March 11, 2014

OHCA's News Currents brings you information on Important Dates, Deadlines, and Late

Breaking Issues concerning long term care and association involvement. Announcements

and updates are categorized into sections to help you navigate easily for information

important to you.

Have you taken advantage of OHCA's Member Resource Section?

User: ohca

PW: support2014

OHCA member log-in codes change periodically. Stay tuned to member communications to stay

up to date, or contact OHCA at 503-726-5260.

View OHCA's archived member communications online.

Assisted Living & Residential Care News

Brookdale Senior Living Inc. buys Emeritus Corporation for $2.8 billion

Brookdale Senior Living and Emeritus Senior Living will merge in a $2.8 billion deal, creating a

new behemoth in the long-term care sector, the companies announced this afternoon.

The transaction is expected to close in the third quarter of 2014. Granger Cobb, currently the

president and CEO of Emeritus, will join the Brookdale board and continue in a consulting role.

Read More...

Oregon DHS Office of Licensing & Regulatory Oversight Next CBC News Hour

April 9

The CBC News Hour is a quarterly Webinar/teleconference for providers of assisted living,

residential care and memory care facilities. It is conducted by the CBC Staff from the Department

of Human Services Office of Licensing & Regulatory oversight. Detailed information about the next

session will be made available via Administrator Alert email. Click here to sign up to receive alerts

directly if you are not already receiving them.

Save the Date

The Community Based Care News Hour will be held quarterly on the 2nd Wednesday of the

month, from 9:00am-10:00am. Listed below are the dates for the next news hours.

April 9, 2014

July 9, 2014

October 8, 2014

ALFA 2014 Conference & EXPO - Contact Us for Registration Discount Code

The Assisted Living Federation of America announced the general conference program for the

ALFA 2014 Conference & Expo, offering world-class keynote speakers and valuable sessions as

well as an exclusive education institute for senior living executives.

Led by keynote speakers former Congresswoman Gabrielle Giffords and her husband astronaut

Mark Kelly, endurance swimmer Diana Nyad, academic Sir Ken Robinson and artist Candy Chang,

the conference sessions are set to lead change and inspire passion. The ALFA 2014 Conference &

Expo will feature 75 educational sessions exploring topics and trends shaping the senior living

business today.

As an incentive to encourage your state members to attend the conference we will provide a

unique promo code per state for a $50 discount. This code will be valid until March 15, which can

be used in addition to the Early Bird rate, providing them a savings of $195 off the on-site

registration price.

ALF/RCF Council Quarterly Meeting March 19th and ALL OHCA ALF/RCF

Members are Welcome

The next quarterly ALF/RCF Council meeting is Wednesday March 19, 2014~ 8:30 a.m. - 11:30

a.m. at the OHCA OHCA Offices.

The draft meeting agenda includes: *February Legislative Session Update * Public policy updates

* Guest: Mary Jaeger, LTC Ombudsman * Guest: Cory Oace, Manager for CBC program, Office of

Licensing & Regulatory Oversight * NCAL PSO progress report * Alliance Insurance Risk

Management

These meetings are open to all OHCA ALF/RCF members. We just ask that you RSVP to

lindak@ohc.com so we can assure sufficient meeting materials. Remember You Get: 2.5 CEUs for

attending.

Questions, please email Linda Kirschbaum or call her at (503) 726-5228.

AHRQ to Offer Free Webinar Series

The Agency for Healthcare Research and Quality (AHRQ) is hosting

a free webinar series on Improving Patient Safety in Long-Term Care Facilities. The webinar series

is intended for nurse administrators and nurse educators who train or work closely with direct

care staff at long-term care facilities. The first webinar, and introduction to the series, will be held

on Wednesday, March 12 from 1:00pm - 2:00pm EST. The dates for the additional webinars in

the series are :

Detecting Change in a Resident's Condition. Wednesday, April 23, 1:00 - 2:00 PM ET

Communicating Change in a Resident's Condition. Wednesday, June 18, 2014 1:00 - 2:00 PM ET

Falls Prevention and Management. Wednesday, August 13, 2014 1:00 - 2:00 PM ET

To sign-up please visit this site.

For more information please see the flyer.

Advancing Excellence Announces New Membership Category for Providers

Advancing Excellence has announced a new membership category - Provider Membership in the

Collaborative. This new membership category allows nursing homes and other providers the

opportunity to connect with the most influential stakeholders in long-term care to influence

national quality improvement efforts and create social change. For more information on the

membership category.

Click Here for the Details

See General, Workforce and AHCA/NCAL for more of this issue's Important Dates, Deadlines, Late

Breaking Issues, and Technical Resources.

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In Home Care/Home Health Care & Senior Retirement Housing News

New HIMSS Unit to Focus On Mobile, Home-health Market

Modern Healthcare, Joseph Conn, 02/24/2014

An arm of the Healthcare Information and Management Systems Society devoted to promoting

mobile health information technology has merged with the Continua Health Alliance, a consortium

of home healthcare device manufacturers and users.

Read the Story

Attention Home Health Agencies

On October 1, 2014 all Medicare claims submissions of diagnosis codes will change

from the International Classification of Diseases, 9th Edition, Clinical Modification

(ICD-9-CM) to the 10th Edition (ICD-10-CM). All entities covered by the Health

Insurance Portability and Accountability Act (HIPAA) must make this transition requiring systems

changes throughout the entire health care industry.

To Read More Click Here

NIA Info and Tips for Alzheimer's Caregivers

The National Institute on Aging has this guide, Caring for a Person with Alzheimer's Disease: Your

Easy-to-Use Guide from the National Institute on Aging, available either online or in print by

request.

See General, Workforce and AHCA/NCAL for more of this issue's Important Dates, Deadlines, Late

Breaking Issues, and Technical Resources.

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Nursing Facility News

Save the Date!

NF Quarterly News Hour Dates

April 23, 2014

July 23, 2014

October 22, 2014

Electronic Health Records (EHR) Data Concern

Surescripts, a major provider of medication history services, has determined that a single data

source for some of its medication history records contains information that may be inaccurate. For

more information click here: EHR med history data concern Feb 2014 and here National Alert

Network Feb 18 2014.

Medicare Beneficiaries Discharged from Nursing Homes Return to Hospitals

within Month

News-Medical.net, News-Medical Staff, 02/20/2014

According to a recent study led by a researcher at the University of North Carolina at Chapel Hill

School of Nursing, a high percentage of Medicare patients who are discharged from nursing

homes will return to the hospital or the emergency room within 30 days, due to requiring more

acute care.

Read the Story Here

REPORT: Culture Change Linked to Reduced Survey Deficiencies

in Nursing Homes

Nursing homes that have embraced culture change demonstrated a significant

reduction in health-related survey deficiencies, a study shows.

Full Story Here

Reform Update: VA Research Pinpoints Most Costly Combos Of

Chronic Conditions

Modern Healthcare, Melanie Evans, 02/26/2014

New research from the U.S. Veterans Affairs Department found that VA

patients who have at least three chronic conditions account for a

disproportionate share of total medical costs.

Read the Article Here

Hospice Providers

Report all status changes for Oregon Medicaid nursing facility (NF) residents

within 2 working days of the change

It has come to our attention that some nursing facilities have received duplicate payments

requiring claim adjustments. To avoid this problem, hospice providers must complete and fax the

DMAP 525 notification form within 1 to 2 working days after the NF resident begins hospice and

each time there is a status change.

Do not wait until the client is eligible for the NF benefit on the MMIS. Reportable status changes

include death; hospice discharge; hospice revocation; and hospice or NF transfer.

Additionally, NFs should not bill the state directly for NF residents on hospice.

Prestige Care Increases Transparency with Online Reporting Program

Prestige Care, Inc., which operates and manages thirty-four skilled nursing facilities in Oregon,

Washington, Idaho and Alaska, was awarded special recognition this year by the Oregon Patient

Safety Commission as a leader in adverse event reporting. Recently, the company has taken on a

large scale initiative to increase their transparency regarding adverse events at all levels and

implemented an online incident reporting program that goes hand in hand with the Oregon

Patient Safety Commission's Patient Safety Reporting Program.

Read more

QAPI. Quality Assurance & Performance Improvement Tools & Resources

Details Available Here

Advancing Excellence Campaign Adds New Membership Category

Advancing Excellence in Long-Term Care (AE) is proud to announce Provider Membership in the

Collaborative. This new membership category allows nursing homes and other providers the

opportunity to connect with the most influential stakeholders in long-term care to influence

national quality improvement efforts and create social change. "We are excited to grow AE's

membership through this new provider category," said Executive Director Doug Pace. "We know

we can reach our goal of making nursing homes better places to live, work and visit through

shared efforts with our committed partners." Provider members will be eligible to hold one seat

on the AE Board of Directors and may participate in or chair a work group, committee or task

force. This new membership category gives providers a parallel path for involvement with the

Collaborative, in addition to using the goals and entering data as active participants in the

Advancing Excellence in America's Nursing Homes Campaign.

For more information on Provider membership and dues, contact Doug Pace at (202) 508-9454

or dpace@aeltcc.org. Website

The Agency for Healthcare Research and Quality (AHRQ) offering No Cost

Webinar Series Starting March 12

Wednesday March 12, 2014 from 1:00 - 2:00 PM (ET)

View Flyer Here

Improving Patient Safety in Long-Term Care Facilities: Introduction to the

Webinar Series

Purpose: This is the first of 4 Webinars which aims to provide nurse administrators and nurse

educators guidance on training using the materials covered in AHRQ's +Improving Patient Safety

in Long-Term Care (LTC) Facilities Training Modules.

Wednesday March 12, 2014 from 1:00 - 2:00 PM (ET)

Target Audience: Nurse administrators and nurse educators who provide staff training to first-

line care staff, or who work closely with staff at long-term care facilities.

Presenter: Marian D. Edmiston, DEd, MSN, RN-BC

No cost registration here.

CE's available

Additional Upcoming Webinars in this Series

Detecting Change in a Resident's Condition. Wednesday, April 23, 1:00 - 2:00 PM ET

Communicating Change in a Resident's Condition. Wednesday, June 18, 2014 1:00 - 2:00 PM ET

Falls Prevention and Management. Wednesday, August 13, 2014 1:00 - 2:00 PM ET

U.S. News & World Report Releases Best Nursing

Homes 2014

U.S. News & World Report released its list of Best Nursing Homes

2014 which highlights the top nursing homes in every state and

nearly 100 major metropolitan areas. The ratings cover almost

16,000 nursing homes. The list provides data and information on

care, safety, health inspections, staffing and more for nearly every

nursing facility in the US. Access the Best Nursing Homes 2014.

OIG Issues Adverse Events in Skilled Nursing Facilities Report

The federal Department of Health and Human Services (HHS)/Office of Inspector General (OIG)

has issued its report on adverse events in skilled nursing facilities (SNFs): "Adverse Events in

Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries."

Some highlights include:

This OIG report is a clinical assessment of the medical care provided in SNFs;

The media often gets confused about what "adverse events" means - it is not equivalent to

"abuse." (This post-acute care report mirrors the 2010 OIG report on adverse events in

hospitals.)

OIG uses the "E-I" template to evaluate harm in the report. "E" means there was

temporary harm that was quickly alleviated and "I" can mean that someone died.

OIG study summary

This study estimates the national incidence rate, preventability, and cost of adverse events in

SNFs by using a two-stage medical record review to identify events for a sample of 653 Medicare

beneficiaries discharged from hospitals to SNFs for post-acute care. Sample beneficiaries had SNF

stays of 35 days or less.

An estimated 22 percent of Medicare beneficiaries experienced adverse events during their SNF

stays. An additional 11 percent of Medicare beneficiaries experienced temporary harm events

during their SNF stays. Physician reviewers determined that 59 percent of these adverse events

and temporary harm events were clearly or likely preventable. They attributed much of the

preventable harm to substandard treatment, inadequate resident monitoring, and failure or delay

of necessary care. Over half of the residents who experienced harm returned to a hospital for

treatment, with an estimated cost to Medicare of $208 million in August 2011. This equates to

$2.8 billion spent on hospital treatment for harm caused in SNFs in FY 2011.

What OIG recommends

Because many of the events that were identified were preventable, the study confirms the need

and opportunity for SNFs to significantly reduce the incidence of resident harm events. Therefore,

OIG recommends that the Agency for Healthcare Research and Quality (AHRQ) and the Centers

for Medicare & Medicaid Services (CMS) raise awareness of nursing home safety and seek to

reduce resident harm through methods used to promote hospital safety efforts. This would

include collaborating to create and promote a list of potential nursing home events - including

events they found that are not commonly associated with SNF care - to help nursing home staff

better recognize harm. CMS should also instruct state agency surveyors to review nursing home

practices for identifying and reducing adverse events. AHRQ and CMS concurred with these

recommendations.

The American Health Care Association (AHCA) put together some talking points to address any

media/family questions this report may generate:

Skilled nursing care providers are committed to continuously improving the quality of

care provided in our centers.

I. Five-Star ranking improvements

Since the launch of the CMS Five Star Ratings System, the percentage of centers with five

stars has increased by 66%. (11.8% in 2009 to 19.6% in 2013)

The proportion of facilities receiving a one- or two-star rating has declined by 23%.

(43.1% in 2009 to 33.2% in 2013)

Analysts attribute the change to a number of factors:

nurses spending more time with residents;

higher Five-Star staffing ratings;

decreasing citations and increasing deficiency-free surveys from state surveyors; and

improvements in clinical care (16 out of 18 quality measures).

II. Quality Initiative

The long-term and post-acute care profession continues to advance quality care through

AHCA/NCAL's national effort, the Quality Initiative, which sets specific goals and deadlines

in areas shown to improve the health outcomes of patients and residents.

Since 2012, skilled nursing centers have safely reduced the off-label use of antipsychotic

medications for about 34,900 individuals living with dementia - a 13% reduction.

And skilled nursing centers have averted sending about 43,300 patients back to the

hospital - safely reducing hospital readmissions by 3.8% nationwide.

We also continue to improve nursing staff stability and ensure that the customer comes

first - that residents and family members are satisfied with their care.

III. Post-acute care patients in skilled nursing centers have increasing, complex

conditions, making adverse events not altogether uncommon or necessarily

preventable.

A large percentage of Medicare admissions (88.8%) require extensive assistance or are

totally dependent on assistance with bathing. This pattern also holds true for transfer,

toilet use and bed mobility.

This activity of daily living (ADL) dependence has been on the rise since 2009, with the

average individual in a nursing center requiring some level of assistance with 4.14 out of 5

ADLs.

These individuals also commonly need therapy from a combination of different types of

therapists. Almost all Medicare admissions (94%) receive at least one type of therapy

(speech, occupational or physical) during their stay and 30% receive all three therapies

during their assessment period.

Q: Why is abuse and neglect still so rampant in nursing homes?

A: "Adverse events" are not the same as abuse and/or neglect.

In fact, the OIG looked for instances of abuse in completing this report and they could not

find even one instance of abuse.

Adverse events are an issue for all health care providers, not just skilled nursing care

centers. (OIG did a similar study on hospitals.)

Skilled nursing facilities care for complex patients with increasing and multiple care needs.

Unfortunately, adverse events are not altogether preventable, but we continue to do all

that we can to ensure patient safety and a high quality of life.

A small number of cases are not reflective of a profession that provides life-improving

rehab for millions of individuals each year.

OHCA and its members are highly engaged with the Oregon Patient Safety Commission and the

Patient Safety Reporting Program. PSO's promote the recognition and reporting of adverse events

in an effort learn from and create improved cultures of safety. We will further examine the report

to see how it can inform our improvement efforts here in Oregon.

To review the full report, click here

CMS: Not Relying on Citations to Combat Post-Acute Care

Problems

McKnight's Long-Term Care News (3/8, Mullaney, 921) reported the

Centers for Medicare & Medicaid Services announced in an Open Door

Forum Thursday that it does not intend to primarily use surveys to

reduce adverse occurrences, but rather is viewing the upcoming Quality

Assurance & Performance Improvement guidelines as a better means to

combat post-acute care problems, rather than levying increased

penalties. When asked how CMS intends to "crack down" on such problems following last week's

Health and Human Services Office of the Inspector General report, agency representatives

emphasized the organization's focus on assisting providers with "implementing quality

improvement initiatives."

Nursing Facility CNA Staffing Update

The following NF CNA Supplemental Forms are now available at: SPD Administrator Alerts.

The supplemental forms include:

2014 Staffing Report, SDS 0718 (04/14) V-2

Direct Care Staff Daily Report (SDS 0717, 04/14), and

Nursing Assistant (NA) Staff Ratio Chart (SDS 0717A, 04/14)

See General, Workforce and AHCA/NCAL for more of this issue's Important Dates, Deadlines, Late

Breaking Issues, and Technical Resources.

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General News & Announcements

OHCA Username and password change:

(www.ohca.com)

Username: ohca

Password: support2014

Nutrition Labels to Get First Makeover in 20 Years with

New Emphasis on Calories, Sugar

The Washington Post

The ubiquitous nutrition label on food packages is about to get its

first overhaul in 20 years, a change that is likely to have a dramatic

effect on what people choose to eat and drink and what products sell on supermarket shelves.

Obama administration officials say the update, scheduled to be formally unveiled Thursday at a

White House event, is necessary to keep pace with the science of nutrition and to reduce

confusion about what qualifies as healthy food (Cha, 2/26).

Full Story Here

Webinar: Protecting People with Chronic Conditions from Influenza/Flu

02/27/2014 02:45 PM EST

View YouTube Webinar Here

Wyden Plan May be Vision for Future Medicare Reforms

Key members of both parties and both chambers of Congress stand before the podium. Insurers

and health care providers welcome it. Seniors' groups are on board, too. If Congress is ever going

to overhaul Medicare, it will almost certainly have to happen this way.

Full Story Here

Fact Sheets on Advance Care Planning for Consumers

The Administration for Community Living recently published a series of Advance Care Planning

Fact Sheets on the Elder Care Locator. The Fact Sheets are designed to help older adults and their

families plan for the care they want when they have a serious illness. The Fact Sheets are about

care planning generally, care during advanced cancer and dementia, family caregivers, and the

services that can help families during serious illness.

View the fact sheets.

Pitfalls Seen In A Turn to Privately Run Long-Term Care

The New York Times

Even as public attention is focused on the Affordable Care Act, another health care overhaul is

underway in many states: an ambitious effort to restrain the ballooning Medicaid cost of long-

term care as people live longer and survive more disabling conditions (Bernstein, 3/6).

Full Story Here

Emergency Nurses Association Joins Groups in Issuing Guidelines for Geriatric

Emergency Departments

Nurse.com, Nurse.com Staff, 03/06/2014

The Emergency Nurses Association, American College of Emergency Physicians, American

Geriatrics Society and Society for Academic Emergency Medicine have issued a comprehensive set

of geriatric emergency department guidelines covering everything from staffing to education to

handling common problems of aging, such as falls, delirium, and dementia.

Emergency Nurses Association Joins Groups in Issuing Guidelines for Geriatric Emergency

Departments

Simple Blood Test May Have Power to Predict Dementia Risk

HealthDay, 03/09/2014

SUNDAY, March 9, 2014 (HealthDay News) -- A blood test has been developed that can predict

with 90 percent certainty whether a senior will suffer from dementia within the next few years,

researchers report.

The test relies on levels of 10 lipids, or fats, in the bloodstream to estimate the chances of either

mild cognitive impairment -- which involves memory loss and a decline in thinking ability -- or the

beginnings of Alzheimer's disease.

Low levels of these 10 blood fats can predict impending dementia symptoms with remarkable

accuracy, said study author Dr. Howard Federoff, executive dean of the Georgetown University

School of Medicine.

"We do not know why all 10 of those lipids are lower in individuals who are predisposed to go on

to cognitive impairment," Federoff said. "We can't directly link this to our current understanding

of the pathobiology of Alzheimer's disease."

Maria Carrillo, vice president of medical and scientific relations at the Alzheimer's Association,

said such a blood test could prove easier to administer than current tests used to detect early

onset of the disease.

Doctors now must rely on expensive MRIs and PET scans that are limited in their diagnostic

ability.

"Blood-based biomarkers would be a great and useful option -- more accessible, less invasive,

easier to gather and less expensive to process," Carrillo said. "Several are under development for

preclinical Alzheimer's disease. More research investment in this area is urgently needed."

The new study involved 525 healthy people aged 70 or older who underwent a full blood exam

and a battery of neurocognitive tests.

The research team then followed the participants for five years. During the course of the study,

74 of the people slipped into dementia or mild Alzheimer's disease.

Doctors compared their blood to the blood of people who remained mentally sharp, looking for

differences. They found that people who later developed dementia started out with low levels of a

series of 10 lipids, compared to the other study participants.

They then performed a second study in which they tested the predictive power of the 10-lipid

review on a separate group of 40 people. "We showed the blood test would be able to identify

people who would develop mild cognitive impairment," Federoff said.

The accuracy of the blood test neither improved nor diminished when researchers added a genetic

test looking for a mutant version of the "APOE" gene that has been linked to Alzheimer's.

In fact, they found the blood test predicted dementia with better accuracy than the APOE test

alone.

Accurate tests that can determine who will eventually develop Alzheimer's could play a key role in

finding a cure for the disease, Federoff said.

With no effective treatments yet available for Alzheimer's disease, the usefulness of an early

warning test for older people remains uncertain. However, Federoff believes that existing drugs

may still have promise in treating people at risk for Alzheimer's who have not yet developed the

illness.

"Will those disease-modifying therapies show promise if you use them in patients at risk for the

disease, before the horse is out of the barn, when they are clinically unaffected?" Federoff asked.

"Can you delay or perhaps even completely stop the progression to manifestation? I think this

opens up a whole new horizon for this type of clinical research."

Carrillo, of the Alzheimer's Association, noted, and Federoff agreed, that further research into the

lipids is needed.

"The results, while intriguing, are preliminary," Carrillo said. "They require replication and

validation by other scientists in larger and more diverse populations to give them credibility,

before further development for clinical use is warranted."

The study results were published March 9 in the journal Nature Medicine.

The study only showed an association between lower levels of the 10 body fats and an increased

risk for dementia. It did not prove a cause-and-effect link.

SOURCE: Howard Federoff, M.D., executive dean, Georgetown University School of Medicine,

Washington, D.C.; Maria Carrillo, Ph.D., vice president of medical and scientific relations,

Alzheimer's Association; March 9, 2014, Nature Medicine

See Workforce and AHCA/NCAL for more of this issue's Important Dates, Deadlines, Late Breaking

Issues, and Technical Resources.

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Workforce

STUDY: Nurse Aide Absenteeism and Nursing Home Quality Are

Associated

A recent study published online by The Gerontologist in January 2014 found an

association between absenteeism of nurse aides and quality of care in nursing

homes.

Complete Article Here

Can you MAKE Your Team Work Like They Own It?

"How can I make my employees work like they own it?" That is the

question Dr. Bryan K. Williams' often gets from well-meaning leaders who

hope to create a strong service culture. Dr. Williams answers this

question by saying "that you really can't MAKE anyone work like they

own it. You can, however, create an environment where they want to."

Click here to read the entire blog version of "Can you MAKE Your Team

Work Like They Own It?", and other great pieces focused on customer

service from Dr. Williams. Dr. Williams is a consultant, trainer, and

author, who focuses on the areas of service excellence and organizational

effectiveness. He has spoken at numerous AHCA/NCAL events, and his passion is to serve others

so they may better serve the world. Here is a link where you can see some of Dr. Williams' book

recommendations on service, leadership and personal development.

Recent RN Graduates Report Fewer Job Opportunities than Earlier Graduates

Study finds new nurses today are less likely to work in hospitals, more likely to work part time,

and to be enrolled in formal education programs.

Full Story Here

Shortage of Caregivers Projected, Despite Increasing Need

The New York Times (2/27, Graham, 9.61M) reports that according to the "employment

projections released by the Bureau of Labor Statistics late last year," there will a shortage of

care-givers in the near future. Citing the projections, the article notes that "more than 1.3 million

new paid caregivers will be needed to meet demand over the next decade." According to the

director of the aging, disability and long-term care program at RTI International, Joshua Wiener,

"There isn't going to be a big increase in the work force that typically fills these jobs - poorly

educated, low income, usually minority women - over the next 10 years." The article reports that

although "usually, big demand and a limited supply would drive up prices in the labor market,"

this is unlikely due to "financial pressures on" Medicaid and Medicare, and the prediction that

"most middle-class families simply can't afford to pay for these services and will do without."

Nurse Caseload, Education Impacts Mortality Rates

Fierce HealthIT, Katie Sullivan, 02/27/2014

Mortality rates after common surgical procedures decrease

dramatically if patients receive treatment in hospitals where nurses

have manageable workloads and hold a bachelor's degree.

Nurse Caseload, Education Impacts Mortality Rates

Latest Cover Oregon News

The Oregonian: Cover Oregon: Oregon Reaches 'Transition

Agreement' With Oracle

Oracle Corp. delivered an ultimatum to the state of Oregon last

week and it has paid off handsomely. After Oracle threatened to

walk away from the state's health care exchange with the IT

project still unfinished, the state agreed to pay $24 million to the

company on Monday and will pay them another $19.9 million by Thursday. Oregon did withhold

payment of $26.5 million and reserved its right haul Oracle into court and litigate their dispute

over the troubled technology project(Manning, 3/3).

The Oregonian: Cover Oregon: Legislature's Budget Committed Approves Two Bills

Two bills on Cover Oregon, the state's troubled health insurance exchange, are headed to the

House and Senate floors after the Legislature's main budget committee approved them Monday.

Senate Bill 1582 would ensure money is available for a temporary health plan that Oregon Health

Authority officials created at the beginning of the year to provide continued coverage for a pool of

high-risk residents who weren't able to enroll through Cover Oregon by Jan. 1. House Bill 4154

would extend whistleblower protections to Cover Oregon employees and allow the governor to

remove all Cover Oregon board members in a single year(Zheng, 3/3).

The Oregonian: Oregon's U.S. Senators Join Call For Federal Probe Of Cover Oregon Health

Insurance Exchange

A decision on whether the investigative arm of Congress will probe the Cover Oregon health

insurance exchange could come as early as this week, and the request for an audit has gone

bipartisan. Oregon's two U.S. Senators, Jeff Merkley and Ron Wyden, both Democrats, have

joined a call by Congressional Republicans for a federal audit of the Oregon's exchange. Thanks to

technical problems, Oregon's is the last exchange in the country that doesn't allow the public to

self-enroll (Budnick, 3/3).

Attention Nursing Assistant Training Program Directors & Instructors

The OSBN still has space available for their orientation on the rules regulating nursing assistant

training programs. This training is both for newly approved faculty and experienced faculty that

are interested in refreshing their knowledge. The training is scheduled for March 27, 2014. This

is also an excellent opportunity to have your questions answered and to interact with other

training programs' faculty. Please email your reservation to penny.patterson2@state.or.us and

include your contact information: name, training program, phone number, and email address.

NIA Info and Tips for Alzheimer's Caregivers

The National Institute on Aging has this guide, Caring for a Person with Alzheimer's Disease: Your

Easy-to-Use Guide from the National Institute on Aging, available either online or in print by

request.

USDOL A to Z: Learn about the Labor Department

The U. S. Department of Labor's (USDOL) E-Newsletter entitled, DOL News Brief, has begun a

series to inform readers about specific terms and programs administered by the Department of

Labor. The web page that contains explanations and information about specific terms and

programs for which the USDOL is responsible. To review the web page and obtain information on

topics as diverse as affirmative action, to ERISA, to youth and labor. For more information go to:

See All The A-Z Terms

Nursing Facility CNA Staffing Update

The following NF CNA Supplemental Forms are now available at: SPD Administrator Alerts.

The supplemental forms include:

2014 Staffing Report, SDS 0718 (04/14) V-2

Direct Care Staff Daily Report (SDS 0717, 04/14), and

Nursing Assistant (NA) Staff Ratio Chart (SDS 0717A, 04/14)

Free E-Verify and Form I-9 Webinars from DHS Available

Do you have any questions about how to complete, retain and store the Form I-9? Would you like

to learn how to enroll in E-Verify or how to handle E-Verify case alerts? If so, please attend a free

webinar for employers or employees. USCIS subject matter experts will discuss the following:

Form I-9 process

How E-Verify works

E-Verify requirements for federal contractors

E-Verify for existing users

Employee Rights

How Self Check works for job seekers

New system enhancements

Please click here to join or review upcoming E-Verify Webinars in March. Share this

announcement with anyone who may be interested!

More resources are available on both (http://www.uscis.gov/e-verify) and

(http://www.uscis.gov/es).

See General and AHCA/NCAL for more of this issue's Important Dates, Deadlines, Late Breaking

Issues, and Technical Resources.

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AHCA/NCAL News

Access AHCA/NCAL Archived Communications Online!

Remember your AHCA log-in is:

User: orquality

PW: 20ltc11

We are the Solution

AHCA serves to be the voice of its more than 12,000-strong membership in

Washington, D.C., but we also know that simple talk is not enough. We

understand that the skilled nursing profession needs policies that protect our

residents' access to important programs like Medicare and Medicaid. We know

that simply cutting these programs and finding political patches is not

sustainable. With the knowledge of long term and post-acute care

professionals, guidance from leadership, and feedback from our tens of

thousands of direct caregivers, AHCA is offering solutions to Congress that can

advance this profession and further enhance the lives of our residents.

Ranging from legislative bills to innovative new programs, AHCA and its

members strive to improve lives by delivering solutions for quality care.

Read More Here

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