Transcript CBO-Purchased Care - National Association of State Veterans Homes

2013 NASVH & NASDVA
Summer Conference
VHA State Home Per Diem Program
Cyndi Kindred, SES
Deputy Chief Business Officer
For Purchased Care
State Home Per Diem
Program Accomplishments
VETERANSHEALTHADMINISTRATION
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Grant Program Update – 2013 Grant
Awards
• VA will award 62 state home construction projects
– 34 conditional grant awards ($78M)
– 28 final grant awards ($124M)
– There are 50+ homes approved for 2013 funding and the
ARRA projects are all closed
• Conditional grant awards signed August 30th
• Complete grant application by February 2014
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Grant Program Update
Initial Applications 2014
• VA received 56 initial state applications for
FY2014
•
15 safety projects
•
2 bed replacement projects
•
2 adult day health care
•
7 new construction projects
Reminder: State grant applications may be submitted year round in
grants.gov.
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How you can help us !
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VA’s Landing Page
www.va.gov/aca
VETERANSHEALTHADMINISTRATION
New State Home Survey Contract
• Contract awarded by Geriatrics and Extended Care Operations
office (GEC-Ops) July 31, 2013 to current vendor, Ascellon
Corporation
• Survey Team- Contractor, VAMC Representative, and VAMC
fiscal surveyor
– Conduct all SVH annual, recognition, for cause, and abbreviated
surveys during the base year - August 1, 2013 – July 31, 2014
– If exercised, four option years - August 1, 2014 – July 31, 2018
– The Ascellon Corporation will conduct the clinical & life safety
components of the surveys in State Home, skilled nursing, domiciliary,
& adult day health care facilities
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New State Home Survey Contract
(continued)
• The VA Medical Center Representative and the fiscal surveyor
will survey the administrative and fiscal components
• GEC-Ops has oversight of the State Home survey process
• The standards used to survey State Homes will not change;
they will continue using VA State Home Per Diem federal
regulation standards
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Types of Surveys
• Annual – Done during the anniversary month of the State Home’s
recognition or agreed upon month by VA and the State Home
• Recognition – A recognition Survey is the VA survey of a State Home used
to determine its compliance with VA standards for the purpose of
recognizing the home as a State Home by VA
– Must be on site 10 business days after official notification and are announced
surveys
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Types of Surveys
(continued)
• For Cause -- Survey authorized by GEC- Ops to investigate specific, or a
series of, incidents, complaints, deficiencies, or events that may jeopardize
the health or safety of residents
– covers specific standards related to the event or series of events.
– The scope of standards reviewed for a for cause survey can be expanded, if deemed
necessary by the survey team.
– Must be on site 15 business days after official notification and are unannounced surveys
• Abbreviated – NEW - An Abbreviated Survey is a survey authorized by GEC
Ops to investigate a specific standard or deficiency found during a survey
– Will cover only the specific deficiency found during a survey
– Includes follow up visits to investigate deficiencies found during a previous survey.
– Must be on site 15 business days after official notification and are unannounced surveys
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Homeless Programs in SVHs
• VHA workgroup established to address the issue
– Representatives from GEC Operations, Office of General Counsel, Chief
Business Office, Homeless Programs, and Construction and Grants
– Evaluating program requirements to determine how State Homes can
establish homeless programs
• State Home requirements
– Addressing whether the VA recognized beds are needed for the original
intent
– Validating resources are in place to meet the homeless program
requirements
• Program requirements and process for converting State Home
Domiciliary beds are yet to be developed
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Newly Recognized State Homes (2013)
• Representing 585 additional beds:
– 470 Nursing Home Beds
– 80 Domiciliary Beds
– 35 Adult Day Health Care Slots
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New Home
Addition
Replacement
Pell City, AL
174 NH 80
Dom
Hanson, KY
* Minneapolis, MN
36 additional
NH
** Minneapolis, MN
Black Mountain, NC
* Spring City, PA
Conversion Beds
** 100
NH
* 35
ADHC
100 NH
** Spring City, PA
* 72
NH
**120
NH
Scranton, PA 16 Dom to NH
Chippewa Falls, WI
72 NH
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State Home Internet Site
• Data Repository of Regulation, Policy and Reports
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Per Diem Rates
Construction Grant Guidance
Bed Changes
Survey Appeals
Occupancy Reports, authorized beds
Handbooks & Directives
Training
• Link: http://www.nonvacare.va.gov/state-homes.asp
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General Overview – State Veterans Homes
Total State Home Facilities - 146
– Skilled Nursing Programs - 137 (24,853 beds)
– Domiciliary Programs - 53 (5,865 beds)
– Adult Day Health Care Programs - 2 (85 slots)
• Total Programs – 192
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Statistical Updates FY 2012 and YTD 2013
Average Daily
Census
FY 2012
FY 2013 YTD
Nursing Home
Basic
17,797
17,410
Nursing Home
SC Veterans
1,871
2,152
Domiciliary
3,644
3,527
ADHC
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(May 2013)
* Public Law Impact
Data Source: SQL database
State Home Per Diem Program
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FY 2013 Year to Date Budget
• FY 2013 Budget - $975,274,023
– Projected Expenditures – $942,570,145
– Average monthly expenditure - $77,040,261
• FY 2014 Budget - $1,070,848,000
VETERANSHEALTHADMINISTRATION
FY 2014 Per Diem Rates
• Rates have been established
• The rates require VHA approval
• Target date for release is September 2013
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10-10SH Applications
Accurately and Timely
Program Audits: Improper Payment Elimination
Recovery Improvement Act - IPERIA
– The VHA Office of Finance conducts annual audits for a
variety of programs including the State Home Per Diem
program
– The findings revealed administrative errors which will
require VAMC’s to request applications that were
submitted previously
– Your cooperation to assure that we have a 10-10SH for
every Veteran is greatly appreciated
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Timely Per Diem Payments
• We want to ensure your payments are timely
• Implementation of the electronic invoicing requirements have
improved timeliness of monthly invoices
• Timely retroactive payments continue to be a concern for
some State Homes
• Please reach out to the State Home Per Diem office if you are
unable to resolve payment delays with your local VAMC
– Point of Contact - Kelly Schneider [email protected] or (520)
395-0310
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