Archive | September, 2012

Case Audit Follow-up for CSI SCs

I continue to be very pleased with how well you have adapted to your new positions as Service Coordinators in the past five months. This is clearly demonstrated in your audit outcomes. I have a few tips as you start to formulate your corrective action plans:

 

1. If you have any questions, please don’t hesitate to ask Cheryl and me.

2. Please respond immediately to Cheryl when you receive your electronic AND your written audit forms. It is your response to Cheryl that triggers your 5 day time period for submitting your Corrective Action Plan and your 30 day time period for completing your Corrective Action Plan. Cheryl will enter the dates into your audit timeline excel file in order to track your progress. You are encouraged to do the same thing in order to track on your end. Question for Cheryl: Are they days working days or calendar days? Please assume calendar days unless you hear otherwise from Cheryl.

3. You should write your Corrective Action Plan on the electronic Audit Report Form and submit electronically to Cheryl within the timeframe listed above. You do note need to write a separate Corrective Action Plan on each individual client form.

4. You only need to write a Corrective Action Plan for items with a double asterix (**). Other comments are there just for your information.

5. A Corrective Action Plan should correct what can be physically corrected (ie obtain the missing physician’s name) AND what you plan to do in the future to reduce the potential to make the same mistake again (ie plan to use AASC Online or Zimbra calendar to prompt reminders to obtain missing information from client).

6. Please schedule an appointment with me, if you haven’t already, to review your Corrective Action Plans. This can be in-person or via phone depending on your preference.

7. If you are missing pieces of information on your intake or assessment forms (ie physician’s name, race, etc.), you may hand write it into your hard file and indicate that you have also updated the information in your electronic file (initial and date this note). You do not need to reprint the entire intake or assessment form.

8. Visual Review.

a. Many of the issues identified with the Visual Review are issues that we need to work out with CSI regarding signage and keypad entry into the buildings. I have shared the visual review forms with your liaison and Sharon already. Please review them with your liaisons at your monthly meeting.

b. I have told CSI that you will be regularly brining brochures and updated print outs of your AASC Online resource directories to your monthly meetings to share with the FCRC chairs for their FCRC binders. Please ask your FCRC chairs where these binders are kept and tell your auditor when she returns for her re-inspection.

 

We are assessing where we are seeing consistent challenges with case files, and we will be planning trainings and clarifying our case management procedures accordingly. Two important upcoming dates to remember are:

 

1. October 2nd. After we conclude our Co-op 102 training, there will be 3 afternoon sessions provided for all SCs by Hannan, including:

a. Working with clients with emergent situations that may include APS or 911 calls, other referal options, or that you may be able to de-escalate because they don’t quite reach the threshhold of an APS referal (by Brenda Carney and Ann Kraemer).

b. Presentation of Hannan’s Professional Development Program by Ann Kraemer.

c. Presentation and Q&A regarding clarifications to Case Management procedures by Cheryl Bukoff. Some of you may have case file “ordering” issues that will be resolved with this clarification. In these situations, it is not a need for “Corrective Action” because you technically meet the letter of our current case management procedures, but that you should consider updating the way you order your files once it is clarified for you. We’ll discuss this.

 

2. October 23rd, 12noon, ADL Assessment Training by Brenda Carney. A number of SCs have client-cases where there is inconsistency with how we have determined challenges with ADLs. After the training, you will likely see a need to conduct an Updated ADL Assessment and corresponding Updated Service Plan.

 

Once again, great job and congratulations with finishing your first audit. I hope it was a good learning experience and I look forward to your feedback.

 

Sincerely,

Rachel

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Changes to Case Management Procedures

Cheryl, Rachel and  Brenda had the opportunity to discuss some of the issues that we have heard the service coordinators are encountering that impact our case management procedures.  After discussion, we are going to revise our case management procedures as follows:
1)  When attempting to offer services to residents/members that are either new or annually, three separate documented attempts without response will constitute a “refusal” of services.  This means that you need to attempt three different types of direct contact with the resident/member and document each attempt.  Only after that third unsuccessful attempt is it considered a refusal.  Seperate direct attempts include telephone messages, notes under the door, or direct mailing.  Once these three attempts have been made and the resident/member does not respond to you then you can document that the resident does not want services at this time in your progress notes.
2)  The “Non-Participation Form” will ONLY be used when a specific service is offered and declined.  The form does not need to be signed by the resident/member when you are simply offering the services of the Service Coordinator, when they are new or annually, and they decline.  A specific service would be a service that is specifically being offered to the resident because of a referral from management, the FCRC, or something that the Service Coordinator deems as being an imminent/emergent need that the resident refuses. The specific service being offered can be detailed in the “comments” box.  A resident/member can sign a “Non-Participation Form” and still be considered an “active client” of the Service Coordinator, still receiving OTHER services, but refuses a specific service.
3)  Group Add Service Logs and Progress Notes are to be completed for ALL residents regardless of client status.  Therefore, any resident that attends an educational session will be included on the group add on the Service Logs and Progress Notes.
4)  Service Logs should be used on any contact with the resident/member and the Service Coordinator needs to utilize the “subcategory” when identifying the type of service provided.  We are asking that all Service Coordinators make a concentrated effort to eliminate “Other” as an option and that you specifically categorize your interactions.
All of these updates go into effect today.  Should you have any questions, please do not hesitate to contact us.

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University of Michigan School of Information Communications Inquiry

As you may recall from our earlier conference call discussion regarding communication needs of service coordinators, a team of University of Michigan School of Information Masters students is conducting an analysis and presenting recommendations regarding the Hannan Service Coordination Program’s communication system this semester.
Diana Bachman, team liaison, is very pleased to be working with the Luella Hannan Memorial Foundation for their School of Information “Contextual Inquiry” project.  The team has five members total:
Diana Bachman
Paul Belser

Yanni Gu

Weichao Li

Meng Xia
Diana has “read only” access to SCoop for the semester, and the team will be looking at our organizational communications structure and policies. The team will interview 10 of us regarding how we communicate, including four PVM SCs (two in Metro and two in Detroit) and four CSI SCs (including one in Kalamazoo). The team will not have access to any client files or documents, but will be signing a confidentiality agreement regarding any Hannan, PVM or CSI information they utilize during their study.
We are excited to have their assistance helping us develop our communications systems. Please help make the team feel welcome, and if you have any questions, please don’t hesitate to contact me directly.
Sincerely,
Rachel
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Medicaid Spend down aka Medicaid deductible

Medicaid Spend down also referred to as Medicaid deductibles are not bills  that have been paid by the beneficiary.   However, they are bills that have been received from any medical appointment and it  includes prescription drug costs. Copies of  these bills must be  submitted to the DHS Specialist monthly.  When the bills are received by the DHS Specialist, they keep a talley and their system will generate a report letting them know what beneficiaries have/have not met the Spend down/Deductible.  If the deductible is not met for 3 consecutive months, the beneficiary will receive a letter informing them that their Medicaid benefits have been suspended.  If this happens, they must reapply.  The Spend down/Deductible  amounts are set by the DHS system and it is based on the  information entered on behalf of the beneficiary. The DHS Specialist DOES NOT PERSONALLY SET THE AMOUNT!

A. Smith,  Dearborn Heights Co-op

 

 

 

 

 

 

 

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Nursing Home Payment

The question was asked, when will a nursing home start “taking” a person’s social security check when they are receiving services at the nursing home … and is there anything that can be done to stop this?

Ann Kraemer states, “I want to reinforce that nursing homes don’t “start taking” resident’s social security.  As Brenda notes [below], Medicare & other insurance programs pay for some of the person’s stay in a nursing home.  If the resident’s Medicare days run out, (ref Brenda’s reference to the 21-100 days Medicare & related insurance limitations)  then the resident has to pay for his/her stay in the nursing home. Residents typically “turn over” their social security checks to the nursing home for a portion of their payment. Keep in mind that nursing homes charge on the average $6-7,000/month so most nursing home residents are looking for ways to pay that tab when their health insurance won’t pay.”

Brenda Carney adds, “For traditional Medicare, Medicare pays 100% of the first 20 days, and then a daily co-payment thereafter for days 21 – 100, as long as they meet the criteria for Medicare Skilled Care.  If they have a secondary insurance (besides Medicaid), they may pick-up some to all of the daily co-payment.  If their secondary insurance is Medicaid, then at day 21 they start charging the daily co-payment until all but $60 of their social security check is depleted then Medicaid kicks in.  If they DO NOT have Medicaid, then the co-payment starts at day 21 and continues until discharge from Medicare.  Therefore, it is HIGHLY recommended that they apply for Medicaid should they not have any savings (over $2000) as it could cost them A LOT.  Nursing Home Medicaid is different than community Medicaid, so it is worthwhile applying for …

Having said ALL of this, there is a Special Director or Olmstead exception that they can apply for which will possibly waive part to all off the monthly payment to the nursing home out of the Social Security check.  Below is a link that explains this application process.  The nursing home social worker should be able to assist with this process.  They have to provide supports for all NECESSARY bills that they need to maintain their apartment while they are in the nursing home.  It does not include Cable TV, etc.  I have applied for this on behalf of a resident successfully and partially successfully.  Do not anticipate that the entire social security check will be preserved.

http://www.mplp.org/Issues/mplpissue.2010-05-05.9554801510

As for food stamps and SSI, while you are in a nursing home, these items are items that can be cut.  However, it does not consistently happen, depending on how long the individual is in the nursing home and the speediness at which the billing office at the nursing home submits and the State changes the resident’s status as Nursing Home in the State computer.  There is no work around that I know of … and cannot be applied for until after they are discharged from the nursing home.  There is a code in the State Medicaid system that needs to have them reflected as being community living for them to be eligible for Food Stamps and SSI.  Conversely, it can take a while when the person is OUT of the nursing home to resume these services as it depends on the speed of the billing office at the nursing home to submit and DHS to change the State database.”

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Corporation for National and Community Service RSVP Programs

The Corporation for National and Community Service is currently seeking applications in the 2013 Retired and Senior Volunteer Program (RSVP) competition. RSVP grants provide support to community service programs that utilize volunteers 55 years of age and older in meeting local and community needs through service. Focus areas for the grants include education, healthy futures, veterans and military families, environmental stewardship, economic opportunity, and disaster services.

 

The application deadline is October 11, 2012. For more information on this opportunity, visit:  http://1.usa.gov/QG418F.

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ACA Moon Festival at Hannan House

The Association of Chinese Americans is hosting a Moon Festival event at Hannan House on Thursday, September 27th, 11am-1:30pm. 4750 Woodward. Donations welcome. RSVP by 9/25/12 to ACA staff at 313-831-1790.

Event includes the origin of the Mid-Autumn Festival, Moon Cake Making Demonstration, and Lunch.

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Host a MASC Meeting

Some Michigan attendees at the AASC Conference wore MASC t-shirts that read, “130 strong”. The Hannan SC team represents 1/5 of the membership. Brenda and I encourage your active participation and would be supportive of you volunteering to host a MASC meeting.

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MASC Meeting

Next MASC Bi-monthly Training and Networking Meeting 9:30 a.m. Friday, September 21, 2012 Parkway Meadows, Ann Arbor MI

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Posting your AASC Online Agency List

AASC Online tip of the day!:

You have the resources your residents/members need at your fingertips. In the upper right-hand corner of your AASC Online Resource Director is the option to Print Agency List. Do it! Then post it on your bulletin board and share it with your residents/members. CSI SCs should bring their FCRC Chairs updates of the Agency list at their monthly meetings for the FCRC Chair to put in their resource binder…..and let your auditor know that you have done this and where the FCRC binder is located. The idea is knowledge is power! Some residents/members would prefer to check out your resource list on their own terms during non-office hours, so make it available. Thanks!

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