Heading Into Winter

It doesn't seem possible, but I have posted nothing here since last Spring. Time does go by way too fast. An update on the new 2010 Medicaid rates !!
Nothing..... Yes, Nothing has happened since the last posting. We still sit here in December of 2010 and do not have a certain rate starting in April of 2009!! Oh.... we are still getting paid by the NY Medicaid system, but at preliminary rates issued in 2009. In fact for 2010 we are getting paid at a rate higher than we will eventually receive. That means we are building up a huge payback amount that will have to be paid back when the State issues an approved rate.
So you say... Why would the State pay you more than they know they will pay when the rates are final? Good question, complicated answer. In a nutshell the rates for all 600 some facilities in the State are changing due to a recalculation of the costs used to determine the rate. Most facilities rates are going up and ours is one of the few that are going down. We are going down because we applied for and received the recalculation earlier. Now the State is saying they are broke and can not finance the recalculation of all facilities in the State so they have "Scale Back Adjustment". This reduces everyones "new" rate. Our problem is we were already receiving the "new" rate and our current payments are frozen at that level without the "Scale Back". We will owe those funds back as soon as our rate is released that includes them.
It would be nice to say we were banking those funds, but they are not excess or "Profit" they are being used every day for payroll, taxes and supplies.
When these new rates are released this may well be "The Winter of Discontent".

Enough doom and gloom. The early snowfall in this area has made a beautifull winter wonderland of the landscape and everyone is excited and looking forward to the coming Christmas festivities. I have on my list of things to do trying to get some pictures posted on this blog of what is going on. I just need to figure out how to do it.

Almost Spring!

Only two days away from Spring it looks like it's been here a week! Very little snow left and disappearing rapidly! Hope we don't have to pay for it later. An update on the Safety Bingo game is that two people have won the first level by getting a straight line Bingo (and a $10 gift certificate) and everyone is now playing for the letter "H". No winners yet. The third and final game will be for a full card.

The shopping cart came on-line this month and had visitors purchasing items for their family here within two days of becoming live! We have some tweaking to do and will brighten it up a bit, but at least it is currently functional. This is really a great way to give a special treat to your family member or friend that is a resident here. You have choices on Florals, Massages, and Barber/Beauty shop. We also provide links for ordering special services from outside providers such as telephone, internet, or premium cable TV.

Our local US Representative, Michael Arcuri, D-Utica, has flipped his vote to "No" now on the Health Care Reform bill. He seems to be simply going with what he sees as the current popular vote. The popular vote has been changed by intensive ad campaigns funded by Insurance and Pharmacy groups that seek to portray the reform bill as poorly put together with lots of special favors for special interests coupled with "Big Brother" Government intruding into decisions and personal lives. Who knows? It will be interesting to see what happens on this "Super Sunday" vote if there is one. Maybe after all the dust settles Hillary can sit in the White House after diner with the Obama's and say.... "I told you so!" : )

NY State is still in a big mess... NY State tax refunds may be delayed because the State has "No cash" according to the Governor. The nursing home rates are still undetermined and it may be months before we know what the 2010 Medicaid rate will actually be. It's just a guess now until they pass a budget.

February in NY

Lots of things going on here this month! Of course we all have put on a pound or two because it is Jelly Donuts month! The employee fund has provided jelly donuts for all three shifts several times and they were all gone at the end of each day. A new Safety Bingo game has started with the first $10 gift card yet to be won. Safety Bingo is a way to have fun playing for prizes while keeping safe and avoiding any accidents. (An accident stops the game.)
Another interesting event in NY during this month was the beginning of Amanda's Law. This is a new law taking effect on the 22nd of February, 2010 that requires a CO (carbon monoxide) detector in every "sleeping unit". You can read more here. Exactly how this plays out in a health care facility setting is yet to be determined. The namesake of the law, "Amanda" passed away due to carbon monoxide poisoning that could have been prevented with an alarm that detects its presence. These detectors work in a similar fashion to smoke detectors but need to be mounted low instead of high because CO is heavier than air.
We are fortunate this month to have an administrative intern working with us. An administrative intern is someone who is working towards a Nursing Home Administrators license. Part of the requirements for this license is an internship in an approved facility with an approved preceptor. Judy was very happy to be able to do this. The intern, Pam Warner, is doing an excellent job keeping us on our toes and spending time in each and every department. You have often heard I'm sure that the best way to learn is teach something, well, we are learning also! : )

NY Budget Crisis

Well, NY admits again that it is in serious financial problems. NY Governor David Patterson is expressing the problems very well in his 2010-2011 budget address. Here is a link to the video

http://www.state.ny.us/governor/press/index_video.html

If you have any trouble with this, let me know.

It is pretty clear that 2010 - 2011 is going to be very rough for healthcare and any other programs depending on government funding. I tell my staff that the sky is not falling, but it's very cloudy. This impacts facilities statewide not just ours. We are unique in that we are a small rural upstate facility with a high Medicaid resident population. We serve an area that is not wealthy and we will continue to serve the local area even when the support system is weakened. Any ideas on how to provide reward and incentive to a hard working and caring staff while funding from the primary sources are falling would be appreciated.

Meanwhile.... we will do the best we can with what we have.