Indiana Health Care Association

IHCA Announces New President

noreply@blogger.com (Indiana Health Care Association) — Tue, 15 Jun 2010 19:41:00 +0000

The Indiana Health Care Association is pleased to announce its new President. Scott Tittle takes over for outgoing President Steve Smith.

Mr. Tittle comes to the Association from Krieg DeVault's Government Affairs, Health Care, and Business Practice Groups. He counsels clients on all aspects of government relations, including the American Recovery and Reinvestment Act of 2009, and health care, regulatory and business legal matters.

Mr. Tittle previously served as Health Care Policy Director to Indiana Governor Mitch Daniels where he was responsible for executing the Governor's health care initiatives through the Indiana General Assembly and the State's health-related agencies.

Survey on the Recruitment and Retention of Indiana's Long Term Care Workers

noreply@blogger.com (Indiana Health Care Association) — Fri, 26 Mar 2010 18:47:00 +0000

View the results of the IHCF and Indiana University's Survey on the Recruitment and Retention of Indiana's Long Term Care Workers here.

Letter to the Editor

noreply@blogger.com (Indiana Health Care Association) — Mon, 08 Mar 2010 16:43:00 +0000

Letter to the Editor
Stephen A. Smith
President, Indiana Health Care Association

The article entitled “Crisis of Care” that appeared in the Sunday, March 7th edition of your paper suggested the care provided in each of Indiana’s for-profit nursing homes was suspect, due entirely to their motivation to achieve an economic gain. IHCA agrees that there is a “crisis of care” in Indiana nursing homes, but implying that the “for-profit” nature of the majority of the providers engaged in providing this type of service is the cause is simply misleading to your readers. The fact that 52 Indiana facilities appeared on the GAO list of poorest performing nursing homes should be a call to action for all stakeholders, not just the for-profit nursing home operators and ownership groups.

What if the “crisis” being described in your story referred to education and not to nursing home care? If you were the parent of a student who was in a class that had the highest failure rate, lowest graduation rate, or lowest test scores of any school system in the country, you would not immediately assume that all of the students were failing, you would assume that the system was failing the students. You would also not assume that the issue would be resolved by providing fewer resources to the failing schools or limiting their options to resolving the issue. However, this is exactly what it taking place in Indiana nursing homes.

For-profit nursing homes in Indiana serve a higher proportion of low-income patients than non-profit nursing homes and are reimbursed less for providing that care. In fact, approximately two-thirds of residents of for-profit nursing homes in Indiana utilize Medicaid to pay for their care. In addition, for every 100 nursing home residents who utilize the Medicaid program to pay for nursing home care in Indiana, 89 are residents of for-profit nursing homes. Medicaid reimbursement currently falls short of meeting costs for these residents by an average of $7/day. In part this is due to an arcane and complex reimbursement system that limits the amount a nursing home can be reimbursed for staff costs, exactly the issue that was cited as the core of the “crisis of care”.

These financial conditions contribute significantly to Indiana having turnover rates for nurses and certified nursing assistants (CNA) that far exceed the national average. Over 90% of all Indiana CNAs change jobs – on average – each year. This undoubtedly has an impact on patient care, but finding a direct solution to this problem will not occur until all stakeholders agree that staff turnover is the real issue to improving the quality of care, and offer real, common sense solutions to reduce staff turnover and improve staff retention. This will require a departure from the historical response of penalizing the providers of nursing home care. Reducing the amount of resources available to solve the problem will obviously not solve the problem.

Finding these solutions now is critical for two reasons. First of all, as we are constantly reminded in the press, the proportion of our population considered “seniors” will roughly double in the next 25 years, and will undoubtedly put an additional financial strain on the long-term care system in Indiana. Second, assuming a staff-to-patient ratio of roughly 1:1, there are over 40,000 Hoosiers employed by nursing homes statewide, a total that now exceeds the number of employees in the state’s automobile industry. Without securing the financial future of these employees we will see a continued erosion of financial conditions in many areas of our state, especially in some rural areas where the local nursing home is one of the largest local employers and economic generators in the community.

There is a genuine crisis of care in Indiana nursing homes, and this is most obvious to the nursing home owners and operators. To focus entirely on for-profit nursing homes ignores the symptoms of the problem and places blame disproportionately on one of the many stakeholders in the process. All stakeholders must be held accountable in order for real reform of the system to occur.

The vast majority of Indiana nursing homes provide a loving, caring environment that maintains or improves the quality of life of their residents. The best way for someone to choose – or evaluate – an Indiana nursing home is to visit one. According to AARP, “The most important element of the selection process, according to the experts, is a personal visit—preferably more than one—to any nursing home you’re considering”. Medicare’s “Nursing Home Checklist” is based almost entirely on a personal visit, and makes no mention of Five-Star ratings, GAO reports, or state survey results as part of their evaluation criteria. The reason is simple: People are the most important part of nursing home care and you can’t experience the people without experiencing the place.

IHCA Member Receives "Best Place to Work in Indiana"

noreply@blogger.com (Indiana Health Care Association) — Wed, 24 Feb 2010 14:26:00 +0000

February 22, 2010 (INDIANAPOLIS) — A total of 70 Hoosier companies from throughout the state are being honored this year as a “Best Place to Work in Indiana” for their strong workplace environment that values employees. The program, now in its fifth edition, is managed by the Indiana Chamber of Commerce.

Forty-seven of the 70 companies received the same designation last year. For 21 companies that made the 2010 list, it was their first time taking part in the evaluation.

The program honors the top companies in the state, as determined through employer reports and comprehensive employee surveys. Winners were selected from two categories: small to medium-sized companies of between 25 and 249 employees (in Indiana or total nationally if there is a parent company) and large-sized companies consisting of 250 or more employees (in Indiana or total nationally if there is a parent company). Out-of-state parent companies were eligible to participate if at least 25 full-time employees are in Indiana.

The Best Companies Group, which handled the selection process, oversees similar programs in 19 other states.

“These 70 companies are among the state’s first-rate employers who take pride in creating an environment that allows workers to feel respected and be productive; they also recognize how this then helps the company be successful and reach its goals,” offers Indiana Chamber President Kevin Brinegar.

“Considering the tough economic times of the past year-plus, it was especially encouraging to see so many Hoosier companies fitting the criteria, as well as so many new companies taking part in the evaluation. That confidential feedback from employees is invaluable and really the most important aspect of the process.”

The actual rankings of the top Hoosier companies will be announced at the Best Places to Work awards dinner on May 6 at the Indiana Roof Ballroom in downtown Indianapolis. Winners will also be recognized via a special section of the Indiana Chamber’s bimonthly BizVoice® magazine and through Inside INdiana Business with Gerry Dick – both of which reach statewide audiences. The 2010 Best Places to Work in Indiana awards dinner is open to the public. Individual tickets and tables are available at http://www.indianachamber.com/.

Additionally, earlier in the day, a session on what makes a company a Best Place to Work will be featured as part of the Indiana Chamber’s 46th Annual Human Resources Conference. To register to attend this HR session, visit http://www.indianachamber.com/.

All companies that participated in the 2010 Best Places to Work program receive an in-depth evaluation identifying strengths and weaknesses according to their employees. In turn, this report can be used in developing or enhancing employee retention and recruitment programs.
For more information on the Indiana Chamber’s Best Places to Work program, go to http://www.bestplacestoworkin.com/.

Best Places to Work in Indiana program sponsors for 2010: Blue Chip Casino; Castle Wealth Advisors, LLC; Crowe Horwath LLP; Image Air Charter; Mussett, Nicholas & Associates; Saint Clair Press; Tilson HR; and Trilogy Health Services. Additional industry-exclusive sponsorships are still available. E-mail jwagner@indianachamber.com for more details.

The 2010 Best Places to Work in Indiana companies listed in alphabetical order, no ranking:
Large Companies (250 or more employees)

AIT LaboratoriesIndianapolis
American Structurepoint, Inc.
IndianapolisAprimo, Inc. Indianapolis
Ash Brokerage CorporationFort Wayne
Blue & Co., LLCCarmelBrotherhood Mutual Insurance CompanyFort Wayne
Centier BankMerrillville
Clark Memorial HospitalJeffersonville
Colliers Turley Martin TuckerIndianapolisColumbus
Regional HospitalColumbus
Crowe Horwath LLPIndianapolis
Draper, Inc.Spiceland
Edward JonesPlainfield
ExactTargetIndianapolis
Fort Wayne Metals Research Products Corp.Fort Wayne
Hall Render Killian Heath & Lyman PCIndianapolis
Hancock Regional HospitalGreenfield
Harrison CollegeIndianapolis
Hendricks Regional HealthDanville
Hilliard LyonsEvansville
Hosparus Inc.New Albany
Ice Miller LLPIndianapolis
Interactive Intelligence, Inc.Indianapolis
Katz, Sapper & MillerIndianapolis
KPMG LLPIndianapolis
M&I BankIndianapolis
Microsoft CorporationIndianapolis
Ogletree Deakins Law FirmIndianapolis
OneAmerica Financial Partners, Inc.Indianapolis
Parkview HealthFort WayneRCICarmel
RW ArmstrongIndianapolisSchneck Medical CenterSeymourS
hiel Sexton Company, Inc.Indianapolis
St. Joseph HospitalKokomo
St. Vincent Health, Corporate CenterIndianapolis
Teachers Credit UnionSouth Bend
The Capital Group Companies, IncIndianapolis
Trilogy Health Services, LLCPetersburg
Turner Construction Company of Indiana, LLC
IndianapolisUnion Hospital, Inc.Terre Haute
WestPoint Financial GroupIndianapolis

Small to Medium-sized Companies (25-249 employees)
Company Location
Allegient, LLCIndianapolis
Bamberger, Foreman, Oswald and Hahn, LLPEvansville
Benefit Associates Inc.Indianapolis
Bernardin, Lochmueller and Associates, Inc.Evansville
Bingham McHale LLPIndianapolis
Communications Products, Inc.Indianapolis
Contact by DesignBloomington
Design Collaborative, Inc.Fort Wayne
Eli Lilly Federal Credit UnionIndianapolis
Employment Plus, Inc.Bloomington
Energy Systems Group LLCNewburgh
First Harrison BankCorydon
Fusion Alliance, IncIndianapolis
Gordon MarketingNoblesville
Harding Poorman Group, Inc.Indianapolis
IndesignIndianapolisIndiana Organ Procurement Organization Indianapolis
International Medical Group, Inc.Indianapolis
J.C. Hart Company, Inc.Carmel
Krieg DeVault LLPIndianapolis
Matrix Integration, LLCJasper
Milestone Contractors, LP
IndianapolisMJ Insurance, IncIndianapolis
Public Safety MedicalIndianapolisSchmidt AssociatesIndianapolis
Software Engineering ProfessionalsCarmel
Somerset CPAsIndianapolisUnited ConsultingIndianapolis

Source: Indiana Chamber of Commerce

IHCA Launches New Administrator Training Tool

noreply@blogger.com (Indiana Health Care Association) — Thu, 04 Feb 2010 14:28:00 +0000

InsideINdianaBusiness.com Report
A new online training and certification program is now available for administrators in the health care field. The Indiana Health Care Association says the program is the only state certified online preceptor training course, created with the goal of providing administrators the highest quality training possible. The program offers audio, animation and in-course quizzes and will be worth six continuing education credits for administrators.

IHCA Launches Online Preceptor Course for Nursing Home Administrators

noreply@blogger.com (Indiana Health Care Association) — Wed, 03 Feb 2010 21:58:00 +0000

Indianapolis, IN- Today the Indiana Health Care Association (IHCA) launched the only state certified online preceptor training course. A first-of-its-kind, the online training and certification includes audio, animation and in-course quizzes to insure administrators receive the highest quality training possible.

IHCA President Stephen Smith lauded the program noting, "administrators utilizing this dynamic new product will retain knowledge they gain much better, and thus be able to apply it to the workplace in a more effective manner while saving time and money."

Smith added, “it is also our hope more administrators will become preceptors through our program allowing for more administrators in training.”

The online program offers 24/7 accessibility providing convenience for administrators needing to take the course on their own schedule. In addition, the program’s certification is valid statewide, and has been approved for six continuing education credits. Administrators will need to complete the course every five years to maintain their certification.

IHCA strives to offer its members affordable and exceptional training and education programs that minimize or reduce training costs. By partnering with Hopkins Associates and Upstairs Solutions, IHCA is able to better train the long term care workforce.

“This course is written with the busy administrator in mind and includes tips on how to draw from your own experience. Content is both comprehensive and practical and includes specific guidance on how to teach your AIT,” said Elaine Hopkins of Hopkins Associates.

Hopkins Associates assembled a development team comprised of individuals who are both experienced practitioners and professional educators. The result is an eight-module online training course with content that is both comprehensive and clear in demonstrating the practical application. The eight-module course incorporates subject areas including, but not limited to, Medical Director, MDS staff, Aspects of Aging, Marketing & Sales, Insurance, Legal Aspects, Public Relations, Corporate Compliance, HIPAA, Abuse Prohibition, Resident Rights, Standards of Competent Practice, and Differentiating Leadership, Management and Supervision.

Upstairs Solutions is providing web-based learning management services and hosting the courses in their high-availability data center. Participants will have secure individual accounts, take online exams after each module, and may print certificates of completion immediately upon completing the training, offering fast turnaround. IHCA staff will be able to track and report on student progress, and Upstairs Solutions will provide any needed technical support.

”This program is a significant addition to the online curricula available for nursing home administrators,” said Tamar Abell, Principal and co-founder of Upstairs Solutions. “We are delighted to help IHCA bring it to life and support them in this innovative project.”

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About the Indiana Health Care Association (IHCA)
The Indiana Health Care Association is Indiana's largest trade association and advocate representing proprietary, not-for-profit and hospital-based nursing home and assisted living communities, adult foster care and adult day services. IHCA's 264 member facilities care for more than 25,000 of Indiana's geriatric and developmentally disabled citizens, the majority of whom are low-income Medicaid recipients. To learn more about IHCA, visit http://www.ihca.org/.

About Hopkins Associates
Hopkins Associates is a training and consulting group founded in Evansville, Indiana, in 1993 and currently based in Canton, Ohio. The company has logged over 200,000 training hours in more than 70 companies for some 6,000 participants. Extensive work has been in the banking and health care environments as well as educational, retail and manufacturing settings. The company website is http://www.hopkinsassociates.com/ .

About Upstairs Solutions
Upstairs Solutions assists senior facilities with compliance and excellence in staff training, continually raising the bar in senior care quality. UpstairsSolutions.com currently offers more than 100 online learning modules for the elder care community as well as a sophisticated learning management system to help track employee training. Two nursing home administrators formed Upstairs Solutions originally to train their own staffs, and today the fast-growing company provides e-Learning to facilities nationwide. To learn more please visit http://www.upstairssolutions.com/

Major Health Care Hurdle Possibly Cleared

noreply@blogger.com (Indiana Health Care Association) — Tue, 19 Jan 2010 19:32:00 +0000

InsideINdianaBusiness.com Report

Ice Miller LLP Partner Kevin Woodhouse outlines why a deal on the "Cadillac" tax is a significant step in the health care debate.

A partner in Ice Miller LLP's health care practice says an apparent deal on a "Cadillac" tax for high-cost insurance plans could move federal lawmakers closer to a final bill on health care reform. Kevin Woodhouse tells Inside INdiana Business the agreement involves an exemption for union members' negotiated health plans until 2017 or 2018. He says an announcement on the deal could come at any time.

The tax, which is only included in the bill that passed the Senate, and other issues surrounding the national health care reform debate will be examined Thursday during a forum being held by Ice Miller and the Indiana Chamber of Commerce.

Woodhouse says several matters, including abortion, still have not been resolved.
He believes federal lawmakers could still have a compromise between the Senate and House health care bills in place by President Barack Obama's State of the Union address on January 27.
The effort could be complicated by today's special election in Massachusetts to replace Senator Edward Kennedy. Democrats could lose their majority in the Senate, if the party's candidate does not win.

That could lead to Republicans trying to block passage of a health care reform bill in the Senate.
Source: Inside INdiana Business, Ice Miller LLP

Kindred Healthcare to Build in Westfield

noreply@blogger.com (Indiana Health Care Association) — Wed, 13 Jan 2010 14:59:00 +0000

LOUISVILLE, Ky.-- Kindred Healthcare, Inc. (the “Company”) (NYSE:KND) today announced plans for a replacement hospital, the opening of a new hospital, development of six new hospital-based subacute units and a new transitional care center in several of its key markets in Texas, Florida, California, Ohio, Indiana and Washington. Once completed, these projects will expand the Company’s capacity to provide a continuum of post-acute care by approximately 130 long-term acute care (“LTAC”) hospital beds, approximately 150 subacute beds and approximately 150 skilled nursing beds. In addition, the Company announced development plans for its Peoplefirst HomeCare and Hospice business in Ohio and Massachusetts.

“These projects reflect our commitment to continuing to develop high quality, cost-effective healthcare services in markets that we believe can benefit from the continuum of post-acute care services and clinical expertise provided by Kindred Healthcare”

Houston, Texas
The Company has signed a letter of intent to lease a new freestanding 72-bed LTAC hospital in the Houston market. This hospital will replace the existing Kindred Hospital Bay Area. The Company plans to convert the current Kindred Hospital Bay Area into a subacute facility pending certain regulatory approvals and renovations. The new Kindred Hospital Bay Area will feature all private rooms and a 12-bed intensive care unit as well as a large procedure/treatment room. Pending state approval, the Company anticipates opening the new hospital in the second quarter of 2010. In addition, the Company plans to develop a 28-bed co-located hospital-based subacute unit at its 110-bed Kindred Hospital Houston, which is located in the Houston Medical Center. Following the opening of these facilities, the Company will have three hospitals and two subacute units in the Houston market.

Dallas, Texas
The Company plans to develop a 32-bed co-located hospital-based subacute unit in its existing Kindred Hospital Dallas. The Company anticipates opening this subacute unit in the third quarter of 2011 pending certain regulatory and other approvals. Following the completion of this project, the Company will operate six hospitals and one co-located hospital-based subacute unit in the Dallas-Fort Worth market.
Melbourne, Florida
The Company has opened Kindred Hospital Melbourne, a 60-bed freestanding hospital in Melbourne, Florida. This is the Company’s tenth LTAC hospital in Florida.

Southern California
The Company has opened a 38-bed co-located hospital-based subacute unit within its Kindred Hospital Brea. The Company currently operates seven hospitals and one nursing and rehabilitation center in the Los Angeles-Orange County-Riverside market.

Cleveland, Ohio
The Company has entered into an agreement to acquire 108 skilled nursing beds from a regional healthcare provider, pending certain regulatory approvals. Pending certain regulatory approvals, the Company plans to transfer 30 of these skilled nursing beds to The Greens Nursing and Rehabilitation Center and 30 skilled nursing beds to an existing co-located hospital-based subacute unit at its Kindred Hospital Cleveland. The Company currently operates two LTAC hospitals, two nursing and rehabilitation centers, one co-located hospital-based subacute unit and an assisted living facility in the Cleveland market.

Indianapolis, Indiana
The Company intends to open a new 120-bed Transitional Care Center (licensed for skilled nursing care) in Westfield, Indiana, north of Indianapolis. The center will specialize in intensive short-term rehabilitation therapy. Pending certain regulatory approvals, the Company anticipates groundbreaking in the first quarter of 2010 and opening in the first quarter of 2011. The Company currently operates two LTAC hospitals, six nursing and rehabilitation centers and one hospice location in the Indianapolis market.

Seattle, Washington
The Company plans to convert a previously closed nursing and rehabilitation center in downtown Seattle into a 50-bed LTAC hospital to be renamed Kindred Hospital Seattle at First Hill that also will include a 30-bed co-located hospital-based subacute unit offering transitional care services. The Company expects to open this facility by the third quarter of 2011 after completion of renovations and the receipt of certain regulatory approvals. The Company also plans to reconfigure its existing 80-bed Kindred Hospital Seattle into a 30-bed LTAC hospital with a 30-bed co-located hospital-based subacute unit and rename it Kindred Hospital Seattle at Northgate. The Company expects to complete this conversion by the fourth quarter of 2010 after completion of renovations and the receipt of certain regulatory approvals. The Company currently operates two additional nursing and rehabilitation centers in the Seattle market.

Peoplefirst HomeCare and Hospice
The Company also announced that Peoplefirst HomeCare and Hospice has acquired the assets of Acclaim Hospice and Palliative Care with locations in the Columbus and Dayton, Ohio, areas. These locations continue to operate under the Acclaim name and generated revenues of approximately $9 million in 2009.

In addition, Peoplefirst HomeCare and Hospice is developing a new location in the Boston, Massachusetts, area. The Company expects to begin serving patients in this market by March 1, 2010. After the opening of the Boston location, Peoplefirst HomeCare and Hospice will serve five markets – Boston, Columbus, Dayton, Denver and Indianapolis.

Management Commentary
“These projects reflect our commitment to continuing to develop high quality, cost-effective healthcare services in markets that we believe can benefit from the continuum of post-acute care services and clinical expertise provided by Kindred Healthcare,” said Paul J. Diaz, President and Chief Executive Officer of the Company. “These markets are ideal settings in which to expand our service lines, commit capital to our cluster market strategy, and benefit from the increasing collaboration between our Health Services Division, Hospital Division and Peoplefirst Rehabilitation Services. Our cluster market strategy is providing us with new opportunities to share best clinical practices, reduce costs and offer a continuum of care that is beneficial to patients and families and attractive to third party payors.”

New Investor Presentation
In advance of the Company’s previously announced participation at the J.P. Morgan Healthcare Conference on January 13, 2010, the Company has posted a new investor presentation on its website, which is available at http://phx.corporate-ir.net/phoenix.zhtml?c=129959&p=irol-EventDetails&EventId=2660607.

About Kindred Healthcare
Kindred Healthcare, Inc. is a healthcare services company, based in Louisville, Kentucky, with annual revenues of over $4 billion and approximately 54,800 employees in 41 states. At September 30, 2009, Kindred through its subsidiaries provided healthcare services in 654 locations, including 82 long-term acute care hospitals, 222 skilled nursing centers and a contract rehabilitation services business, Peoplefirst rehabilitation services, which served 350 non-affiliated facilities. Ranked first in Fortune magazine’s 2009 Most Admired Companies “Health Care: Medical Facilities” category, Kindred’s mission is to promote healing, provide hope, preserve dignity and produce value for each patient, resident, family member, customer, employee and shareholder we serve. For more information, go to www.kindredhealthcare.com.
Source: Kindred Healthcare Inc.

FSSA Releases Details of New Eligibility System- The Hybrid System

noreply@blogger.com (Indiana Health Care Association) — Mon, 14 Dec 2009 17:20:00 +0000

INDIANAPOLIS (December 14, 2009) - Indiana's Family and Social Services Administration has been known for bad customer service, subpar timeliness, and high error rates in the way it determines eligibility for Medicaid, Food Stamps (SNAP) and Temporary Assistance for Needy Family (TANF) programs. From 1990 to 2002, Indiana was fined eight times for more than $60 million by the federal government for its failure to make decisions on SNAP eligibility in a timely manner. Thirty-five percent of the Medicaid long-term care applications (FFY 2003) and 25 percent of the TANF applications (FFY 2006) approved by FSSA contained errors, and in FFY 2005, FSSA paid SNAP recipients $33.9 million more than they were entitled.

It was this crisis that led Governor Mitch Daniels in 2005 to begin the process of developing a system that would serve our clients better by offering more options to apply, a more accountable and efficient system, and a better customer service environment. What was then called the Eligibility Modernization project was intended to change the eligibility system from one where modern forms of access, such as the Internet and interactive voice response (IVR) systems, were not available. A system where 48 percent of FSSA clients found it difficult to reach their caseworker and 15 FSSA employees, along with 21 of their co-conspirators were convicted of welfare fraud.

As is common knowledge, the Eligibility Modernization project did not achieve many of the goals it set out to accomplish. Timeliness and accuracy remained low, and clients often complained of poor customer service. As a result, earlier this year, Governor Daniels and Secretary Anne W. Murphy cancelled the state's contract with International Business Machines (IBM), the company that had served as the prime contractor for the Eligibility Modernization project.

Since cancellation, FSSA has been working tirelessly to develop a new system to determine eligibility that would incorporate the lessons learned from both the old, pre-modernized system and the modernized system. FSSA began by soliciting input from providers, clients, advocates, employees, and the general public. FSSA established an email address (hybridinput@fssa.in.gov) and received hundreds of responses from individuals sharing their experiences and suggestions. FSSA also received responses by mail from individuals who did not have access to email. Additionally, FSSA created a small working group of providers and advocates from all around the state to provide input to the Division of Family Resources' (DFR) team as they were developing a hybrid.

The Hybrid System, detailed here, is a direct result of the lessons learned from pre- and post-modernization; input from clients, advocates, providers and the general public; and the work done by DFR staff. As the pilot region rolls out, FSSA will continue its dialogue with clients, advocates, providers and the public by keeping the email address activated, and establishing advisory groups in each region as they roll-out to continually receive updates on how the Hybrid System is working.

The Hybrid Plan:

After considering many different regions, the Vanderburgh Region will be the first to roll-out sometime in January (the exact date will be released in a subsequent announcement). The Vanderburgh region contains Daviess, Dubois, Gibson, Knox, Perry, Pike, Posey, Spencer, Vanderburgh, and Warrick counties.

The largest difference between the Hybrid System and the modernized system will be an increased focus on face-to-face contact.

County office staff will be increased. This staff will transfer from the Service Centers (more information on staffing changes in Vanderburgh County and changes to the Service Centers are detailed below).

Team Concept: FSSA caseworkers (SEMs) and contractor staff will be formed into teams that will work together on cases.

Clients will be served by a team in their county (as opposed to the modernized system, where your case could be handled by employees from all over the state).

Each team member will have the personal knowledge to assist their clients with their case.
Teams will allow newer workers to be paired with more experienced workers to learn from their example.

The two-tiered system will remain.

Under the two-tiered system, a different employee approves benefits than the employee who processes the case. This adds more accountability and allows mistakes to be corrected early.

Each team will contain both tiers.

The two-tiered system has helped to eliminate claims of employee fraud since it was instituted.

The increased options to clients seeking to apply for benefits, make changes to their case, or receive information or help with their case will remain.

Clients will still be able to fax/mail documents.

Clients who wish to call and talk to one of their team members will have their calls automatically transferred to their local office rather than a centralized call center (as was the case in the modernized system).

Clients will still be able to call the IVR to receive information on their case 24 hours a day, 7 days a week.

Clients will still be able to apply on the internet and complete their application by using the electronic signature.

To reflect a shift to a more personalized, locally based system, FSSA will now be communicating directly with area providers and advocates.

In the modernized system, FSSA contracted outreach and problem resolution to a vendor. In the Hybrid System, FSSA will communicate directly on a regional basis with providers and advocates. (For regional contact information, go to http://www.in.gov/fssa/dfr/4081.htm)

Providers and advocates will also receive periodic updates from FSSA on any changes or relevant information.

In the Hybrid Regions:

Regional Managers will have more control of day-to-day operations.

There will also be a Deputy Manager and additional supervisors to help in the management of the local offices.

In the Vanderburgh Region: 20 employees will be transferred from the Service Center to the county offices.

The remaining employees in the Service Center will staff the Change Center.

Change Centers are regional centers that will handle:

Medicaid-only redeterminations

All changes related to cases in their region

Processing of Food Stamp Interim Reports

Hoosier Healthwise ApplicationsBenefit Recovery

Document Center

There will be a centralized document center charged with attaching documents to the
appropriate cases.

County Offices:

County Offices will be equipped to help clients with all aspects of their cases.

Clients can apply, fax, or scan documents

Clients may talk to one of their team members

Specialized workgroups will exist for the Aged, Blind, and Disabled population

Contract Information:

Rather than contracting with one large entity, as was done in the modernized system, FSSA is in the process of establishing individual contracts with its vendors.

This will allow FSSA more direct control and management of their contracts and will improve responsiveness and accountability.

The contracts being established by FSSA have these major features:

The contract lengths are shorter than the contract with IBM.

The contracts are predicate upon the contractors meeting performance measures

Time-line for Hybrid System implementation:There is no time-line. FSSA will watch the pilot region carefully to make sure the Hybrid System is working before it begins planning the next region. Once the next region is determined, FSSA will announce the choice to the public.
Additional Information:

All other counties will remain under the system they currently have. Clients should operate as usual until FSSA announces any changes coming to their county.

As the Hybrid Plan was being developed, FSSA remained in constant contact with its federal partners.

During the implementation of the Hybrid Plan in the Vanderburgh Region, FSSA will continue working to improve timeliness, accuracy, and the client experience in the remaining regions.

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Krieg DeVault Legislative Update

noreply@blogger.com (Indiana Health Care Association) — Fri, 11 Dec 2009 19:24:00 +0000

As you are aware, the Legislature has been hard at work, holding December hearings on a variety of issues that will be considered during the 2010 Legislative Session. Due to the short timeframe of the 2010 session, which requires the Legislature to adjourn by March 14, 2010, the Ways and Means Committee, the Tax and Fiscal Policy Committee and the Rules Committee all will hold hearings in December.

The Tax and Fiscal Policy Committee held two hearings on Senate Joint Resolution (SJR) 1, the constitutional amendment placing the tax caps already in state statute into the constitution. The committee did not have a quorum at the first hearing and so a second hearing was called to take official action. After hours of public testimony from trade associations and the general public, the committee approved the constitutional amendment 9-3, with Senator Connie Sipes (D-New Albany) joining the Republicans on the committee in voting yes. The other three Democrats voted no. Please find attached a copy of SJR 1 for your review.

The Ways and Means Committee has held two hearings and will hold a third hearing on Monday, December 14th to amend and vote on the legislation under consideration by the committee. In addition to hearing testimony on HJR 1, the constitutional amendment placing the tax caps already in state statute into the constitution, the House Ways and Means Committee has also held hearings on: House Bill 1003, Indiana Worker Preference on Public Works Projects, which requires contractors to employ a certain number of Indiana employees or risk losing contracts and House Bill 1004, Assessed Value of Homesteads and Farmland, which will place a cap on the increase in assessed valuation on a homestead or farmland in a given year. The committee will also hear House Bill 1003, Contracting of Public Assistance Eligibility on Monday, which prohibits the Family and Social Services Administration from contracting out certain intake functions for public assistance eligibility determination. Please find attached copies of these bills for your review. We will provide you an update on committee action next week, including any amendments added to legislation.

Also next week the House Rules Committee will hear testimony on House Bill 1001, Lobbyists, Campaign Contributions, authored by House Speaker Pat Bauer on Wednesday, December 16th. This legislation reduces the threshold for reportable expenses from $100 a day to $50 a day for legislative lobbyists. The legislation places a one-year "cooling off" period on legislators, barring them from lobbying the Legislature for 365 days after leaving office. The bill also prohibits campaign contributions for statewide elected offices during the Legislative Session and prohibits campaign contributions by individuals receiving contracts from the state. Please find this legislation attached for your review.

Legislation passing out of committee during December will be eligible for floor activity in the House and Senate on the first day of session. This means that the Legislature will be off to a very quick start in January when they reconvene for the 2010 session. As always, please do not hesitate to contact any member of our Government Affairs Team with any questions you may have.

Thank You,

Krieg DeVault Governmental Affairs Team

Phase II Final Rule Published

noreply@blogger.com (Indiana Health Care Association) — Fri, 11 Dec 2009 17:52:00 +0000

Today the Final Rule for Phase II was published in Indiana's Register.

Final Rule
LSA Document #09-215(F)
Amends 405 IAC 1-14.6-2, 405 IAC 1-14.6-4, 405 IAC 1-14.6-7, 405 IAC 1-14.6-9, 405 IAC 1-14.6-18, 405 IAC 1-14.6-21 and 405 IAC 1-14.6-23 through 405 IAC 1-14.6-25 to change the reimbursement methodology for nursing facilities and applicable definitions; add definitions of "allowed profit add-on payment" and "tentative profit add-on payment" and amend other definitions; change certain rate applicability dates, minimum occupancy rates,case mix index, the reimbursement to facilities that have more than eight ventilator-dependent residents, reimbursement for facilities that meet certain quality of care measures, special care unit reimbursement, and identify providers that are eligible for such special care unit reimbursement; change certain add-on applicability dates, allowable per day cost elements, the calculation of the administrative component, create allowed direct care component profit add-on in children's nursing facilities, define a new allowed direct and indirect care component profit add-on calculations, and a new allowed capital component profit add-on; change the end and effective dates of certain allowable compensation methodologies; change the end date of the collection of the quality assessment fee; and change the end date of the closure and conversion fund. Effective 30 days after filing with the Publisher.

Read more here: http://www.in.gov/legislative/iac/20091209-IR-405090215FRA.xml.pdf

Indiana Nursing Facility Medicaid Reimbursement Update “Phase II”

noreply@blogger.com (Indiana Health Care Association) — Tue, 17 Nov 2009 20:56:00 +0000

By Robert Thomas

The Select Joint Commission on Medicaid Oversight (SJCMO) approved the Family & Social Services Administration (FSSA) “Phase II” changes at its October 20, 2009, meeting. The rule which was published as LSA Document No. 09-215 in the May 2009 Indiana Register, received the support of all three long-term care trade associations at the September 30 meeting of the SJCMO. FSSA has indicated January 1, 2010, as the anticipated effective date of “Phase II.” Key elements of “Phase II” are:

Rebasing of the report card score add-on per diem based on each nursing facility’s latest published report card score as of the end of each state fiscal year (June 30). The revised add-on amounts are:

Report Card Score (RCS)Report Card Score Add-on Per Diem
0 - 82 $ 5.75
83 - 265 $5.75 – ((RCS – 82) x $0.03125)
266 & above $0

Note: The report card score add-on will not be subject to the Maximum Annual Increase (MAI) limitation.

Rebasing of the special care unit (Alzheimer’s unit) add-on per diem from $10.80 to $12.00 for each Medicaid resident day in the special care unit. The add-on per diem will be based on the resident assessment data (MDS) on file as of March 31 of each year and will be effective July 1 of each year.

Note: The special care unit add-on is subject to the MAI limitation.

For nursing facilities that qualify for the ventilator add-on payment, the add-on increases from $8.79 per day to $11.50 per day for all Medicaid resident days.

Increasing the minimum occupancy penalty from 85% to 90% for direct care and indirect care costs for facilities with greater than 50 beds.

Payment of a flat “price-based” amount for administrative costs versus the current cost-based methodology. The per diem will be 100% of the average allowable cost of the median patient day.

Reduction or elimination of efficiency rate incentives for the direct care, indirect care and capital components based on quality report card scores. Children’s facilities are exempt from this provision as it relates to direct care. The efficiency incentive percentages prior to the application of penalties for poor report card scores are as follows:

Direct Care – 30%Indirect Care – 60%Capital – 60%
The actual percentage incentive is based on the report card score and the following sliding scale:

Year One
Report Card Score (RCS) Allowed Efficiency %
0 - 82 100%
83 - 357 100% – ((RCS – 82) x 0.36232%)
358 & above 0%

Year Two
Report Card Score (RCS) Allowed Efficiency %
0 - 82 100%
83 - 279 100% – ((RCS – 82) x 0.50505%)
280 & above 0%

Establishes a ceiling on the efficiency rate incentive for direct care at 10% of the direct care median.

Note: The ceiling is not case-mix adjusted.

The direct care component will be excluded from the MAI limitation calculation.
Reduction of the Medicaid case-mix index (CMI) for certain residents falling into the lowest four Resource Utilization Group (RUG) categories (PB2, PB1, PA2 & PA1). The revised case-mix scores are phased-in over a two-year period. The reductions are not clinically based but are rather an economic disincentive for nursing facilities to admit such residents. When fully phased-in, the reductions represent a decrease of approximately 58% compared to the original clinically based case-mix score. The CMI changes are as follows:

RUG-III Current CMI Year One CMI Year Two CMI Year Three CMI
PB2 0.73 0.48 0.41 0.30
PB1 0.66 0.44 0.38 0.28
PA2 0.56 0.38 0.32 0.24
PA1 0.50 0.33 0.28 0.21

Note: Existing residents are grandfathered and will not have their case-mix scores reduced.

Likewise, new residents who are incontinent and have a cognitive performance score other than zero, 1 or 2, will retain the current CMI scores.

Revisions to the annual cost report submission requirements, including:
An electronic copy (ECR file) of the Medicare cost report is no longer required to be submitted. A written copy must still be submitted.

A copy of the trial balance crosswalk used to prepare the Medicare cost report is no longer required to be submitted.

A copy of the trial balance/general ledger crosswalk used to prepare the Medicaid annual report is required to be submitted.

Need additional information?
Contact your BKD Health Care advisor with questions or for assistance in assessing the impact of these changes on your organization.

201 N. Illinois Street, Suite 700
P.O. Box 44998Indianapolis, IN 46244-0998
317.383.4000
FAX 317.383.4200

Sign up to attend a Town Hall Meeting with your Legislator

noreply@blogger.com (Indiana Health Care Association) — Sun, 16 Aug 2009 13:48:00 +0000

Legislative Town Hall Meetings - IHCA is conducting a number of town halls around the State to generate input to build a compelling 2010 legislative agenda for long term and post acute care. As of this week, the following meetings are confirmed:

8/24/09
Sen. Sue Erringon
3:00 p.m. - 4:30 p.m.
Golden Living Center
2701 Lyn-Mar Drive
Muncie, IN 47304

8/25/09
Rep. Don Lehe
10:00 a.m. – 11:30 a.m. (CST)
Regency Place of Dyer
2300 Great Lakes Drive
Dyer, IN 46311

8/26/09
Rep. Charlie Brown
10:00 a.m. - 11:30 a.m. (CST)
South Shore Health and Rehabilitation
353 Tyler St.
Gary, IN 46402

Who should attend: Administrators, staff (including but not limited to all level nurses, activity directors, etc.), members of resident councils, social service representatives, resident families and all others with an interest in long term and post acute care issues.

Please RSVP by calling 317-616-9013 or emailing amendoza@ihca.org Don't see your community? Stay tuned. We are scheduling more town hall meetings and will update this page in the future.

***Please note this new meeting location.
For questions, please contact Amy Mendoza, director of public affairs and communication at 800-466-IHCA or amendoza@ihca.org.

Newburgh Dislocated Worker Pilot Program A Success!

noreply@blogger.com (Indiana Health Care Association) — Fri, 07 Aug 2009 21:40:00 +0000

Matching Dislocated Workers with Employment in Long Term Care

IHCF and Indiana Department of Workforce Development are planning statewide career fairs for dislocated workers. The Dislocated Worker Pilot Program was launched at Millers Merry Manor in Wakarusa this past spring. A second program was launched on August 7, 2009 in Newburgh. The career fair introduced long term care careers to dislocated workers in the local area. The hands-on-approach assist unemployed workers in identifying careers in long term care. IHCF will be contacting members to serve as host facility for the career fair and invite human resource representative to attend the career fair.

Next Dislocated Worker Career Fair: Coming soon!

Career fairs will be held through August and September. Check back frequently to view future dates.

Dislocated Worker Program Fact Sheet (PDF, 47kb)

For additional information, contact Dorothy Henry, Executive Director at dhenry@ihca.org or at 317-646-6406 ext. 207.

IHCA President: Massive Federal Medicare Cuts Will Hurt Seniors, Cost Jobs

noreply@blogger.com (Indiana Health Care Association) — Mon, 03 Aug 2009 22:54:00 +0000

Urges Indiana Congressional Delegation to Help Ensure Seniors’ Care Needs Remain
Key Priority of Health Care Reform

Indianapolis, IN – The President of the Indiana Health Care Association (IHCA) warned
that new federal Medicare cuts of up to $16 billion resulting from a recent announcement by the Obama Administration that it has put into effect a new Medicare regulation will significantly endanger Indiana seniors’ care and jeopardize the state’s already fragile economy and caregiver jobs base.

“We intend to make certain the interests of seniors remain a priority for lawmakers as they pursue health care reform in Washington, and will make sure they understand that the Medicare funding cuts on top of the Medicaid funding crisis already facing Indiana’s seniors and providers is unsustainable,” Stephen Smith, President of IHCA said.

Continued Smith: “Having now just suffered a massive Medicare funding cut of up to
$16 billion – distinct and separate from the reductions our sector has willingly and
cooperatively agreed to shoulder as part of achieving broader reform – we are alarmed
the sheer size of the cumulative cuts we ultimately suffer will be especially damaging to seniors in states like Indiana, where our Medicaid program is already under extreme strain. Medicare and Medicaid funding are inextricably linked, and the combination of cuts to both programs squeezes our local facilities in a manner harmful to Medicare beneficiaries’ care needs, detrimental to our state’s local economy, and injurious to our caregiver jobs base.”

Smith noted that Indiana nursing homes are seeing an increasingly diverse patient base, and providing a greater variety of acute care, rehabilitative and convalescent services that cannot be delivered elsewhere – care services which are now in jeopardy due to the sheer size and scope of the Medicare funding cuts. These massive funding cuts, Smith said, will undermine facilities’ ability to effectively treat this more medically complex patient population, and also put the jobs of the direct care workforce they depend upon in substantial danger.

“Achieving a sweeping health care reform bill we can all be proud of, and which will
improve the health of every Indiana resident is a necessity, not an option,” Smith
continued. Yet, protecting vulnerable seniors in the process must always remain a key
priority from which we must not deviate.”

During the upcoming August recess, Smith said, the long-term care community will ask
federal lawmakers to keep the interests of seniors and those who care for them foremost in their minds. “We intend to explain in a tangible, informative manner why it is essential for Congress, upon its return to Washington in September, to recalibrate its thinking on health care reform and scale back these enormous Medicare cuts.”

About the Indiana Health Care Association (IHCA)
The Indiana Health Care Association is Indiana's largest trade association and advocate representing proprietary, not-for-profit and hospital-based nursing home and assisted living communities, adult foster care and adult day services. IHCA's 264 member facilities care for more than 25,000 of Indiana's geriatric and developmentally disabled citizens, the majority of whom are low-income Medicaid recipients. To learn more about IHCA, visit http://www.ihca.org/.

IHCA Praises new Consumer and Workforce Satisfaction Data

noreply@blogger.com (Indiana Health Care Association) — Mon, 15 Jun 2009 13:50:00 +0000

Statistical Analysis Finds Consumer and Staff Satisfaction Levels Reach New Highs

Indianapolis – The Indiana Health Care Association (IHCA) praised the results of the
new 2008 National Survey of Consumer and Workforce Satisfaction in Nursing Homes
recently released by independent research firm My InnerView (MIV). The national study
found that 85 percent of consumers report their satisfaction as either “excellent” or
“good”, while 66 percent of care staff also say their facility is an “excellent” or “good”
place to work.

“As consumer and workforce satisfaction have reached the highest levels in 2008, we
applaud the efforts of care staff in Indiana’s nursing homes,” said Steve Smith, President
of the Indiana Health Care Association (IHCA). “These findings reflect the profession’s
commitment to quality-improvement initiatives and demonstrate that improvements in
the workforce are linked to consumer satisfaction and ultimately quality of care.”

States the new MIV study: “Although satisfaction levels are high, job stress is a
significant opportunity for nursing home leaders to address in order to improve nurse and
nursing assistants’ satisfaction, while meeting resident choices and preferences is one of
the top priority items for improving resident and family satisfaction.” Other highlights of
the report include data that support the view of aligning financial incentives with
organizational performance.

This month, the Indiana Health Care Foundation (IHCF) will conduct a staffing survey of
Indiana nursing homes. The survey will address job satisfaction among directors of
nursing and direct care workers such as staff registered nurses, administrative registered
nurses, licensed nurse practitioners and certified nurse assistants. Smith stressed the
goals of the Indiana survey as a continuing exercise in quality improvement.

“Our goal is to take a closer look at factors influencing job satisfaction among direct care
workers in Indiana nursing homes specifically,” said Smith. “We recognize there is
always room for improvement, especially as we look for ways to address our State’s
staffing shortage in long term care.”

About the Indiana Health Care Association (IHCA)
The Indiana Health Care Association is Indiana's largest trade association and advocate
representing proprietary, not-for-profit and hospital-based nursing home and assisted
living communities, adult foster care and adult day services. IHCA's 264 member
facilities care for more than 25,000 of Indiana's geriatric and developmentally disabled
citizens, the majority of whom are low-income Medicaid recipients. To learn more about
IHCA, visit http://www.ihca.org/.