Federal Regs for AL? Not So Fast

Last week’s edition of McKnight’s Long Term Care News featured a blog post that encouraged the assisted living community to prepare for federal regulation, instead of trying to prevent it. In a strongly worded post, McKnight’s encouraged the assisted living community to embrace federal regulations, since 20 percent of assisted living residents receive Medicaid benefits.

David Kyllo

NCAL Executive Director David Kyllo responded to that post, pointing out that a robust model of regulation for assisted living is already in place, at the state level.

Says Kyllo:

In the eyes of most seniors, the assisted living concept—and its emphasis on providing the maximum level of choice in lifestyle and daily living activities—is doing just fine. Seniors strive to avoid more restrictive, institutionalized settings. State governments, as shown in our just published “2012 State Regulatory Review,” continually add to or refine oversight of assisted living centers. States offer a far more dynamic government regulation structure than the federal government could ever deliver. For example: in 2011, 16 states made statutory, regulatory, or policy changes impacting assisted living/residential care communities.  At least four of these made major changes.

Agreeing with the McKnight’s post that “federal rules can muck things up,” Kyllo pointed out that assisted living was created by consumers to meet their needs, not the federal government.

As more states make policy changes impacting assisted living communities, NCAL will continue to support their work and remind the public that a top-down, one-size-fits-all approach simply doesn’t work in today’s world of person-centered care.

Ahead of the Quality Curve

NCAL Executive Director Dave Kyllo joins stakeholders to kick
off the Advanced Standing Program.

Already this year, several care providers have rolled up their sleeves and taken their quality efforts to the next level. As part of AHCA/NCAL’s Quality Initiative, we’ll be sharing their stories and celebrating their achievements throughout the year. This week we’re looking at why New Jersey stands out from the rest when it comes to implementing quality goals in a way that’s a win-win for assisted living residents and providers.

The Health Care Association of New Jersey (HCANJ) Foundation is teaming up with the New Jersey Department of Health and Senior Services (DHSS) to create a new quality designation for assisted living communities. The Advanced Standing Program identifies and recognizes communities that meet compliance regulations and have high-quality standards in place, which will include quality benchmarks from NCAL’s Performance Measures report. Communities must use and maintain the standards to earn the designation.

What makes this program unique? For providers, officials say it’s the first time a state has integrated oversight responsibilities with quality measures, and this encourages everyone to strive for excellence. For consumers, the program incorporates quality data for measurable results and lists Advanced Standing communities on DHSS and HCANJ websites, as a tool that consumers can use when choosing a residence for their loved one.

AHCA/NCAL members can read more about New Jersey’s Advanced Standing Program in the March issue of NCAL Focus. And if you have a quality story to share, log onto our Quality Initiative website and tell us about it.

Save the Date: CMS Webinar on Antipsychotics

Mark your calendar! CMS has just announced a webinar launching their national action plan to reduce the use of antipsychotic medications in skilled nursing care centers. The CMS broadcast is open to the public, but targeted more for federal and state surveyors, providers, clinical professionals and consumers.

This webinar ties perfectly with AHCA/NCAL’s newly launched Quality Initiative and our goal to reduce the off-label use of these drugs 15 percent by December 2012.

That means there’s no time to waste. Save the date now:

Thursday, March 29, 2012
1:00pm EST – 2:00pm EST
http://surveyortraining.cms.hhs.gov/

Too often, antipsychotic medication is used in an attempt to modify behavior in individuals who are living with some type of dementia. They increase the risk of death as well as falls with fractures, hospitalizations and other complications resulting in poor health. This use is considered off-label by the FDA, which issued a “black box” warning for the elderly with dementia. Moreover, these drugs are expensive, costing Medicare hundreds of millions of dollars. This issue is getting more and more attention, from partnering provider organizations and the media, and especially from CMS.

AHCA/NCAL realizes that if we are to be the low-cost, high quality solution in our nation’s health care delivery system, then we must do more to prevent and reduce the off-label use of antipsychotics. That's why we're challenging our members to reduce these medications by 15 percent by the end of the year, compared to our other Quality Initiative goals which have a three-year target.

One of the best ways for facilities to learn about what they can do is to hear from fellow providers. If your facility(ies) is already doing innovative things to reduce the off-label use of antipsychotics, then we want to hear from you. Email us your story: qualityinitiative@ahca.org.

And to learn more about AHCA/NCAL’s Quality Initiative, its 15 percent reduction goal for antipsychotics, and resources to achieve this goal, please visit qualitiyinitiative.ahcancal.org.

The Future of Medicare: Lawmaker uses the “K” Word

A recent use of the word “kaput” by a Congressman caught our attention. In a Congressional Quarterly* article, Sen. Ron Wyden (D-Ore.) said, "Without a bipartisan effort to protect Medicare, what the years ahead ensure is that senior citizens and health care providers will be getting a steady diet of cost shifting and arbitrary cuts until the Medicare guarantee is kaput.” (That is “kaput” as in “to cease functioning; break down.”) Wyden and Rep. Peter Roskam (R-IL) noted that Medicare will be back at the top of the Congressional agenda after the fall elections.

AHCA President and CEO Governor Mark Parkinson regularly emphasizes the need for cooperation and collaboration at all levels of government and between the government and the health care sector. We have to work together and find innovative solutions to help reduce our country’s health care costs. AHCA recently offered a proposal with one such solution: it aims to reduce hospital readmissions, thereby improving the quality of care in long term and post-acute care facilities and cutting health care costs.

Even though Medicare may be in the backseat on Capitol Hill until post-election season, AHCA will continue its efforts to reach out to policymakers with meaningful conversations in 2012. It’s critical to make sure our lawmakers know how important it is for the country to fulfill its commitment to seniors.

*Subscription required.

The Super Tuesday Contest

As the GOP candidates prepare for tomorrow’s Super Tuesday battle for delegates, AHCA/NCAL is recalling the candidates’ views on long term and post-acute care. What does the future of long term care look like for these presidential hopefuls?

With Mitt Romney entering tomorrow’s 11-state contest in the lead, AHCA/NCAL thought today would be the perfect opportunity to brush up on his political views. Do you know Romney’s vision for long term care funding streams? Check out the former Massachusetts governor’s answer to our question about long term care funding under his leadership.