tag:blogger.com,1999:blog-77339337908735256142024-02-08T08:21:18.278-08:00Harding Nursing HomeBob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.comBlogger21125tag:blogger.com,1999:blog-7733933790873525614.post-45978303387063211462011-08-03T12:29:00.000-07:002011-08-03T12:42:07.324-07:00Hack alertWell it took a serious event to get me to blog again. Our website got hacked!! A person that had toured the home pointed someone in their family to our website and they happened to look in the "forums" area. Note the forums are gone now. What a suprise!! Someone, (probably a bot)had been posting porn materials for four months.<br />It really is amazing how people with technical knowledge can work their way into seemingly secure areas. Often what we think is secure is certainly not. Makes you wonder if they have so much technical knowledge, why aren't they working making big bucks in an IT department somewhere. Why waste that talent on stupid stuff? Is there money in that somehow?<br /><br />Much bigger questions than I can answer. I just want to say we are sorry if anyone was offended by the brief encounter with the dark side of the information age. we will try to prevent this from happening but I'm sure someone is also trying to find new ways into the system.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-49024351220086479742010-12-09T05:41:00.000-08:002010-12-09T06:01:41.967-08:00Heading Into WinterIt 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 !!<br />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.<br />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.<br />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.<br />When these new rates are released this may well be "The Winter of Discontent".<br /><br />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.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-12494587409897667292010-03-19T13:29:00.000-07:002010-03-19T14:02:10.597-07:00Almost 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.<br /><br />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 <span class="blsp-spelling-error" id="SPELLING_ERROR_0">Florals</span>, Massages, and Barber/Beauty shop. We also provide links for ordering special services from outside providers such as telephone, <span class="blsp-spelling-error" id="SPELLING_ERROR_1">internet</span>, or premium cable TV.<br /><br />Our local US Representative, Michael <span class="blsp-spelling-error" id="SPELLING_ERROR_2">Arcuri</span>, D-<span class="blsp-spelling-error" id="SPELLING_ERROR_3">Utica</span>, 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 <span class="blsp-spelling-error" id="SPELLING_ERROR_4">Obama's</span> and say.... "I told you so!" : )<br /><br />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 <span class="blsp-spelling-corrected" id="SPELLING_ERROR_5">until</span> they pass a budget.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-70582715720129878122010-02-20T08:50:00.000-08:002010-02-20T09:22:41.226-08:00February in NYLots 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.)<br />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 <a href="http://dos.state.ny.us/code/COAlarm.htm">here.</a> 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.<br />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! : )Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-67135327794063034592010-01-21T09:41:00.000-08:002010-01-21T10:10:34.064-08:00NY Budget CrisisWell, 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<br /><br /><a href="http://www.state.ny.us/governor/press/index_video.html">http://www.state.ny.us/governor/press/index_video.html </a><br /><br />If you have any trouble with this, let me know.<br /><br />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.<br /><br />Meanwhile.... we will do the best we can with what we have.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-51851711459126582582009-12-17T08:33:00.000-08:002009-12-17T08:52:54.444-08:00Christmas 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.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-36799766893812498522009-12-16T12:11:00.000-08:002009-12-16T12:39:35.294-08:00Survey is final for 2009Well 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: <cite>www.medicare.gov/nhcompare<b><br /><span style="font-weight: bold;"><span style="font-weight: bold;"></span></span><span style="font-style: italic;"><span style="font-weight: bold;"></span></span><br /></b></cite>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.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-54413196363753981452009-11-07T08:34:00.000-08:002009-11-07T09:16:26.441-08:002009 NY SurveyThe 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.<br /><br />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.<br /><br />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.<br /><br />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.<br /><br />A final Statement as to our being in "compliance" is then issued.<br /><br />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.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-57568910605531792102009-05-06T10:03:00.000-07:002009-05-06T10:19:28.116-07:00OMIG ResultsWe 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.<br /><br />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.<br /><br />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.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-37609630569557392462009-05-01T07:33:00.000-07:002009-05-01T07:38:18.759-07:00Local EventsHere 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.<br /><br />There is a contest going to name the rabbits. If you have suggestions send them in or stop by!Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-39245704313010595112009-03-24T13:27:00.000-07:002009-03-24T13:36:10.703-07:00FinancialWow.... 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!Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-85274735424913080962009-02-10T19:27:00.000-08:002009-02-10T19:40:08.095-08:00Auditors InWell, 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.<br />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!!<br />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.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-44587242929022484082009-01-20T10:49:00.000-08:002009-01-20T12:44:41.706-08:00Survey 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 : )<br /><br />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.<br /><br />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:<br />1/ A possible Follow-up survey to insure our plan of correction was in fact put into place and<br />2/ A new Survey profile Summary is issued.<br /><br />Then the survey process is complete !!! wow !! (well.... until the next one : ))Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-69806020791537948472008-12-23T05:04:00.000-08:002008-12-23T05:24:18.010-08:00Merry Christmas!Almost Christmas and we have lots of fresh snow to make it a very white one! The trees are covered with a fresh fluffy snow that sets off the beautiful grounds and morning sunrise. I have to figure out how to post pictures on here.<br />The <span class="blsp-spelling-error" id="SPELLING_ERROR_0">Utica</span> Observer Dispatch posted a story released Friday 12/19/08 that talked about the new "Star" ratings for nursing homes. The Star rating program is a federal program that comes out of their "Nursing Home Compare" web informational efforts. This really is a good basic tool and there is a link to it from our home site <a href="http://www.hardingnh.com/">http://www.hardingnh.com</a> The premise of the Star ratings is to make it similar to hotel type ratings based on survey results and patient care standards. A great idea that is tough to roll out and make <span class="blsp-spelling-corrected" id="SPELLING_ERROR_1">consistent</span> because of the non-standard way that surveyors <span class="blsp-spelling-corrected" id="SPELLING_ERROR_2">interpret</span> the guidelines. It's a good start and better than nothing, but will be improved over time. I am pleased to report we are a "3 Star" home! <span class="blsp-spelling-corrected" id="SPELLING_ERROR_3">Doesn't</span> sound all that impressive, but compared to others in central NY, we are doing Great!<br />The Fire Alarm upgrade is almost completed and the installation of sprinklers is making great progress. The sprinkler piping in the rooms does not look very homey. It looks kind of industrial. We will have to come up with some creative way to mute that stark orange pulmbing going through the rooms. Any ideas? Email me at <a href="mailto:rharding@hardingnh.com">rharding@hardingnh.com</a>Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-11978841851599565662008-12-06T08:20:00.000-08:002008-12-06T08:28:54.728-08:00Still WaitingWell... It's been almost a month now and no real report from the survey process. We know it was a "good" survey, but nothing is final yet. It takes awhile as it is formally written up and reviewed by everybody in the survey team as well as their administration.<br />On a happier note: Construction has started on a sprinkler system throughout the entire building. This is being done by abj Fire Protection Co. They are another part of the same company that is upgrading the fire alarm system. When this process is complete, we will have a state of the art fire detection system and a fully sprinklered building. Resident and staff safety and security will be enhanced from our already secure environment.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-78805490753378206662008-11-15T08:30:00.000-08:002008-11-15T08:54:59.936-08:00NY State SurveyWe are currently undergoing a NY State Survey. This is a process where State employees from various <span class="blsp-spelling-corrected" id="SPELLING_ERROR_0">disciplines</span>, (Nursing,Dietary,Social Services,Environmental) come as a team to check the operation of the nursing home against State and Federal guidelines. They arrived on Wednesday 11/12/08 and "expect" to be finished sometime Monday or Tuesday the 17th or 18th.<br /> This is an extensive review of nursing care plans, dietary services, administrative process, building and grounds. The focus is mainly on patient care and satisfaction. That is really a good thing, because that is what the care is all about, high quality of service and comfort for residents here. During the review the surveyors will examine charts and documents as well as interview residents and families. This process is repeated in every nursing home across the nation.<br /> The fact that every State is doing this means that it is an ongoing effort to train the surveyors in every state and even within areas of the State to be consistent in how they interpret the regulations and how they "score" the facility. So.... the process has it's flaws, but it sure is better than having no oversight on how the State and Federal monies of Medicaid and Medicare are being used for services of value.<br /> In other events, the Fire Alarm system is being upgraded to a state of the art detection and alarm system that will not only tell us what zone the problem is in, but exactly what room it is in. This will be an ongoing project for many weeks.<br /> A group from the Elementary School visited residents on Wednesday that they have been writing to in a "Pen Pal" program. These young people were so dedicated that they WALKED from the elementary school to here and back for the visit. They had to walk because the school is saying they do not have the funds for operating buses to field trip events. What a shame.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-73719560601025359972008-11-01T11:51:00.000-07:002008-11-01T12:15:33.250-07:00Melting SnowWow !! Today the snow began melting in earnest. The early snow we had was very heavy and wet. Thousands of homes were without power for various lengths of time. As of Friday, only about 300 homes were still without power. Because of the elevation of <span class="blsp-spelling-error" id="SPELLING_ERROR_0">Waterville</span>, we were getting snow when others were getting rain. All this happened on Tuesday night and all day Wednesday. Our generator here kicked in a couple of times as they had to cut power to fix some lines. In general, the village of <span class="blsp-spelling-error" id="SPELLING_ERROR_1">Waterville</span> itself had <span class="blsp-spelling-corrected" id="SPELLING_ERROR_2">continuous</span> power.<br /><br />So..... We have some minor flooding in the basement storage areas as the melting snow from the new roofing drains overpower the center courtyard area. No resident areas are affected and we are able to direct the melting water directly into a storm drain using temporary drain tubes. The long term fix will have to have more permanent drains installed to route the new drainage load from the roof.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-42147595312594603712008-10-24T06:30:00.000-07:002008-10-24T06:39:54.915-07:00Discovery TodayFound a great site today that came through on Google Alerts. I had set up a Google Alert for Harding and Nursing. The usual stuff that comes is about Harding's that died (obits) or things happening at Harding University college of Nursing. But this site is a great way to look for facilities all around the country and compare some key indicators. A really great feature is the linking into UTube videos on aging related issues. Hope this works as a link.<br /><br /><a href="http://local-nursing-homes.com/Nursing-Home/335585/HARDING-NURSING-HOME.html">HARDING-NURSING-HOME<br /></a><br /><br /><a href="http://local-nursing-homes.com/Nursing-Home/335585/HARDING-NURSING-HOME.html"></a>Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-28123524660687550442008-10-23T11:49:00.000-07:002008-10-23T11:58:50.722-07:00Alzheimer's Program 10/22/08An excellent educational forum on Alzheimer's disease was held last night at the nursing home. The presenter was Lisa Casler, FNP (a Family Nurse Practitioner with Bassett Health Services) She spoke on traditional and new practice in the treatment and management of Alzheimer's and other related dementias. We hope to be bringing more of this high caliber of education to the Waterville area.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-2637135952884708442008-10-15T08:42:00.000-07:002008-10-15T08:50:31.629-07:00Educational ProgramNote that on October 22, 2008, at the Nursing Home (220 Tower St, Waterville, NY) we will be hosting an educational session on Alzheimer's Disease Treatment Options and Interventions. This will be presented by Lisa Casler, FNP with Bassett Health Services. You may call (315) 841-4156 to register or speak directly with Colleen Sullivan-Marris, Social Worker.<br /><br /> If you are concerned about someone in your family who may face Alzheimer's challenges now or in the future, or are just interested in learning more about this disease process please attend.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0tag:blogger.com,1999:blog-7733933790873525614.post-86064269541158156032008-10-14T13:23:00.000-07:002008-10-14T13:34:24.222-07:00First postingThis is the first of regular updates on what is going on at Harding Nursing Home in beautiful upstate New York. Waterville, NY is a great rural setting that offers family values, a close knit community and excellent support organizations (school, fire department, municipal services, skilled nursing home, new library etc. . All have many opportunities for volunteer service with your neighbors.<br /><br /> Check back for further updates. Always feel free to ask questions or post your views. If I don't know the answer, I'll do everything possible to find someone who does have the answer and have them help us both out.Bob Hhttp://www.blogger.com/profile/16856412742951420946noreply@blogger.com0