Georgia is the statewide association of over 150 key not-for-profit and
other mission-focused organizations dedicated to providing quality
housing, health care, community-based and other related services for
older Georgians. The mission of LeadingAge Georgia is to represent and
promote the common interests of its members through leadership,
advocacy, education and other services in order to enhance each
member's ability to serve older Georgians.
Conversations with Ginny
"We must know that we have been created for greater things, not just to be a number in the world, not just to go for diplomas and degrees, this work and that work. We have been created in order to love and to be loved." ― Mother Teresa
Carol Silver Elliott, president of Jewish Family Home in New Jersey and incoming president of LeadingAge led a discussion at the PEAK conference called "Keeping the Faith in Faith-Based Services: Is it Really Important Anymore?" Carol was joined by leaders of faith-based organizations across the country and the consensus was that faith is important for LeadingAge members but it is how it is expressed that is important. The panel agreed that leading with the principles and beliefs of our faith is what is important and that if we do this it will show in our actions. They agreed that it is important to value and make feel welcome residents/clients, staff and volunteers without regard to their religious affiliation. They also agreed that our principles and beliefs show when we focus on the well-being of residents, clients and staff. I see the beliefs and principles reflected on the websites of most of our provider members – whether faith-based or mission-based. I see servant leaders in action as of our members serve on our committees and boards, present at our educational programs, mentor fellow LeadingAge Georgia members and when at work in their communities.
Simon Sinek, whose TED Talk "How Great Leaders Inspire Action" was voted one of the top 25 TED Talks of all time said it's important that when you're hiring staff you "share your purpose, your cause, your belief." He said "you are not just offering a person a job, you are hiring people who believe what you believe. Mother Theresa also said "the fruit of love is service, which is compassion in action." I wonder how many individuals realize the importance of the work they are applying for when interviewing at our member communities/organizations.
In recent months, there has been a barrage of news coverage regarding inappropriate reporting of staffing levels and abuse in nursing homes. In her recent op-ed in the "The Hill," LeadingAge president Katie Sloan responded to the lambasting of nursing homes. She cautioned "recognize that a continual drumbeat of negativity about nursing homes and the people who work in them makes it ever harder for nursing homes to attract and retain capable and talented people."
We have the ability to be part of the change that is needed regarding how people think about nursing homes. Without a doubt, our members are servant leaders focused on making a difference in the lives of older adults. Our challenge is to share the vision. We need to make the drumbeat be that working in long-term care is much more than a job. It's a chance to live a meaningful life -- a chance to live a life of service-- a chance to bring joy to elders and it's a chance to sleep at night knowing you did some good. We also need to let those we hire know that we value them, the work they do and that we care about their well-being.
At the national leadership conference recently there was talk about the need for public relation campaigns that portray the work of long-term care staff in a positive light. My counterpart in Wisconsin told us that their state spent $150,000 on this type of campaign and wished they spent $250,000 on it. I challenge us to establish a culture of celebrating the importanr work of staff in long-term care settings. Let's start small and go bigger in our efforts. I challenge you to work with your team and make a video (you can use your smart phone) and convey the importance of working in long-term care. Please feature members of your team talking about why they work in long-term care and how they feel about making a difference in the lives of older adults. Please keep it to four minutes or less, send it to me along with a signed release that allows LeadingAge Georgia to use the video for an awareness campaign. Our professional development committee will review the submissions and select one to be featured at our business meeting in December. Katie Sloan will be at our meeting and will get to see us changing the culture in Georgia to one that values individuals who chose a life of service in nursing homes and other long-term care settings.
We have some important educational opportunities coming up that will enhance your ability to bring well-being to the older adults you serve. Please join us for the Culture Change Summit on Palliative Care on September 27th. If you haven't signed up yet for our national conference coming up in October in Philadelphia please register and learn from the best of the best.
For all of you who have signed up to be a sponsor and to play in our golf tournament – a big thank you --and to those who have not yet signed up please do so! I hope you have already signed up to be a part of the upcoming Profiles in Aging --- my favorite event. We still need sponsors and submissions of nominations of older adults to be honored.
2018 Profiles of Positive Aging Honoree Entry Form
You're invited to experience an inspiring event with your colleagues and community heroes & heroines for the sixth annual Profiles of Positive Aging Awards Gala. This event is intended to unveil the beautiful truths about aging. On November 18, 2018 (3:00 pm – 5:00 pm), we'll pay tribute to Elders who have changed our lives, achieved a positive aging lifestyle, and continue to give of their tremendous talents and wisdom across our great state and nation.
The Profiles of Positive Aging Gala is designed to support the educational arm of LeadingAge Georgia, the Georgia Institute on Aging. The purpose of the Institute is to provide affordable, quality professional development for individuals working in the field of aging. Currently, the Institute provides education to over 1300 professionals, via 25-30 events each year, who are dedicated to providing the best care and services to older Georgians.
PLEASE NOTE: Date has changed to November 18, 2018
Click HERE for tickets
Wellbeing is Everyone's Business
by Jacque Thornton
As our nations health care system moves from fee for service to a well care model, it's imperative that we all join in to assist staff, residents, clients, patients to live their best lives. To achieve the 8 dimensions of wellness inclusive of the 7 dimensions of well-being, we must do things differently. The status quo just won't do.
We have a number of programs coming up that can help you and your team enhance the wellbeing of those you serve:
Profiles in Positive Aging Debuts at the Center for Civil and Human Rights
The public is invited to attend an inspiring exhibition honoring 22 unsung community heroes and heroines at the inaugural Profiles in Positive Aging Exhibition to Re-frame Aging in partnership with the Center for Civil and Human Rights in Atlanta. The exhibit will feature older adults in Georgia, nationally, and globally, who have multiple life lessons to share as learners, innovators, and teachers. Experience the living gallery of Georgia's elders engaged in positive aging. Invite your family, friends, and colleagues to attend this wonderful exhibition honoring exemplary people who are living positive and influential lives while embracing aging as they continue to learn and grow well past retirement age.
The Center for Civil and Human Rights museum will now become home to the storyboards about these individuals to reach the broader public as we work collectively to overcome ageism in our society—one story at a time. In addition, Story Corps is lending their support and technology to help us record the oral history of the elders featured during the Exhibit. Please join us for this unprecedented moment at the Center for Civil and Human Rights museum on Sept. 25th. The exhibit is opened from 10 am - 2 pm.
Click here for tickets at the special rate of $14 each.
LeadingAge Meeting + Expo
If you haven't registered yet for the LeadingAge Meeting + Expo coming up October 28th – 31st in Philadelphia please register now. The education sessions planned are highly relevant topics with cutting edge information designed to reinforce our passion for what we do and prepare us to help older adults thrive. Some of the sessions that look enticing are: Hospice Deep Dive: The Intersection of Policy, Practice and Partnership; Technology Deep Dive: Shaping the New Health Care Ecosystem; Social Connectedness and Engagement Technologies: Provider Case Studies; Nature Meets Nurture: Designing a WELL Building; Lifelong Learning Through University Partnerships; A New Model of Home Support; Managing Wellness Over Illness; The Slippery Slope Between Functional and Frail in Independent Living Residents; Meeting the Rising Acuity Needs in Assisted Living; and Transition Support: Enhancing Self-Management at a Critical Crossroad.
Click HERE to register
Georgia Night Dinner
Networking with peers and colleagues is as powerful as the exceptional continuing education you'll experience during the LeadingAge annual meeting in Philly. Join us for an evening of delicious cuisine over the beautiful skyline of Philly at R2L Restaurant. Just a few blocks from the convention center, I recommend strolling by the historic City Hall or Union League to take in the rich history before or after you dine with us.
Click HERE to register
Center for Positive Aging Golf Tournament - WE NEED YOU!
Our annual golf tournament is your tournament and it supports the important work of the Center for Positive Aging and the Georgia Institute on Aging. We ned your support to make this a success and fund our mission!
The competition will be a scramble format, with prizes awarded to the top three teams, both men and ladies. The 1st place team is awarded custodianship of the trophy for a year (won by Lenbrook-Atlanta CCRC). Additionally, there are numerous prizes for longest drives, closest to the hole, and oldest and youngest participant.
2018 Tournament Itinerary
Columbus Day: Mon., Oct. 8th
8:15 am: Registration | Practice Range
9:00 am: Shotgun Start
11:30 am: Lunch on the Fairway
2:30 pm: Presentation of Prizes
Tournament Hosted at RiverPines Golf Club
Enjoy the many attributes of RiverPines. Designed by nature and enhanced by man, this 18-hole Championship Course and Par-3 Course will challenge you with woods, ravines, creeks and ponds. Lush Bermuda grass fairways and carefully-cultivated bentgrass greens will inspire you to play your best as you wind your way through this picturesque Chattahoochee River setting—a short drive from downtown Atlanta.
Ways To Support:
- Hole Sponsorship
- Closest to the Hole Sponsorship
- Register a Foursome
- Register a Twosome
- Donate Golf Balls
- Donate Door Prizes
Click HERE for registration brochure
National Adult Day Services Week:
by Ginny Helms
This week we celebrate all of our members who work in adult day programs. You improve the lives of individuals who attend your programs – helping participants to be part of a community with friends and staff who care about them. You provide meaningful, person-centered activities that ensure socialization and enhance well-being. Many of you provide medical oversight that helps keep those you serve healthy. We know your clients have at least one good meal a day because you feed them and they sleep better at night because they've had a full day. You also help families sleep better because they know their loved ones are in good hands with you. We know that there are challenges with running/working in an adult day program but you do it anyway. Thank you for the important service you provide that greatly enhances the lives of older adults and individuals with disabilities.
There are a lot of individuals who could use your services, families who could use the peace of mind that comes from having their loved in an adult day program and individuals/organizations who could help support your mission. I strongly encourage you to take advantage of it being National Adult Day Services Week and increase awareness of your programs. Engage your team and submit information to your local media this week! Ask those you serve, their families and staff to tell their stories about the importance of your services – why they come to your center, what it means to them and how it has enhanced their lives. Pictures paint a thousand words so ask for one or more individuals to let you snap their photo for the media, get a media release and send it along with some quotes from those you serve. Send your article/press release with the stories and photos to your local media and post it on Facebook. Please like the LeadingAge Georgia Facebook page and we'll repost it.
I'd like to thank the leaders of our Adult Day Services of Georgia Association for their great work with us as we work with the State to address transportation issues and referrals from case managers. I am also grateful for their collaboration on helping to secure an increase in funding this past legislative session. You all are wonderful.
Help with HR
The LeadingAge Human Resources committee plans to begin offering HR classes via Come to Meeting so that our members who don't have full time human resource staff can build their HR skills and better manage HR responsibilities. We'll be sending out a survey to inquire what topics you would like to have offered. Please respond to the survey when it comes out so we can see how to best serve your HR needs. Traci Montgomery of Wesley Woods provided a stellar training on providing performance reviews as part of the Leadership Academy training and more training like this will be available to you in the near future. A big thank you to the HR committee for the work you all are putting into this new training.
Medical Supplies and Equipment
||■Smith & Nephew
When was the last time your community analyzed medical supplies costs? Can't remember? Let Value First do a cost study for you. A cost study is a detailed, line-item analysis of what your community is currently paying compared to pricing available through Value First group purchasing organization. Whether your distributor is McKesson, Medline, Neil Medical, Holladay (or a different company) we can do an analysis for you. This is a free service available to LeadingAge/Value First members.
Request a Cost Study Today!
To submit your cost study request click the following link: https://form.jotform.com/61243365476155
For additional information contact Value First representative Vanessa Ceasar at firstname.lastname@example.org or (404) 421-3956
This is your GPO!
Value First, an affiliate of Vizient/Provista, is a group purchasing organization owned by LeadingAge national and twenty-five state associations, including LeadingAge Georgia. Value First is designed to leverage the buying power of thousands of senior service providers across the country to get the best pricing on a comprehensive array of products and services. This is your GPO
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Atlanta Home Care Partners
3006 Clairmont Road
Atlanta, GA 30329
4040 Nine McFarland Drive, Suite 1000
Alpharetta, GA 30004
assist with planning, we are sharing information
holidays and observances for each month
2 months early.
This month we are sending you information for November
November 1 All Saint's Day
November 6 Election Day
November 11 Veteran's Day
November 13 Caregiver Appreciation Day
November 15 Great American Smokeout
November 22 Thanksgiving
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LeadingAge Georgia Public Policy Report
by Tom Bauer, LeadingAge Georgia Policy Advisor
Now that Labor Day has come and gone, the next phase of the general election campaigning is in full swing. The outcome of November elections will likely impact some of LeadingAge Georgia's public policy issues, especially budget requests and other legislative items which require funding.
This is the first year that Governor Deal has not issued budget instructions requiring state agencies to cut their budget. Thus, it is more probable that some LeadingAge (LA) budget priorities might receive increased funding. Along with CO-AGE (Coalition of Advocates for Georgia's Elderly), LA, is supporting increased funding to shorten the waiting list for home and community based services (HCBS), which allows persons who would otherwise qualify for Medicaid to remain at home rather than in a nursing home. CO-AGE is requesting $10 million to address the waiting list of 12,000 individuals who are in need of in-home services.
The Georgia Department of Community Health (DCH) met in late August and approved a budget request for increases in Medicaid. DCH is asking for $72.9 million in additional funding for the current fiscal year (FY 2019, which runs through next June 30), and $195.8 million more for fiscal 2020. For the 2020 budget, $88.9 million is for increased Medicaid enrollment, and $66.6 million is requested to offset a slight decrease in the federal Medicaid matching rate. That request proposal now goes to the governor's office and then to the General Assembly in January.
Implementation of SB 406 (Fingerprint check)
The DCH budget request for FY '20 also includes a substantial amount to implement SB 406, which requires fingerprint checks of prospective employees working directly with patients in nursing homes and other long term care settings like personal care homes and adult day centers.
Life Plan Communities/CCRCs
LeadingAge intends to introduce legislation in the 2019 General Assembly to change the name of continuing care retirement communities (CCRCs) to Life Plan Communities (LPCs). CCRC members, along with the Georgia Department of Insurance, have been asked to review the current CCRC law to recommend any other minor changes necessary.
Members and staff of LeadingAge are members of work groups developing the following issues:
- Medicaid Funded Assisted Living
- Personal Care Home Requirements
- Medicaid Coverage for More Georgia Seniors
Profiles in Positive Aging Exhibit Debut
Center for Civil & Human Rights
September 25, 2018
Click here for tickets
Culture Change Summit
September 27, 2018
Engage at Every Age Expo
October 3, 2018
Center for Positive Aging Golf Tournament Fundraiser
October 8, 2018
Leadership Academy Fifth Event
October 10, 2018
Adult Day Services Symposium
October 19, 2018
Registration coming soon
LeadingAge National Conference
October 28-31, 20018
Philadelphia Convention Center
Georgia Night Dinner at the LeadingAge National Conference
October 28, 2018
Profiles of Positive Aging Gala - Note: Date Change
November 18, 2018
Click HERE for tickets
Technology & Aging Summit
November 15, 2018
Information coming soon
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Engage at Every Age Expo 2018
Engage at every age is a multi-cultural expo for the greatest generations of our time — to connect, inspire, become informed, empowered, and sample the rich heritage of our collective communities! Join LeadingAge Georgia and other proud partners for a spectacular experience to include Senior Idol and Top Chefs! Your residents and clients will have a marvelous opportunity to access the following galleries:
- Wellness & Well-being "Healthy Living"Gallery
- Forever Young Gallery
- Cultural Arts | Theatre | Entertainment Gallery
- BizHub & Financial Gallery
- Social Engagement | Tech Savvy Square
- and so much more...
This event is free and open to the public. LeadingAge Georgia members are serving as judges for Senior Idol and Top Chefs. Be Engaged. Be Inspired.
Click here for more information.
Where We Live: Communities for All Ages
Check out what's happeing around the US.
100+ inspriring examples from America's local leaders.
Click HERE to read more.
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2018 Annual Culture Change Network of Georgia Summit
Person-Centered Palliatie Care: A Key to Well-Being
Our Culture Change Summit is coming up in just over a week. Make sure to sign up now to increase your knowledge and ability to help those you serve access palliative care.
Older adults often experience pain associated with chronic conditions and acute illnesses. When the pain is not managed, the quality of life for the person diminishes and the person suffers from pain, isolation and depression along fatigue, loss of appetite, difficulty sleeping, and any a host of other symptoms that diminish well-being.
We're calling on you and your team to join us for this important summit on palliative care, to learn best practices and to help ensure that older adult who need palliative care receive it.
We will talk about what palliative care is, how it's different than hospice care, and how it is the key person-centered approach to providing relief from the symptoms and stress of chronic and acute illnesses.
It is all about improving quality of life and well-being for the individual who is experiencing the illness as well as their family/care partners. Palliative Care is not just about treating pain. It also treats depression, It helps give people the strength they need to carry on with daily life.
Research shows that once people know what palliative care is and what it can do, 92% want palliative care for themselves and those they love. We will discuss how we can come together as a community of caring to advance awareness and access to palliative care in Georgia.
Click HERE to register
The Eden Alternative Training
CMP Funds Continue to Support Transformative Culture Change Education to Georgia Nursing Homes Via The Eden Alternative® in Six Locations Throughout The State: Project Space Is Limited
RISE UP for Person-Directed Care in Georgia is a powerful, new grant opportunity that will help nursing homes improve quality of care and quality of life for their residents and advance their culture change journey. Thanks to the Georgia Department of Community Health, grant funds will make it possible for up to six people from each organization to experience the three-day in-person Certified Eden Associate Training, a power-packed culture change certification from The Eden Alternative®. The Culture Change Network of Georgia partnered with The Eden Alternative to bring this opportunity to Georgia.
Click HERE for more information.
2018 CCNG Advisory Group Meeting Dates & Update
Friday, October 12, 2018 | 9:30am – noon | Location: TBA
Adult Day Services Symposium: SAVE THE DATE
October 19, 2018
Information coming soon
2018 GADSA Leadership Team
President: Claire Russell, The Homeplace
Vice-Presidents Public Policy: Ned Morgens, Skylark Senior Care;
Aysha Cooper, SarahCare of Snellville
Vice-Presidents of Members: Carla Jones, Rosswoods; Peggy Padgett, Georgia Infirmary Adult Day Health
But the history of population health management predates fee for service payments or the American colonies and contributes significantly to the story of modern day medicine. It is a fact that for all the attention that is generated with the advent of new drug therapies or invasive procedures for the health-related maladies that plague mankind today the greatest reductions in deaths from diseases throughout written history are largely due to our collective ability to identify and document the cause of the congenital or acquired conditions and, where possible, mount society supported efforts to eliminate or eradicate them. The mobilization of the communities of Europe during the bubonic plague of the 1300s, the use of Variolation in Africa in the 1700s to provide immunity from smallpox, the eradication of the London Cholera epidemic of 1854, the 1860 publication of The etiology, concept and prophylaxis of childbed fever by Ignaz Semmelweis which led to the widespread practice of routine handwashing by physicians, iodization of salt in 1924 to reduce thyroid disease, the fortification of bread with niacin in 1934 to reduce pellagra, the enrichment of milk with Vitamin D in the 1930s to reduce rickets, the addition of fluoride to community water supplies in 1945 to reduce tooth decay, the vaccines for polio, German measles, diphtheria, and influenza, the Framingham heart study, the eradication of blindness from guinea worm infestations, safety belts for automobiles, the detection and removal of colon polyps to reduce colon cancers and the distribution of clean needles and condoms to reduce the spread of HIV. None of these advancements would have been possible in the absence of the collection, aggregation, analysis, reporting and utilization of data on populations of afflicted individuals in conjunction with a perception of the benefit to society at large from the reduction of illness from these conditions. The importance of this element of the transformation of medicine is critical. First because all of these are examples of primary and secondary prevention-based interventions versus treatment for an individual. Of equal importance, no direct transactional benefit is accrued to the individuals allocating the resources to support them. These advancements are not possible without first understanding the cause of the condition and then designing, developing and deploying resources first for the benefit of those at greatest risk for acquiring the affliction and, as is often the case, on reducing the burden of illness on those in the earliest stages of affliction. Many of these interventions have their origins in the military. Most of them required a level of organizational structure, processes and outcome monitoring and management beyond the singular scope of even the best practitioners of their day. All of them were aided by the marshalling of the resources of society either through civic, non-profit or governmental support for the benefit of the community at large.
The true origin of population health management, then, lies here; in the understanding that even as we have evolved newer methodologies to treat and cure diseases it is our society-funded advancements in prevention and early detection that have led to the greatest decreases in human suffering. Regardless of your political proclivities the evidence here suggests that it takes a village to eradicate or control the greatest health threats to a population. The one patient at a time business model of fee for service medicine evolved alongside and benefitted from the collective wisdom gained from managing community health issues. The aggregation and management of victims of tuberculosis led to the specialty of thoracic surgery, the treatment of injuries in the theater of war led to the field of trauma surgery, the development of antibiotics and the use of helicopter transport for emergency medical services. But with each new diagnostic and therapeutic modality the cost of health care escalated to the point where the expense incurred from the treatment of one individual with a severe illness could exhaust the generational wealth of an entire middle class family. The desire to reduce the risk of financial ruin from catastrophic illness was, in part, the genesis of employee sponsored health insurance. The subsequent belief as a nation that American seniors should be protected from destitution related to the cost of medical care led to the establishment of the single-payer, national social insurance program known as Medicare.
The introduction of Medicare Part A and Part B in 1966 were game-changers for low-income seniors in communities around America and, frankly, for the hospitals and providers that had served them for years without compensation. Prior to the establishment of this citizen-funded, government-managed health insurance option many of these seniors had been turned away from some hospitals or impoverished due to the cost of treatment for a catastrophic illness. But as beneficial as Medicare was its Fee for Service model led to misaligned incentives by compensating for the treatment of illness and not the prevention of disease. The predictable consequence spawned the medical industrial complex, with the design and development of larger brick and mortar medical treatment infrastructures, the buying up of providers of care and the arms-race-like acquisition of health centered technologies to attract and retain this new revenue stream. Early on it became evident that the system as implemented provided little supervision with regard to over-utilization of diagnostic and therapeutic resources, showed disregard for site of service as a variable in care delivery and rewarded poor performance by paying for complications and their resultant prolonged hospitalizations. The financial impact was so great that many of the medical groups, hospitals and drug manufacturers that were opposed to the passage of Medicare in the beginning became less vocal in their protestation of "government intervention in health care" as they began to reap the benefits of more patients with the ability to pay for the increasing cost for their services. by 1973 Congress and the President were enacting legislation in an attempt to manage the rising costs of government funded health care. But despite the best efforts of the executive and legislative branches U.S. healthcare costs as a percentage of Gross Domestic Product continued to grow at non-sustainable rates. This backdrop sets the stage for the tectonic shift in the U.S. healthcare landscape euphemistically known as managed care.
The epochal shift in the health care terrain is being driven by the convergence of three distinct but related factors in managed care: 1) the lack of personal accountability of a large segment of society for their health and well-being, 2) the realization that the fee for service employer-based and government sponsored insurance models reward the treatment of disease vs the prevention or reduction of illness and has led to the current medical industrial complex and 3) that the cost of primary or even secondary prevention of illness is cheaper than treatment by orders of magnitude for most conditions. Health policy in the United States for the last 45 years has been shaped around the second and third of these factors. We have not focused on the first because as a society we lack the desire or the capacity to hold individuals accountable for the modifiable risk factors that drive the majority of preventable deaths in this country. It is a fact that diet, sedentary lifestyle, obesity, smoking and alcohol are the cause of the majority of premature deaths in this country. We have decided as a nation to hold the providers and underwriters of health care costs accountable for increasing the engagement, education and empowerment of individuals with regard to their health.
All substantive health policy in the U.S. since the Health Maintenance Organization Act of 1973 has attempted to shape U.S. health care based on these two premises. The legislative solutions have attempted to catalyze the collaboration of payers, providers and high performing integrated care delivery system by ratcheting down the pool of inflation adjusted per capita dollars available for total cost of care. The architects of these social engineering policies are aware that the current state individual provider's practice, designed for optimization of the fee for service model, lacks to tactics, the team and the tools to successfully meet the performance and quality benchmarks to be competitive in this new environment. One recent study observed that for the average primary care provider with a panel of 2300 members it would take 21 hours a day for them to provide all of the annual acute, chronic and preventive care functions necessary for their membership3. Health policy architects are counting on market forces to drive the evolution of new symbiotic relationships while eliminating non-competitive models and rewarding those that lower costs, improve quality and enhance the experience of the member receiving care. The most sweeping and recent of these solutions is the Affordable Care Act and the Health Care and Education Reconciliation Act of 2010. The stated intend of the legislation is to improve access, increase quality and lower the cost of health care through (among other mechanisms) moving the majority of government sponsored health payments to value-based compensation and away from volume based fee for service compensation. As could be expected all major commercial health plans have quickly followed this trend.
So while the Fee for Service based health care delivery industry has invested time, talent and resources toward maximizing profits in a volume-based, unit-cost maximizing, specialist incentivizing, complication rewarding treatment of disease-based business model the payers of health care are economically catalyzing an antithetical care management model that rewards prevention, health maintenance and reduced utilization of services. As in the case of the ice shipping service and refrigeration these two models could co-exist together for a time. But in the same way that the Industrial Revolution gave the refrigeration proponents a competitive advantage over the ice shippers, the Information Revolution that the electronic age as spawned will provide opportunities to change health care delivery in ways that have yet to be imagined. And those changes are not 100 years into the future but are happening today.
Simply stated health care providers today are first and foremost in the information management business. The successful emerging health care organizations will be the ones that collect, store, analyze, report and utilize health information in a manner that delivers the most value to health care consumers and payers. The tactics for doing so and the importance of population health in achieving this goal are the topic of the next installment in this series.
3Annals of Family Medicine; www.annfammed.org; VOL. 10, NO. 5; SEPT/OCT 2012 396
by: Michael Vincent Smith, MD
News Throughout the Spectrum of Aging Services
Federally Assisted Housing (HUD-Subsidized)
Getting Ready for RAD for PRAC
by Colleen Bloom, LeadingAge
In 2017, LeadingAge members successfully urged Congress to allow interested Section 202/PRAC communities to convert their rental assistance to the Section 8 platform though an expansion of the Rental Assistance Demonstration (RAD) program. With passage of the HUD FY18 budget, RAD for PRAC became a reality. Since that time, LeadingAge has engaged members of the self-appointed Housing Advisory Group to discuss and provide recommendations as to how HUD should best implement its new RAD for PRAC authority, and helped to coordinate discussions among key external stakeholders as well.
HUD Leaders Welcome LeadingAge Staff; Share Priorities for 202 Expansion
LeadingAge staff took full advantage of the one-hour meeting to introduce LeadingAge, share some member concerns with communications and consistency, and dialogue about our housing with services priorities and innovative examples. Mr. Seats and his staff shared about Office of Multifamily Housing staffing challenges, concerns with information technology and system needs, timing expectations for release of the announcements for new 202 funds and implementation of RAD for PRAC, and plans to do a "look back" on the Multifamily Transformation to evaluate lessons learned.
HUD Senior Living: Supplementing Meals Project
by Ginny Helms
Directors of HUD senior living homes have been telling us that many of their residents struggle to stretch their monthly income to pay all of their expenses and sometimes have to choose between medical care and groceries. In light of this, we have been working with Robyn Crittenden, Commissioner of the Georgia Department of Human Resources and Abby Cox, Director of the Georgia Division of Aging Services to develop a plan for supplementing groceries for residents in HUD senior living homes. Jan Bequeath, former president of the Alzheimer's Association has offered to volunteer and gather information we need regarding existing grocery/meals programs in our HUD communities. This information will allow us to better understand the gaps and potential solutions for supplementing meals. Please partner with us on this effort and give Jan the information she needs when she calls your community.
Home and Community Based Services
Hospice to Receive 1.8% Payment Update
by Aaron Tripp, LeadingAge
On August 6, 2018 the Centers for Medicare and Medicaid Services (CMS) published the fiscal year (FY) 2019 Hospice Wage Index and Payment Rate Update final rule. The hospice payment update percentage for FY 2019 is 1.8%.
CMS Releases Latest Version of Comprehensive Home Health Data Set
by Robert Holly
As part of its ongoing mission to increase transparency and better inform health care stakeholders, the Centers for Medicare & Medicaid Services (CMS) has rolled out the fourth version of a massive data set highlighting utilization, payment and demographic information culled from thousands of home health providers. Released on August 28th, the Home Health Agency Public Use File showcases data from 10,138 home health agencies, nearly 6 million claims and $18 billion in Medicare payments. Information on submitted charges and chronic condition indicators is also included in the sprawling file, which covers calendar year 2016.
Life Plan Community/CCRC
How to Share Campus Space for the Good of Young and Old
by Geralyn Magan, LeadingAge
"Intergenerational shared site" may not be a term most Americans understand well, but it represents a "concept whose time is now," according to a new report from Generations United (GU) and the Eisner Foundation.
Several LeadingAge members, featured in the new report, have obviously gotten that message.
All in Together: Creating Places Where Young and Old Thrive features several examples of how LeadingAge member organizations are sharing campus space with the younger generation.
For example: NewBridge on the Charles, a residential community operated by Hebrew SeniorLife in Dedham, MA, shares its 162-acre campus with a private school for students in kindergarten through 8th grade. The shared-site program includes intergenerational activities at all grade levels. About 10 older adults regularly help out in classrooms.
CMS Finalizes PDPM Rule
by Aaron Tripp, LeadingAge
A CMS fact sheet on the final rule, effective October 1, 2018, is also available
highlighting the three main provisions of the rule, those being the new case-mix
classification system, the Patient-Driven Payment Model (PDPM), and policy updates to the SNF quality reporting program (QRP) and value-based purchasing program
(VBP). Of note, CMS states that the rule "moves Medicare towards a more valuebased, unified post-acute care payment system" which signals that this is likely foundational to the future concept of a unified post-acute care prospective payment
system as mentioned in the IMPACT Act of 2014.
OIG to Investigate CMS Oversight of Skilled Nursing Staffing Measures
by Alex Spanko
In the wake of controversy over nationwide skilled nursing staffing levels, the health care industry's top government watchdog has stepped in to investigate. The Department of Health and Human Services (HHS) Office of the Inspector General (OIG) announced that it will launch a probe into the way skilled nursing facilities maintain their staffing records — with a focus on the Centers for Medicare and Medicaid Services' (CMS) oversight of those requirements.
Nursing Homes: Is Federal Regulation Tough Enough?
by Barbara Gay, LeadingAge
That question will be explored at a House Energy and Commerce Subcommittee on Oversight hearing September 6. Committee members will hear from representatives of the Centers for Medicare and Medicaid Services (CMS), the Health and Human Services Office of Inspector General, and the Government Accountability Office.
In announcing the hearing, the subcommittee chair, Rep. Gregg Harper (R-MS), said that, "This is the latest step in our ongoing investigation into the treatment of patients at nursing homes." He cited press reports of abuse and neglect occurring in nursing homes, including resident deaths at the Hollywood Hills nursing home in Florida which resulted when the public utility company failed to restore power to the nursing home after Hurricane Irma in 2017.
Dished: Senior Living Providers Feed a Growing Appetite for
by Tim Regan
The senior living industry is increasingly looking to local farms to help feed residents, and
while the practice isn't always cheaper, many providers agree it is the wave of the future.
Chicago-based senior living provider Pathway to Living launched a farm-to-table dining
program in May to bring fresh produce to its residents. Similarly, Vero Beach, Floridabased
Harbor Retirement Associates (HRA) in July announced a new "farm-to-fork" menu refresh to incorporate more local, seasonal fruits and veggies into its residents' diets.
CDC Issues Flu Vaccination Guidelines for 2018-2019
by Lois A. Bowers
Last year's severe flu season affected move-ins and income at senior living communities across the country. As the industry prepares for another flu season, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices has issued its influenza vaccination guidelines for 2018-2019. The CDC continues to recommend that everyone 6 months old and older receive an annual flu shot with any licensed, age-appropriate flu vaccine. The good news is, several types of vaccines will be available this year, and the agency does not prefer one vaccine over another.
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Coffee Chats with Congress Help Make Advocacy Real In Your Community with Coffee Chats With Congress
Our advocacy and health policy teams meet regularly with lawmakers to educate them on the policy issues that impact our provider organizations. But, as terrific as our staff is in Washington, legislators also want to hear from you, our members, because you are on the front lines watching how these issues play out day after day in your communities, and how they affect the residents and families you serve.
LeadingAge is launching "Coffee Chats With Congress" this summer and fall. This campaign is asking LeadingAge members to set up conversations with their legislators so that they can talk about the good work they're doing and the challenges that their community encounters.
Download our Coffee Chat With Congress Toolkit and join us as we educate our members of Congress on the issues facing our members and residents every day.
September is National Disaster Preparedness Month by Colleen Bloom, LeadingAge
Disasters don't plan ahead. You can. LeadingAge's Disaster Resources: Preparedness, Response and Recovery webpage includes links to help members find the most appropriate resource for them in any phase of disaster planning, response or recovery.
Not Just Nursing Homes' Problemby Katie Smith Sloan
Lawmakers' current focus on and investigation into abuse and neglect in nursing homes, while well-intentioned, threatens to derail ongoing efforts to improve the quality of care for older adults nationwide.
Let me be clear: neither I nor any member of the association I lead, would for a minute argue against nursing home regulation or of righting wrongs in the administration and management of nursing homes. We make no apology or excuses for poor quality of care. Errors should be fixed. Improvements are imperative.
What we urge lawmakers and the public to recognize is that solutions have been put in to place to correct problems now under scrutiny. Whether at hearings, such as last week's Energy & Commerce subcommittee hearing, "Examining Federal Efforts to Ensure Quality of Care and Resident Safety in Nursing Homes," or through investigations, such as the OIG's probe into CMS' oversight of nursing home staffing standards, a consistent emphasis on failures of operation, without consideration of the context in which providers operate could very well result in poor policy decisions.
To be sure, the deaths of residents at the Hollywood Hills nursing home in Florida last year, a much-discussed topic at the Sept. 6 House committee hearing, never should have happened. It was a preventable tragedy. Shortly afterward, CMS finalized a requirement that all nursing homes have disaster preparedness plans in place. The regulations are very detailed, and state surveyors -- the employees charged with ensuring that nursing homes follow CMS dictates -- will penalize providers that do not comply with requirements.
Let's move forward. When considering how to right wrongs, in the case of natural disasters, policymakers would be wise to explore the interplay of municipalities and public leaders with nursing homes. Some of our members, nonprofit skilled nursing facilities, report that as they've implemented their plans, they've encountered difficulty in getting cooperation from the state and local agencies that are crucial partners in order to protect or transport seniors in the event of a disaster. How might elected officials encourage collaboration to help us all achieve a desired goal -- the safety of our older adults? Consider that, nearly one year after Hurricane Irma wreaked havoc in Florida, none of the more than 1,000 nursing homes and assisted living facilities in South Florida are on Florida Power & Light's highest priority list for power restoration. Nursing homes must be given the same priority in restoration of utility and other services that is given to hospitals in order to ensure residents' safety and security. Older adults deserve no less.
On nursing home staffing, a second topic of lawmaker and media interest, understaffing and inaccurate reporting are issues that must be addressed. Our members advocated for improvements to the old approach of self-reporting staffing data. We worked side by side with CMS and other stakeholders to create a better approach. With the rollout of self-reporting's replacement, PBJ, glitches and errors have occurred. We expect these issues will be resolved, and in a relatively short time, the reporting process and data output will be better than it was before. That's good news.
Finally, lawmakers investigating CMS' efficacy in nursing home oversight would be well-served to look not just at whether regulations, such as RoPs, are being imposed, but whether the state agencies charged with overseeing enforcement of CMS rules have the resources required to do their jobs. Look hard. The unevenness of surveyors findings and enforcement actions taken by state surveyors is well documented. State survey agencies are frequently short staffed, and turnover at these agencies is often rampant, which means that those responsible for surveying nursing homes may have neither the training nor the experience to know what they are seeing and whether conditions comply with federal standards and requirements. To those lawmakers interested in improving CMS' output, we urge ensuring that a state's nursing home Medicaid reimbursement levels and the funding of its survey agency is part of the annual CMS approval process for state Medicaid plans. CMS should ensure that reimbursement rates are sufficient to cover staffing and other essential costs of complying with federal quality standards and whether the state is investing sufficient resources in its survey agency. Approval of a state's Medicaid plan should be contingent on these factors.
No question: nursing home operation is complicated. It is important to recognize that nursing homes generally -- not only LeadingAge's members -- work hard to provide the highest quality of care and services to their residents. We all must recognize that achieving high quality requires a commitment of federal and state resources into the provision of care and the agencies called upon to enforce standards. Recognize that substantial progress has been achieved in the decades since the Nursing Home Reform Act was enacted. Recognize that a continual drumbeat of negativity about nursing homes and the people who work in them makes it ever harder for nursing homes to attract and retain capable and talented people. Each of us is aging. This is not someone else's problem. It is every one of ours.
Katie Smith Sloan is President and CEO of LeadingAge, the association of nonprofit providers of aging services.