Winter 2020 Volume 1, Issue 1
Senior Living
Wish of a Lifetime Makes Senior Dreams Reality
Creating an Optimal Senior Living Environment Industry Changes Require Maximum Support Championing Legislative Priorities for Seniors Residents Build Mobility Carts for Less Fortunate INAUGUR AL EDITION
THEY TRUST YOU TO BE THEIR GUARDIAN.
YOU CAN TRUST US TO BE YOURS. ÂŽ
We personally empower you and your team to be the best. We get to know you and your residents and deliver customized pharmacy solutions that meet the needs of your individual community. We treat you and your residents with honesty, respect, and kindness. So that together, we can provide the best, personal service to those who matter most: our mothers and fathers, grandparents and friends.
GUARDIANPHARMACYFLORIDA.COM
Contents
WINTER 2020 VOLUME 1, ISSUE 1
Cover Story a Wish 8 GoWishon,ofMake a Lifetime program makes dreams come true for seniors.
8
By Nick Fortuna
Features H&S Maximizes Member Value with 6 FAHA Managed Care Organizations By Dana McHugh, FAHA H&S Consultant
13
Taking Necessary Steps to Create a Better Senior Living Environment By Steve Bahmer, President & CEO, LeadingAge Florida
15
Making Florida Livable for All By Richard Prudom, Secretary for the Florida Department of Elder Affairs
16 18
Where Hospitality Meets Healthcare: UCF Offers First-Ever Bachelor’s Degree in Senior Living Management
19
18
Supporting Members through Major Industry Changes By Connie Cheren, Regulatory and Compliance Specialist, LeadingAge Florida Mercy in Motion: Giving the Gift of Mobility By Nick Van Der Linden, Director of Communications, LeadingAge Florida
19
Departments 5
Chair’s Message Building Champions for the Aging Services Community By Joel L. Anderson, CEO Village On The Isle
12
Legislative Roundup: A Recap and Forecast for Health Care Issues By Hayden Dempsey, Esquire Greenberg Traurig
LeadingAge Florida 1812 Riggins Road, Suite 1 Tallahassee, FL 32308 (850) 671-3700 www.leadingageflorida.org LeadingAge Florida Executive Staff President/CEO Steve Bahmer sbahmer@LeadingAgeFlorida.org
S upport Our Advertisers 22 Advertiser Index About the cover Freedom Village resident Charlie Grace realized a dream when he flew a P-51 Mustang over Orlando as part of the Wish of a Lifetime program. Learn more on page 8.
›
Vice President of Operations Dawn Jimenez djimenez@LeadingAgeFlorida.org Vice President of Advocacy Susan C. Langston slangston@LeadingAgeFlorida.org
Janet Stringfellow, Affordable Housing Chair Kevin Smaage, ALF/HCBS Chair Garry Hennis, CCRC Chair Aimee Hilton, Nursing Home Chair
LeadingAge Florida Officers Joel L. Anderson, Chair Bruce Jones, Chair-Elect Roger A. Stevens, Immediate Past Chair Kip Corriveau, Secretary Lisa Lyons, Treasurer
Publication Team
Senior Living magazine serves as a LeadingAge Florida member resource that supports the LeadingAge promise: to advocate, educate and serve aging services professionals. Managing Editor Nick Van Der Linden Director of Communications, LeadingAge Florida For advertising inquiries, please contact Katie White at kwhite@thewymancompany.com or (352) 388-7031. Senior Living is the official publication of LeadingAge Florida. All rights reserved. Contents of this publication may not be reproduced without permission from LeadingAge Florida.
S E N I O R L I V I N G • W I N T E R 2020
3
Celebrating all the people who provide quality care, support and companionship to our
seniors
.
CONNECT WITH US SunshineHealth.com @SunHealthFL
Chairman’s Message
Building Champions for the Aging Services Community
W
ith so many dedicated, mission-driven people in our field of aging services, I am extremely honored to serve as Chair of LeadingAge Florida. LeadingAge Florida was established as a not-for-profit trade association in 1963, and it presently represents more than 250 quality housing and service providers – comprising more than 500 facilities – who support more than 80,000 of Florida’s finest seniors! I’ve been a member of LeadingAge Florida since 2010 and have served on the Board of Trustees, related committees, and public policy groups for seven years. I’m grateful for the vision and leadership of LeadingAge Florida’s Board and Steve Bahmer with his outstanding executive and administrative team who continuously focus on increasing our membership value and support. I’m also excited about LeadingAge Florida’s new magazine, Senior Living. In addition to being an impressive and informative resource for providers, business partners and valued stakeholders, the new magazine will feature stories about life at our communities, including some amazing and accomplished residents, innovations, expanded missions and programs, and the many ways our members faithfully support their local communities across this great state. This new magazine will help strengthen LeadingAge Florida’s brand promise, which is to Advocate. Educate. Serve. Our business is changing quickly and facing constant challenges. As members, we must engage everyone and use a variety of communication tools to cultivate champions for our purpose. We need to foster relationships and build champions who support effective senior living policy and the essential funding necessary to deliver quality care, develop and support new approaches in care and service delivery systems, help find solutions to address our increasing workforce shortages, promote and enhance quality, ensure access to housing and services for our growing aging population, and never lose sight of nor minimize the importance of the role we play in caring for today’s and tomorrow’s seniors. Like the iconic World War II Uncle Sam image with the caption stating, “I want you,” LeadingAge Florida wants you as we develop champions for our greater mission and purpose. We also want your feedback to help us improve our membership experience as we make a meaningful impact together on the field of aging services in Florida. I hope you thoroughly enjoy this inaugural edition of Senior Living. Please share your feedback with Steve, and please also offer your ideas for content that will inspire us and drive us to reflect on why we do what we do every day in service to others.
JOEL L. ANDERSON VILLAGE ON THE ISLE
Our business is changing quickly and facing constant challenges. As members, we must engage everyone and use a variety of communication tools to cultivate champions for our purpose.
S E N I O R L I V I N G • W I N T E R 2020
5
FAHA H&S Maximizes Member Value with Managed Care Organizations By Dana McHugh, FAHA H&S Consultant
S
ometimes serving members is about knowing who to call. And that knowledge can yield big results. Recently, a FAHA H&S nursing home member was faced with approximately $450,000 in outstanding Medicaid LTC claims from one health plan. That is a large amount of outstanding dollars, and the failure to recover them would have had dire consequences for the nursing home. Leadership at this LeadingAge Florida member nursing home asked FAHA H&S to intervene with the health plan on its behalf. It took several strategically placed phone calls over a four-hour period, but in the end, the health plan released the $450,000, which was wired to the nursing home’s bank account the next day. This is just one of many examples of critical claims assistance that have occurred since FAHA H&S began serving the membership in 2013. FAHA H&S is a subsidiary of LeadingAge Florida. By forming FAHA H&S, the LeadingAge Florida Board provided its members the opportunity to join a network of missiondriven, quality nursing homes and assisted living facilities with the goal of leveraging the network to drive more positive relationships with managed care organizations. The initial focus of FAHA H&S was to ensure fair contracts with managed Medicaid long-term care health plans. Since then, FAHA H&S has achieved that goal, and today members have access to Medicare Advantage, Commercial and Medicaid managed care contracts. Contracting for the network includes all lines of business. As the baby boomers age into Medicare, Medicare Advantage membership continues to grow in Florida and nationally. FAHA H&S members can choose to access Medicare Advantage contracts that historically had not been accessible to them. Further, additional membership benefits include continuing education on managed
6
care policies and processes for all staff levels, as well as important communications via a twice-monthly newsletter. In addition, staff assistance is available to help with claims processing questions, issues, credentialing and other managed care administrative questions.
What’s Next? FAHA H&S continues to evolve as the requirements of participation and payment mechanisms become more sophisticated. Value-based payment (VBP) will become more prevalent and more challenging. Nursing homes will have managed care contracts that include VBP. The current statewide Medicaid managed care (SMMC) contract between AHCA and the health plans already requires that health plans contract a portion of the network providers, including nursing homes, under value-based payment arrangements. Medicare Advantage plans’ VBP agreements will become more involved and require a higher level of accountability to be successful. Because of this move toward more complex contracting arrangements,
it is important to own your data and understand how internal processes can affect data and outcomes. As value-based payment for Medicaid and Medicare become more prevalent, FAHA H&S is negotiating now with health plans to ensure LeadingAge Florida members will thrive in this environment. FAHA H&S members are uniquely situated to maximize value through value-based payment arrangements. These member communities have existing infrastructures and services in place – beyond the number of skilled nursing beds on campus – that are attractive to managed care organizations. There is opportunity to leverage these infrastructures and services, as well as the population of the campus, to establish positive value-based payment arrangements with managed care organizations. FAHA H&S can help you establish those positive arrangements. To learn more about how FAHA H&S can benefit your community, please contact Dana McHugh at (850) 339-2909 or FAHAHS@ leadingageflorida.org.
Join our community of aging professionals as we come together around our common goal – expanding the possibilities for Florida’s seniors. Let’s make progress together by exchanging ideas and experiences with colleagues, while exploring bold new approaches.
Let’s continue working together – innovating, serving, and elevating our field.
Together, we can.
Join theLeadingAge LeadingAge Florida 57th Annual Convention and Exposition on Join usus atatthe Florida 57th Annual Convention and Exposition July 27-29, 2020 at the Gaylord Palms Resort and Convention Center, where together we will!
on July 27-29, 2020 in Orlando, where together we will!
Go on, Make a Wish
Wish of a Lifetime program makes dreams come true for seniors By Nick Fortuna
D
ebbie Grubb has never seen a kangaroo, a lemur or the adorably bug-eyed rainforest mammal known as a kinkajou, but she knows what their fur feels like and what they smell like, and in her mind’s eye, the picture is crystal clear. Grubb, 72, who was born blind and has become a prominent advocate for the disabled, had an experience to remember in November 2016, when she got to make some new friends at the Exotic Animal Experience attraction in Orlando. She’s among 15 residents from Freedom Village Bradenton to have their wishes granted by the Wish of a Lifetime program, which has made dreams come true for almost 2,000 seniors since it was founded in 2008. Wish of a Lifetime was started by former professional athlete and business executive Jeremy Bloom to honor his grandmother, Donna Wheeler, who helped raise him. With funding from corporate sponsors, the nonprofit has created rewarding and life-affirming experiences for seniors in all 50 states. Wish of a Lifetime started out modestly, with about 10 wishes granted in its first year, but it’s on track to finish 2019 with about 250 wishes granted. Any senior may apply, and the program receives hundreds of requests each year. From every dollar contributed to Wish of a Lifetime, 75 percent goes toward fulfilling wishes, 17 percent supports fundraising efforts, and 8 percent covers administrative costs. “There is so much life that our seniors have left to live, and yet they find themselves in-
8
Freedom Village friends cheer on Jim Willis on as he readies for his hang gliding experience. Photo courtesy of Tara Tomlinson Photography.
credibly isolated, so what Wish of a Lifetime does is provide opportunities and reminds seniors of their incredible legacies through the granting of a wish,” said Jared Bloomfield, special projects manager for Wish of a Lifetime. “I find it incredibly rewarding to unearth and tell these amazing stories.” Grubb’s story certainly qualifies as noteworthy. She grew up around animals and has had four guide dogs over the years, including current buddies Dena, 13, and Kopper, 4. An avid reader since childhood, she especially enjoyed the adventures of Disney’s “Winnie the Pooh” and the bear’s kangaroo friend Kanga, so when it came time to select her Wish of a Lifetime, the young girl inside her knew just what to pick.
With a busload of friends from Freedom Village, Grubb arrived at Exotic Animal Experience for a hands-on lesson in zoology. She said that unlike people with good eyesight, who can take in a visual all at once and hold that picture in their mind, the blind have to use descriptions from other people and senses like touch and smell to construct a mental picture piece by piece. The residents of Exotic Animal Experience helped her do just that by being themselves. The lemur jumped on her and let her touch its fur, the kangaroo stood patiently as Grubb’s hands traced his ears, and the kinkajou seemed disappointed when Grubb ended their cuddling session. For Grubb, it was an experience to savor.
Jim Willis began his tandem hang gliding experience from 2,500 feet above Orlando. Photo courtesy of Tara Tomlinson Photography.
“I have a real affinity for all animals,” she said. “The animals that I saw, people had tried to describe them to me, and I had read about them, but I just wanted to touch them for a minute and experience my own version of seeing. I got a sense of them that I’d never been able to get before, and it was important to me because animals have played such an important role in my life. I’ll never forget it, and when I think about it, I always smile.” As a young woman, Grubb became the first totally blind person to work as a teacher in her native Maryland. She has spent much of her life ad-
vocating for the disabled, focusing on issues such as braille literacy, accessible voting, audible pedestrian signals, educational opportunities for the blind, and the rights and responsibilities of guide dog owners. She has lived at Freedom Village since 2012, shortly after losing her husband, Frela, who also was blind. Grubb said her goal has always been “to earn my oxygen on this Earth,” and she travels far and wide to champion her causes.
But she still makes time to have a little fun, especially if it involves the comforting feel of soft fur. “All of the animals that I got to see were so wonderful, and the experience made me very happy,” she said. “My wish of a lifetime isn’t the last thing – I’m far from over – but this was a wish that really has enriched my life because I just remember these precious little animals that I got to see, and how gentle they were. It was a wonderful experience. It filled an emotional longing that I had to understand these animals and to touch them with my hands so that I could remember them.”
Hang Gliding at Age 87 For many seniors in retirement communities, life has become more about looking S E N I O R L I V I N G • W I N T E R 2020
9
America. They love Freedom Village, which Jim described as “the friendliest place I know,” but the inviting setting hasn’t quelled their wanderlust. In October, they were just about to visit Africa for the first time, spending three weeks, mostly on safari, in Zimbabwe, South Africa and Botswana. “We’ve wanted to do this for a long time, and we figured that if we were ever going to go, we’d better go this year because you never know at our age,” Jim said. “I think that’s what keeps you going – having a goal to get to. I’ve had lots of operations, but I keep coming back and doing what I want to do to get it all in.”
A Flight 73 Years in the Making
With the help of friends, Debbie Grubb, who is blind, enjoys the Exotic Animal Experience in Orlando. Photo courtesy of Linda Reitz of Coffee House Studios.
backward than about looking forward. At age 87, Jim Willis got the thrill of a lifetime by looking straight down. On a trip to New Zealand a decade prior, Willis had been excited to go hang gliding for the first time, but the wind conditions suddenly worsened and made it too dangerous to run off the cliff and take flight. Willis always considered it a missed opportunity, but through Wish of a Lifetime, he finally got his chance in January 2017. It was sunny and warm in Orlando that Tuesday when Willis, his wife of almost 70 years, Nancy, and a busload of friends from Freedom Village arrived at Wallaby Ranch, a well-known hang-gliding destination. An airplane lifted Jim and a professional hang glider 2,500 feet above the ground so they could begin their tandem flight. With his friends cheering him on, Willis and the guide circled above for 15 to 20 minutes during their gradual descent, taking in distant sights like Walt Disney World before the pro skillfully landed them just a few steps from the other Freedom Village residents. “I just absolutely loved it,” Willis said. “It was really wonderful. I always felt like I missed out on something in New Zealand, and I had this chance with Wish of a Lifetime to do it, and I grabbed it up. It was a beautiful day, and you could see for miles. You could see the busload of people who had come with us standing in a field, and they just looked like little dots down there.” 10
Willis said he was a little nervous before taking flight, “but once you’re up there, I didn’t find it scary at all.” Willis and his wife have lived at Freedom Village for nine years, and they took an interesting path to get there. They met through mutual friends at the University of Wisconsin and immediately hit it off. While they were expecting their first child, Jim was drafted by the Army to fight in Korea, but with the war winding down, fathers and expectant fathers were granted a reprieve. Willis then worked at his family’s farm supply store for 13 years before becoming a loan officer at a bank and working his way up to vice president. A 90-year-old cancer survivor, Willis is a father to four, a grandfather to 15 and a great-grandfather to 22. Willis has always had a sense of adventure, and he has the battle scars to prove it, having endured four shoulder replacements, four hip replacements and two knee replacements. Growing up in northern Wisconsin, Willis and his family would ski every weekend and looked forward to annual trips to major ski destinations like Aspen, Colorado. “That’s kind of like flying,” Willis said. “You have the same floating feeling when you’re skiing as you do when you’re hang gliding. You’re moving fast through the air, and you’re almost weightless.” Willis and his wife keep their passports at the ready, having traveled to Japan, China, Vietnam, Australia, the UK, Russia and South
Between his service in the military and as a commercial airline captain, Charlie Grace logged 26,400 hours of flight time – more than three full years. But it wasn’t until age 91 that his career as a pilot reached its highest altitude. Thanks to Wish of a Lifetime, Grace finally got the chance to fly the P-51 Mustang, a sleek-looking, single-prop fighter-bomber designed in 1940 to do battle with the Luftwaffe’s best fighters. Grace, a native of Cincinnati, had joined the Army Air Corps in 1944 with hopes of becoming a P-51 fighter pilot, but despite passing all the required tests, he wasn’t assigned a flight class before World War II ended. He then served in the Army Reserves before enlisting in the Air Force in 1950 and becoming an F-89 fighter jet pilot. After being discharged in 1955, Grace enlisted in the Air Force Reserves, eventually achieving the rank of lieutenant colonel before retiring with 38 years of service. He made flying his career as a civilian, spending 31 years with Republic Airlines, including 29 as a captain. It was a distinguished career, but Grace still felt that one important experience was missing from his résumé as a pilot. “For my generation, the P-51 was the ultimate airplane,” he said. “It was the hottest fighter in World War II, and I missed out on it then. This is an airplane that you dream of. I flew jet fighters, and those were fun too, but there’s something about that old prop that made you feel like you were in a real airplane.” Grace finally got to fly a P-51 Mustang in May 2017, seven decades after he had skipped his high school prom and final exams to join the Army Air Corps. He and 17 other residents of Freedom Village packed a bus bound for Kissimmee, and with his friends watching from a balcony positioned along the runway, Grace settled in at the controls.
This P-51 had dual controls, meaning that either Grace or the flight instructor seated just in front of him could control the plane. The flight instructor got them 1,000 feet off the ground before handing over the controls to Grace, who proved to be just about the best backseat driver one could imagine. After climbing to 8,000 feet, Grace’s first maneuver was a clearing turn. Then came a barrel roll, an aileron roll, an Immelmann turn and a Cuban 8, all complex maneuvers that involve flying upside down for a short stretch. Grace’s flight instructor said he still had the goods. “The instructor said he had a young fighter pilot with him in the backseat, which was a real compliment,” Grace said. “I felt so comfortable in that airplane after all these years. It’s just such a marvelous feeling to be able to do those things still and to feel like you’re 25 again.” For his final trick, Grace pulled off a 360-degree overhead approach, banking sharply to one side as the plane begins its descent and completing a full circle before touching down. “The airplane and I were just working together,” Grace said. “The airplane has a ten-
Charlie Grace realized a dream when he flew the sleek P-51 Mustang. Photo courtesy of Linda Stansberry Photography.
dency to bounce, but we came in, we touched down, and we never bounced. It was a smooth landing, and we came to a stop right in front of the balcony where my friends were standing. A couple of them were pilots, and they were very envious. The rest of them thought I was really crazy to be flying at this age.” Grace’s memorable flight came less than a year after he had lost his wife of almost 30 years, Barbara Turner-Grace, a former mayor of Bradenton Beach, to cancer. They had met through Grace’s son, David, a doctor of inter-
nal medicine who had Barbara as a patient. Charlie Grace has lived at Freedom Village for 16 years. Now 93, Grace said his goal is to reach 100. With memories of his dream flight fresh in his mind, he doesn’t feel his age. “Knowing that I have done this and that very few people could have done it, I feel very proud of myself, and I feel that the people here at Freedom Village feel the same way,” he said. “I got to do the most wonderful dream of my life, and I’ll never forget it.”
S E N I O R L I V I N G • W I N T E R 2020
11
Legislative Roundup:
A Recap and Forecast for Health Care Issues By Hayden Dempsey, Esquire Chair, Florida Governmental Law & Policy Practice Group Greenberg Traurig
A
fter interim legislative committee weeks that ran from September through December, the 2020 Florida Legislative Session will begin on January 14 and end March 13. And although legislative leaders haven’t listed health-related issues among their top priorities for the upcoming session, the Legislature will once again be taking up a number of items that will affect Florida’s senior living providers. The 120-member House of Representatives again will be led by Speaker Jose Oliva, a republican from Miami-Dade County. The Speaker has historically focused on health issues during his tenure in the House, and last session he passed legislation that re-
12
pealed the Certificate of Need (CON) program for hospitals and expanded the use of telehealth services. In October, the House announced an initiative to review every agency’s base budget as part of a reprioritization exercise to identify ways to adjust historical spending to address current priorities. The Health Care Appropriations Subcommittee in the House was charged with evaluating a total of $654.4 million, and a report on potential spending reprioritization is due by mid-January. Meanwhile, state revenue estimators predict a slight budget surplus in 2020, but larger deficits in following years. Those predictions, as well as Gov. Ron DeSantis’ announced priorities to raise starting teacher
salaries and increase spending on the environment, could make it challenging for senior living providers that are seeking the first inflationary adjustment for nursing homes in nearly 10 years. The 40-member Senate will again be led by President Bill Galvano, a Bradenton attorney. President Galvano passed a number of his priorities last session, including establishing a pathway for the creation of three new toll road corridors that could reshape Florida, and he recently presided over the removal of former Broward Sheriff Scott Israel. We expect that together, Speaker Oliva and President Galvano will tackle a list of high-profile issues of interest to senior living providers, including the recreational use of marijuana and the abolition of the Constitutional Revision Commission. It would take a constitutional amendment to eliminate the Commission, which meets only every 20 years and was the source of the 2018 proposed amendment to enshrine a resident’s bill of rights in the state Constitution. Although the minimum wage debate will not be legislative, backers of a proposed Constitutional amendment to increase the minimum wage to $15 per hour have generated sufficient signatures to put the issue on the 2020 ballot. The wording of the amendment still needs state Supreme Court approval before it can go on the ballot. If it passes, however, it will undoubtedly impact senior living and long-term care providers. Other high-profile issues that we anticipate will be considered this session include climate change mitigation; continued discussion of restoration of voting rights and Amendment 4 implementation; deceptive and targeted advertising related to vaping; the state hemp program; Florida election security; debate on e-Verify; statewide broadband service and Hurricane Michael insurance claims.
Taking Necessary Steps to Create a Better Senior Living Environment By Steve Bahmer President & CEO, LeadingAge Florida
S
hort-term priorities. Long-term blueprints. These two approaches informed LeadingAge Florida’s advocacy planning throughout the summer and fall in preparation for the 2020 Legislative Session. And the result is an agenda that spans multiple years with a focus on solving immediate problems while designing a longer-term plan to strengthen the entire continuum of care for older adults. Our efforts were uniquely aided this year through our participation as a founding member of the Coalition for Silver Solutions, where we, the AARP, the Florida Health Care Association, and the SEIU identified shared shortterm issues and solutions. Those solutions represent key elements of LeadingAge Florida’s 2020 legislative agenda. At the same time, the Coalition has set its sights on 2021 and beyond, and will begin the work after the current session of putting together a blueprint for the future of services and supports for older adults in Florida. This year, LeadingAge Florida and our Coalition partners are working to secure a 2.4 percent recurring inflationary increase to the base nursing home Medicaid budget. Florida nursing homes haven’t had an inflationary rate increase in five years, even as the costs of providing care have continued to soar. In total, this agenda item would add $115 million for nursing homes in the FY2021 budget. Because funding drives staffing, and staffing drives quality, the only way for this new funding to reliably drive quality improvement is for it to be recurring – predictable funding that providers can rely on year over year.
There are never any guarantees in the legislative process, but we are seeking recurring funding so nursing homes can invest in the people and processes that deliver the highquality results legislators rightly expect. Driving this agenda item for us will be our Director of Nursing Home Public Policy, Tyler Sununu, whose expertise in nursing home operations and regulatory issues will be critical in securing this funding increase. Meanwhile, we’ll also be asking legislators to review the Prospective Payment System formula with an eye toward increasing the total dollars allocated to the Direct Care and Quality components. The Coalition is also working on a number of ways to streamline the Medicaid-funded Home and Community Based Services programs. During our evaluation of short-term opportunities, it became clear that much can be done to reduce redundancy, save money, and reduce the waiting lists of people who are awaiting necessary services. As we look toward a longer-term plan, the Coalition will continue to work on nursing home funding and HCBS issues, but we’ll also begin to address large, systemic issues such as the workforce crisis and the critical lack of affordable housing for low-income seniors. Regarding affordable senior housing, LeadingAge Florida continues its partnership and participation in 2020 with the Florida Housing Coalition. As part of that effort, we will once again be supporting efforts to protect the dollars in the Sadowski Trust Fund and to require accountability when those dollars are spent on anything other than affordable housing. That’s just one of our short-term housing priorities.
But this year, we’re pushing further and taking a longer-term view with housing as well. We now have data that demonstrates that investments in affordable housing with services not only provide the best solution for seniors, but also ultimately save money in Medicare and Medicaid. The results are clear, and they provide a strong foundation for seeking additional state investments in the construction and preservation of affordable senior housing. By now, the results of surveys are well known: Seniors prefer to age in place, which is to say, in their own homes. And for many, that would remain an option, so long as they have access to the supportive services they need to continue living independently. LeadingAge Florida is evaluating a pilot program that would provide wellness nurses and service coordinators in affordable housing communities to help ensure seniors are getting the preventive care they need, and that they have transportation and other supports they need to live independently. If we can show that the program works – and we think it will – we’ll seek legislative and executive branch support to scale the program statewide. In addition to our nursing home, HCBS, and housing agendas, LeadingAge Florida is lending its considerable assisted living expertise to an ALF modernization bill that has been revived for the 2020 session. The bill updates the ALF laws to, in part, incorporate the use of technological advances and innovations in health and safety to make the assisted living experience better for Florida’s seniors and staff. S E N I O R L I V I N G • W I N T E R 2020
13
The bill recognizes, for example, that assisted living communities are residential models with a health care overlay by expanding services and choices in the residential setting through the use of technological advances, such as assistive devices and wearables for wander management. It also increases housing options for seniors by expanding resident admission criteria to allow the same services that are provided at home to be provided, if appropriate, to the resident in his or her assisted living home (e.g., home health care services). Susan Anderson, our Director of Assisted Living Public Policy, has led our efforts through the fall to improve the bill so we can support it and help get it passed. Once this round of modernizations is complete, LeadingAge Florida has a long-term set of ALF policy priorities for the 2021 session that will clarify key issues for our assisted living members and streamline the operation of your assisted living communities. We’ll be working on that agenda later this spring and encouraging participation from all assisted living providers to help us refine and pass it next year. After three years of very tough negotiations and tremendously hard work from our staff,
our members, our business partners, and our partners at the Florida Life Care Residents Association (FLiCRA), we succeeded in 2019 in passing a bill that enhanced protections for CCRC residents, strengthened the Office of Insurance Regulations oversight, and included incentives for high-performing CCRCs. And we had hoped that would be the last of it, at least for a while. But with any bill of this scope and scale – it was the most significant modification of Chapter 651 in more than 30 years – there are bound to be items that require clean-up. 2019’s House Bill 1033 was no exception. LeadingAge Florida has always been supportive of necessary, well-considered reforms, but we have always weighed those reforms against any potential harm they may do to the CCRC field or to CCRC residents. We are careful, in other words, to ensure that additional regulation doesn’t ultimately drive up costs for the very residents our CCRC members provide care. A thorough review of the final legislation, once again with the help of our task force of members, business partners, and this time the investor community, identified a provision that needs to be remedied to prevent
increases in borrowing costs for our members, and thus to prevent increases in fees to residents. Susan Langston, our Vice President of Advocacy; Mary Ellen Early, our Public Policy Liaison; and Hayden Dempsey, our lobbyist from Greenberg Traurig; are pursuing a surgical fix for this issue, and our team will be working to get it through the process during the 2020 session. Short-term priorities: Increasing Medicaid funding for nursing homes; reducing the HCBS waiting list; modernizing assisted living regulation; protecting Sadowski funding; and resolving an issue in the CCRC reform bill. These are the key issues we’ll be working on – with your help – during this year’s legislative session. Long-term blueprints: Ensuring sufficient affordable housing for seniors and reducing Medicaid spending as a result; utilizing those savings to fund other needs in the system; revising the reimbursement system to truly incentivize quality outcomes; and innovating to help resolve the workforce crisis all of our members face. These are the building blocks of the longerterm plan we are working on – with your help – for sessions to come.
HD TV, WIFI, ENGAGEMENT, VOICE The way they want it.
MODULAR & SCALABLE The all-in-one quality solution giving residents the options they want.
Contact SeniorTV for a FREE quote and meet all your residents needs. 800-890-7770
14
SENIORTV.COM
Making Florida Livable for All
By Richard Prudom Secretary for the Florida Department of Elder Affairs
A
t the Department of Elder Affairs, we are focused on improving the well-being of Florida seniors and their caregivers through several initiatives, including protecting older Floridians from abuse, neglect and exploitation; implementing important changes to the guardianship program; expanding the
Dementia Care and Cure initiative across the state; and facilitating Livable Communities throughout Florida that support our Age-Friendly Initiative – Livable Florida. From time to time, it is appropriate to take a step back and evaluate the direction an organization is taking. An agency’s mission and vision are critical to establish direction and better link our daily work to a greater goal. To that end, I am excited to announce that the Department of Elder Affairs has recently unveiled a mission and vision that will serve as the guiding force for our efforts and the work we do every day to serve Florida families. Mission: To promote the well-being, safety, and independence of Florida’s seniors, their families, and caregivers. Vision: For all Floridians to live well and age well.
In April, I was honored to join Governor DeSantis and state and national leadership from AARP to announce Florida as only the fourth state in the nation to achieve the Age-Friendly Designation. By implementing age-friendly practices and principles in local communities, we achieve inclusiveness, engagement and well-being of all regardless of age or ability and help to make those communities places seniors want to call home. It is a pleasure to lead a department filled with dedicated employees who carry out the mission and vision of DOEA, and I applaud them for all their hard work, day in and day out, to serve seniors and their families. It is our true honor to do so. There are many exciting things going on at DOEA and across the Aging Network right now, and I am proud to work with our partners as we strive to make Florida a place where we all can live well and age well. S E N I O R L I V I N G • W I N T E R 2020
15
Where Hospitality Meets Healthcare UCF Offers First-Ever Bachelor’s Degree in Senior Living Management
T
oday’s aging population wants and expects more from life than their parents before them. They want to travel, experience new things, lead an active life, and enjoy a lifestyle they have worked hard to achieve. With the University of Central Florida’s Bachelor of Science in Senior Living Management, students can gain the skills, knowledge and expertise to help support and shape the lifestyles that residents in senior living communities deserve. UCF’s Rosen College of Hospitality Management provides students with an unrivaled opportunity to live, learn and work in the heart of hospitality. UCF Rosen College educates the next generation of industry leaders through internationally recognized faculty, innovative academic programs, cutting-edge research, and strong industry and community partnerships. Beginning in the fall semester of 2020, UCF Rosen College of Hospitality Management will introduce the Senior Living Management Bachelor of Science degree, which is an interdisciplinary program that combines the art and science of hospitality management with aging studies and health care management. The Senior Living Management Program is the first degree program of its kind in the United States to combine the exceptional customer service approach found in hospitality management with an emphasis on establishing a high standard of living for residents by focusing on creating a feeling of home and community. The undergraduate degree program was designed to adapt the culture and philosophy of hospitality to the senior living industry, meeting a call from industry leaders who understand that a culture of hospitality presents a strategic advantage for senior living communities by enhancing the overall experience of the residents. The objective of the program is to prepare graduates for managerial positions in the senior living industry. This degree program will not require a medical or nursing degree. There is no patient care involved, just management of all aspects of a home
16
or community. The major components focus on courses in hospitality management, healthcare management and gerontology. The curriculum covers all aspects of managing senior living communities including lodging operations, marketing, communications, accounting and financial management, legal aspects, food and beverage operations, facilities management, and events and entertainment management. Students also will be required to complete three units of supervised internships in senior living communities in the United States or abroad. The program is designed to be completed in 2-6 years and is available in face-to-face, fully online, or a combination of the two formats. The learning method selected depends on whether a student has an associate’s degree, starts as a freshman, or wishes to enroll part-time. As such, the program will be attractive not only to high school graduates, but to employees currently working in the industry who want to advance to managerial positions. The senior living management degree program focuses on developing business acumen and management skills for independent and assisted living housing and continuous care retirement communities, where hospitality services are important components.
The program is assisted by an active advisory board, composed of top executives from the senior living industry. UCF Rosen College is currently accepting applications for potential students who have the passion to work in the senior living management sector.
Program FAQ • Designed to be completed in 2-6 years. • Study in person, online or a combination of formats. • Part-time studies make the program attractive to current senior living employees who want to advance.
Contact information hospitality.ucf.edu rosenadmission@ucf.edu rosencollegeonline@ucf.edu
The state’s leading advocate for quality senior living.
LeadingAge Florida serves the entire continuum of care for senior living service providers including affordable housing, assisted living, nursing homes, home and community based services, continuing care retirement communities and other multi-service providers. Â
Contact us today to become a member and learn how we can best serve you.
Follow us! @LeadingAgeFlorida
linkedin.com/company/leadingagefl
@LeadingAgeFL
Supporting Members through Major Industry Changes
By Connie Cheren Regulatory and Compliance Specialist, LeadingAge Florida
T
he year 2019 will be remembered by those of us who work in longterm care as the year of change. It seemed every month there was some new initiative that providers had to implement. It brought PDPM, Medicaid PPS, Phase Three of the Mega Rule, and changes in the quality measures. The year ended with CMS announcing the posting of an icon on Nursing Home Compare for facilities with citations of deficiencies related to abuse, neglect or exploitation. The icon posting brings a lowering to two stars in the health inspections category, with a cap of four stars overall, which can have a devastating impact on a facility. Coupled with all the changes came what appeared to be more aggressive surveys with deficiencies cited at a higher scope and severity. There were 37 immediate jeopardy citations in Florida between October 2018 and June 2019. It seemed compliance no longer meant substantial compliance. Instead, we saw many deficiencies cited for one-time observations, and many of these observations did not have a negative resident outcome. Surveyors seemed to no longer look for patterns of deficient practices, and it seemed that resident outcomes were not taken into consideration when deficiencies were cited. To address these changes, LeadingAge Florida implemented several initiatives to help members. We let our members know
18
that I am available to answer regulatory questions throughout the year and during survey if needed. Thankfully, I was able to help several members with successful informal dispute resolutions. In addition, we published actual deficiencies every Friday with a corresponding article in our LeadingLink newsletter on suggestions to avoid these citations. We also set up bi-weekly conference calls with our members to discuss regulatory issues. I personally helped several of our members prepare for survey and was on site for their surveys. I saw first hand the intense scrutiny surveyors are giving the clinical record. As we know, change is the word that best describes long-term care right now, and some of these changes have a significant impact on the daily operations of providers. Quality and compliance is a year-round, ongoing effort. When staff understand the regulations and have systems in place, any changes will be less stressful. In 2020 and beyond, should we re-think how staff are assigned responsibilities? It seems it may be impossible to avoid deficiencies unless the care plan addresses all of a resident’s needs, and the clinical record is “perfect,” and the resident has no unresolved complaints. To achieve this, I believe it will take getting nurses to the bedside and assuming total responsibility for the resident from
admission, completion of the MDS, care planning and documentation. The more information placed on the MDS (i.e., quality measures, reimbursement, etc.), the more nurses have to be pulled from the bedside to offices to complete the MDS, leaving a higher resident-to-nurse ratio on the floor. Nurses may be completing tasks for the residents (i.e., passing medications, doing treatments, etc.) while CNAs complete tasks such as bathing and dressing, but it will take more than task completion to ensure compliance with all the regulatory and documentation requirements. A combination of auditing, tracking, rounding and measuring your outcomes is required. What will 2020 bring? Now that the Mega Rule has been completely implemented, will a new, even bigger rule be phased in over three years? Will the Medicaid PPS recognize the quality indicators and reimburse based on residents’ positive outcomes? All LeadingAge staff, both LeadingAge Florida and national, will continue to learn as much as we can about the current landscape, potential future challenges and how to keep you, our members, best informed and prepared on how to implement any changes and assimilate them into your dayto-day operations. We also will continue to provide training and individual assistance for our members on any regulatory or reimbursement changes.
Prior to receiving his PET cart, Anthony Wanyoike’s disability left him crawling on his hands and knees, unable to perform basic tasks. Photos of Anthony courtesy of Partners for Care, a compassion driven, non-profit organization that plays a critical role in the distribution of Mobility Carts in Kenya and East Africa as part of their goal of eliminating needless suffering and death by preventable diseases.
Mercy in Motion Giving the Gift of Mobility
By Nick Van Der Linden Director of Communications, LeadingAge Florida
M
obility. Most of us never give it a second thought. But for 37-year old Anthony Wanyoike of Kenya, his inability to move is his harsh reality, and one that has left him crawling on his hands and knees for years. Anthony, the oldest of a family of five children, was born disabled after his mother labored for four days with no help. His disability has left him crawling in the dirt, unable to perform many daily tasks. Anthony is not alone. He is one of more than 20 million people in the world’s devel-
oping countries who are unable to walk due to landmine explosions, illness, birth defects or accidents.
Beginning of Something Special Just two countries away, Larry Hills was working on a solution. While on a missionary trip in Zaire (now Congo), Africa in 1994, Hills told friend Mel West of the need for sturdy durable wheelchairs for people who were immobile for exactly these reasons. West reached out to his friend, inventor Ear-
ly Miner, who immediately went to work on developing the first Personal Energy Transportation (PET) Cart. Once PET Cart prototypes passed field testing, shipments of carts began arriving in Zaire, where Hills set up a location to receive the cart frames, assemble them, and distribute them. In 1997, the group operated out of West’s garage and a room at the Community United Methodist Church in Columbia, Missouri. As news of the project spread, though, others expressed interest and the project grew. Larry and his wife Laura later retired to S E N I O R L I V I N G • W I N T E R 2020
19
Penney Retirement Community in Penney Farms, Fla., in 2000 and began exploring ways to establish a production site to continue the work the group had started in Missouri. Beginning once again in a garage, the operation later moved to a small space next to a local auto repair shop where the first PET Cart was produced at Penney Retirement Community in 2001. The operation continued to grow, and under Hills’ leadership, a large facility was built in 2008 that later expanded into a larger warehouse. The site now also includes a metal shop, a refurbished office and a break room. PET International later changed its name to Mobility Worldwide, and the PET Cart became the Mobility Cart. Hills has since retired from the operation, and the task of continuing his job now lays with many, including Dave Quirk and Sid Rooy, office coordinators at Mobility Worldwide at Penney Retirement Community. The Mobility Worldwide shop at Penney Retirement Community builds and ships on average 800 Mobility Carts a year, and residents there recently built and shipped their 11,000th cart. Since 1994 more than 80,000 Mobility Carts have been built across the country and distributed in 106 countries.
Where the Rubber Meets the Road It was a dark and rainy Monday morning in October when Quirk turned on the lights, began brewing his coffee and started his shift. Soon the once-silent workshop would be filled with the sounds of table saws, power tools and welding torches. “Here’s our paycheck,” Quirk said as he pointed to before and after pictures of a person crawling on the ground and then using one of their Mobility Carts. “Now this person not only has the gift of mobility, but (the cart) lets this person bring back dignity to themselves, and contribute to the community.” On the walls of the workshop hang countless pictures of happy recipients and a world map littered with red dots, representing the countries where carts have been shipped. The shop also has all the tools and supplies one could imagine and is divided into different sections and stations. “We can make pretty much anyone productive in five minutes,” Quirk said. “Our stations are set up like a General Motors assembly 20
Thanks to his PET cart and generous donations, Anthony now runs a small business selling candy, and water. He says the cart provided him a second life.
station with patterns and jigs in place to help guide the person who is manning the station.” This is necessary due to the large variety of volunteers who work in the shop throughout the year. “Last year we had over 12,000 volunteer hours, 7,000 of which came from residents at Penney Retirement Community,” Quirk said. “We get people from all over the country and all ages that come and volunteer. We partner with Ridgeview High School here in town. Students working on their International Baccalaureate degree need 10 hours of international community service, and we’re the best place for that in town. “But we also have people from churches or families that volunteer their time. We have one family that picks a not-for-profit each year for their family reunion and donates their time. In they come with kids 8 to 9 years old all the way up to great grandpas that are 90 years or older. We have something to do for everyone.” The Mobility Cart is a sturdy, three-wheeled vehicle propelled by hand-crank or pull handle that can be operated by a man, woman or child who is mobility impaired. Designed to function in some of the world’s most remote regions, the mobility cart is built on a frame consisting of steel and wood. Every cart is built from scratch by volunteers. “There are five criteria for our mobility carts,” Quirk said. “They have an undercarriage made out of steel, they have an industrial strength chain, wood for easy local repairs, solid rubber tires and a space for storing capacity. If you ask someone to make a cart, it would cost roughly
$600 to $700, but because of our donations and volunteering, it only costs $300 and given at no cost to the recipient.”
Senior Volunteers Lend a Hand The Mobility Worldwide shop located on the campus of Penney Retirement Community was the second affiliate workshop and is now part of 29 workshops around the country that develop the Mobility Carts. Carts built at the Penney Retirement Community location however, have a unique distinction – they’re multicolored. This makes them recognizable compared to others. They are so distinctive that one of Penney Retirement Community’s residents recognized one of their carts in Guatemala, said Office Coordinator Sid Rooy. “Our residents John and Kay worked 20 years in the mountains of Ecuador and 15 years in the mountains of Guatemala,” Rooy said. “They decided to return to visit their old colleagues, and they ran into someone riding a multicolored cart. Kay walks up to the man and asks him how long he’s had his mobility cart, to which the man replied that he celebrated his fourth birthday last month. Confused, Kay asks, ‘What do you mean?’ ‘Before I crawled in the dirt and I was totally dependent, said the man. I had to beg for everything I got. Then I got my mobility cart. I was able to start my own business, I got married, I have a baby and I can support my family. When I received my mobility cart my second life started. I have two birthdays now. One the good Lord gave me, and one that the cart gave me.’”
Penny Retirement Community residents enjoy volunteering their time to build the carts.
“We’ve had people that come in and perform a certain task for several years who then developed dementia. Their spouse will bring them into the shop because they remember a certain activity because they did it for years and continue their constructive activity.”
Dave Quirk, Office Coordinator Mobility Worldwide at Penney Retirement Community
The evolution of the Mobility Cart can be seen hanging from the ceiling at the Mobility Worldwide shop at Penney Retirement Community.
Rooy spent 36 years teaching in Latin America and had students in his classes whose families, friends or members of their community lost limbs due to landmines or illness. When looking for a retirement community, he said the Mobility Worldwide project was key for him and his wife in choosing Penney Retirement Community. “We have students who come from Ridgeview High that have to put in 10 hours
of international community service,” Rooy said. “I had one girl who was born and raised in Pakistan who came in and worked 27 hours as opposed to the required 10. When I signed her form, I said most students only come in and work 10. You came in and worked 27 hours, why is that?” Rooy paused as he fought back tears. “She looked me in the eye and said, ‘Because I feel at home here,’” he said. “That’s
the spirit we have here. Anybody who comes and works here is part of a family because you’re working on something for the good of other people. You’re investing your life constructively. I think that’s why we have a higher rate of men living and living longer in our community than in other communities that I’ve visited. Because we have people who are active and who are working. They are the ones carrying the ball.” Quirk added: “Our community’s life expectancy is 89 years compared to the average of 79 in the United States. We can find something to do for anyone here. Sometimes we have people with disabilities who may not be able to operate machinery come in and count and verify parts or work on mobility cart assembly instructions. We’ve had people that come in and perform a certain task for several years who then developed dementia. Their spouse will bring them into the shop because they remember a certain activity because they did it for years and continue their constructive activity.” Families and recipients send pictures and stories back to the shop at Penney Retirement Community to let them know how the carts are doing, whether improvements could be made, and how it has made an impact on their lives. “It’s one of the reasons I keep coming back,” Quirk said. “To hear the stories of the people that you’ve given the gift of mobility and how it has impacted their lives.” Rain or shine, people from across the state and country continue to come as they can and leave as they must to donate their time for the betterment of others, such as Anthony Wanyoike, the 37-year old Kenyan whose disability at birth left him forced him to crawl. Through Mobility Worldwide and one of its distribution partners, Partners for Care, Anthony was able to get his own Mobility Cart. A local pastor, Milka Njambi, also raised funds to purchase a cool box, candy, water, biscuits and handkerchiefs for Anthony to start his own business. He is grateful for the donation and says he no longer has to crawl on the ground, and his business will help him become self-sustainable. He can be seen driving his cart around town with a smile from ear to ear. He says his dreams are now a reality thanks to the donation. To find how out you can get involved, visit www.mobilityworldwide.org. S E N I O R L I V I N G • W I N T E R 2020
21
Advertiser Index Thank You, Advertisers Bouchard Insurance.......................................................Outside Back Cover Cutler Associates, Inc................................................................................22 Eldergrow...................................................................................................11 Guardian Pharmacy...........................................................Inside Front Cover Health Care Professional Consulting Services, Inc. dba HCPCS, Inc........22 M&T Bank – Healthcare Banking................................................................22 Remedi SeniorCare........................................................... Inside Back Cover SeniorTV....................................................................................................14 Sunshine Health Long-Term Care.................................................................4
Would you like us to feature your community’s residents in an upcoming issue of Senior Living? If so, please contact Nick Van Der Linden at NVanDerLinden@ LeadingAgeFlorida.org or call (850) 702-0309.
When your community wins, we are there to cheer them on. Wouldn’t you rather work with a specialist who understands your industry? M&T’s dedicated Healthcare Banking Group brings over 30 years of specialized experience to your relationship. We know the one-size-fits-all approach doesn’t work for retirement communities. Instead, M&T’s approach is to learn about the uniqueness of your community and its residents, so solutions can be designed to meet your needs. Contact your healthcare banking specialist today to find out what it’s like to work with a team that understands the Florida market and the intricacies of your community. Florida Healthcare Banking Peter Schatz Commercial Senior Relationship Manager 561-801-7903 pschatz@mtb.com
Equal Housing Lender. ©2019 M&T Bank. Member FDIC. mtb.com
Integrated Facility Solutions for Senior Living Construction Management • Design Build
Dedicated senior living focus, with approximately two-thirds of work for
not-for-profit providers Specialized teams for your project type Experts at working in resident-occupied buildings Focused on quality, affordability, sustainability and expedited completion Tampa, FL | Malvern, PA | Worcester, MA | 904.591.3873 | WBocchino@cutlerdb.com | CutlerDB.com
22
864285_Health.indd 1
24/04/17 11:51 PM
WITH REMEDI SENIORCARE PHARMACY,
When administrators and caregivers asked for a more accurate and cost-effective way to dispense medications, Remedi’s technology-enabled pharmacy services answered with PAXIT®, our groundbreaking, 24-hour, unit-dose medication management system. Reducing inventory to just two days means dramatically decreased waste. Six-point optical verification and pill-level traceability means unsurpassed accuracy. Combined with our assured on-time medication delivery and trusted ease of conversion, Remedi is the winning way.
LEARN WHY THOUSANDS OF LONG-TERM CARE PROFESSIONALS HAVE CHANGED TO PAXIT!
RemediRx.com
ACCURACY
MEDICATION COSTS
EVERYTHING FLOWS IN THE RIGHT DIRECTION.
