HHS/CMS :: Critical New Information On Nursing Home Quality Available..

This press release from the United States Department of Health and Human Services (HHS) just now hit my inbox.. Okay, so actually, the way my Mind works these days, by the time "Publish Post" is toggled, this latest from these fingertips will have been probably two hours in the making..... :grin:

The referenced websites, all from the Centers for Medicare and Medicaid Services (CMS), include:

• Multi-Year Action Plan for Further Improvement of Nursing Home Quality; for comparison purposes, see also the 2007 Action Plan..
• Special Focus Facility Initiative..
• Nursing Home Compare..
• Quality Improvement Organizations (QIOs)..
• Certification and Compliance: Nursing Homes..
• Centers for Medicare and Medicaid (CMS)..

EXTREMELY IMPORTANT to note is that they reference there are currently 134 long term care facilities that are continuously making it to the CMS' naughty list.. One hundred and thirty-four facilities.. ONE is one too many because each of those 134 facilities represents the very real possibility of reprehensible, wholly preventable Human Life loss..

Should you wish to reach CMS, their contact information is as follows:

• Department of Health & Human Services
  Centers for Medicare & Medicaid Services
  Room 352-G
  200 Independence Avenue, SW
  Washington, DC 20201
  Telephone: (202) 690-6145

Cyber hugs from Talking Rock..

Critical New Information Added to Nursing Home Compare Web site :: Multi-year Plan for Improved Nursing Home Quality Also Released

Medicaid beneficiaries and families searching for top quality long-term care services can find critical new information added today to the Centers for Medicare & Medicaid Services' (CMS) Web site Nursing Home Compare.

For the first time, information about nursing homes on the Compare Web site will list whether a home is or has been on CMS' special focus facility (SFF) list. The agency's SFF initiative gives heightened scrutiny to nursing homes that have a history of poor performance or repeated violations of state and federal health and safety rules.

"Today's expansion of information on Nursing Home Compare will give beneficiaries a more complete picture of a nursing home's history of providing quality care," CMS Acting Administrator Kerry Weems said.

The SFF initiative was created because a number of facilities were consistently providing poor quality of care, yet were periodically instituting enough improvement that they would pass one survey only to fail the next (for many of the same problems as before). Such facilities with a "yo-yo" compliance history rarely addressed underlying systemic problems that were giving rise to repeated cycles of serious deficiencies.

In November 2007, the agency began publishing a list of Medicare and Medicaid participating nursing homes that have a history of serious quality of care problems and had failed to show significant improvement. In February 2008, CMS took the next step and published an updated, expanded list of nursing homes in the SFF initiative and included the category they fell within such as new additions, not improved, improving, recently graduated or no longer in the Medicare and Medicaid programs.

As of April 2008, there are 134 SFFs, out of about 16,000 active nursing homes. CMS works closely with states to select participants and as homes improve their quality of care and "graduate" from the program, or fail to improve and are terminated from Medicare and Medicaid, new homes are added to the list. This movement of homes off the list allows more facilities with problems to be added as the program continues.

Once a facility is selected as an SFF, the state survey agency conducts twice the number of standard surveys and will apply progressive enforcement until the nursing home either

• significantly improves and graduates from the SFF initiative
• is granted additional time due to promising developments
• is terminated from Medicare and/or Medicaid

CMS and the state can more quickly terminate a facility that is placing residents in immediate jeopardy.

Nursing homes that have the SFF designation, including information about that designation, will now be noted on Nursing Home Compare, which can be accessed at www.medicare.gov. The site helps families find nursing homes in their area. Information about the homes includes performance scores on quality measures, staffing information and a three-year history of the home's health, safety and fire inspection reports. The Web site will be updated with new information quarterly.

"Today's action is the next step in our commitment to bring transparency and accountability to the process families must go through to find the care that is best for them and their family member," Weems said.

Further Actions Planned

The publication of the SFF list was the first major step in CMS' latest efforts to improve nursing home care. A comprehensive, multi-year look at future actions the agency will take was also released today.

The "2008 Action Plan for Further Improvement of Nursing Home Quality" consists of several inter-related and coordinated approaches:

• Consumer Awareness and Assistance: to include an increasing array of information about long-term care that will be written in an easy-to-understand format and available to the public at www.medicare.gov. Already posted there is the "Guide to Nursing Homes" and the "Compare" data. These tools can be used by Medicare beneficiaries and their family members to better understand the quality and value of Medicare's nursing home benefit.
• Survey, Standards and Enforcement Improvement: several initiatives are being developed to improve the effectiveness of the annual nursing home surveys as well as those prompted by consumer complaints. The agency also plans to work in partnership with states to improve current enforcement efforts.
• Quality Improvement: The agency is focusing on several key areas to improve health care quality in nursing homes including a special focus from the quality improvement organization (QIO) program on prevention of bed sores, reduction in the use of physical restraints and greater emphasis on developing individualized care plans to improve a resident's quality of life.
• Quality Through Partnerships: Through its QIOs, CMS has coordinated an unprecedented, collaborative campaign, "Advancing Excellence in America's Nursing Homes" designed to improve both the delivery and measurement of quality care. Through its work with QIOs, state survey agencies, and the nursing home industry and consumers, CMS is well on track to achieve these goals.

A copy of the full 2008 nursing home action plan can be found at:

• cms.hhs.gov/CertificationandComplianc/12_NHs.asp

Rome, Georgia :: Owner of 2 Nursing Homes suing DHR and CMS over funding loss..

Just found the following story in my ever burgeoning inbox.. In circumstances such as this story involves, resources that immediately come to mind to contact include:

• State disability advocacy office
• Long term care ombudsman (National Long Term Care Ombudsman Resource Center)
• Local center for independent living (CIL)
• News media (e.g. Congress.org Media Guide) -- Don't forget to get your story out there widespread so disability advocates can see it..

In addition to the above, don't forget about your local disability self-advocacy organizations, too.. Coming immediately to mind are:

• American Disabled for Attendant Programs Today (ADAPT)
• People First

Checking out the ADAPT website and/or contacting them directly should provide leads to local ADAPT chapters.. Calling your local CIL or trying some creative keyword combination searches will point you in the direction of your area's nearest People First chapter..

Article :: Owner of two nursing homes filed a federal lawsuit..
By Mike Gellatly, Rome News-Tribune Staff Writer, 2007-07-07
Rome News-Tribune..

Synopsis :: George Houser of Forum Healthcare, owner of two Rome, Georgia, nursing home facilities (Mount Berry and Moran Lake) filed a federal lawsuit against Georgia Department of Human Resources (DHR), Centers for Medicare and Medicaid Services (CMS), and others.. Federal funding supporting skilled nursing services stands to be pulled from these two long term care centers on July 15, 2007.. Based on the article, ceasure of funding appears to be related to (previous) quality of care.. Funding currently being provided is earmarked for the discharge and transfer of affected residents..

CMS Press Release: 17 States Receive Grants for Alternatives to Institutional Care..

Yeah, it wasn't missed by these fingertips that Georgia didn't make the cut for these grants.. Don't know what it is, but Land of the Olmstead decision and we always seem to be among the last to implement things.. :(

FOR IMMEDIATE RELEASE
January 12, 2007
CONTACT: CMS Public Affairs
(202) 690-6145

CMS AWARDS DEMONSTRATION GRANTS TO 17 STATES FOR ALTERNATIVES TO INSTITUTIONAL CARE

Seventeen states will receive more than $23 million in grants for FY 07 and up to $900 million over 5 years for demonstration programs that will help build Medicaid long-term care programs to keep people in the community and out of institutions.

Today’s awards, announced by Leslie Norwalk, acting administrator for the Centers for Medicare and Medicaid Services (CMS), are the first round of grants that will total $1.75 billion over five years (2007-2011) to help states shift Medicaid’s traditional emphasis on institutional care to a system offering greater choices for individuals and a full range of home- and community-based services. This Money Follows the Person (MFP) "rebalancing" initiative was included in the Deficit Reduction Act of 2005 (DRA) currently being implemented by CMS.

"There is more evidence than ever that people who need long-term care prefer to remain in their own homes and communities whenever possible," Acting Administrator Norwalk said. "States will also get more for their money by giving the elderly and people with disabilities more control over how and where they get the Medicaid services they need. With these grants, the states propose to transition over 20,000 individuals from institutions and into community settings.

"Because experience shows that money following the person’s own preferences improves satisfaction and can reduce Medicaid costs too, we intend to continue taking steps, such as those taken through these grants, to remove barriers, real or perceived, that prevent them from participating fully in community life."

The Medicaid program traditionally pays for care for elderly and disabled individuals living in institutions who need help with activities of daily living. Previously, in order to fund home and community-based services, states had to establish a "waiver program" apart from the approved State Medicaid plan.

To assist states in offering greater choices, the DRA made changes in Medicaid that will allow states to add home- and community-based services to their permanent array of benefits without having to go through a waiver program. Under a DRA provision separate from the MFP initiative, states now have the option to provide home and community-based services without a waiver program.

States receiving grants today under the MFP initiative (see list below) will design programs with four major objectives:

• Increase the use of home and community-based, rather than institutional, long-term care services;
• Eliminate barriers or mechanisms that prevent Medicaid-eligible individuals from receiving support for appropriate and necessary long-term services in the settings of their choice;
• Increase the ability of the state Medicaid program to assure continued provision of home and community based long-term care services to eligible individuals who choose to move from an institutional to a community setting; and
• Ensure that procedures are in place to provide quality assurance for individuals receiving Medicaid home and community-based long-term care services and to provide for continuous quality improvement in such services.

All states were eligible to apply for participation in the five-year demonstration that requires a commitment to participate in the demonstration services for at least two consecutive years. A second round of state grants may be announced later this year using 2007 grant money.

States receiving grant funds may be eligible to receive a higher percentage of federal matching dollars to help cover the costs for people moving out of institutions and into community settings. The higher matching rate will be applied to certain services provided to an individual for a one-year period after the individual moves out of an institution and into the community. The state must continue to provide community services after that period as long as the person needs community services and is Medicaid eligible.

"These demonstration grants are a clear sign of our continued commitment to expand choice to all individuals wanting to live meaningful lives in the community," acting administrator Norwalk said. "These grants will help give them the independence to live at home and be an active part of their communities."

For more details about the New Freedom Initiative, of which this demonstration is part, visit the CMS (New Freedom Initiative) web site.

2007 MONEY FOLLOWS THE PERSON
REBALANCING DEMONSTRATION AWARDS

State -- FY 2007 Award Amount

• WI -- $8,020,388
• NY -- $192,981
• WA -- $108,500
• CT -- $1,313,823
• MI -- $2,034,732
• OK -- $3,526,428
• AR -- $139,519
• MD -- $1,000,000
• NE -- $202,500
• NH -- $297,671
• CA -- $90,000
• IN -- $860,514
• TX -- $143,401
• SC -- $34,789
• MO -- $3,398,225
• IA -- $307,933
• OH -- $2,079,488
• Total -- $23,750,892

CMS PRTF: Alternatives to institutes for children with mental illness..

A Centers for Medicare and Medicaid Services (CMS) press release..

December 19, 2006
CMS GRANTS WILL HELP STATES DESIGN ALTERNATIVES TO INSTITUTIONS FOR CHILDREN WITH MENTAL ILLNESS

With the proper supports, children institutionalized with mental illness that could thrive in their homes and communities will now have the opportunity to do so in 10 states that today received grants from the Centers for Medicare and Medicaid Services (CMS) to design innovative new programs for such children.

The agency announced $218 million in grants over five years to state Medicaid programs to develop care delivery systems under the Community Alternatives to Psychiatric Residential Treatment Facilities (PRTF) demonstrations. The grants will provide a comprehensive package of community-based services for children with mental illness.

States receiving grants today estimate that, by 2011, 11,000 children with serious mental illnesses will benefit from the new programs these grants will fund. Those states receiving grants today include: Alaska, Florida, Georgia, Indiana, Kansas, Maryland, Mississippi, Montana, South Carolina and Virginia. These states will receive a total of $21 million in the first year of the program, which will run through 2011.

"We believe these grants will result in a more caring, compassionate approach to meeting the needs of these children," said Leslie Norwalk, CMS Acting Administrator. "Integrating them back into their homes and communities gives them the best opportunity to lead successful, productive lives as adults."

Programs approved for funding under this demonstration will include 24-hour support and crisis intervention in the community setting, training for families, respite care for those families and after-school support programs for children in the demonstrations.

The demonstrations will be evaluated both for cost-effectiveness and quality of treatment and outcomes for the children involved.

Funds for these grant awards were included in the Deficit Reduction Act of 2005 (DRA). Further information about this grant program is on the CMS web site at: Psychiatric Residential Treatment Facilities demonstration grant information.