? May they contactthe receiving facility? If so, how and when?

■ Coming back home: How is it decidedwhen patients and staff may return to thefacility? What is considered and who decides?

You also might want to include informa-tion about what will happen if the facilitydoesn’t evacuate. Also think about includingphotos (if you have some) of recent evacua-tions and excerpts of testimonials from grate-ful/relieved patients and family members.

Be careful that you not disclose any pro-prietary or confidential information, such ashome addresses and telephone numbers,medical needs census data, etc.You can tellpeople the entire preparedness plan (or aredacted version of it) is available for inspec-tion in the main business office during thehours of x and y. Encourage readers to makecomments and ask questions, should they

Consider distributingkey elements of your

facility’s plan to patients,staff and families

by Robin A. BleierGood disaster planningcan be good PR, too

Disaster Preparedness/Risk Management

These are the official online CareerCenters of theFlorida Association Directors of Nursing Administration,

Florida Medical Directors Association, andFlorida Health Care Social Workers Association.

www.fadona.org, www.fmda.org, and www.fhcswa.net

What would you do if youdiscovered the Golden Egg?Visit the CareerCenters at

www.fadona.org, www.fmda.org, and www.fhcswa.net

These are the official online CareerCenters of theFlorida Association Directors of Nursing Administration,

Florida Medical Directors Association, andFlorida Health Care Social Workers Association.

These CareerCenters are a treasured new online resource designed toconnect long-term care industry employers with the largest, most quali-fied audience of nurses, nurse administrators, directors of nursing, nursepractitioners, medical directors, physicians, physician assistants, social work-ers, social service designees, and directors of social services in Florida.

Job Seekers may post their resume (it’s FREE) — confidentially, ifpreferred — so employers can actively search for you.

Let these CareerCenters help you make your next employment connection!

have any. If you really want to hit a homerun, convene a special Resident/FamilyCouncil meeting to release your summaryand to discuss your facility’s readiness plan.

FHCA has a good one-page template youcan use to prepare a summary of your facil-ity’s plan to distribute to those who areinterested. Go to www.fhca.org and click on“What’s New,” then “Hurricane PlanMember Alert.”Click on the link at the bot-tom of the page to access the template.

Avoiding problemsDebbie Afasano of FHCA has a saying

about how insecurity breeds anxiety, soreducing insecurity will reduce anxiety. I’dadd this corollary: Insecurity breeds anxietyand anxiety can breed problems in yourfacility at the very time you can’t affordthem. Keeping everybody informed and onboard in advance can pay dividends before,during and after the emergency.

(Robin Bleier is chair of the FHCA DisasterPreparedness Committee and the Principal of RBHealth Partners, Inc., a clinical risk consultingcompany, and Care Resources-Elder CareManagement. Contact her at (727) 786-3032,or via e-mail, [email protected].)


American Health Care Association and National Center for Assisted LivingAHCA/NCAL offer hundreds of long term care professional development resources. Categories include Care Practice,Compliance & Regulation, Staffing & Retention, Consumer Resources, Nurse Aid Training, Assisted Living and manymore. 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 FHCAmembers 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.

Entrees to HealthEntrées to Health is Florida’s premiere USDA-approved manufacturer of enhanced protein-based products, gourmetentrées and complete meals. Our delicious product offerings are uniquely formulated to provide maximum nutritionalbenefits for patients suffering from diabetes, renal failure, obesity, heart disease and more. A sister company toFood With CareTM Inc., Entrées to Health is dedicated to providing the highest quality products with compassionand integrity. For additional product information please visit us at www.entreestohealth.com, or call us at (407)936-0340 ext.12.

FMS Purchasing & ServicesFMS has a full line of products and services in its Group Purchasing Program. FMS services member needs by ensuringmaximum 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 IncentiveProgram. Call (800) 456-2025.

Hamilton Insurance AgencyHamilton Insurance Agency has 25 years experience, with an emphasis on the healthcare industry, and is proud toprovide 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 documentationsolutions, policy and procedure manuals, regulatory guides and in-service training programs for the long-termcare professional. Our manuals and guides are comprehensive, easy-to-use and continuously updated. Our formsand resources offer peace of mind and quality and better than competitive prices. Call (800) 438-8884.

Office DepotOffice Depot offers Florida Health Care Association members extra discounts and services due to the cooperativepurchasing power of FHCA. We offer a wide variety of benefits, including 50 items which have been reduced basedon volume ordering up to 80 percent off the list prices (the “High Use Item List”); next-day delivery on any amountof products (no minimum order); an award-winning Web site which links you to your pricing and into the ware-house and keeps 18 months of tracking information at your fingertips. Call (800) 422-2654 for information or toset up an account; call (800) 386-0226 to place an order.

Senior CrimestoppersThe Senior Crimestoppers program is a proven, effective, proactive crime prevention system that combinesproven components to help provide safe, crime-free facilities for patients, staff, visitors and vendors. Personallock 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 materialsfor 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 SERVICE CORPORATION SAVES YOU MONEYWe are proud to recommend these fine vendors who provide

quality goods and services. They help keep you and FHCA on top!

FHCA Bulletin Board(Note all programs preceded by an asterisk (*) haveregistration brochures available via FHCA Fax-on-Demand at (850) 894-6299. Some meetings notedherein may also carry CE credits. Additional infor-mation can be found at www.fhca.org. Click on“Seminars/Events.”)

Continuing Education/ Training“New Federal Interpretations =New Challenges”August and September, dates and sites TBA

Seminar will detail the new emphasis on F 248, 249,250, 501, and 309. Speakers will include CynthiaPearse, Karen Goldsmith and Debbie Afasano

Meetings/EventsFHCA Board of Directors meetingFriday, August 25Marco Island Marriott Resort & Spa


PulseIn addition to all FHCA members and associate members, FHCA Pulseis 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 facedby the long term care providers we represent.

Note to FHCA Pulse readers F H C A

Web siteWeb site• NEWS, BULLETINS• MEMBERSHIP• REGULATORY• REIMBURSEMENT

www.fhca.org

Letters from across FloridaOn the ball“Dear Governor Bush,

Sunset Point Rehabilitation and Nursing Center provided exceptional care (to my mother), andif ever there were a place that should receive any honor, this would be it.The staff was amazinglypleasant, attentive and accommodating. I have never seen a staff in any field work so hard andwithout stop, break, complaint or even one negative word.Yes, I was there often and no, I am notjust reporting on my observations of the care my mother received. I diligently watched over the care of my mother, but also observed the care given to other patients. Every interaction, whetherwith a nurse, doctor, food service worker, cleaning staff or rehabilitation provider, I saw genuine care and concern and a confidence that this was indeed an amazing place. I hope this facility is aconsideration if you ever get a chance to visit rehab and nursing providers. It really sounds like your state is on the ball and addressing the needs of the elderly.”

—Mrs. Clare Brubaker, Mechanicsville, MD, to Gov. Jeb Bush in praise of the care at Sunset Point Rehabilitation & Nursing Center, Clearwater

Pulse August 2006 - fhca.org

Documents

Transcript of Pulse August 2006 - fhca.org