Tag Archives: nursing homes

New West TN Veterans home site announced

News release from Department of Veterans Services
NASHVILLE – Tennessee Department of Veterans Services Commissioner Many-Bears Grinder, Department of Intellectual Developmental Disabilities Commissioner Debra Payne and Department of General Services Deputy Commissioner John Hull in partnership with Tennessee State Veterans Home Executive Director Ed Harries formally announced the site of the future West Tennessee State Veterans Home today at 11293 Memphis Arlington Road in Arlington. Senate Majority Leader Mark Norris (R-Collierville) and Representative Ron Lollar (R-Bartlett) support the milestone announcement made in their district.

“More than 214,000 Tennessee Veterans are over the age of 65 years old, which is 42 percent of our state’s Veteran population,” Grinder said. “We are fortunate to have four existing Tennessee State Veterans Homes, but we know more of these high-quality resources are needed to serve our aging Veteran population. Shelby County has the largest Veteran population in the state which exceeds 56,000 Veterans.” Continue reading

Site chosen for new veterans nursing home in West Tennessee

State officials have selected the old Arlington Developmental Center site in northeast Shelby County for a new $70 million West Tennessee veterans nursing home, reports the Commercial Appeal.

Officials of the Tennessee State Veterans’ Homes Board told the state Senate’s Veterans Affairs Subcommittee Thursday of the site’s selection over other sites reviewed in Fayette, Shelby and Tipton counties. The board hopes to acquire 40 to 45 acres, behind the Arlington Sports Complex which fronts on Memphis-Arlington Road west of Paul Barret Parkway and north of Interstate 40.

The nursing home will house 144 Tennessee veterans of U.S. military service.

The U.S. Department of Veterans Affairs will pay $45.5 million of the Arlington home’s price tag. The state and local governments and private fundraising must generate the remaining $24.5 million before the VA releases its funding for construction.

Shelby County government has allocated $2 million, and the state has allocated $650,000 so far on site selection, planning and preparation. Fundraising efforts are under way by the West Tennessee Veterans Home board, a nonprofit group based in Memphis.

The Tennessee State Veterans’ Homes Board runs homes in Humboldt, Knoxville and Murfreesboro, and four others are in various stages of planning: 108-bed homes in Clarksville, Cleveland and the Tri-Cities area of northeast Tennessee, and the 144-bed home in Arlington. The Arlington home will be the second in West Tennessee.

Contractor problems created backlog in TennCare nursing home applications

Nursing home applications got so backed up when TennCare changed its processing system that administrators reported more than half of their patients did not get timely eligibility determinations, reports The Tennessean.

Jesse Samples, executive director of Tennessee Health Care Association, which represents nursing homes, told TennCare Director Darin Gordon in an email that the problem was causing serious cash flow issues for its members and stressful circumstances for patients.

Gordon responded that the agency’s internal statistics showed better performance but admitted its “more limited approach” in communicating applications was causing frustrations.

The emails obtained by The Tennessean through an open records request reveal that TennCare cannot place all the blame for its backlogged Medicaid applications on the federal government. After a class action lawsuit was filed on behalf of people seeking coverage, the state agency argued in court papers that healthcare.gov, the federal insurance exchange, had caused the issues. But nursing home applications were not filed through that website.

Nursing home applications got backlogged because TennCare stopped having state employees with the Department of Human Services process them and outsourced that work to a private contractor. The applications got sent to a new service center operated by Cognosante LLC, which was awarded a four-year, $31 million contract.

…The state wound up taking punitive actions, levying a fine of almost $1 million, said Sarah Tanksley, a TennCare spokesperson.

“TennCare’s new service center, Tennessee Health Connection, experienced an unexpectedly high volume of applications in the first quarter of 2014 while also experiencing some technical difficulties associated with the startup of this new call center,” Tanksley said. “As a result, the state took significant actions to address the problems and levied significant fines against the vendor.”

Cognasante and TennCare then worked for several weeks to improve the service, she said, and resolved the application problems early last year.

Effort underway to raise $25M — $100 at a time — for West Tennessee Veterans Home

An effort is underway to raise $25 million for construction of 144-bed West Tennessee Veterans Home somewhere in Shelby, Fayette or Tipton counties, reports the Commercial Appeal. The fundraising drive is called Project 100 and asks businesses, churches, governments and other organizations to donate $100 for each vet that is an employee or member.

Telling people that you have to raise $25 million seems like an impossible amount, said (Holly) Swogger, chairwoman of the overall effort.

“So what we thought about doing is just breaking it down to smaller amounts,” she said.

There are 71,000 veterans in Shelby, Fayette and Tipton counties who go to church, have a job and are part of a civic or community organization.

If people from those churches, workplaces and civic groups raise $100 for each of their veterans, that’s $300 a vet, she said.

And $300 for each of the 71,000 veterans is $21.3 million.

…The Federal Department of Veterans Affairs will pay 65 percent of the cost to build the more than $60 million home, but only after 35 percent of the money is raised locally.

The effort has more than $2.650 million, including a $2 million commitment from Shelby County, Swogger said.

Audit finds $2M Medicaid overcharge by nursing home company

News release from state comptroller’s office:
A large corporation that operates dozens of nursing homes in Tennessee included nearly $2 million in improperly allocated Medicaid costs in one of its reports, according to an audit released by the state Comptroller’s office today.

Auditors uncovered $1,929,205 of expenses not allowed under Medicaid rules and regulations at Signature HealthCARE, LLC, a Louisville-based corporation that operates 112 long-term care locations in nine eastern and southeastern states, including 26 nursing facilities in Tennessee.

In its home office cost report for the 2009 calendar year, Signature reported total operating expenses of $46.3 million, of which $29.2 million were claimed as allowable Medicaid costs and allocated to its subsidiary operations.

The Comptroller’s office performs examinations of nursing facilities participating in Tennessee’s $900 million Medicaid Long-Term Care Program and has authority to audit any costs reported on annual Medicaid cost reports, including expenses that are allocated from home office operations located outside the state of Tennessee.

The auditor’s report identifies expenses that are not allowed for reimbursement by the state’s Medicaid program. These included improper charges for costs not related to patients’ care, marketing expenses and compensation for nursing facility owners. The allocated share of the disallowed expenses to 22 of Signature’s Tennessee nursing facilities is $561,624. The balance of the improper expenditures was allocated to facilities in other states.

“The finding in our report exposes significant non-allowable costs that were allocated to long-term care facilities operating in Tennessee,” Comptroller Justin P. Wilson said. “It is important to understand that often there are substantial costs incurred on behalf of Tennessee nursing facilities by large healthcare home offices both inside and outside the state. These costs must fit into certain categories in order to be subsidized by Medicaid. Unfortunately, a number of Signature’s expenses during the reporting period didn’t fit into those categories.”

To view the report online, go to: http://www.comptroller.tn.gov/sa/

State stops admissions to two TN nursing homes

MEMPHIS, Tenn. (AP) — Tennessee Health Commissioner John Dreyzehner has suspended new admissions to two West Tennessee nursing homes because of alleged inadequate conditions at the facilities.

A news release from the Tennessee Department of Health says Dreyzehner has suspended admissions to Oakwood Community Living Center, a 50-bed licensed nursing home in Dyersburg, and Ripley Healthcare and Rehabilitation Center, a 144-bed licensed nursing home in Ripley.

Department investigators found violations of administration, performance improvement and nursing services standards at Oakwood. The department says surveyors found violations of administration standards at Ripley Healthcare.

The state imposed penalties of $1,500 for each of the facilities. A special monitor will review their operations.

The nursing homes can have the right to a hearing before the Board for Licensing Health Care Facilities or an administrative judge.

Nearly 3,000 rejected for TennCare nursing home coverage under new point system

In an effort to curtail costs while meeting the health needs of aging baby boomers, TennCare officials have put in place new rules that create a higher hurdle for families to qualify for nursing home coverage. Since then, The Tennessean reports that nearly 3,000 people who probably would have been judged to need nursing home care in early 2012 are instead getting only limited home visits.

The new guidelines are under fire from state legislators and advocates for the elderly and disabled. They question why TennCare launched the point system by emergency rule — a move that limited the degree of public input. Only one hearing, attended by 36 people, was held, just two months before the rules took effect in July 2012.

“I would contend that it was really without any real legislative or stakeholder input at that point in time,” said Jesse Samples, executive director of the Tennessee Health Care Association, which represents nursing homes.

Now that the system is in place, however, the state intends to keep it. Patti Killingsworth, TennCare’s chief of long-term care, told a state Senate committee in December that the agency has no plans to abandon the point system, saying there could be a “significant financial impact if standards were relaxed.”

The agency’s goal was to save $47 million in fiscal 2013 by diverting 20 percent to 25 percent of nursing home applicants to home or community-based care, Killingsworth said. The state is just under that range with a 19.6 percent diversion rate.

…Tennessee, which previously allowed people to qualify for Medicaid-funded nursing home care with only one deficiency of daily living, such as not being able to walk, now stipulates that applicants score nine points on a 26-point evaluation administered by TennCare nurses.

Someone could be incontinent, have problems walking, be unable to manage their medicines and still not score nine points.

…After complaints from families and nursing homes, a state Senate committee asked TennCare officials to explain the system at a hearing in December.

Since that hearing, legislators have introduced two bills — one that would require the director of the Tennessee Commission on Aging and Disability to have input on decision making about the Choices program, and another that would require an accounting of the money that Medicaid-contracted insurers make under the program.

TennCare provides incentives to these contractors, known as managed-care organizations, to lower overall health spending.

TennCare also has taken some actions since the hearing. In a follow-up letter to Sen. Joey Hensley, R-Hohenwald, Killingsworth said the agency may consider more information from applicants who seek a “safety determination,” an override that has allowed more than 750 people to qualify for nursing home care when they did not score nine points.

Killingsworth said TennCare will give nursing homes a 10-day window to submit additional information when an application has been denied, and it may expand some definitions — for instance, including diagnoses other than dementia when evaluating an applicant’s behavior.

Legislators told TennCare Choices creating barrier to nursing homes

A TennCare process for deciding who qualifies for nursing home care came under fire at a legislative hearing Thursday when people complained about a program called Choices creating barriers, reports The Tennessean.

Choices gave families the option of deciding whether to put a loved one in a nursing home or get state assistance to provide at-home care when it was launched in 2010, but the program has evolved. Last year, it launched a new rating score for determining who qualifies for skilled nursing care. That system rates people according to deficiencies of daily living, such as whether they are able to walk or feed themselves. People are falling through the gaps because the scoring system is flawed, according to testimony before the Senate Health and Welfare Subcommittee.

Carol Westlake, the executive director of the Tennessee Disability Coalition, told about the plight of a Jackson man denied a nursing home slot even though he was paralyzed on one side from a stroke, in a wheelchair and unable to give himself insulin shots to control diabetes.
She said the new evaluation system and appeals process create lengthy delays for families when they are desperate for help.

“You need a process that works efficiently and effectively at the moment in which you need that,” Westlake said.

Patti Killingsworth, an assistant commissioner with TennCare, said the bureau is working to address the concerns raised.

…Since the launch of Choices, the number of people in home- or community-based care other than nursing homes has risen from 5,000 to 13,000, Killingsworth said in her testimony.
The cost can be half or a quarter less than the expense of nursing home care, she said.

“While 40 percent of our members are now receiving their services in home- and community-based settings, we still spend roughly 80 percent of the funding on institutional care,” Killingsworth said.