Involuntary Discharges and Transfers to Face Scrutiny

Involuntary Discharges and Transfers to Face Scrutiny

Corey J. Ohalek
Associate General Counsel
Vrable Healthcare, Inc.

Recently, the Office of Inspector General (OIG) announced it would increase federal oversight regarding involuntary discharges and transfers issued by SNF’s. Specifically, the OIG will be focusing on “whether State agencies have effectively investigated and enforced proper transfer and discharge procedures.” The OIG noted that “discharge/eviction was the most common complaint to the Long-Term Care Ombudsman Program.” Also, the OIG indicated that, due to the quantity, it is worth investigating involuntary discharges and transfers. CMS has estimated that “as many as one-third of all residents in long-term care facilities are involuntarily discharged.”

Involuntary discharge

One of the main areas of review for the OIG is the “lax or ineffective State enforcement.” The OIG plans to review how the State LTC Ombudsman address involuntary transfers and discharges and “the extent to which State survey agencies investigated and took enforcement actions against nursing homes for inappropriate involuntary transfers and discharges.” The State LTC Ombudsman is not the only entity that the OIG is focused on in its review and it will also review the” extent to which nursing homes meet CMS requirements for involuntary transfers and discharges.”

Although the OIG’s main focus will be the actions and/or inactions of State agencies, the OIG’s actions should place all SNF’s on notice to review and adhere to the state and federal regulations regarding involuntary transfers and discharges. “State ombudsman and enforcement agencies may strengthen their involuntary discharge and transfer enforcement activities to ensure that they are not perceived as being lax or ineffective.”

Find more information here.

RESIDENT RIGHTS Continuation

Catherine Denlinger, MSW, LSW
Director of Social Services
The GRAND of Dublin

RESIDENT RIGHTS

This SSS (Social Services Series) will be the continuation and completion of Ohio & Federal Nursing Home Residents’ Bill of Rights. During our last series we looked at the first five resident rights. We will resume summarizing the resident rights continuing with number twenty-five.

25. Residents have the right to be informed in writing of the basic rate charged by the center, services available and any additional charges related to such services. The basic rate of the center shall not be changed unless a 30 day notice is provided to the resident and/or the resident’s responsible party.

26. Residents have the right to receive their bill on a monthly basis for any charges not included in the basic rate.

27. Residents have the right to be free from financial exploitation. Residents have the right to manage their own financial affairs and/or the right to quarterly accounting statements if the center is delegated this responsibility. Residents have the right to review a complete record of their funds, transactions, bills, etc.

28. Residents have the right to access their valuables/property that are on deposit at the center at reasonable hours.

29. Residents have the right to receive notice prior to a room change and/or having a roommate as well as an explanation to the fact. The Grand has all private rooms.

30. Residents have the right not to be discharged or transferred from the center unless for the following reasons: for the safety of other residents in the center, the health of residents in center would be endangered, the resident’s health has improved and he/she no longer meets the criteria for services provided in the center, and/or the welfare/needs of the resident cannot be met in the home. Other reasons may be that the resident has failed to pay for the services provided in the home, the center’s license has been revoked and/or the home is being closed, the resident receives Medicaid and the center is terminating the Medicaid program w/in the center, the resident receives Medicare and the center is terminating the Medicare program w/in the center.

31. Residents have the right to voice grievances and recommend changes to the center’s employees, to The Department of Health, or to any other person not associated with the center (Ombudsman, Legal Rights, family, friends, etc.). Residents are able to do this per their choice, free from restraint, interference, coercion, discrimination or reprisal.

32. Residents have the right to be informed of any significant change in their health status as well as their responsible party/emergency contact. The center shall make every reasonable effort to notify the resident and/or their responsible party/emergency contact as soon as the significant change is noted.

Resident Rights – Ohio & Federal Nursing Home Residents’ Bill of Rights.

Catherine Denlinger, MSW, LSW
Director of Social Services
The GRAND of Dublin

Resident Rights

This SSS (Social Services Series) will be a continuation of Ohio & Federal Nursing Home Residents’ Bill of Rights. During our last series we looked at the first five resident rights.  We will resume summarizing the resident rights continuing with number six.

  1. Residents have the right to request and obtain the name and any specialty of any physician and/or any other person that is responsible for his/her care or coordination of care in the center.
  2. Residents have the right to request/assign/select an attending physician that is not on the staff of the nursing center if they so wish (in accordance with the rules and written policies/procedures of the nursing center).
  3. Residents have the right to partake in the decisions that affect his/her life including but not limited to communication with the physician and/or staff of the nursing center regarding their care/treatment planning, medical condition, prognosis, etc. Residents further have the right to access their medical record as well as to give and/or withhold informed consent for treatment after the consequences of that choice is explained.
  4. Residents have the right to withhold payment for physician visits if the physician did not actually visit the resident.
  5. Residents have the right to confidentiality of their medical records. Residents have the right to refuse the release of their records to anyone outside the nursing center, except in cases of a transfer to another center, hospital or health care system.
  6. Residents have the right to privacy, especially during medical examination and/or care/treatment of their person.
  7. Residents have the right to refuse care/treatment.
  8. Residents have the right to be free from physical/chemical restraints or prolonged isolation. Physical or chemical restraints or isolation may be used in an emergency situation without authorization of the attending physician only to protect the resident from injury to self or others.
  9. Residents have the right to utilize the pharmacy of their choosing.
  10. Residents have the right to exercise all civil rights.

To review these rights in more detail please visit: Lawriter – ORC – 3721.13 Residents’ rights. codes.ohio.gov/orc/3721.13 and/or https://www.ohca.org/nursing_home_residents_bill_of_rights

What is DME (Durable Medical Equipment)?

Andre Hartley, CPht
Central Supply Manager
The GRAND of Dublin

What is DME (Durable Medical Equipment)?

DME, or Durable Medical Equipment, is a reusable item ordered or prescribed by a physician to a person with an illness, disability or injury.  These items serve a medical purpose and can stand repeated use.  They can be used in the home or in a care facility.

We have residents at the Grand who bring in their own DME to use while they are here.  Having familiar equipment that they know how to operate can be a comfort to those recovering in a new environment.  For any residents who are unable to bring in their own, the central supply department has a wide array of DME that can be borrowed or rented (depending on insurance) during a stay here.  Below are a few examples of some common DME you or your loved one may need to use during a stay:

DMEOxygen concentrators/generator: for those with trouble keeping up the oxygen levels in their blood.  This device takes in air, removes the nitrogen from it, and delivers purified oxygen to the user.  Just by plugging it into an outlet, it provides an endless supply of oxygen at up to 10 liters per minute, or LPM.

Low Air Loss, Alternating Pressure or Dual Therapy Air Mattress: As prescribed by a physician, this mattress system is for residents who have certain types of wounds or are at high risk for skin ulcers.  Tiny holes in the cover of these mattresses continually blow out air to reduce skin pressure.  This air flow also wicks away moisture from the skin to prevent breakdown.  This type of mattress also contains multiple cells of air that inflate and deflate very slowly to change pressure points and promote circulation.

Nebulizer machine:  A small device for residents who need certain inhaled medications, or breathing treatments.   You may need to use one of these machines if you have a chronic condition such as asthma, or an acute issue like pneumonia.  A nebulizer uses an air compressor to disperse medication in the form of a mist that can easily be inhaled.

Negative-Pressure Wound Therapy Pump or NPWT Pump:  As prescribed by a physician, NPWT promotes healing of certain types of wounds by applying a vacuum through a sealed dressing.  The reduced pressure caused by the vacuum draws fluid away from a wound and increases blood flow to the area.  The sealed dressing turns an open wound into a closed wound in a controlled environment.

These are just a few examples of the DME available for use by our residents here at The Grand.  Our Therapy department also carries an array of wheelchairs, walkers and other mobility devices for use by our residents.  If you would like more information about the availability of a particular DME item during your stay, please ask about it during your tour!

New Medicare Cards to Debut in April 2018

New Medicare Cards to Debut in April 2018

by Corey Ohalek
Associate General Counsel
Vrable Healthcare, Inc.

MedicareAs the technology world expands, so does the risk of fraud and identify theft. In order to combat “fraud, fight identity theft, and keep taxpayer dollars safe,” the Centers for Medicare and Medicaid Services (CMS) will be issuing new Medicare cards to Medicare enrollees beginning in April 2018. The previously enacted Medicare Access and CHIP Reauthorization Act of 2015 mandates CMS to remove Social Security numbers (SSN) from all Medicare cards by April 2019. SSN-based Health Insurance Claim Numbers (HICN) will be replaced with “a new, unique, randomly assigned number called a Medicare Beneficiary Identifier (MBI).” Congress’s belief is that the change from the SSN-based HICN will “better protect private healthcare and financial information, as well as federal healthcare benefit and service payments, from fraud.” Beneficiaries will not see a change in the “enrollees’ benefits, and the effective date of the new cards remains the date that each beneficiary was or is eligible for Medicare.”

April 2018

In April 2018, new cards will be issued through the mail with mailings occurring in phases based on geographic location dictated by CMS. CMS will provide additional details on the timing of the new cards as the mailing progresses. Providers, such as Vrable Healthcare, Inc., have been preparing their facilities for the upcoming change to ensure a smooth transition to the new cards. Lastly, as an effort to provide more protection to enrollees, CMS has made it clear that it will “never ask enrollees for personal or private information or charge a fee to obtain the new card. In fact, enrollees need not take any action to obtain these new Medicare cards.”

For more information on the upcoming changes to the Medicare cards, click here.

The GRAND News February 2018

Newsletter for February 2018

Looking for Love- Valentines Facts

  • 141 million Valentine’s Day cards are exchanged annually, making Valentine’s Day the second-most popular greeting-card-giving occasion.
  • Over 50 percent of all Valentine’s Day cards are purchased in the six days prior to the observance, making Valentine’s Day a procrastinator’s delight.
  • Research reveals that more than half of the U.S. population celebrates Valentine’s Day by purchasing a greeting card.
  • Americans spend around $277 million on Valentine cards every year, second only to Christmas
  • Groundhog Day was originally observed on February 14
  • Valentine’s Day is a $14.7 billion industry in the U.S
  • On Valentine’s Day, nearly 189 million stems of roses are sold in the U.S
  • A kiss on Valentine’s Day is considered to bring good luck all year

Valentine’s Day Raffle

We will be raffling off Valentine’s gift baskets. Each department has created a unique and creative basket for Valentine’s Day.  Raffle tickets are $1.00. Drawing will be February 14.

Groundhog Day

Every February 2, thousands gather at Gobbler’s Knob in Punxsutawney, Pennsylvania, to await the spring forecast from a special groundhog. Known as Punxsutawney Phil, this groundhog will emerge from his simulated tree trunk home and look for his shadow, which will help him make his much-anticipated forecast. According to legend, if Phil sees his shadow the United States is in store for six more weeks of winter weather. But, if Phil doesn’t see his shadow, the country should expect warmer temperatures and the arrival of an early spring.

February 13th

Fat Tuesday Mardi Gras party

♪ ♪ live music ♪ ♪

French donuts!

February 14th

Valentine’s Day formal! Music, treats, chocolates and dancing

February Firsts

Many firsts happened in February. Here are just a few.

2004 Facebook launched.

1971 Alan Shepard became the first person to golf on the moon.

1968 Mr. Rogers’ Neighborhood debuted.

1964 The Beatles first appeared on The Ed Sullivan Show.

1959 Barbie first introduced.

1948 First Polaroid “Land” camera went on sale.

1937 Nylon material patented by DuPont.

1935 Monopoly first sold in stores.

1930 Elm Farm Ollie became the first cow to fly in a plane.

1923 King Tut’s burial chamber opened.

1920 The Royal Canadian Mounted Police formed.

1910 Boy Scouts founded.

1878 Phonograph patented by Thomas Edison.

1849 Gold seekers arrived in San Francisco.

 

What’s Lucky in February?

Lucky Colors: Pink and Red

Lucky Day: Monday

Lucky Letters: F and Y

Lucky Numbers: 3 and 7

Lucky Plant: African violet

If you, your Church, and/or organization are interested in volunteering in the facility please contact Tarah Boyer, Regional Activities Director 614.389.0822 or tboyer@grandofdublin.com

 

Answering Skilled Nursing and Nursing Home Admissions Questions

by Danielle Batdorff, BSHA/HIS
Director of Admissions
Jada Palm

Hospital Liaison
The GRAND of Dublin

If a person has never been through the process, the thought of entering a skilled nursing or rehab facility can be a little overwhelming. It’s natural to have several questions. We’ve put together a list of the most commonly asked questions to help you better understand what to expect.

What is skilled nursing?

Skilled nursing is a type of intermediate care in which the patient or resident needs more assistance than usual. This setting is designated for physical, occupational, and speech therapies, to aide in strengthening the patient who has a goal of returning to their home at baseline. Skilled nursing services are offered to patients who need IV medications administered, who may have wound care needs, or who may need teaching on medication management, an example of this would be newly diagnosed diabetics.

What is the difference between short-term care and long-term care?

Short term care is a temporary solution that may last from a few days to a few months. Long term care is typically utilized for in-house placement for the duration of the patient’s life.

What social activities are offered?

Skilled nursing facilities offer a full calendar of social events and activities. Residents are encouraged to join in as many activities and social events as they like. Some examples include; art classes, ice cream socials, bingo and cards, game and movie night, quest performers and church services.

In addition, they offer wellness programs, exercise classes, beauty salons, small dining areas, café and restaurant style dining rooms, and outdoor sitting and walking areas.

What should I bring with me?

It is recommended that you bring comfortable clothing for working out in therapy along with good fitting shoes. Personal hygiene items (all labeled with your name), photo ID, insurance cards, advanced directive paperwork (Power of Attorney and Living Will paperwork).

What are the rooms like?

Some facilities offer both single and double occupancy rooms. Each facility has its own characteristics which make it unique and sets it apart from the other down the street. An example; The GRAND offers single occupancy rooms with walk-in showers, individual heating/cooling units, refrigerators, Wi-Fi and cable. Patient’s medications are locked securely in each patient room and we strive to provide a home like atmosphere.

What does Medicare cover?

Medicare part A covers skilled nursing care under certain conditions for a limited time.

  • You must have a qualifying hospital stay. This means you meet the minimum 3 night inpatient hospitalization requirement.
  • You have part A and days left in your benefit period.
  • Your doctor has ordered skilled services due to a medical condition which requires the need for 24/7 nursing care and therapy services offered 5 to 6 days a week.

Medicare covered services include;

  • A semi-private room
  • Meals
  • Skilled nursing care
  • Physical and Occupational Therapy
  • Speech-Language Pathology Services
  • Medical Social Services
  • Medical supplies and equipment used in the facility
  • Ambulance transportation (when other transportation endangers ones health) to the nearest supplier of needed services that aren’t available at the SNF
  • Dietary Counseling

Medicare part A will pay as follows;

  • Days 1-20 – pays at 100% with no patient responsibility
    (Remains $0 co-insurance for 2018)
  • Days 21-100 – patient responsibility of $164.50 per day co-insurance
    (2018 co-insurance will be $167.50)

Additional information can be obtained through Medicare.gov

How do I find out what my insurance will cover?

Insurance benefits and eligibility will be checked prior to admission to the building, but you may also call the member services number on your card and a customer service representative will provide you with details of your coverage options.

What is the next step and what can I expect once I select a facility?

Once you have selected a facility you will notify your hospital social worker and he/she will send the referral to the building for review. You may choose to tour the building. Your clinical is then reviewed by the admissions and nursing team to make ensure the facility can clinically manage your stay, and then the hospital liaison will visit you in the hospital to answer any questions you may have. If you need an authorization from your insurance to admit, the facility will then start that process. Once authorization has been received the facility will communicate with the hospital social worker.

What are your staffing ratios?

At The GRAND skilled setting, our ration is 1:12 or 1:13, with an STNA on each hall. Our staffing ratios are significantly above average.

How often is therapy provided and will I have a schedule?

Therapy is provided at the discretion of your ordering physician, the therapy team, and your needs. You can ask for a specific schedule if that works better for you. At The GRAND, the therapy team will meet with you either the day of your arrival or the next day.  An example, some prefer mornings, some prefer afternoons and some prefer to have their therapies separated. Meaning occupational therapy may be planned for the afternoon and physical therapy planned for the mornings.

What sets your facility apart from the others?

The GRAND offers several amenities that set us apart from our competitor’s. We have Digger and Finch pub, our ice cream parlor, Movie Theater, beauty salon, pharmacy, chapel, licensed in-house therapy team and team of dedicated nurses and STNA’s and low patient/staff ratios, we offer outstanding service to our residents.

What are your visitation hours and/or restrictions?

Each facility will have set hours of operation. The most common hours of operation most facilities follow are 8am to 8pm, 7 days per week. The GRAND’s hours are 8:30am to 8pm, Monday through Friday and 9am to 8pm, Saturday and Sunday. There may or may not be restrictions on when visitors can be with their moved one. The GRAND does not have such restrictions and provides security 7 nights per week.

Hiring Assisted Living LPNs – Night Shift

We are currently looking for experienced LPNs to join our team at The Grand, located at 4500 John Shields Parkway, Dublin, OH 43017.

This position will be working in our 20 bed Assisted Living unit, duties will include, but not limited to med pass, and supervision of the Assisted Living unit.

The Grand has 143 beds consisting of Skilled Nursing, Assisted Living and Independent Living.  You will be working at a one of a kind, state of the art facility in Central Ohio.

Our philosophy is to embrace the ideals of quality care, dignity, independence and vitality. By fostering these ideals for every individual, and by providing necessary skills and care, we promote health and welfare of both the individual and the community.

Company Overview

Vrable Healthcare is a growing Ohio company owned privately by a pharmacist and nurse with the vision of providing exceptional care across Ohio. We believe our first responsibility is to the patients we serve. We respect the physical, emotional and spiritual needs of our patients and find that compassion is essential to fostering healing and wholeness.

We believe our patients and their families deserve the best possible healthcare experience. We are committed to the pursuit of excellence in all that we do. Teaching and learning are fundamental in our efforts.

We believe our employees are the source of our success. Our organization must reflect the rich diversity of our communities. We are committed to providing a work environment that enables our employees to fulfill their professional, family, and community responsibilities.

Our every action must advance our mission: To improve the Quality of Life & Health of those we serve.

Qualifications

  • Currently licensed as a LPN in Ohio.
  • Minimum of one (1) year of nursing experience in a setting serving the same age/type of resident population served by this facility.
  • LTC experience required.
  • Must have strong computer skills.
  • Excellent verbal, written, and interpersonal communication skills.
  • Completion of an approved course of practical or vocational nursing study.

Vrable Healthcare is a trusted name providing skilled nursing and rehabilitation services throughout Ohio.  We offer competitive wages and benefits including 401k, tuition assistance, and paid vacations.

Visit us online at www.vrablehealthcare.com

Interested in joining our team?  Qualified candidates should apply at www.applyatvhc.com

EOE

Hiring Assisted Living LPNs – Day Shift

Assisted Living LPNs – Day Shift

We are currently looking for experienced LPNs to join our team at The Grand, located at 4500 John Shields Parkway, Dublin, OH 43017.

This position will be working in our 20 bed Assisted Living unit, duties include, but not limited to med pass, and supervision of the Assisted Living unit.

The Grand has 143 beds consisting of Skilled Nursing, Assisted Living and Independent Living.  You will be working at a one of a kind, state of the art facility in Central Ohio.

Our philosophy is to embrace the ideals of quality care, dignity, independence and vitality. By fostering these ideals for every individual, and by providing necessary skills and care, we promote health and welfare of both the individual and the community.

Company Overview

Vrable Healthcare is a growing Ohio company owned privately by a pharmacist and nurse with the vision of providing exceptional care across Ohio. We believe our first responsibility is to the patients we serve. We respect the physical, emotional and spiritual needs of our patients and find that compassion is essential to fostering healing and wholeness.

We believe our patients and their families deserve the best possible healthcare experience. We are committed to the pursuit of excellence in all that we do. Teaching and learning are fundamental in our efforts.

We believe our employees are the source of our success. Our organization must reflect the rich diversity of our communities. We are committed to providing a work environment that enables our employees to fulfill their professional, family, and community responsibilities.

Our every action must advance our mission: To improve the Quality of Life & Health of those we serve.

Qualifications

  • Currently licensed as a LPN in Ohio.
  • Minimum of one (1) year of nursing experience in a setting serving the same age/type of resident population served by this facility.
  • LTC experience required.
  • Must have strong computer skills.
  • Excellent verbal, written, and interpersonal communication skills.
  • Completion of an approved course of practical or vocational nursing study.

Vrable Healthcare is a trusted name providing skilled nursing and rehabilitation services throughout Ohio.  We offer competitive wages and benefits including 401k, tuition assistance, and paid vacations.

Visit us online at www.vrablehealthcare.com

Interested in joining our team?  Qualified candidates should apply at www.applyatvhc.com

EOE

Hiring Assisted Living Hospitality Aides – Night Shift

Assisted Living Hospitality Aides – Night Shift

Night Shift 7pm – 7am

We are currently looking for Hospitality Aides to join our team at The Grand, located at 4500 John Shields Parkway, Dublin, OH 43017.  The position will work in our 20 bed Assisted Living Unit.

The Grand has 143 beds consisting of Skilled Nursing, Assisted Living and Independent Living.  You will be working at a one of a kind, state of the art facility in Central Ohio.

Position Summary: Responsible for providing resident related (non-hands-on) care.

Position is applicable prior to successfully receiving state testing as a Nursing Assistant. Performs host/hostess duties in accordance with accepted standards of non-hands-on resident care

Our philosophy is to embrace the ideals of quality care, dignity, independence and vitality. By fostering these ideals for every individual, and by providing necessary skills and care, we promote health and welfare of both the individual and the community.

Company Overview

Vrable Healthcare is a growing Ohio company owned privately by a pharmacist and nurse with the vision of providing exceptional care across Ohio. We believe our first responsibility is to the patients we serve. We respect the physical, emotional and spiritual needs of our patients and find that compassion is essential to fostering healing and wholeness.

We believe our patients and their families deserve the best possible healthcare experience. We are committed to the pursuit of excellence in all that we do. Teaching and learning are fundamental in our efforts.

We believe our employees are the source of our success. Our organization must reflect the rich diversity of our communities. We are committed to providing a work environment that enables our employees to fulfill their professional, family, and community responsibilities.

Our every action must advance our mission: To improve the Quality of Life & Health of those we serve.

Qualifications:

  1. Minimum of High School diploma or G.E.D. equivalent.
  2. Capability of becoming a State Tested Nursing Assistant.
  3. Excellent communication and interpersonal skills.

Education: Minimum of High School diploma.

We offer competitive wages and a benefit package.

If you are interested in a rewarding career please apply on line at www.applyatvhc.com.

Visit us at www.vrablehealthcareappone.com