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Updates for Maryland Nursing Facilities
March 17, 2010
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Below is a summary of recent updates on public policy initiatives. LEGISLATIVE UPDATES Only three and half weeks remain in the 2010 Legislative Session. The budget committees continue to work on budget decisions and the policy committees are finalizing bills for the "courtesy date." The "courtesy date" is the date that the committees aim for when reporting bills out of their committee and sending them over to the opposite chamber. By reporting by the "courtesy date," bills are assured a hearing in the opposite chamber. LifeSpan will be sending out a full legislative report next week on the latest developments on the budget as well as a status report on the bills that made the "courtesy date." NEW KEPRO CONTACTS AND UPDATES KePRO has recently appointed Ms. Shari Glickman as Project Director, replacing Jenine Woodward, and Linda L. Gregory, R.N. as Nurse Manager, replacing Elizabeth McHenry. Ms. Gregory will be the primary management contact for level of care issues, and Janis Grady will remain the primary manager in charge of nursing facility field review operations. Additionally, KePRO is in the process of filling vacancies to replace field reviewers who have left in the last few months - at least one is scheduled to start this month. Additionally, they are training current in-house reviewers to fill in in the field when necessary. According to DHMH, KePRO has also been working with DHMH to rectify problems resulting from the unexpected resignations of several field reviewers and inadequate training of replacements. Those facilities that experienced significant erroneous recoveries as a consequence of these problems either have received or will shortly receive corrected reviews. DHMH is also working with the Operations people to facilitate repayment of the recovered monies in cases where takebacks have resulted in a significant hardship to the facility.
In addition to addressing field operations, KePRO has also put procedures in place to shorten wait times on their Provider Services lines and to ensure that calls to staff are returned within one business day. Already the percent of calls where the caller "gives up" and hangs up, as well as the average wait time, have significantly decreased. LifeSpan held several calls with members and DHMH to bring these issues to the attention of DHMH. DHMH has asked that providers continue to provide them with updates on the progress of working with KePRO. Jane Sacco (saccoj@dhmh.state.md.us) and Susan Panek (paneks@dhmh.state.md.us) are the DHMH points of contact. LifeSpan thanks Ms. Sacco and Ms. Panek for their efforts to work with the industry to address our concerns.
OTHER NEWS IN MEDICAID
STATE SETTLES SMITH V. COLMERS - WHAT IT MEANS FOR NURSING FACILITIES
On Thursday, March 11th, Judge Pierson signed an Order granting preliminary approval to a settlement in Smith v. Colmers. As you may recall, Smith v. Colmers concerned how the Department of Health and Mental Hygiene determines the cost of care contribution by Medicaid long-term care recipients, specifically whether pre-eligibility medical expenses must be deducted from recipient's available income when determining their cost of care contribution. It is our understanding that the settlement provides for (1) cash reimbursement to nursing homes of up to $16,000,000 over the next two years; and (2) programmatic changes to insure that PEME is properly deducted in the future, thus freeing up recipients’ post-eligibility income to pay for pre-eligibility care. CMS has approved the reimbursement component of this settlement. On May 12th, the Court has scheduled a hearing to consider final approval of the settlement. The deadline for providers to submit a claim for reimbursement will be Friday, June 25, 2010.
Prior to the May 12th hearing for final approval of the settlement, Judge Pierson also ordered Plaintiff's attorneys to send out a Notice of the proposed settlement to all Medicaid recipients with PEME and all providers who responded to the July 2008 subpoenas. Providers should be receiving this Notice in the next few days. Plaintiff's attorney's will also be establishing a website, which should be up and running in the next few days with information and forms about the settlement. The website address will be www.MarylandPEMESettlement.com.
In the next week or so, providers will also be receiving a package from the Plaintiff's attorneys (Zuckerman Spaeder). The package will contain a "Roadmap" explaining the terms of the settlement, what providers need to do, and the deadlines for acting as well as forms providers will need to file. LifeSpan will continue discussions with the Plaintiff's attorneys and provide you with any additional updates.
MHCC TO SITE TEST REVISED LONG-TERM CARE SURVEY
The Maryland Health Care Commission has revised the long-term care survey. According to the Commission, the revisions reduced questions, streamlined the survey process and hopefully will make it easier to complete. The Commission will be testing the new survey this month. LifeSpan thanks our members for volunteering to the test sites - Adventist Health Care, Lifebridge Health, Senior Network, Todays Care and Family, Country Meadows and Johns Hopkins. LifeSpan will provide you feedback on the testing.
PRINCE GEORGE'S SUSPENDS DUPLICATIVE NURSING HOME LICENSURE PROCESS
Nursing facilities in Prince George's should have received a letter from Dr. Donald Shell, Health Officer, instructing the facilities that "due to significant funding cuts and the duplication of Prince George's County and State nursing home inspection," Prince George's Health Department suspended nursing home licensure as of January 4, 2010. Facilities will continue to be licensed and surveyed by the State Office of Health Care Quality. LifeSpan would like to thank Delegate James Hubbard for his work on this issue. Last year, at the request of LifeSpan, Delegate Hubbard sent a letter to the County Executive questioning the duplication of efforts between Prince George's County Health Department and the Office of Health Care Quality and recommended that Prince George's County eliminate this function.
DHMH CONVENES WORKGROUP ON RESTRUCTURING OF LTC CARE
JOIN LIFESPAN'S ADVISORY COMMITTEE
DHMH convened the first workgroup on the Restructuring of the Long-Term Care Delivery System. This workgroup was put together as a result of House Bill 113 from the 2009 Session. The workgroup will be making recommendations on how long-term care should be restructured. The goals of the workgroup appear to center on the need to develop an integrated care system rather than the current, fragmented system in Maryland. Secretary Colmers has indicated that he wants to study all options and that the Department does not have a preconceived notion for the final outcome. He also stated that he would be interested in implementing pilot programs throughout the State rather than a statewide program. Danna Kauffman is serving as the LifeSpan appointee to the workgroup. LifeSpan will be convening an internal advisory committee to work on this issue. If you are interested, please contact Danna Kauffman at dkauffman@lifespan-network.org. It is important to have all care settings represented on our advisory committee.
CHECK OUT THE BEACON'S EDUCATION CALENDAR
Rarely a day goes by where the Beacon Institute or LifeSpan is not hosting an education seminar or a peer-to-peer for our members. Make sure you check out our monthly calendar located on our website at www.lifespan-network.org. If you don't see something you what, let us know and we will work to bring it to you. The following nursing facility topics are being held for the remaining days in March:
ON BEHALF OF THE LIFESPAN STAFF, WE THANK YOU FOR YOUR MEMBERSHIP AND PLEASE LET US KNOW OF ANY ISSUES OR CONCERNS THAT WE CAN HELP YOU ADDRESS
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Questions? Suggestions?
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