pulse april 2002 - fhca

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FLORIDA HEALTH CARE ASSOCIATION

Update

2002 legislative session nearing end

At press time, the Florida legislature was in the last

days of the 2002 regular session.Several important LTC issuesremain unresolved, and additionalspecial sessions may be necessary to deal with state budget and reapportionment issues.

Therapy caps loom

Legislation has been filed inCongress that would repeal the

$1,500 cap on outpatient therapyservices imposed by the BalancedBudget Act. The cap is currentlyunder a moratorium, but withoutit the cap would be re-imposed on January 1, 2003. See LTCBusiness News, page 10.

National NursingHome Week

This year’s National NursingHome Week celebration is

May 12-18th, guided by thetheme,“Celebrating Seasons ofLife.”To obtain promotional materials and further information,contact the American Health CareAssociation at (202) 898-6301.

Health care summit

Afree two-hour “Real Solutionsfor Seniors” health care sum-

mit is planned for April 16th at the Hilton Oceanfront Resort inDaytona Beach. Dr. GeraldWoodard and Tracie Farrar, RNare scheduled to present on geri-atric, nursing home staffing, homehealth, security and “bedside” issues.For information, contact Jon MarcCreighton at (386) 760-7773. Florida Health Care Association

P.O. Box 1459Tallahassee, FL32302-1459

PRSRT STDU.S. Postage

PAIDTallahassee, FLPermit No. 1007

Anew Aon Risk Consultants study showsthat between 1990 and 2001, the nation’s

nursing homes saw a tenfold increase in per-bed liability insurance claims and atripling of the average claim size, much of it attributed to litigation activity in Florida.

Worse, the study shows all U.S. nursinghomes are having to pay much more formuch less insurance coverage, and increasedinsurance premiums are eating into modest

Medicaid reimbursement rate increasesmade between 1995 and 2000.

The study, “Long Term Care GeneralLiability and Professional Liability ActuarialAnalysis,” was commissioned by the Ameri-can Health Care Association and looked atsome 20,000 individual non-zero insuranceclaims from long term care facilities acrossthe country. The facilities included in thedatabase combined operate approximately440,000 licensed nursing home beds and32,000 assisted living/independent livingbeds, or 26 percent of all beds nationwide.

More claims, more oftenThe report also focused on the frequency

of lawsuits/claims. In 1990, there were 3.6claims per 1,000 occupied beds nationally,but by 2001, the number had tripled to 11 claims per thousand beds. In Florida,the report estimates 2001 activity at 29

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

APRIL 2002

Dark Days AheadSee Page 5

Stern warning:FHCA member DeWayneHarvey, right, says Floridianscannot just stand by andwatch nursing homes close if their medical directorscan’t get liability insurancecoverage. Harvey spoke forFHCA at a press conferenceoutside the House chamberswith Dr. John Potomski,Chairman of the Board,Florida Medical DirectorsAssociation. See page 13 for more details.

Study shows the soaring costof U.S. nursing home lawsuitsFlorida claims are driving up the national average; insurers continue to exit the long term care market

CONTINUED ON PAGE 7

CONTINUED ON PAGE 7

FHCA APRIL 2002 Pulse2

Florida Health CareAssociation

John Overton, PresidentKelley Rice-Schild, Senior Vice President

Karen Soehner, SecretaryDion Sena, Treasurer

Bill Phelan, Executive Director

FHCA PulseAPRIL 2002

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.

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

Overtonesby John Overton

FHCA President

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 nursing homesand assisted living facilities we represent.

Note to Pulse readers

I’m delighted to report our Quality Credentialing Foundation is alive and well.The 13 men andwomen who serve as foundation board members are some of the very best and brightest pro-

fessionals in long term care.Their mission — to help improve the overall care delivery in Florida'snursing homes — is clearly understood and embraced by this group. We see that as a moral obligation of one generation to another.After all, our parents deserve no less.

Still, there are many skeptics who doubted our resolve. Some were convinced that this was nothing more than a ploy to accomplish a shorter-term goal. Even some of our colleagues questionedour ability to keep the focus on quality. But the QC board accepted that as a challenge. They continue to give a great deal of time and effort in this cause. Short-term barriers to progress are recognized as long-term opportunities. I’m convinced this foundation will make a difference in thequality in our nursing homes, because the public demands no less.

On boardMost of our association’s nursing home members have signed on to their willingness to participate

in our credentialing process. The fact that FHCA membership is contingent on QC participationwill be our greatest strength in moving forward, for if we are really serious about improving quality,there is no other way than to mandate participation.

To date these are the three major accomplishments of our efforts:■ Appointment of the Quality Credentialing Foundation and 88 percent of the FHCA

membership enrolled in the program.■ Thirteen of the original 27 member facilities on the AHCA Watch List and in the Quality

Credentialing program’s Early Warning System are now no longer on that watch list.■ Development of a mentoring system with Quality Credentialing Foundation members assigned

to specific member facilities.

Florida leadsYou will be hearing a lot more about this foundation in the future. What’s also interesting is

that American Health Care Association is adopting our Quality Credentialing model to roll outnationwide. That’s pretty impressive.Yet it shows, as has been the case so many times before, thatFlorida leads the way in quality improvement.

Our members often tell me that what our profession needs more than anything else is publicappreciation and respect for the tireless efforts of so many good people who devote their lives to carefor Florida’s most vulnerable citizens. Once it is clearly understood that our profession can improvequality on its own, gradually public acceptance of us will improve. Of that I am very confident.

More on “report cards”And finally, I note the Agency for Health Care Administration has translated its own nursing

home guide into Spanish and made it available on its Web site. That’s great, but any consumer guide that doesn’t also include basic customer satisfaction information is less than complete, in myview. We look forward to the day when consumers have the complete picture so they can make a more informed choice.

Full speed ahead with FHCAQuality CredentialingThe eyes of the nation are again on Florida

FHCA APRIL 2002 Pulse 3

LPN supervision rule adopted

The new rule represents a compromise

by Karen SoehnerFHCA SECRETARY ANDCHAIR, NURSING SERVICESAND CNA TASK FORCE

The Florida Board of Nursing adoptedrules last month implementing Ch.

400.23(3)(c) F.S., which emerged out of the2000 legislative session.The new rule, FAC64B9-16, “LPN Supervision in NursingHome Facilities,” went into effect March26th and sets forth requirements LPNs mustfollow if they are to be qualified to supervisein nursing home facilities.

FHCA’s attempts to include assisted living facilities in this rule were met withresistance by the Florida Nurses Association.In fact, under the very first draft version of the rule, LPNs were nearly renderedobsolete in all provider areas by a change in the definition of “direct supervision” bywhich LPNs could only perform taskswhere an RN was physically present. AsFHCA’s representative, I strongly opposedthat position and participated in the devel-opment of the current rule language whichstates that an LPN working in a nursinghome shall qualify to supervise by meetingall of the following requirements:

There is a provision in the rule whichstates that nursing homes utilizing LPNs ina supervisory role shall complete at least 16hours clinical supervisory experience underthe direction of an RN who is physicallypresent within the patient care unit and whowill assume legal responsibility for the nursing practice of the LPN.

“Five-year LPNs”The good news is an LPN who has at

least five years of full-time clinical nursingexperience may complete the 16-hoursupervisory training and begin supervisoryduties immediately following the training.These “five-year LPNs” will have untilAugust 31, 2002, to complete the 30-houreducational requirements of this rule.

Other requirements address RN super-vision of the LPN and specific tasks/activi-ties an LPN may delegate to the CNA orany unlicensed personnel. For the completerule, visit the “Members Only” section ofFHCA’s Web site, www.fhca.org.

■ Completing a minimum 30-hour post-basic, Board of Nursing-approved LPNsupervisory education course prior toaccepting any supervisory assignments(The FNA would have it no other way).

■ Demonstrating a work history of no lessthan six months of full-time clinicalnursing experience in a hospital or nurs-ing home (The Florida Board of Nursingmembers would have it no other way).

■ In lieu of the 30-hour post-basic nursesupervisory education course, LPNs mayqualify to supervise if the LPN has suc-cessfully completed a supervisory courseon a post-graduate level and a providercredits the nurse for such course, as longas each component of the course con-tent of 64B9-15.003(3) (a)-(m), FAC. istested and competency demonstrated tothe provider (N0068).

Rice-SchildnamedSenior VPMiami Region I Vice Presidentis former Johnson Excellencewinner and 2001 NursingHome Administrator of the Year

FHCA President John Overtonnamed Region I Vice PresidentKelley Rice-Schild as FHCA Senior

Vice President.The appoint-ment was lateroverwhelminglyapproved bythe FHCA Boardof Directors.

Rice-Schild ispart of four

generations of her family whoown and operate the FlorideanNursing Home in Miami. Lastyear she was named FHCANursing Home Administrator of theYear and also received the WalterM. Johnson, Jr. Circle of ExcellenceAward, the highest honor anyFHCA member can receive.

Rice-Schild fills a vacancy created by the resignation of PatFreeman and will serve out theremainder of the term prior tonew elections in July.


LTC LEGAL

ISSUES andTRENDS

by Karen GoldsmithGoldsmith, Grout

& LewisFHCA Legal Consultant

Quirks in the state appeals processNew legal and AHCA policy changes can make it tricky

Many FHCA members are missing the oppor-tunity to appeal, or to have complete reso-

lution of, the issues raised in a survey because ofincomplete knowledge of the process. In addition,policy changes at the state level and provisions ofSB 1202 have made significant changes in theappeals process.

When a provider receives a conditional license,a letter should accompany it advising the providerof its right to appeal, the parameters of the docu-ment which must be filed and the timeframes.An election of rights form will be attached. If youare requesting an informal hearing, you will onlyhave an opportunity to argue your case before anemployee of the Agency for Health Care Admin-istration.An informal hearing is rarely used whenthere is a genuine issue of fact.You should alwaysconsult counsel before asking for an informalhearing.

The election of rights form include twooptions which require you to admit the facts thatform the basis of the deficiency(ies).You shouldalso seek advice of your counsel before admittingany issues.

Formal hearing requirementsIf you seek a formal hearing, you must submit

information adequate to meet the requirementsof Florida administrative law. The election formrefers you to the pertinent statute but does notclarify specifically what is required. Severalproviders have been dismayed to find that theyhave had their requests for hearing challenged byan Order to Show Cause by the AHCA clerk, list-ing the infirmities in their request. In some cases,the request has been denied and the providershave lost an opportunity to challenge state issues.

A Petition for Formal Administrative Hearingmust include:■ Name and address of the agency affected

and its file number■ Identifying information on the person

requesting the hearing■ Identifying information on the facility’s

representative■ An explanation of how the facility’s substantial

interests will be or have been affected■ Information on the manner in which the

provider received notice■ Information on the disputed issues of fact■ A statement of law as to why the agency

identified should change its decision■ A statement of what the provider wishes the

agency to do.Since the Agency is taking a hard line on the

contents of the request for hearing, it behooves

you to seek legal advice before filing your petition.It is confusing and misleading to providers to sup-ply them with an election of rights which appearsto be a simple document and then holding theirfeet to the fire for the legal content of theirrequests.You are not required to use the electionof rights form.AHCA has not adopted its use bylaw. It is supposed to be a convenience for you.Instead, it can be a trap; either getting you toinadvertently admit facts with which you disagreeor throw away your rights to a hearing.

If you have one or more subsequent surveysand are still not in compliance, your conditionallicense will continue, however, you will be givenno new point of entry into the administrativeprocess. If you feel that the new or uncorrecteddeficiencies are invalid, you will need to amendyour existing petition or file a new one.

IDRParticipation in Informal Dispute Resolution

is not a prerequisite for a hearing. Rememberfrom earlier articles that IDR is a federal process.It does not affect your responsibility to ask for astate hearing.Nor does the fact that you are await-ing either an IDR, or the results of one, toll thetime for filing your petition. However, if you succeed in having a deficiency downgraded inscope and severity at IDR, AHCA normallychanges the state classification as it has adoptedthe federal matrix in its classification process.

The lesson to be learned from this is give yourattorney all the information that you have, includ-ing any correspondence from AHCA, copies of all2567’s (even if you do not think you want to chal-lenge one or more of them), your IDR docu-ments and synopsis as well as any results received.

Another new wrinkle in the system is that you will receive a letter from AHCA when yourconditional license is forwarded. This letter willgive you a point of entry. Sometime later you willreceive an administrative complaint regarding yourconditional status. Many people have challengedboth of these and have ended up with two admin-istrative law judges assigned for the same matter.If you challenge your conditional license from the letter and later receive the complaint, contactyour attorney to be sure your rights are protected.

Adequate requests for Formal AdministrativeHearing are sent by AHCA to the Division ofAdministrative Hearings, where they are assignedto a neutral ALJ.There has been a trend lately tomove these cases rapidly through the administra-tive process.As a result, it has become difficult tosettle these cases - time just will not permit themto move through the AHCA system.

Rice-Schild

CONTINUED ON PAGE 15

Advertise in FHCA’s

Pulsecontact Ian Cordes at Corecare Associatesph: 561/659-5581 • fax: 561/659-1291

e-mail: [email protected].


Despite SB 1202, dark days remain

by Andrew R. McCumber

Guest Commentary

The flood of lawsuits could drive 2002 claims

above $800 million

Senate Bill 1202 took effect May 15,2001. Long term care providers were

in desperate need of financial stability. HasSB 1202 provided this stability; can it, or is it still too early to tell?

While SB 1202 was announced andcheered by long term caregivers as a step inthe right direction, it was never viewed as a panacea. When asked to predict theimmediate effect of SB 1202 on the rapidlyescalating number of claims filed and therapidly growing size of each facility’s litiga-tion losses, most long term care insiderspredicted some dark days before the trueimpact of SB 1202 could properly beassessed.

Overwhelming the systemDark days indeed. Anecdotal evidence

suggests what most of you have likelyobserved. In an effort to beat the grace peri-od provided by the legislature prohibitingremedial application of the new punitivedamages provisions for causes of action filedbefore October 5, 2001, the larger plaintiff ’sfirms “emptied their stables.” Even with noextensions provided for obtaining serve ofprocess, most of these filed actions wereserved before February 5, 2002.As a result ofthis rush to file cases whether fully investi-gated or not, a legal and claims system whichwas already overwhelmed has been pushedbeyond its ability to handle these claims,and the review and assessment process per-formed by claimants and providers/insurersalike has slowed to a crawl.

At first blush, most of these cases filed in a rush — often without sufficient investi-gation by the state’s plaintiff ’s lawyers —appear to be even less objectively meritori-ous as a whole than the claims we were seeing before May 15, 2001.Verification ofthis first impression, however, has been diffi-cult with all parties routinely providingextensions to the others because the workload for all quickly became unmanageable.It seems quite likely, however, that thepotential exposure faced by the long termcare industry in Florida for losses paid in2002 may well exceed $800 million whichrepresents a significant increase over the totallosses incurred in 2001, despite the passageof SB 1202.

An end in sight?The good new is that the same industry

insiders who predicted these dark days donot expect this blood bath to continueindefinitely in the face of SB 1202. As new claims which arose under the law worktheir way through the system, we will bebetter able to quantify the progress made.Unfortunately, this progress may still bethree years away.

It must be understood that most of the claims still being filed arose out of inci-dents which occurred prior to May 15, 2001and are therefore governed by the old lawprovisions with all of the problems that misguided legislation caused. By studyingand tracking the frequency and severity ofclaims filed for incidents which occurredafter May 15, 2001, we will be in a betterposition to evaluate the true effect of SB1202. This remaining time period under the old law’s four-year statute of limitations,called “the tail,” is a crucial time for longterm care providers.

Prudent insurersThe purpose of SB 1202 was to bring

available and affordable insurance back toallow facilities to again become viable busi-nesses channeling resources to patient careinstead of plaintiff ’s lawyers. Unfortunately,insurance companies evaluate the potentialmarket by reviewing historical data.Through the present time, none of the available data on claim frequency or theseverity of industry losses would entice aprudent insurer to re-enter this market andprovide the necessary stability for nursinghomes to return to economic viability.

These are indeed dark days. The state’slargest provider of long term care services,

Beverly Enterprises, has withdrawn from thestate since the enactment of SB 1202 as adirect result of the liability losses which con-tinue to spiral out of control. Clearly, furthersteps will be needed by the state’s lawmakersto prevent additional solvent long term careproviders from exiting the state, to providethe type of stability which will entice theinsurance carriers to return, and mostimportantly, to prevent the type of instabili-ty which will ultimately lead to the closingof nursing homes, with the state ultimatelybecoming involved in operating Florida’snursing homes to ensure that the state’s mostvulnerable citizens are not abandoned. Isthere a light at the end of the tunnel? Willlong term care pro-viders realize the bene-fits of SB 1202 in time? Stay tuned.

(Andrew R. McCumber is a partner in theTampa office of Quintairos, McCumber, Prietoand Wood,P.A.Contact him at (813) 287-1100.)

News


FHCA-FALA merger

Ageneral membership vote will be takenthis summer during the FHCA 2002

Annual Conference Meeting to approvethe FHCA-FALA merger approved by theFHCA Board of Directors last Fall. No votewas taken in February during the Legisla-tive Meeting due to lack of a quorum.

National AL week

This year’s National Assisted LivingWeek theme, Honoring The Spirit of

Our Nation, will be celebrated the week of September 8-14, 2002. National Assisted Living Week, founded in 1995,is an opportunity for families, residents,staff, volunteers and the community to celebrate the exceptional involvement from those who foster a truly caring spirit.

LPN turnover

According to the Hospital andHealthcare Compensation Services

Assisted Living Salary & Benefits Report,2001-2002, some 33 percent of LPN staff employed in assisted living facilitiesturned over in 2001.The survey reports12.9 percent of LPN positions were leftvacant during that period, and it took anaverage of 19 days to fill a vacant positions.

Assisted living: Where weare, where we’re goingThe FALA president speaks frankly about the presentand future of assisted living in Florida

always backed AHCA in closing poorperformers because poor performers havea negative impact on our entire profes-sion. At the same time, AHCA needs torealize that good operators don’t needany more regulation.

Political actionLegislators realize each one of our

residents represents about 12 votesamong themselves and their “extendedfamily” of family members, volunteers,clergy, staff and acquaintances.You’d alsobe surprised at how many state legisla-tors have their own parents or familymembers in our ALFs!

Bush-BroganWe’re right with them on consumer-

directed care,“aging in place” and build-ing a more fluid continuum of care. Wethink there ought to be a greater relianceon assisted living, because on a cost basis,ALFs are the most economical deliverysystem for the very services elderly peo-ple need and want. We also provide ourresidents emotional security, interactionwith others and coordinate or assist themin getting the care they need.The Bush-Brogan team is thinking creatively, andwe need more of that too.

LTC Ombudsman CouncilThey’re supposed to be mediators,

not inspectors. They should solve prob-lems, not look to create additional ones.Some of them come in with pre-con-ceived ideas about what an ALF shouldhave and not what the law and rules stateis needed. I think it’s a great idea thatFHCA sends Pulse to each of the 17ombudsman offices so the volunteers canget a better idea of what nursing homesand ALFs face on a daily basis. But I also

Larry Sherberg is President of the FloridaAssisted Living Affiliation and operates

56-bed Lincoln Manor in Hollywood.An18-year ALF veteran, Sherberg was theALF representative on the Task Force on theAvailability and Affordability of Long TermCare chaired by Lt. Gov. Frank Brogan.

Historic FHCA-FALA mergerIt was mentioned in passing for some

time. During the Brogan task force thatmet during 2000 we began to work moreclosely with the FHCA people.While atdifferent levels, we were all working forsimilar goals. We had conversations onmutual interests that led to more conver-sations and eventually led to the merger.John Overton’s, Betty Conard’s and BillPhelan’s foresight and credibility played a major role in making this a reality.

ALF diversityALFs vary in the type and care level

of residents. Lengths of stay vary up to 20years. Some ALFs handle a younger, inde-pendent clientele — they’re more like ahotel with a restaurant — some are inde-pendent living units with a social worker,while other ALFs have secure units for earlystage Alzheimer’s and dementia, and so on.There’s no one-size-fits-all in AL.ALFs area social model with a medical component.

Medical vs. social modelThe last thing ALFs want is to become

“nursing home junior.”We don’t want toend up as the full institutional/medicalmodel with people in uniforms doinghourly charting.We’re more an extensionof the person’s house and home andbelieve in “aging in place.”

RegulationIt’s our goal to avoid the heavy regu-

lation nursing homes have because it is acost our residents have to bear.We are notcost-reimbursed, so if government wantsheavy regulation, then give us correspon-ding reimbursement. Otherwise, we haveto cut services or benefits to pay for thesecosts. In the more specific sense, we have

by Larry SherbergPRESIDENT, FLORIDA ASSISTED LIVINGAFFILIATION

CONTINUED ON PAGE 8


claims per thousand beds, or nearly triple the national average.

Per-bed loss costs are trending up in allstates, but particularly in Georgia (50 per-cent increase),West Virginia (50%),Arkansas(45%), Mississippi (40%),Alabama (31%) andCalifornia (29%), where litigation activity ishigh. “It won’t take long at these annualtrend rates to reach Florida-level loss costs,”the report gloomily predicts.

Billions out the windowLong term care providers represented

in the study report $1.9 billion in generaland professional liability insurance claimsincurred between 1990 and 2001. Theexpected ultimate cost of claims incurred inthis period is $3.7 billion, taking into con-sideration the claims in the pipeline and theas-yet-to-be-determined outcomes in opencases. Some $1 billion in claims is expectedfor 2002 alone, according to the Aon report.

The 2002 Aon national study is consis-tent with those it performed in 2000 and2001 for the Florida Health Care Asso-ciation, which showed lawyers receivingalmost half of all claims payouts.

Insurers fleeingAs has been the case in Florida for years,

insurers that have not already exited themarket are responding to the onslaught oflitigation and claims by increasing premiumsand deductibles and drastically decreasingboth per-occurrence and aggregate insur-ance coverage limits.The report noted thatpremiums increased 130 percent between2000 and 2001, well in excess of the 24 percent loss increase nationally for that year.On average, a facility now pays $250,000more in premiums for $500,000 less cover-age per claim, and aggregate coverage limitswere reduced by $2.3 million per insured,according to the Aon report.

Nursing home lawsuitsCONTINUED FROM PAGE 1

FHCAWelcomes New Members

)

ASSOCIATE MEMBERSHarbourwood Nursing Center,

Clearwater

ASSISTED LIVING FACILITIESAlterra Clare Bridge Cottage of

Leesburg, LeesburgHawthorne Village, BrandonHawthorne Village,Winter HavenArbor Glen, NaplesAspen Willowwood Retirement

Community, Fort Lauderdale

ASSOCIATE MEMBERS

Advanced Answers, Coral SpringsBill Sherer Corporation, OcalaEldercare Risk Management, Inc.,

Elgin, ILHospice of Emerald Coast, Lynn HavenShearon Teaters, Brooksville

CORPORATE MEMBERSCovington Investments,Atlanta, GACross Key Manor, Inc., Bonita SpringsIntegrated Health Services, Inc.,TampaSenior Health Management, LakelandSun Healthcare Corporation,

Fernandina Beach

Liability insurance harder to get• National premium levels increased 130 percent

between 2000 and 2001• On average, $250,000 more dollars of premium

was charged per insured for almost $500,000 less coverage per claim

• Per-occurrence limits were decreased by almost$500,000 per insured

• Annual aggregate limits of liability available werereduced on average by $2.3 million per insured

• Insurance companies continue to exit the marketplace

*Source: “Long Term Care General Liability and Professional Liability Actuarial Analysis,

Aon Risk Consultants, February 28, 2002”

CONTINUED FROM PAGE 1Update

SB 1202 FAQs online

FHCA has compiled a list of the 44 most often-asked questions about SB

1202 compliance.The Q&A is divided into 11 subject areas including staffing,training, risk management and care plans. Go to www.fhca.org and click on “Members Only.”

Nursing home guide in Spanish

The Agency for Health Care Admini-stration has translated its Nursing

Home Guide into Spanish and posted it on its Web site, www.fdhc.state.fl.us.


Top topics: More than 125 registrantsattended the recent FHCA LegislativeMeeting in Tallahassee and heard brief-ings from, Top, left to right and down,Department of Health Sec. Dr. JohnAgwunobi and Department of ElderAffairs Sec. Terry White. Rep. MarcoRubio (R-Miami) says it’s important longterm care facilities remain financiallyhealthy so that Florida remains elder-friendly, and Molly McKinstry of AHCAdescribes its new liability insuranceenforcement process. FHCA’s Legislatorof the Year awards go to Sen. GinnyBrown-Waite (R-Brooksville) and Rep.Carole Green (R-Ft. Myers), and FHCAPresident John Overton details the FHCA-FALA merger.

2002 FHCA Legislative Meeting

remember when the LTC OmbudsmanCouncils included an ALF representative itappeared to be better. Most professionals arejudged by their peers, why are we different?

Success in ALFTo be successful, you need to be both a

caregiver and a business person. If you’re justa caregiver, the business part will eat you up,and if you’re just a business person, not car-ing, you’ll soon be out of business.As long aswe remain a social model, the communitycan accept us better and know that we arean integral part of the long term care con-tinuum community.

The futureI think eventually you’ll see all long term

care providers coming together under oneumbrella as FHCA and FALA have done.The needs of our disabled and elderly over-lap and integrate.As long as people are livinglonger, our roles are continuously changing.We must put the needs of the people first,and that’s where I believe the Bush-Broganadministration is heading. We’ll all have agreat future if we can just survive the present!

Assisted LivingCONTINUED FROM PAGE 6

News from across FloridaNews from across FloridaNews from across Florida

FHCA District IV Vice President Tom Robbins,left, and District XIV past president Jon MarcCreighton discuss their respective candidaciesfor public office during FHCA’s LegislativeMeeting. Robbins is a candidate for FloridaHouse, District 53, and Creighton is a candi-date for Florida Senate, District 16. Both arerunning as Republicans.

Dr. LIN Jiabin, second from left, Vice Presidentof Beijing Hospital and personal physician toPremier Zhu Rongji of China, visited with staffand ombudsman volunteers at WaterfordConvalescent Center in Hialeah Garden. Dr.LIN’s visit was to learn more about geriatriccare and was arranged by the U.S. StateDepartment’s International Visitor Programand Miami-Dade Community College. “We toldhim all states look to Florida as an elder careleader,” administrator Roberto Vital reported.


CMS clarifies transportand transfer rules

You need a CNA for transferring, not necessarily

for transporting

by Lee Ann GriffinFHCA POLICY & QUALITYASSURANCE COORDINATOR

The Centers for Medicare and MedicaidServices clarified its position in Chapter

4 of the State Operations Manual, regardingthe transporting and transferring of resi-dents. CMS notes it was never its intent torequire the services of a CNA to transportresidents by driving a van or pushing awheelchair. However, CMS says that trans-ferring a resident, for example, from bed to wheelchair or from wheelchair to toilet,does require the services of a CNA. CMS iscurrently reviewing other tasks which mightbe assigned to non-CNA personnel.

More nursesAs the pool of licensed nurses steadily

shrinks, Congress and the federal govern-ment are well aware of the serious chal-lenges faced by health care recruiters as theystruggle to fill nursing vacancies. Both theU.S. House and Senate have since passedtheir own versions of the Nurse Reinvest-ment Act, which would provide tuitionassistance to nursing students willing towork in shortage areas after completing theirstudies. Similarly, President Bush’s proposedbudget includes a 20 percent increase infunding for the Nurse Education Act, whichprovides scholarships and grants for nursingstudents.

Medical error trainingWe are receiving provider calls regarding

the new two-hour continuing educationrequirement for medical error preventiontraining. The Board of Nursing has givenFHCA information on two groups offeringthe new two-hour Prevention of MedicalError training for health care providers licensed under Chapter 456. Nurses renew-ing their licenses in April will need to meet this CE requirement. Contact BertRodgers Schools at (800) 432-0320(www.bertrodgers.com) or Robert AndersonContinuing Education at (800) 532-2332(www.andersonce.com) for more information.Nurses renewing their licenses this monthmust have completed this training. MedicalError Prevention training for nurses will also be featured at the May 28-30 NurseLeadership Program.

CNA testing updateThe new CNA testing vendor,Experior,

Inc., now says it’s back on schedule in pro-

a screening will be required at the time anapplication to test is submitted to the testingvendor. This screening requirement, con-ducted prior to the certification of a nurseaide, was approved by the Florida legislaturein 2000, but is just now slated for imple-mentation this year. FHCA has been work-ing with the Board of Nursing to reduce thepotential for duplication of backgroundscreenings.

AwardsWe are currently accepting nominations

for the 2002 Excellence in Nursing awards and the CNA Excellence in Long Term Careaward. We’re also accepting submittals in the 2002 CNA essay contest. Winners willbe announced during FHCA’s NurseLeadership Training Program May 28-30that the TradeWinds Hotel in St. Petersburg.You can contact FHCA for a nominationform or visit the “Members Only” section ofthe FHCA Web site, www.fhca.org.

cessing and scheduling applicants. By mid-April it expects the largest backlog of appli-cants to begin testing. By the way, Experioralso reports a very small number of facilitiesare applying to be in-facility test sites. Ifyou’re interested in your facility becomingan in-facility test site, go to Experior’s Website at www.experioronline.com and downloadthe application form.We strongly encourageyou to consider this as a smart way to keepup your staffing.

CNA background screeningThe Florida Board of Nursing is gearing

up to conduct criminal background screen-ings of those who apply to sit for the CNA competency evaluation. Under theirplan, information necessary to conduct such


Submitrequiredplans

The Fire Protection Specialists(Life Safety Surveyors) who inthe past were conducting theannual surveys, are now backworking out of the AHCA areaoffices, not the Office of Plansand Construction. The Office ofPlans and Construction will stillhave the oversight for the finaldecisions on fire-life safety, willcontinue the review of plans forany new construction or reno-vation/repair projects and willconduct construction surveys.

Some facilities have not giveninformation on their projects tothe Office of Plans and Con-struction. Examples of what must be submitted for reviewinclude re-roofing an area of thefacility’s roof, the replacement ofHVAC central units and hotwater heaters or boilers. Mostlocal building departmentsrequire approval from the AHCAOffice of Plans and Constructionbefore they will issue a buildingpermit. If you question whethera project needs to be reportedcall the AHCA Office of Plans andConstruction at (850) 487-0713.

(Editor’s note: Special thanks toMax Hauth, Hauth Health CareConsultants, Lakeland. Contacthim at (863) 688-0863.)

LTCBUSINESSNEWS

by Steven R. Jones, CPAand Dawn Segler, CPAMoore Stephens LovelaceFHCA CPA Consultantwww.ms-lovelace.com

Last month we reported on reductions in theMedicare Part A rates scheduled to go into

effect October 1, 2002. On January 1, 2003,reductions in Part B reimbursement are scheduledto go into effect. On that date, the moratoriumimposed on the $1,500 therapy limits is scheduledto expire. As you know, these limits were imple-mented in 1999 as mandated by the BalancedBudget Act of 1997. Recognizing the problemsthese limits imposed on the health care industryand Medicare beneficiaries, Congress approved atwo-year moratorium in December 1999, whichwas extended another year in 2000. However,unless Congress acts to extend the moratorium or repeal the caps altogether, the limits will againbe imposed at the end of this year. In response to the looming loss of coverage for Part B beneficiaries, a bill was introduced in the U.S.House of Representatives on February 28, 2002entitled, “The Medicare Access to RehabilitationServices Act of 2002,” which eliminates the limits.A companion bill was introduced in the Senatelast September.

New Medicare billing editsPer a recent program memorandum issued to

carriers, the Centers for Medicare and MedicaidServices will put into place a new set of billingedits on July 1, 2002. The purpose of the edits is to search the residents’ claims histories to seewhether any services paid by either the carriers orfiscal intermediaries should be subject to consoli-dated billing.The memorandum explains that uponthe receipt of a Part A skilled nursing facilityclaim, the Common Working File will search paidclaims history to determine whether any servicessubject to consolidated billing were incorrectlypaid within the dates of the SNF stay by the car-rier.The CWF will compare the period betweenthe SNF “from” and “through” date to the lineitem service dates of the claims in history. Con-solidated services that coincide with the SNFclaim dates will be identified. CWF will electron-ically transmit the unsolicited response edit to thecarrier that originally processed the claim. Uponreceipt of the unsolicited response, the carrier stan-dard system software will perform an automatedadjustment to each claim. Services subject to con-solidated billing will be denied at the line level.

These same coding files will be used to imple-ment other edits that are scheduled to go intoeffect on April 1, 2002. These edits are aimed at

identifying services included in the SNF Part AProspective Payment System rate and thereforecannot be billed by other providers, therapy serv-ices provided to a SNF Part B resident whichmust be billed by the SNF for the service to becovered and preventive services (e.g., vaccines)provided to beneficiaries in a covered Part A staythat must be billed by the SNF on a separate PartB bill. The November 2001 PM implementingthese CWF edits goes on to state claims rejectedas a result of these edits cannot be appealedbecause the actions are not considered denials.Instead the rejections are considered “misdirectedclaims,” which are returned to the provider so thatthe proper provider may bill the proper entity.

Part B appeals process:Streamlined?

For those Part B claim denials that can beappealed, Benefits Improvement and ProtectionAct of 2000 provisions scheduled to go into effectOctober 1st, are likely to make that process more problematic. On that date, the legislationimplements shorter time frames for filing appealsand rendering decisions in response to thoseappeals. The Office of Inspector General con-ducted a study and issued a report in Januarywhich recommends the delay of the new timeframes due to the existing backlog in the appealssystem.

New ambulance fee screensIn a Final Rule issued in February, CMS

published the new fee schedule for ambulanceservices. The fee schedule replaces the current retrospective reasonable cost payment system forproviders and the reasonable charge system forsuppliers of ambulance services. The Final Rulealso establishes new Health Care CommonProcedure Coding System codes to be reportedon claims for ambulance services. Starting April 1, 2002, the fee schedule will be phased in over a five-year period. The first phase-in period willbe from April 1, 2002 until December 31, 2002,during which time the payment rate will be made up of 80 percent of the respective currentpayment allowance and 20 percent of the feescreen amount. In 2003, the payment will consistof 60 percent of the current rate and 40 percent of the fee screen payment, and so on until theservice is paid entirely under the fee schedule.

More Medicare cuts on the horizonPart A reductions come October 1st; Part B cuts on January 1st — unless Congress acts now



Comparing ‘compare’ Web sitesby KoKo OkanoFHCA POLICY AND RESEARCH COORDINATOR

Make sure the information about

your facility is accurate

Now, anyone who has a computer andaccess to the Internet can get informa-

tion about your facility, and I’m not justtalking about the address, telephone num-bers and bed count, but also performanceratings, recent and past survey results, staffhours and Quality Indicators.

Computers may be perfect, but thehuman beings who input the data on thesefederal and state Web sites aren’t, and canoften make mistakes. That means youshould be very concerned about whetherthe information on that Web site is accurateand timely. After you read this, get onlineand check out your facility.

Nursing Home CompareThe Centers for Medicare & Medicaid

Services offers Nursing Home Compare,which posts your facility’s most recent sur-vey results, staff hours, and eight QualityIndicators as resident characteristics:■ Physical restraints■ Pressure ulcers■ Incontinence■ Dependence in eating■ Bedfast■ Restricted joint motion

within each of 11 area office/geographicregions. Each star represents 20 percent ofthe facilities within the region. One starequates to the bottom 20 percent and fivestars represents the top 20 percent of facili-ties within a region. The Nursing HomeGuide also offers the facility’s survey resultsduring the past four years with cited F-tagnumbers, dates and scope and severity. Go to www.fdhc.state.fl.us and click on “NursingHome Guide.” According to AHCA, itsNursing Home Guide has as many as 800 hits per day.

Be a regular visitorBecause clerical, technical and data

transmission errors are also possible, be sureyou regularly check both these sites toensure that what the world knows aboutyou is accurate. However, whether suchoften highly technical information is mean-ingful and/or useful to consumers is anoth-er topic for another day.

■ Unplanned weight loss/gain■ Behavioral symptoms

Both staff hours and the QIs are comparedwith the state and the national averages.You can search the facilities by state,county, city, zip code or facility name. Go to www.medicare.gov and click on “NursingHome Compare.”

Nursing Home GuideOn the state side, the Agency for Health

Care Administration has its Nursing HomeGuide on its Web site. Users can select afacility from the master list or search for one by AHCA area office, name, county,payment forms or services offered, such as Alzheimer’s care.

AHCA uses a “scoring-ranking algo-rithm” to “rate” a facility using one to fivestars — five as best and one as poorest — ineight categories of care.The scores are com-puted based on the facility’s survey resultsduring the past 45 months and then ranked

What about customer satisfaction?(Editor’s note: Following is excerpted from a guest editorial written by FHCA President

John Overton and published in the March 2, 2002 edition of the Sarasota Herald-Tribune.)

“…[T]he larger question (is) whetherany of the nursing home “consumer in-formation” out there is of any real helpto families who are looking for a longterm care provider. I argue much of itisn’t, because it’s needlessly complex anddoesn’t even measure simple customersatisfaction, which is the very first thingpeople ask us about when they come in.Even the state’s own nursinghome reporting mechanismdoesn’t ask the basic yes-or-noquestion, “Is this a facility youwould recommend to a friendor family member?”

As more and more families becomepersonally acquainted with the tremen-dous challenge of caring for an agingfamily member, having the most helpfuland user-friendly long term care informa-tion in hand will be of critical importance.Without it, families could well end upknowing all about the “price” of longterm care, yet nothing of its great value.”

Notice to FHCAmembers

While the FHCA ServiceCorporation believes that theagreement with EquiPower, LLCwas terminated by mutual agree-ment of the parties, a formalnotice in accordance with theagreement has been provided toEquiPower, LLC to ensure there is no misunderstanding that theagreement between FHCAService Corporation andEquiPower, LLC is terminated.

It has come to our attentionthat some providers havereceived invoices fromEquiPower, LLC and are unsure of their obligation to EquiPower,LLC. If a provider is not aware ofhis/her obligations, it may bebest to provide your attorney acopy of any agreement executedwith EquiPower, LLC.

Employee entitled to jury trial where ‘mosaic of evidence’ suggested retaliation for takingFMLA leave

The Family and Medical Leave Act, like other federal and state laws, prohibits an employerfrom penalizing an employee for taking advantageof rights and protections afforded under the law.Some employers apparently believe that an em-ployee’s request for leave gives them a “green light”to reexamine the employee’s performance anddecide not to bring the employee back from leave.As a recent federal court decision shows, this maybe a costly course of action. The case involved an employee named Snelling who informed his supervisor that he had gastroesophogeal reflux disease and a hiatal hernia and would likely needsurgery. Almost immediately, Snelling received acorrective action and performance improvementplan and was subjected to close scrutiny of his work whereas other employees who failed to meet their goals did not receive improvement plans.Snelling went on leave and was fired upon hisreturn for failing to meet goals, misrepresenting theamount of work done, and allegedly failing to perform work requested by his supervisor.Snelling sued under the FMLA.

The employer filed a motion for summaryjudgment, arguing that Snelling was fired for legit-imate reasons unconnected with the leave.However, the judge was not convinced and deniedthe motion. Instead, he found that Snelling had presented a “mosaic of evidence” which wouldallow a reasonable jury to find that the reasonsgiven were pretextual and that Snelling actually was fired in retaliation for taking leave. For example, Snelling appeared to be “singled out”for more harsh treatment than other employeeswith similar problems and the improvement plan hereceived contained expectations which the supervi-sor admitted were impossible to meet. In addition,there was evidence that the leave came at a badtime for the company, leading a supervisor to comment that they were “screwed” becauseSnelling’s absence would come just before animportant inspection by a governmental agency.Another supervisor allegedly remarked that “maybe we will get lucky and be able to get rid of him while he’s gone.” The company also tried to argue that Snelling was, in fact, restored to his jobin that he was paid for one day upon return.However, the judge found that this was merely an extension of the leave at the employer’s requestdue to the absence of

Snelling’s supervisor and that the companywould not be allowed to circumvent the law by“restoring an employee on one day and then terminating that employee the next day.”

Court rules that simple comment establishes need forFMLA leave, reversing summaryjudgment for employer

The Department of Labor’s FMLA regulationsstate that no “magic words” are needed to invokethe protections of the statute to an eligibleemployee who otherwise is qualified to take leave.Instead, the employee need not even mention theFMLA and must only state that leave is needed.A case in point is a recent federal appellate courtdecision reversing summary judgment for theemployer where the employee (S) merely statedthat she could not come to work because of“depression again.” The trial court did not thinkthis was enough to put the employer on notice ofthe need for FMLA leave, but the appellate courtdisagreed. Central to the latter court’s decisionwere the facts that the employer had knowledgethat S had suffered from depression for years andhad afforded prior FMLA leave for this condition.As the court put it, “a jury could consider the difficulty one suffering from depression has withcommunication, together with the [employer’s]general knowledge of [S’s] depression, in objec-tively evaluating whether the [employer] was onnotice of her need for FMLA leave.” The courthastened to add that the employer still might chal-lenge the notice as untimely, unclear, insufficient,or in violation of the employer’s policies (e.g., theemployee failed to call in or show up by the startof her shift). Given the remedial purpose of thestatute and the modest burden on the employeeseeking leave, employers should not act too hastily in responding to what may turn out to belegitimate FMLA leave requests. The court diduphold summary judgment for the employer on a claim under the Americans with Disabilities Actbecause S’s absenteeism prevented her from performing the essential functions of the job.

Effeminate male worker entitled to jury trial on sex discriminationharassment and claims, rules federal court

A federal judge has allowed a plaintiff to take hisclaims of sex discrimination and harassment to a jurywhere co-workers allegedly created a hostile workenvironment because the male worker was consid-ered to be “impermissibly feminine for a man.”Among other things, plaintiff presented evidencethat co-workers mocked his masculinity and im-plied that he was homosexual. For example, theyallegedly taped pictures of Richard Simmons inpink hot pants at his work station, asked him if hewas going to march in a gay parade, asked him if

LABORRELATIONS

COUNSEL

by Mike MillerKunkel, Miller & Hament

FHCA Labor RelationsConsultant

The court said the employee was singled out for dismissal



Insurance concerns plague medical directors

by Peggy RigsbyFHCA GOVERNMENT SERVICES DIRECTOR

Lawsuits and sky-high liability insurance are driving doctors out of

nursing homes

Thanks to FHCA Bylaws and CredentialsCommittee chair DeWayne Harvey for

speaking up for both long term care profes-sionals and the physicians who practice in them during a statewide press conferencelast month in Tallahassee.

Harvey and Florida Medical DirectorsAssociation Chairman of the Board Dr. JohnPotomski spoke outside the House chamberto warn that care for the elderly will suffer if facilities and medical directors can’t getliability insurance.

Dr. Potomski said nursing homes withonly bare-bones insurance coverage makethe facility’s medical director the nearest“deep pocket” in a nursing home lawsuit.Hesaid insurers are increasing their physicians’premiums 500 percent or more and are limit-ing, cancelling and/or not renewing coverageif the physician practices in a nursing homeor serves as its medical director. In somecases, insurers have not renewed an entire

can’t just sit by and watch as doctors leaveand nursing homes close.

NHA licensingThe Florida Board of Nursing Home

Administrators has approved our request toallow FHCA conference attendees to applycontact hours earned at our FHCA 2002Annual Conference to either the 2000-2002or 2002-2004 biennium. This is a great benefit to members and we appreciate theboard’s ruling.

A reminder: Every nursing homeadministrator license will expire on July 1,2002. When you renew, your renewal willextend from August 1, 2002, throughSeptember 30, 2004. The Department ofHealth has enacted rules to stagger profes-sional licensing periods to make license pro-cessing more manageable. Renewal packetswill be mailed to administrators at the endof this month, so be sure to watch your mail.

group practice’s coverage if even one mem-ber of the group practices in a nursing home.The current and potential shortage of doc-tors in nursing homes is clearly a great chal-lenge that threatens a facility’s very existence.

“If our nursing homes can’t get medicaldirectors, the law says we can’t keep ourlicense and we close the doors; it’s that sim-ple,” DeWayne Harvey said. “The terribletragedy of this is that it is coming just as themany nursing home improvements madelast year are beginning to take effect.”

Dr. Potomski urged the House selectcommittee on the topic to take actionbecause the current situation is “unsustain-able.” Harvey agreed, saying, “We as a state


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FMS Purchasing & ServicesFMS has a full line of products and services in its Group Purchasing Program.FMS services member needs by ensuring maximum savings and service. Fivearea managers throughout the state assure members an immediate response.Our services include: audits, a toll-free number, cost analysis, service reportsand the Manufacturers Value Incentive Program. Call (800) 456-2025.

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Office DepotOffice Depot offers Florida Health Care Association members extra discountsand services due to the cooperative purchasing power of FHCA. We offer a

wide variety of benefits, including 167 items which have beenreduced based on volume ordering up to 80 percent (the “HighUse Item List”); next day delivery on any amount of products (no

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Congratulations to the staff at FloridaLutheran Retirement Center in DeLand and administrator Jon Conrad.The facility received five stars in all AHCA performance categories, placing it amongthe top 20 percent of all facilities in Volusia,St. Johns, Nassau, Flagler, Duval, Clay andBaker counties. Conrad also reports theWinter edition of The Good Samaritantells the story of Gerald Daniels, the localminister who in 1954 secured the land onwhich Florida Lutheran was constructed in 1958. Daniels and his wife Margueritehave since become residents of the facility.

* * *FHCA Pulse welcomes news items, press

releases, photos or guest articles of 500words or less. For information, call (850)224-6242.You may fax items to (850) 224-9823. Information also can be mailedto: Florida Health Care Association, P.O.Box 1459,Tallahassee, FL 32302-1459.

he had AIDS yet, called him a “sword swal-lower,” and posted cartoons mocking gaymen at his work station. The companyargued that the plaintiff had no claimbecause federal law does not protect againstdiscrimination based on sexual orientation.Plaintiff admitted that he was homosexual,although he alleged that he had not dis-closed this to co-workers.The court statedthat the line between discrimination basedon sexual orientation and sex was not clearand that other courts had approved a causeof action based on “sex stereotyping” by one sex against members of the same sex.Thus, the court reasoned, “if an employeracts upon stereotypes about sexual roles inmaking employment decisions, or allows theuse of these stereotypes in the creation of ahostile or abusive work environment, thenthe employer opens itself up to liabilityunder Title VII’s prohibition of discrimina-tion on the basis of sex.”The court offeredno opinion on whether plaintiff ultimatelywould prevail in the case, leaving him withthe task of convincing a jury that the harass-ment was sufficiently severe or pervasive to interfere with his employment.

Labor Relations CounselCONTINUED FROM PAGE 12

News from across FloridaNews from across FloridaNews from across FloridaCONTINUED FROM PAGE 8

FHCA Calendar of EventsPrograms marked with an asterisk (*) have registration brochures in FHCA Fax-On-Demand at (850) 894-6299 or on the FHCA Web site at www.fhca.org. Sponsorships are available for each

program listed. Contact Melody Gordon at (800) 771-3422.

A P R I L

Wednesday, April 3*FHCA Alzheimer’s and

Related Dementia: Train-the-Trainer & CMS Pilot Project

for Quality IndicatorsTHE ROSEN PLAZA HOTEL, ORLANDO

REGISTRATION 7:30 – 8:30 a.m.8:30 a.m. – 12:45 p.m. - ALZHEIMER’S AND RELATED

DEMENTIA: TRAIN-THE-TRAINER1:30 – 4:45 p.m. CMS PILOT PROJECT FOR

QUALITY INDICATORS

FHCA CANNOT GUARANTEE YOUR REGISTRATIONWILL BE PROCESSED UNLESS IT IS RECEIVED THREE DAYS PRIOR TO THE PROGRAM DATE.

Monday, April 15FHCA Committee Meetings

Annual Conference Committee Meeting

Associate Member SupportCommittee Meeting

Legislative Committee MeetingTHE WESTIN DIPLOMAT RESORT & SPA

HOLLYWOOD

Tuesday, April 16FHCA Board of Directors Meeting

THE WESTIN DIPLOMAT RESORT & SPA HOLLYWOOD

April 21–27National Volunteer Week

Tuesday, April 23*FHCA CNA

Train-the-Trainer SessionCORAL TRACE HEALTH CARE, CAPE CORAL

M A Y

Wednesday, May 1*FHCA Alzheimer’s and


for Quality IndicatorsCLARION SUITES RESORT &

CONVENTION CENTER, PENSACOLAREGISTRATION 7:30 – 8:30 a.m.,

CENTRAL DAYLIGHT TIME8:30 a.m. – 12:45 p.m. - ALZHEIMER’S AND RELATED DEMENTIA: TRAIN-THE-TRAINER1:30 – 4:45 p.m. CMS PILOT PROJECT FOR

QUALITY INDICATORS

FHCA CANNOT GUARANTEE YOUR REGISTRATIONWILL BE PROCESSED UNLESS IT IS RECEIVED THREE DAYS PRIOR TO THE PROGRAM DATE.

Thursday, May 2*FHCA Alzheimer’s and


for Quality IndicatorsHILTON JACKSONVILLE RIVERFRONT, JACKSONVILLE

REGISTRATION 7:30 – 8:30 a.m.8:30 a.m. – 12:45 p.m. - ALZHEIMER’S AND RELATED DEMENTIA: TRAIN-THE-TRAINER1:30 – 4:45 p.m. CMS PILOT PROJECT FOR

QUALITY INDICATORS

FHCA CANNOT GUARANTEE YOUR REGISTRATIONWILL BE PROCESSED UNLESS IT IS RECEIVED THREE DAYS PRIOR TO THE PROGRAM DATE

May 6 –12National Nurses Week

May 12–18National Nursing Home Week

Monday, May 27*FHCA MDS 2.0

Basic Training(Pre-Nurse Leadership Conference)

TRADEWINDS ISLAND GRAND ST. PETERSBURG BEACH

Monday, May 27*FHCA CNA

Train-the-Trainer(Pre-Nurse Leadership Conference)


May 28 –30*Nurse Leadership Training Program

TRADEWINDS ISLAND GRAND, ST. PETERSBURG BEACH

FHCA CANNOT GUARANTEE YOUR REGISTRATION WILL BE PROCESSED UNLESS

IT IS RECEIVED BY MAY 24

Thursday, May 30

FHCA Quality CredentialingSummit Meeting


J U N E

Monday, June 3

FHCA Committee Meetings & Board of Directors Meeting

THE RITZ CARLTON, SARASOTA

Tuesday, June 4

FHCA Board of Directors Meeting

THE RITZ CARLTON, SARASOTA

June 6 –13National Nurses Assistant’s Week

Tuesday, June 11

*FHCA CNA Train-the-Trainer Session

ALACHUA NURSING & REHABILITATION CENTERGAINESVILLE

J U L Y

Sunday, July 21

*FHCA Preceptor Training forNursing Home Administrators

Pre-Annual ConferenceTHE WESTIN DIPLOMAT RESORT & SPA

HOLLYWOOD

Sunday, July 21

*FHCA CNA Train-the-Trainer SessionPre-Annual Conference

THE WESTIN DIPLOMAT RESORT & SPA HOLLYWOOD

July 22–23

*FHCA Annual Trade ShowFOR EXHIBIT BOOTH INFORMATION,

CONTRACT AND SPACE AVAILABILITY, CONTACTMELODY GORDON, FHCA DIRECTOR OF MEETINGPLANNING, AT (800) 771-3422, EXTENSION 27,

OR E-MAIL [email protected]

O C T O B E R

October 6–9

AHCA & NCAL National Convention

NEW ORLEANS, LA


Under SB 1202, the burden in an admin-istrative proceeding to impose sanctions (rev-ocation, fines, etc.) has shifted. The providerhas a higher burden to prevail than in the past.SB 1202 does not affect the burden on AHCAin rating cases.Therefore, you may have twoparallel proceedings; one to sanction you andone in which you have challenged the ratingof your facility.Typically, these have been con-solidated for judicial economy.We have founda great deal of resistance from AHCA indoing this, ostensibly because the burdens aredifferent. However, we believe that an ALJ isperfectly capable of applying more than onestandard of proof to the same facts.

If you have any questions, please feel freeto e-mail me at [email protected].

LTC Legal Issues and TrendsCONTINUED FROM PAGE 4

pulse april 2002 - fhca

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