Christmas Wrappings!

A great new activity was tried this week! The Resident Council came up with offering to wrap Christmas presents for staff and community members for a small donation fee. The donations went directly into the Resident Council funds. This helped them earn some discretionary funds as well as helping others with the rushed and sometimes dreaded task of wrapping presents.

Survey is final for 2009

Well here we are!! Mid December and we have acceptance of the survey response that we submitted. These were minor issues if you remember from earlier postings, but it is all major to the Health Department until they have accepted the Plan of Correction (POC). Eventually this survey will make it to the most recent survey on Nursing Home Compare: www.medicare.gov/nhcompare

In other news, we also completed a survey by a team from the Syracuse Office of the Health Department that reviewed our nurse aide training program. We were approved to continue the program through October 31, 2011. This approval to continue our training of certified nurse aides is important because we can observe during training and identify trainees that are most suitable for employment here. It takes special abilities and compassion to become a good nurse's aide. The training program itself is 100 hours of both textbook work and practical application. If you are interested, please contact us at (315) 841-4156 to see when classes are available.

2009 NY Survey

The NY State Health Department team arrived on October 19th. Of course un-announced as always, but the unusual thing this year was it was on a Monday. In the past, the team would get all their paperwork together on Mondays and then visit a facility on Tuesday. They came with all the paperwork needed on a Monday! I think the process is becoming better organized.

Four Health Department people were on the team, an RN Team Leader, a Sanitarian, a Social Worker and another Nurse. They come prepared with a list of resident records they want to review for their sample. These were chosen from information in their office files. For example, we submit detailed patient care reports called MDS's on all residents at multiple times during their stay. These reports are used to profile the care residents are receiving. These reports plus any complaint reports plus any items from their previous surveys they want to follow up on make up the initial sample residents and files to look at. While doing this they also make observations on their unit tours and during observations of medication passes and meal times. In addition, they review the environment, life safety, kitchen, and quality assurance assurance efforts of the facility. To top this off and as a very important part of the survey process, they interview resident's families and meet with the Resident Council.

Wow !! What a lot of work to accomplish! They stayed through Wednesday October 21st and left after an "Exit Conference" Overall I feel the survey was very resident focused and the issues brought to our attention were valid and relatively minor. We will not know exactly what our deficiencies will be until their final report which should arrive sometime this month.

When this "SOD" (Statement of Deficiencies) arrives we will respond with our "Plan of Correction". This plan addresses exactly what we are going to do about any findings they may have had. The next step is their review of our response. This could include a follow-up survey or a desk review of our response. We should know by December how the response was accepted.

A final Statement as to our being in "compliance" is then issued.

Please note that by NY State law, the State Survey results are always posted publicly for anyone to review at any time. The on-line postings always lag somewhat because of the lengthy process as above.

OMIG Results

We have the OMIG (Office of Medicaid Inspector General) audit results in !! It looks at this time our Medicaid rates will be decreased about $32,000 a year from 2003 forward. That is a big hit, but remember from earlier posts, that is their job. Reduce Medicaid costs and make sure that the state is only paying for well documented and supported costs. Can't really fault that. We are looking for some documentation they felt was missing as well as trying to make sure that some things disallowed have not already been disallowed somewhere else prior to this report.

The process goes like this. We received a tentative exit report summary yesterday. The exit conference is scheduled for May 21st, 2009. At that time the final report is presented plus or minus any changes since the tentative report. So, we have a short window to supply additional information and could possibly reduce some of the decrease.

After the Exit Conference (held here) the finalized report is brought back to the OMIG offices for converting into rate changes for the previous years. These rate changes are calculated for the years 2003 and forward and a due to the state amount is declared. Then we have to start paying it back! I will find out more what those terms are at the conference.

Local Events

Here we are in may already! Many things going on this month as we head towards summer. Every year we raise four to six ducks to put down on the pond out front. (The one that is teaming with Goldfish!) This year we also have four baby rabbits in the center courtyard. They are very shy and spend a lot of time under the bushes, but they will get bolder as they get used to the surroundings.

There is a contest going to name the rabbits. If you have suggestions send them in or stop by!

Financial

Wow.... It's been a long time again! The year end audit is completed and we are bracing for a very tough 2009. The State of NY has seriously reduced our Medicaid rate citing budget problems. That of course gives us big budget problems. The current cut is about $10.00 per patient per day. This translates to about $20,000 per month or $240,000 for the year. We are in very big trouble with a $240,000 reduction in revenue. Call your legislator, congressmen etc. to let them know we understand there is a budget crisis. However, you can not balance it on one industry!! Nurses, Aides and all the rest of the healthcare support staff are still being asked to do more with less. We can't cut their pay as well!

Auditors In

Well, things have been wild at Harding Nursing Home so far this month! Alarm system is waiting for the last connections to the elevator roof hatches and the sprinkler system. The sprinkler system is finishing the last few rooms and will begin test in two weeks according to foreman Mike Wood.
The sprinkler test is first air at a low pressure, then a greater pressure and check to see if it "loses pressure over time". This is followed by a mix of air and water to greater than normal pressures and finally full working water pressure. If there are any leaks I hope they find them while it still has air in it!!
This week internal auditors are looking over every account to help us make sure our records are accurate, up to date and ready for year ending procedures. A fun time to be sure.

Survey Results!

At last !! We have formal paperwork on the results of our last survey that was conducted in November of 2008. It sure takes time doesn't it? The survey was "completed" November 17th, 2008. We get the statement of deficiencies Monday January 12th and we must respond by Friday January 16th. So much for equal time : )

The two (yes that's only two) deficiencies were isolated issues and fell into a very low category of D on a scale of D, E, or F with F being the worst level of Minimal issues. The next group is G, H or I that are deemed Significant issues. This is followed by J, K and L that are deemed Immediate Jeopardy issues. (These could pose real and immediate problems to residents) The thing about the three ratings at each rating level is the number of residents affected. The first category letter represents isolated or very few residents affected. The next letter in a category means more residents effected. The final letter means widespread.

You will be able to see the full survey results soon on-line. I will also post a link when I have one. The final steps in this process are:
1/ A possible Follow-up survey to insure our plan of correction was in fact put into place and
2/ A new Survey profile Summary is issued.

Then the survey process is complete !!! wow !! (well.... until the next one : ))