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Hurricane Season 2004. . Emergency Plans. Check Current Plans to Ensure They Are Up-to-dateConsider Lessons Learned From Recent ExperienceCheck Vendors to Ensure They Will Honor Agreements
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1. Agency For Health Care AdministrationRegulatory Update Training September 2004 / January 2005 Presenters:
Polly Weaver, Chief of Field Operations
Molly McKinstry, Chief of Long Term Care Services
Susan Acker, Ph.D., Director of Nursing Services
Agency for Health Care Administration-Division of Health Quality Assurance
2. Hurricane Season 2004
3. Emergency Plans Check Current Plans to Ensure They Are Up-to-date
Consider Lessons Learned From Recent Experience
Check Vendors to Ensure They Will Honor Agreements Supplies, Transportation, Receiving Facilities
Consider Secondary Evacuation Plan/location If Initial Is Affected
Ensure Appropriate Receiving Facility
Prior to Evacuation, Reach Agreement on Supplies and Resources and Who Will Provide
4. Emergency Preparedness Test Emergency Generators
Check Supply of Drinking Water; If Contractor Is Used Ensure Service Provider Is Able to Meet Needs
Check Non-perishable Food Supplies; Assure Regulatory Minimums Are Met
Review Loss of Power Plans
5. Evacuation Notify AHCA Of Evacuation
Staffing and Other Basic Requirements to Meet Resident Needs Are Not Waived
Ensure Resident Information Follows the Resident
When Returning Residents to a Facility After Damage, Obtain AHCA Approval First
6. Emergency Resources First Contact: Local Emergency Management http://www.floridadisaster.org/County_EM/county_list.htm#
Florida Emergency Information Line
800-342-3557
Emergency Support Function 8
850-410-1822
800-320-0519 (request ESF-8)
7. Regulatory Update Regulatory Changes
AHCA Information Regarding Trends
Regulatory Statistics
8. 2004 Legislative Changes Inactive License for a Portion of Facility
Rule Must First be Established
Allows a Contiguous Portion of Nursing Home Beds to Become Inactive for 12 Months, Renewable Annually
Retains Ability for Entire Facility to be Inactive for up to 18 Months
Established Requirements for Request and Approval
Staffing
CNA Increase to 2.9 Delayed from May 1, 2004 to July 1, 2005
Certificate of Need
Allows Development of New Nursing Home Beds in Limited Circumstances; An Exception to the CON Moratorium
Rural Counties in Limited Circumstances
Counties Without a Nursing Home Where a Nursing Home Closed Since July 2001
9. 2004 Legislative Changes Nursing Homes
CNA In-service Hours
Requires In-Services Hours as a Condition of CNA Certification Rather Than Nursing Home Employment
Refers the In-Service Requirements of S. 464.203(7), F.S.
Remains 18 Hours Annually
DON Signature on Care Plans
Allows Another RN to Sign Resident Care Plans for DON
RN Must Have Institutional Responsibilities in Writing
RN Cannot be a Temporary Staff Person
Gold Seal
State and Federal Nursing Homes are Deemed Financially Stable and Not Required to Submit Financial Statements
10. Nursing Home Gold Seal
Thirteen Homes Received the Award in November, 2004
Performance Criteria Include:
Financial Soundness and Stability
High Quality of Care Ranking Among Other Nursing Homes in Their Region
Excellent Record With the State Long-term Care Ombudsman Program
No Conditional Licenses nor Nursing Home Watch List Appearances in the Past 30 Months
Evidence of Community Involvement
Stable Workforce
11. Gold Seal Awards New Gold Seal Recipients:
Baldomero Lopez Memorial Veterans Nursing Home, Land O Lakes
Bay Village of Sarasota, Sarasota
Life Care Center of Hilliard, Hilliard
Mayflower Healthcare Center, Winter Park
Miami Jewish Home & Hospital for the Aged, Miami
Ponce Plaza Nursing and Rehabilitation, Miami
Sunnyside Nursing Home, Sarasota
Waters Edge Extended Care, Palm City
12. Nursing Home Gold Seal Renewing Gold Seal Recipients:
Harbours Edge, Delray Beach
John Knox Village Medical Center, Tampa
The Pavilion for Health Care, Penney Farms
River Garden Hebrew Home for the Aged, Jacksonville
Village on the Green, Longwood
13. Report to the LegislatureMay 2004 Status Report
Nursing Home and Assisted Living Facility: Adverse Incidents & Notices of Intent Filed
http://www.fdhc.state.fl.us/Publications/index.shtml
Also see Semi-Annual Report on Nursing Homes Report to the Legislature December 30, 2004
14. Adverse Incidents Reported to AHCA
15. Adverse Incident Analysis For The One Year Period May 15, 2003 Through May 14, 2004, The Agency Received:
3,175 Nursing Home Adverse Incidents
1,996 Assisted Living Facility Adverse Incidents
19,378 Total Reports Submitted - 5,171 Were Determined To Be Adverse Incidents After Final Facility Staff Review
16. Adverse Incident Analysis AHCA On Site Visits In Response To Adverse Incidents:
84 On-Site Visits To Nursing Homes
48 On-Site Visits To Assisted Living Facilities
Of These Surveys 3 Nursing Homes And 5 Assisted Living Facilities Were Cited For Class I and/or Class II Deficiencies
17. Adverse Incident Outcomes
18. Nursing Home NOIs
19. Characteristics of Reported Litigation
20. Notices of Intent Past 3-Years 548 Nursing Homes Reporting NOIsMay 2001 - May 2004
21. Notices of Intent Past Year 339 Nursing Homes Reporting NOIsMay 2003 - May 2004
22. Nursing Home Complaints Filed in Clerk of CourtComplaint Service Dates June 2002 - April 2004
23. Nursing Home Complaints Filed in Clerk of CourtBy AHCA Receipt Date June 2002 - April 2004
24. Number of Nursing Homes on The Watch List
25. Nursing Home Deficiencies
26. Nursing Home Deficiencies for Failure to Have Sufficient Staff to Meet Resident Needs
27. All Nursing Home Staffing Deficiencies
28. Grant Proposal RequestsUse of Civil Money Penalty (CMP) Funds CMPs Returned to Florida Based Upon Medicaid Participation of Sanctioned Nursing Homes
Deposited in State Quality of Long Term Care Improvement Trust Fund
Authorization to Spend $500,000 Annually
Expenditures Must be Consistent with State and Federal Requirements
29. Federal Guidance Federal Regulations 42 CFR 488.442(g) and Section 7534B of the State Operations Manual Direct
Use of CMPs for Protection of Health or Property of Residents of Facilities That the State or the Centers for Medicare and Medicaid Services (CMS) Finds Deficient
30. Federal Guidelines Prevention of Deficient Practice Through Educational Means by Development of Videos, Pamphlets, or Other Publications Providing Best Practices
Development of Public Service Announcements on Issues Directly Related to Identified Deficient Areas
Employment of Consultants to Provide Expert Training to Deficient Facilities
Issuing Grants to Facilities for Projects Such As the Eden Alternative
Other Projects That Directly Benefits Facility Residents
31. Federal Limitations A Loan to a Facility Having Financial Difficulty Meeting Payroll or Paying Vendors is an Inappropriate Use of the Funds
Funds Cannot Be Used to Bring a Facility Into Current Regulatory Compliance
Projects Should Be Limited to Funding on Hand and Should Be Relatively Short-term Projects
32. Grant Proposals All Florida Nursing Homes May Apply
Proposals Must be Innovative and:
Provide Well Conceived Vision/Plan with Detailed Explanation and Steps to Achieve Improvement
Propose Achievable Goals
Provide Education Plan for Residents/Staff
Provide Detailed Implementation Plan
Provide Budget of Expenditures
33. Grant Proposals All Florida Nursing Homes May Apply
Proposals Must be Innovative and:
Provide Well Conceived Vision/Plan with Detailed Explanation and Steps to Achieve Improvement
Propose Achievable Goals
Provide Education Plan for Residents/Staff
Provide Budget of Expenditures
34. Grant Process Initial Request for Interest and Proposals, Nursing Home Letter December 22, 2004
Applications Will be Provided for Completion
Proposals Will be Reviewed Within Available Funding
Presentation May be Requested
35. Grant Participation Recipients of Grants Will Enter Into a Contract With the Agency
Contracts Will Generally Be One Year; No More Than Two Years
Monitoring Will Be Developed Based Upon the Project
Quarterly Reports
Onsite Reviews
36. Grant Information & Proposal Submission Bureau of Long Term Care Services
Barbara Dombrowski
Phone: (850) 922-0048
E-mail: dombrowb@fdhc.state.fl.us
37. Top 10 Nursing Home Deficiencies
38. Top 10 Nursing Home Deficiencies
39. Top 10 Nursing Home Complaint Allegations
40. AHCA Resources