Coleman Breaks Ranks with Republicans to Vote Against Medicaid Cuts
By Bill Gray
Both Dayton and Coleman side with the long-term care community in opposing proposed spending reductions.

After intense pressure from the American Health Care Association and Care Providers of Minnesota staff and members over the last few days, both of Minnesota's U.S. Senators voted against a proposed 1.5 percent cut to Medicaid rates that would have had a profoundly negative effect on the entire continuum of long-term care services in all 50 states.  Of particular note was Senator Norm Coleman's vote to oppose the cuts, which were supported by his own political party.  Coleman was one of only eight Republican Senators to break ranks and vote against the proposed cut.

The vote to remove the cuts from the proposed Senate spending legislation passed 53-43, putting long-term care in a much better position that it would have been in going into eventual budget conference committee with the U.S. House of Representatives.  Your calls and the calls of your colleagues to Coleman as well as Dayton were instrumental in securing this victory, and we thank you for answering the "call to action" we issued earlier this week.

Care Providers thanks Senator Norm Coleman, as well as Senator Mark Dayton, for standing up for what was right in this debate.  Now is not the time to be cutting the federal contribution to state Medicaid programs.  Coleman and Dayton understand this, and we commend them for their leadership.  Please consider giving them a quick call or e-mail thanking them for their votes.

Bill Gray
952.851.2490
bgray@careproviders.org

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State Senate Republicans Come Out Against Cuts to Long-Term Care
By Bill Gray
Caucus goes against Governor Pawlenty’s budget priorities.

Speaking of thanks, Care Providers of Minnesota would like to thank the Senate Republican Caucus for coming out against Governor Tim Pawlenty's proposed cuts to long-term care in its own spending blueprint.  Released just this afternoon, the Senate Republicans are touting their plan as one that "does not raise taxes or cut nursing homes."

"Our plan recognizes the needs of some of our most valued citizens: our seniors and our military," said state Senator Cal Larson.  "Nursing homes simply can't sustain any more cuts, and with our plan they don't have to.  We also show our support for our military with bonuses for re-enlistment and bonuses for serving in the War on Terror."

Specifically, the Senate Republican Caucus plan comes up with $160 million to cover the projected deficit, plus another $41 million in supplemental spending, by using $100 million from a "racino" and Canterbury Park, $50 million from the surplus in the Healthcare Access Fund, $32 million from the budget reserve and $19 million from across-the-board cuts in agency operating budgets.  Regarding the Canterbury Park proposal, we'd like you to weigh in to our E-Poll this week and tell us what you think about the state capturing funds from such an arrangement and dedicating some of those funds to long-term care.  Please take a moment and answer our E-Poll, which appears in the left-hand sidebar just below the newsletter table of contents.

The Senate Republican Caucus' plan is the first of four expected counterproposals to the Governor's proposed budget.  The next one will likely be coming from the House Republican Caucus, with the Senate and House Democratic Caucuses following close behind.  We'll continue to keep you posted as the different proposals are released to the public.

Bill Gray
952.851.2490
bgray@careproviders.org

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Association Board Member Appointed to BENHA
By Bill Gray
Jim Birchem to serve four-year term.

Governor Tim Pawlenty announce the appointment this week of Care Providers of Minnesota Board member Jim Birchem to the state Board of Examiners for Nursing Home Administrators.  Birchem will serve a four-year term ending in January of 2008.

In addition to serving on our Association Board, Jim serves as the Care Providers representative to the National Center on Assisted Living.  He is President/CEO of ElderCare of Bemidji, which owns and operates two nursing homes, six assisted living communities and one congregate apartment for seniors.

Congratulations to Jim Birchem on being recognized for his leadership by the Governor in his appointment to the state Board of Examiners for Nursing Home Administrators!

Bill Gray
952.851.2490
bgray@careproviders.org

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Several Imperative Initiatives Advance in House
By Patti Cullen
Closure potential, rate notice requirement proposals heard.

On March 8, several “technical” bills brought forward by the Long-Term Care Imperative were passed out of the House Health and Human Services Policy Committee and sent to the House floor for further action.  H.F. 1755 (Samuelson, R-New Brighton) was amended onto H.F. 1754 (Samuelson, R-New Brighton) with a few technical amendments added to both original bills. 

H.F. 1755, as amended, establishes timelines for the Department of Human Services (DHS) to adjust nursing facility property rates following the completion of a construction project.  DHS must provide a rate notice within 60 days of receiving the information.  Further, during the 60-day period, and until the rate notice is provided,  a nursing facility may raise the rates by the amount anticipated to be allowed.  Any amounts collected from private pay residents in excess of the allowable rate must be repaid to private pay residents. Provisions of H.F. 1755 can now be found as part of the text to H.F. 1754.

H.F. 1754, as amended, allows the Commissioner of Human Services to negotiate a planned closure for nursing facilities beginning July 1, 2004, if the proposal has no cost to the state.

Patti Cullen
952.851.2487
pcullen@careproviders.org

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House Committee Passes Imperative Bill Concerning Assisted Living
By Jonathan Lips
Technical bill designed to alleviate some long-term care insurance headaches passes house committee.

As members are aware, one of the items on the legislative agenda of the Long Term Care Imperative is a bill designed to help residents obtain coverage under long term care insurance policies for services received in senior housing establishments.

Many policies cover services delivered in “assisted living facilities,” but technically there is no such place in Minnesota.  Though coverage determinations are complicated and depend on many factors, it appeared that one of the obstacles was the simple fact that Minnesota uses the terminology “housing with services establishment” instead of “assisted living facility.”

To help alleviate this problem, the Imperative proposed a technical bill that reads as follows:

“For purposes of consistency with terminology commonly used in long term care insurance policies, a housing with services establishment that is registered in accordance with Section 144D.03 and that holds, or contracts with an individual or entity that holds, a home care license and all other licenses, permits, registrations or other governmental approvals as are legally required for delivery of the services the establishment offers or provides to its residents, constitutes an “assisted living facility” or “assisted living residence.”

We are happy to report that the House version of the bill (HF 1936 / Finstad) passed out of the Health and Human Services Policy committee on March 8 and was re-referred to the House floor, where it can be voted on for final passage.  The Senate companion (SF 1671 / Moua) is scheduled to be heard March 11.

The Minnesota Board on Aging submitted a letter of support for the bill, writing that it would promote understanding of long-term care alternatives and products.  While no one testified against the bill, AARP-Minnesota submitted a letter of opposition, stating that the bill broadly defines “assisted living” without including quality standards and consumer protections, such as 24-hour awake staff.

Jonathan Lips
952.851.2480
jlips@careproviders.org

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Joint Underwriting Asssociation Bill Passes House Committee
By Jonathan Lips
The House commerce committee has approved a bill authorizing the Joint Underwriting Association to issue liability policies with higher limits.

A compromise version of a Long Term Care Imperative bill aimed at liability insurance passed the House Commerce Committee March 9.

In it is original form the bill required the Minnesota Joint Underwriting Association to issue professional liability insurance policies with coverage limits up to $3 million; specifically, it required the JUA to offer providers a $2 million policy and a $3 million policy in addition to the $1 million policy it currently offers.

After long conversations with the JUA and the author of our bill in the House, we arrived at a compromise bill which authorizes the JUA, but does not require it, to offer a $2 million policy in addition to the $1 million policy, provided that the applicant demonstrates that it needs the higher limits in order to conduct its business -- for example, that a mortgagee, lessor, etc. is requiring more than $1 million in coverage.

To illuminate the “business need” requirement, the JUA insisted on including the following language, which we agreed to do since these words already appear in the Minnesota statutes that govern the JUA:  "Prudent business practice or mere desire [to have a $2 million policy] is not a sufficient standard" for the association to issue the larger policy."

We are pleased with this outcome, and expect the Senate companion of this bill to be heard in committee next week.

Jonathan Lips
952.851.2480
jlips@careproviders.org

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Scholarship Bill Moves on As Amended
By Patti Cullen
Nursing facilities can place employment restrictions on recipients.

H.F. 2499 (Samuelson, R-New Brighton), a bill amending the nursing facility employee scholarship program, was passed out of the House Health and Human Services Policy Committee on March 8, and was sent to the House floor for further action.  The bill allows a nursing facility to require a term of employment of up to one year, following completion by an employee of a degree attained using scholarship funds.  Employers could require employees who voluntarily terminate employment prior to the end of the required term of employment to reimburse the employer for scholarship funds received. 

Representative Samuelson amended the bill in committee to reflect some of the concerns express by labor unions requesting exceptions under certain circumstances.  As amended, employers could not request reimbursement if there were no jobs available in a higher job classification or if they needed to relocate due to a spouse job change.  Association Vice President Patti Cullen testified in support of the bill, and responded to questions by committee members about the bill.  One of the issues brought up was whether the new language would have a chilling effect on workers even applying for scholarships—we responded that this has not been a factor for facilities already applying some continued employment restrictions.  Further, if facilities believed employees would stay longer once they completed their schooling , the employers themselves may do a better job in promoting the program.

Patti Cullen
952.851.2487
pcullen@careproviders.org

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Capitol Update on Various Bills
By Patti Cullen
Committee deadline week full of activity.

The following is a summary of several bills that have been heard during the last few days of rather frantic activity at the Capitol.  The complete text of these bills can be accessed via the state legislative website at http://www.leg.state.mn.us.  Click on the box for legislation/bill status and follow the instructions.  Committee deadlines for the Senate have also been set this week; unfortunately they are not the same deadline as the House, so we are in new territory with respect to committee process.  The first deadline in the House is Friday, March 12; for the Senate it is Friday March 19.  By first deadline,  bills must have passed out of the policy committees in one body or the other.

S.F. 2381 (Dibble, DFL-Minneapolis), is a bill that strengthens the Minnesota Clean Indoor Air Act.  The bill was heard on March 9, 2004 in the Senate Health and Family Security Committee.  The section of particular interest to long-term care is Section 5, which modifies the current regulation of smoking in health care facilities and clinics, which includes nursing homes, boarding care homes and licensed residential facilities.  The bill allows smoking only by the residents/patients in these settings, and only in a separate, enclosed room with a separate ventilation system.  The future of this bill in the House, however, is not as “bright” as in the Senate.

H.F. 2425 (Samuelson, R-New Brighton) relates to collaborative service models for the elderly waiver.  The bill, brought forward by the counties, and approved by the Department of Human Services (DHS), requires DHS to issue requests for proposals for collaborative service models between counties and managed care organizations, to integrate elderly waiver services and additional nursing services into the prepaid medical assistance program (PMAP).  Further, the bill prohibits statewide coverage under PMAP before July 1, 2006.  The bill passed out of the House Health and Human Services Policy Committee on March 8, and was referred to the House floor.

Several rate exception bills were heard in the House or Senate health and human services policy committees, and were referred to the House or Senate finance committees for “possible inclusion in the supplemental appropriations bill.”

S.F. 2020 (Sparks, DFL-Austin) is a nursing home bed moratorium request for the Comfortcare Good Samaritan facility in Austin, where a new facility would be constructed using existing beds plus some transferred beds within the Good Samaritan organization.

H.F. 1804 (Samuelson, R-New Brighton) provides for a rate increase determination for the Ramsey County Nursing Home.  Ramsey County Commissioner Victoria Reinhardt described the funding gap of $327,000 in operational dollars, and provided statistics to demonstrate the continued need for the facility in the community.  They are requesting about $110,000 for their operating rate.  A “tricky” aspect of this request is the fact they are a county-owned facility, generating additional federal funding through the intergovernmental transfer program.  If the facility closes, there would be an annual funding loss of nearly $2 million.
H.F. 2188 (Cox, R-Northfield) removes the division of costs between the state and counties for the cost of placements that have exceeded 90 days in ICFs/MR that have seven or more beds.  Repeal of the 20% county financial contribution would go into effect immediate after passage of the bill.  The bill also requires the commissioner of human services to develop recommendations and legislation concerning the future services provided to people now served in ICFs/MR.  Recommendations are to be reported to the house and senate human services committees by December 15, 2004.

H.F. 2639 (Heidgerken, R-Freeport) is a “repeat” bill designating certain nursing facilities as metropolitan facilities for purposes of medical assistance reimbursement.    The bill requires nursing facilities located in areas designated as metropolitan areas by the Office of Management and Budget to be considered metro in order to determine rate increases and to establish nursing facility reimbursement rates under the new nursing facility reimbursement system.    While there was no financial implications (there are no increases planned and the new system is not yet being implemented) on the state budget for this year, the bill was laid over for possible inclusion in the omnibus bill anyway.

Patti Cullen
952.851.2487
pcullen@careproviders.org

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Further Details of Governor’s Supplemental Budget Released
By Patti Cullen
Legislative committees hold oversight hearings to understand budget proposals.

The Senate Health and Human Services Finance Division meeting of March 9, 2004 began the stage of the legislative session where the budget proposal from the administration (the Governor’s Supplemental Budget) is closely scrutinized, comments presented, and each legislative body then comes up with their alternative plan.

At the March 9 meeting, Assistant Commissioners from the Department of Human Services began presenting the budget pages affiliated with their various programs.  Due to the numerous questions, only the health care division was “featured” at this hearing; other divisions, including continuing care, will present on March 16.  Pages 25 through 29 of the budget book cover continuing care changes:  “outyear” forecast changes due to the new nursing facility payment system; elimination of the automatic nursing facility cost of living adjustment for APS facilities for the 2006-2007 fiscal years; elimination of the scholarship program for nursing facilities;  1.5% reduction for continuing care providers; and continuing to hold down the caseload growth under the Community Alternative for Disabled Individuals and Traumatic Brain Injury waivers.

Details from the Supplemental Budget, including all budget pages by agency, are posted on the Department of Finance website at:  http://www.finance.state.mn.us/

Patti Cullen
952.851.2487
pcullen@careproviders.org

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DHS Releases SMRT Bulletin for GAMC
By Patti Cullen
Form changes and referral requirements noted.

The Department of Human Services (DHS) has issued bulletin #04-21-02,
 “State Medical Review Team (SMRT) Announces Revised Forms and Referral Requirements for Certain GAMC Cases.” The SMRT has revised several forms related to the disability process to comply with the Health Insurance Portability and Accountability Act.  In addition, DHS has identified certain General Assistance Medical Care (GAMC) enrollees whose claims history suggests possible eligibility for the medical assistance program.  DHS Bulletins can be found on their website at www.dhs.state.mn.us. 

Patti Cullen
952.851.2487
pcullen@careproviders.org

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MDH Adds New Features To Case Mix Website
By Todd Bergstrom
The Minnesota Department of Health has updated a couple of features on the department's web site.

 Recently the Minnesota Department of Health (MDH) has updated the department's nursing facility case mix web site.  MDH's Minnesota Case Mix web site is found here.

The changes are listed below.

• An educational handout about nursing rehabilitation is now available.
• The first Q&A about discharge tracking was revised to make the topic clearer.

Todd Bergstrom
952.851.2486
tbergstrom@careproviders.org

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SNF Workgroup Set for March 23
By Patti Cullen
Topic is Medicare PPS Consolidated Billing.

The March meeting of the Skilled Nursing Facility (SNF) Workgroup is set for Tuesday, March 23 from 1:00 to 3:00 p.m. at Sholom Home West in St. Louis Park (952-935-6311).  The topic for this meeting is Medicare PPS Consolidated Billing.  The speaker is Deborah Elsey from LAWCO.  These meetings are free and open to interest SNF providers.

Patti Cullen
952.851.2487
pcullen@careproviders.org

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U.S. Department of Labor Investigates Assisted Living and Skilled Nursing Facilities
By Walter Eisner
A nationwide survey to determine long term care employer's compliance with labor requirements.

Our national affiliates, the American Health Care Association and the National Center for Assisted Living have notified the Association of an impending investigation by the U.S. Department of Labor.  We will brief readers as more details come from Washington on what this investigation means to Minnesota providers.

The U.S. Department of Labor’s Wage and Hour Division (DOL) has just announced plans to conduct a “statistically valid investigation-based national compliance survey of nursing homes and residential care facilities,” which will include assisted living facilities and other types of residential care settings.  The nationwide survey will determine long term care employers’ compliance with the minimum wage, overtime, and child labor requirements of the Fair Labor Standards Act (FLSA).  

According to DOL officials, the investigation of both assisted living and nursing facilities will begin in about two weeks and continue through the end of May.  An outside contractor will tally the results and investigation findings might be released as soon as late July.   Investigators will measure both the number of FLSA violations and the severity of those violations.  In other words, DOL not only will examine whether an employer is in or out of compliance, but also will examine the degree to which the employer is out of compliance, e.g. number and amount of back pay awards. 

Nursing facilities and assisted living residences are part of a multi-year DOL initiative targeting industries with low-wage workers and also includes the garment industry and agriculture.  This new investigation will mark DOL’s third investigation of nursing facilities and assisted living/residential care communities since the investigations began in 1997.  The 2004 investigative survey is designed to measure what affect DOL’s educational and compliance efforts have had on FLSA compliance levels in assisted living and nursing facility settings since the last surveys were conducted in 2000 and 2001.

Unlike the past DOL investigations where assisted living/residential care and nursing facilities were examined separately, DOL will conduct a single, simultaneous investigation of both professions utilizing the same methodology as was used in past investigations, including the same industrial classifications or “SIC codes.”  However, there will be no recidivism study (reexamining those found out of compliance in previous investigations) according to DOL officials we spoke to yesterday.  In addition, the sample size will be smaller for the assisted living/residential care sector and nursing facility sector when compared to previous studies when each sector was examined independently.

In 1997 and 2000, DOL found FLSA compliance levels in nursing facility settings of 70 and 40 percent respectively.  (While DOL reported a 40 percent compliance level in 2000, our further analysis showed that the level was 55 percent when we utilized the same criteria that was used in 1997.)  For assisted living and residential care, DOL found compliance levels of 57 percent in 1998 and 60 percent in 2001.  

NEW EDUCATIONAL GUIDANCE RELASED
Accompanied by the announcement of the new investigation was the release of three new fact sheets specific to the long term care setting.  AHCA and NCAL have worked exclusively with the DOL over the last two years to develop these fact sheets on the three most common areas where DOL has found violations in long term care settings, including child labor, hours worked, and overtime.  The guidance was developed as a direct result of concerns that NCAL and AHCA raised in the late 1990s about DOL’s generic compliance information for employers that did not relate to long term care settings or workers.  Several NCAL and AHCA members reviewed the guidance when it was in the final stages of being drafted.  We believe the new fact sheets will help providers better understand FLSA requirements. 

All three fact sheets are posted on NCAL’s and AHCA’s Members Only Web sites at www.ncal.org and www.ahca.org.  The fact sheets have not yet been posted on DOL’s Web site but should be soon.  Once they are posted by DOL, they can be found at www.wagehour.dol.gov and www.youthrules.dol.gov.  Compliance with the FLSA is important and we are asking all AHCA/NCAL affiliates to help disseminate these links to their member facilities. 

We will keep you posted on all developments with the DOL investigation.  If you have specific questions, please contact David Kyllo at 202/898-6312 or e-mail dkyllo@ahca.org, or Priscilla Shoemaker at 202/898-2850 or e-mail at pshoemaker@ahca.org.

Walter Eisner
952.851.2484
weisner@careproviders.org

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Medicare Issues New Swing-Bed Rates
By Patti Cullen
Region rates in effect January 1, 2004.

The Centers for Medicare and Medicaid Services (CMS) has updated the regional Medicare swing bed skilled nursing facility (SNF) rates for routine SNF-type services provided by swing-bed hospitals during calendar year 2004.  The new rate for Region 6, which includes Minnesota and North Dakota, is $145.42. 

In recent weeks several members have expressed concern over the increased use of swing beds, particularly in hospitals designated as critical access hospitals.   As a reminder, MN Statutes 144.562 govern the use of swing beds in Minnesota.  Included in the licensing conditions for swing beds is the following:  “eligible hospitals are allowed a total of 1,460 days of swing bed use per year, provided that no more than ten hospital beds are used as swing beds at any one time.  The commissioner of health must approve swing bed use beyond 1,460 days as long as there are no Medicare certified skilled nursing facility beds available within 25 miles of that hospital.”

Patti Cullen
952.851.2487
pcullen@careproviders.org

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CMS Revising Life Safety Code Protocol
By Pam Guyer

The Centers for Medicare & Medicaid Services (CMS) is revising the State Operations Manual (SOM) Appendix I survey protocol for the Life Safety Code (LSC).  According to CMS, the revisions are being made in order to "provide guidance to surveyors to better implement the requirements of the 2000 LSC during fire safety surveys…and to ensure consistency in the survey process across the country."  CMS also is changing the format of Appendix I to resemble that of the Appendix P survey protocol for the health survey.  For example, the draft includes 6 numbered tasks such as Off-Site Survey Preparation, Entrance Conference, and Information Analysis and Decision Making.

The American Health Care Association (AHCA) submitted comments on the draft protocol to CMS on January 16, 2004.  AHCA’s comments include identifying areas of inconsistency in the draft, sections that do not match or exceed the 2000 LSC, protocols that are unnecessary or confusing, and instructions for decision making that conflict with CMS’ established protocol.  To view AHCA’s comment letter and CMS’ proposed protocol, please click here.

At a later date, AHCA will have an opportunity to comment on a revised LSC interpretive guidance that is currently going through the CMS revision and internal clearance process.

Pamela Guyer
952.851.2485
pguyer@careproviders.org

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CMS Drafts Severity Guidance for Specific Deficiencies
By Pam Guyer
Your Comments can be sent to AHCA.

The Centers for Medicare & Medicaid Services (CMS) and its contractor American Institutes for Research (AIR) released two additional drafts in the series of surveyor guidance they are developing for determining the severity of deficiencies at specific F tags. The newly released drafts provide guidance for the requirements at F501 Medical Director and F520/F521 Quality Assessment and Assurance ((QA&A). As with the pressure ulcer and incontinence draft guidance released for comment last fall, these drafts were developed with the help of expert panels. CMS asked the American Health Care Association (AHCA) and other stakeholders for their review and comments on the new drafts. AHCA will be submitting comments to CMS. If you have comments you would like included, please forward to:jmyder@ahca.org
Comments are due to CMS by April 26, 2004 so be sure to allow plenty of time when forwarding them on to AHCA. 

The CMS drafts are in a PDF file online. The attachment contains a cover memo from Thomas Hamilton, Director of the CMS Survey and Certification Group; ¡§Tips for Reviewers;¡¨ Attachment A, lists of expert panel members that helped to develop the drafts; Attachment B, the draft guidance for Medical Director and QA&A; and Attachment C, Severity Grid for Rating Nursing Home Deficiencies.

Medical Director
Pages 1-7:

• Statement of intent of the regulation at 42 CFR 483.75(i)
• Definitions
• Overview
• Medical Direction (Roles of the medical direction)
• Survey Process

Pages 8-10:

• Investigative Protocol (This is the first time that CMS has drafted such a protocol for the medical director requirement.)
• Determination of compliance (Task 6 decision making)

Pages 11-13:

• Deficiency categorization according to severity levels 1-4; criteria for deciding which levels apply to deficiencies at F501
  Quality Assessment and Assurance (QA&A)
  The draft changes will appear in Appendix P survey protocol and Appendix PP survey guidance. Current Task 5F for QA&A will be replaced by the suggested text in the draft. F tags 520 and 521 and corresponding requirements will be combined into one F tag F520.

Pages 14-16:

• New Task 5F
• Statement of intent of the regulation at 42 CFR 483.75.
• Definitions
• Overview of the purpose of Quality Improvement and related resources

Pages 17-21:

• Quality Assessment and Assurance Committee composition, functions and processes Pages 22 V 23:
• Investigative Protocol (This is the first time that CMS has drafted such a protocol for QA&A requirements.)
• Determination of compliance (Task 6 decision making)

Pages 24-25:

• Deficiency categorization according to severity levels 1-4; criteria for deciding which levels apply to deficiencies at F520.

  Pamela Guyer
  952.851.2485
  pguyer@careproviders.org

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CMS Satellite Training Schedule
By Pam Guyer
View List of 2004 Sessions Available.

The Centers for Medicare and Medicaid Services (CMS) utilizes satellite, Webcasting and Internet based technologies to provide training and information to regional offices, state agencies and providers.  Some of the training sessions available cover topics such as hydration, pressure ulcers, incontinence, wound care, and decision making.  The satellite and Webcast programs average 2 ½ hours in length. There are dates on which each program is broadcast live.  After these dates, programs are archived and made available for viewing on the web for a period of time ranging from 30 days to one year, 24 hours a day, 7 days a week. If you are interested in seeing a more extensive live of training available, or for details on viewing the live broadcasts and archived programs go to the CMS web site at http://cms.internetstreaming.com/.

Pamela Guyer
952.851.2485
pguyer@careproviders.org

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The Billing Institute Held Starts Next Week
Jennifer Eyrich
This two-day program for Billing Office Professionals can save you time and money!

The staff in your billing office might not have a direct hand in patient care, but the work they do has a tremendous impact on your facility.  With the changing financial environment it’s more important than ever to have a well-informed billing staff.  The Billing Institute is a two-day program designed for the long-term care business office manager and their selected staff who manage the accounts receivable for their facility.   Private Pay, Medicare, Medicaid and Third Party Payers from private and long-term care insurance will be covered by a variety of expert speakers, along with plenty of time for questions and answers from participants.  Plus – All registrants will receive sample forms, resources and billing manuals, both in print and on CD-ROM.

The course facilitator is Nancy Curtis of Pathway Health Service.  Nancy has over 23 years experience in health care accounting, working in a variety of settings including housing, hospitals and nursing homes.  She has served as a field accountant overseeing the business office operations of numerous providers as well as a business office manager.  She is currently consulting on business office practices, policies and procedures as well as trouble shooting on specific accounting issues.

The Billing Institute (MN04-90412)
Mar 16 & 17, 2004
8:30 am – 4:30 pm (8:00 am Registration)
Room 114, Care Providers of Minnesota
$225 Members / $275 Non-Members

Register by clicking here, or by calling Nancy McCoy at 952.851.2494.

Jennifer Eyrich
952.851.2483
jeyrich@careproviders.org

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Spring Leadership Conference Registration Now Available
By Jennifer Eyrich
The "Big Event" for Spring will be held April 20 & 21 in St. Paul.

Do not miss the best two days of spring when Care Providers of Minnesota presents our Leadership Conference (formerly known as Spring Conference) designed with decision-makers in mind. 

In two jam-packed days we will cover a host of topics that range from managing your money to containing your risk, from increasing your quality to finding your fit.  Curious?  We hope so.  This two-day event promises to leave you full of great ideas, plans for new initiatives, opportunities for involvement and a myriad of fresh information that will make you wonder why anyone would miss it!

Members from around the state have offered their best efforts and energies to help make this conference timely, tactical and targeted to meet your needs as a provider.  We are inviting the best to teach and share their insights as well as their wisdom on “what’s next”.  This is the main event for spring, the gathering of our best minds bringing you the latest in business innovation and healthcare practices.  Put it on your calendar, bring your leadership team and look forward to a fabulous time for learning, networking and moving forward!

In addition to great educational programming, day one of the conference will also feature a trade fare.  If you are interested in exhibiting at this event, contact Jennifer Eyrich at 952-851-2483 or jeyrich@careproviders.org.

Click here to register or contact Nancy McCoy at 952-851-2494.

Spring Leadership Conference (MN04-90416)
Tuesday & Wednesday, April 20 & 21, 2004
Day 1:  9:00 am – 6:00 pm
Day 2:  9:00 am – 4:15 pm
8:30 am Registration both days.

Holiday Inn St. Paul East
2201 Burns Ave (I-94 and McKnight Rd.)
St. Paul  55119

$300 Members / $375 Non-Members
CEU available:  11.5 (for Nursing Home Administrators)

Jennifer Eyrich
952.851.2483
jeyrich@careproviders.org

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Spring Video Training Special from Caresource
By Jennifer Eyrich
Update your video training library and save with this member special from Caresource.

Caresource, in cooperation with CPM, is offering a series of three training videos at specially discounted prices through May 31. The three programs are:

Managing Difficult Resident Behavior
20 min. VHS, Plus 16-page Presenter's Guide

Activities of Daily Living – 9 Ways to Do Them Safely
20 min. VHS, Plus 16-page Presenter's Guide

Balancing Act – Your Fall Prevention Program
24 min. VHS, Plus Presenter's Guide

These programs are normally priced at $179 each for non-members and $149 each for members. Through May 31, you may order any one of these tapes for $99, any two for $159, or all three for $199. Shipping and handling, normally 10%, will be waived on credit card and prepaid orders.

To order, phone 800-448-5213 or click here.

You must use the code A-3 or CPM when you order to take advantage of the discount price.

Jennifer Eyrich
952.851.2483
jeyrich@careproviders.org

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Board of Directors To Review Latest Financial Data
By Todd Bergstrom
2003 LTC Imperative Financial Study completed.

On Thursday, March 18, 2004, Larson, Allen, Weishair & Co., LLP will present the results of the 2003 Long-Term Care Imperative Financial Survey to the Care Providers of Minnesota Board of Directors.

Members who would like a preview of the presentation may visit our website here.

Todd Bergstrom
952.851.2486
tbergstrom@careproviders.org

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Member Visit - Good Shepherd Care Center
By Janet Nicol
A multicultural facility.

Good Shepherd Care Center is tucked into a hill on Johnson Parkway just south of I94 in Saint Paul.    Built in the early 60’s, this facility which currently has 141 beds originally housed 300 residents.  According to Administrator, Mary Roy, downsizing has allowed them to increase the number of private rooms to 59 and also provided additional office space and common space.  Good Shepherd has a 31 bed transitional care unit and  a behavior unit.  In addition, the Garden Level provides a special environment for resident’s with dementia/Alzheimer’s disease. 

Mary described Good Shepherd as being a multicultural facility and noted that they are working to build partnerships with the surrounding community.  They are particularly proud of the informal partnership they have developed with Earth Star Project which serves American Indian elders.  They have devoted one section of the facility to this project and have begun to decorate this unit with Native American art.  Mary mentioned that they a large number of Native American Volunteers who continue to assist with this unit. In addition, Mary noted they consistently have a significant number of Laotian clients.  They plan to continue to seek new partnerships with the community. 

Janet Nicol
952.851.2489
jnicol@careproviders.org

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Member Visit - Texas Terrace Care Center
By Janet Nicol
Focusing on rehabilitation.

 Texas Terrace Care Center was built in the early ‘70’s.  In 1996 an addition was built for rehabilitation services.  They are proud of their therapy department which provides outpatient therapy in addition to serving the needs of their residents.  Texas Terrace is a very community based facility.  Administrator, Ernie Gershone, grew up in the area and feels this has allowed him to develop closer ties between the community and the facility.  The community is older and thus it is very important to  maintain a high visibility in the community. 

Ernie notes that Garden Terrace, their dementia program, is very well known in the community.  They are now partnering with the Struthers  Parkinson’s Center to provide staff training related to the care of their residents with Parkinson’s disease.  Texas Terrace continues to serve the Jewish Community in St. Louis Park.  In addition they often have ten or more Russian speaking residents – fortunately they also have staff that speak Russian.  Ernie is particularly proud of the low turnover within the staff.

Janet Nicol
952.851.2489
jnicol@careproviders.org

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Send Us Your News!
By Bill Gray
Member News Section is all about YOU!

Our Member News section is intended to give you an opportunity to share your news with the rest of the Care Providers of Minnesota community.  If you have something you'd like to share, be sure to let us know so we can pass the word along.  Contact Nathaniel Davis at the Association office.

We want to be your source for letting the profession know about your successes.  In our profession, good press is worth sharing!

Bill Gray
952.851.2490
bgray@careproviders.org

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U of M Invites Health and Housing Professionals To Distinguished Lecture in Aging
April 2, 2004.

The University of Minnesota Center on Aging has scheduled Mary Tellis-Nayak, President and CEO of the American College of Health Care Administrators, to give a Distinguished Lecture in Aging, a program developed to address the challenges of translating research into practice for an aging society. The lecture is scheduled for Friday, April 2nd from 8:30 am - 10:00 am at Walker Methodist Health Care Center, 3737 Bryant Avenue South, in Minneapolis, Minnesota.

Her topic, Creating the Long-Term Care Leadership for the Future, will address the training, skills and professional rewards needed to attract new talent and retain experienced professionals who are responsible for creating high quality living environments for older adults. Nayak argues the traditional long-term care model has fostered compliancy managers and does not fit the future of aging services. She says creating a new focus requires listening to the voices of administrators and directors of nursing. It also demands a thorough examination of research aimed at understanding the characteristics of the eldercare leader and a willingness from the long-term care community to support the development of new leadership and training programs.

A continental breakfast will be served. Providers may register for the free-of-charge presentation by contacting Dean Neumann, Center on Aging Provider Liaison, at 612-624-7990 or dneumann@umn.edu. (Parking and driving directions will be sent to those who register).

Nathaniel Davis
952.851.2491
ndavis@careproviders.org

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Enhanced Quality Measures Conference Call Hosted by Stratis Health
By Nathaniel Davis

The Centers for Medicare & Medicaid Services unveiled in January 2004 an updated Nursing Home Compare website that includes enhanced quality measures and easier navigation at www.medicare.gov.  The enhanced measures are part of CMS' ongoing commitment to use public reporting to improve the quality of care available in the nation's nursing homes.

Stratis Health is hosting a free conference call for Minnesota Nursing Homes introducing the CMS Enhanced Quality Measures on March 23 12:00-1:00 p.m., or on March 25 2:00-3:00 p.m.

Registration is available online at www.stratishealth.org or by contacting Barb Olson at 952-853-8503.

Nathaniel Davis
952.851.2491
ndavis@careproviders.org

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MNDONA President Testifies at HHS Hearing
By Pat Oss, MNDONA Secretary

Juli Miller, President of the Minnesota Directors of Nursing of Long-Term Care Association, testified February 25th at the Health and Human Services Policy hearing chaired by Rep. Boudreau.  Juli's remarks focused on the negative impact that the current survey process has on not only the nursing director but the entire staff of a facility.  She also noted that Minnesota has a much higher number of deficiencies than the surrounding states, and that we are 10th in the nation for the number of deficiencies cited, per information furnished by the Minnesota Department of Health. 

Ms. Miller is also a member of Commissioner Mandernach's "Kitchen Cabinet".  She is serving on the sub-committee that is focusing on survey findings and review with a goal to analyze trends in current and historical survey findings, identify underlying causes and work together with all stakeholders to focus on areas that will truly improve the quality of care in our state.

Nathaniel Davis
952.851.2491
ndavis@careproviders.org

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Bill Introductions
By Patti Cullen
Week of March 8, 2004.

Bills Introduced in the Senate

Senator Kiscaden introduced--
S.F. No. 2610: A bill for an act relating to health; requiring a study of alternatives for providing regulatory oversight of nursing homes.  Referred to the Committee on Health and Family Security.  Patti Cullen

Senator Rosen introduced--
S.F. No. 2625: A bill for an act relating to counties; providing for a rate increase determination for the Martin County nursing facility; amending Minnesota Statutes 2002, section 256B.431, by  adding a subdivision.  Referred to the Committee on Health and Family Security.  Patti Cullen

Senator Vickerman introduced--
S.F. No. 2636: A bill for an act relating to human services; changing a nursing facility payment rate; amending Minnesota 2002, section 256B.431, by adding a subdivision. Referred to the Committee on Health and Family Security.  (Companion Bill is H.F. 2849.)  Patti Cullen

Senator Kiscaden introduced--
S.F. No. 2667: A bill for an act relating to human services; changing the effective date for provisions allowing the continuation of a recipient's life estate or joint tenancy interests for purposes of medical assistance recoveries; requiring the commissioner of human services to refund money recovered; amending Minnesota Statutes 2003 Supplement, sections 256B.15, subdivision 1; 514.981, subdivision 6.  Referred to the Committee on Health and Family Security.  (Companion Bill is H.F. 2525.)  Jon Lips

Senator Higgins introduced--
S.F. No. 2675: A bill for an act relating to human services; clarifying medical assistance coverage of skilled nursing facility and hospice services for dual eligibles; amending Minnesota Statutes 2002, section 256B.0625, by adding a subdivision.  Referred to the Committee on Health and Family Security.  Jon Lips

Senator Ruud introduced--
S.F. No. 2708: A bill for an act relating to human services; requiring nursing facility case-mix payment rates to be based upon statewide averages; amending Minnesota Statutes 2002, sections 256B.431, by adding a subdivision; 256B.434, by adding a subdivision.  Referred to the Committee on Health and Family Security.  (Companion  Bill is H.F. 2507.)  Patti Cullen

Senators Lourey and Anderson introduced--
S.F. No. 2717: A bill for an act relating to health; increasing the required nursing hours in nursing homes under specified circumstances.  Referred to the Committee on Health and Family Security.  (Companion Bill is H.F. 2866.)  Patti Cullen

Senator Pappas introduced--
S.F. No. 2786: A bill for an act relating to human services; creating an exception to the intermediate care facility for persons with mental retardation and related conditions payment system; amending Minnesota Statutes 2002, section 256B.5012, by adding a subdivision.  Referred to the Committee on Health and Family Security. (Companion Bill is H.F. 2851.)  Patti Cullen

Bills Introduced in the House

Simpson introduced:
H. F. 2805, A bill for an act relating to health; requiring approval of an exception to the moratorium on certification of nursing home beds; appropriating money.  The bill was read for the first time and referred to the Committee on Health and Human Services Policy.)  Patti Cullen

Nelson, P. introduced:
H. F. 2814, A bill for an act relating to human services; modifying procedures for calculating nursing facility operating payment rates for a project approved under the moratorium exception process; amending Minnesota Statutes 2002, section 256B.43, by adding a subdivision.  The bill was read for the first time and referred to the Committee on Health and Human Services Policy. Patti Cullen

Harder introduced:
H. F. 2849, A bill for an act relating to human services; changing a nursing facility payment rate; amending Minnesota 2002, section 256B.431, by adding a subdivision.  The bill was read for the first time and referred to the Committee on Health and Human Services Finance.  (Companion Bill is S.F. 2636.)  Patti Cullen

Mariani introduced:
H. F. 2851, A bill for an act relating to human services; creating an exception to the intermediate care facility for persons with mental retardation and related conditions payment system; amending Minnesota Statutes 2002, section 256B.5012, by adding a subdivision.  The bill was read for the first time and referred to the Committee on Health and Human Services Finance. Patti Cullen

Huntley and Thao introduced:
H. F. 2866, A bill for an act relating to health; increasing the required nursing hours in nursing homes under specified circumstances. The bill was read for the first time and referred to the Committee on Health and Human Services Policy.  Patti Cullen

Huntley introduced:
H. F. 2891, A bill for an act relating to health; providing for the protection of conscience and religious liberty in health care; proposing coding for new law in Minnesota Statutes, chapters 62Q; 145.  The bill was read for the first time and referred to the Committee on Health and Human Services Policy.  Jon Lips

Gunther, Swenson, Harder and Cornish introduced:
H. F. 2931, A bill for an act relating to counties; providing for a rate increase determination for the Martin County nursing facility; amending Minnesota Statutes 2002, section 256B.431, by adding a subdivision.  The bill was read for the first time and referred to the Committee on Health and Human Services Finance.  (Companion Bill is S.F. 2625.)  Patti Cullen

Samuelson, Nornes and McNamara introduced:
H. F. 2941, A bill for an act relating to health; requiring a study of alternatives for providing regulatory oversight of nursing homes.  The bill was read for the first time and referred to the Committee on Health and Human Services Policy.  (Companion Bill is S.F. 2610.)  Patti Cullen

Samuelson introduced:
H. F. 2942, A bill for an act relating to human services; modifying nursing facility case mix calculations; amending Minnesota Statutes 2002, sections 144.0724, subdivisions 3, 4; 256B.438, subdivision 4.  The bill was read for the first time and referred to the Committee on Health and Human Services Finance.  (Companion Bill is S.F. 1876.)  Patti Cullen

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