2013 NASVH & NASDVA
Summer Conference
VHA State Home Per Diem Program
Cyndi Kindred, SES
Deputy Chief Business Officer
For Purchased Care
State Home Per Diem
Program Accomplishments
VETERANSHEALTHADMINISTRATION
2
Grant Program Update – 2013 Grant
Awards
• VA will award 62 state home construction projects
– 34 conditional grant awards ($78M)
– 28 final grant awards ($124M)
– There are 50+ homes approved for 2013 funding and the
ARRA projects are all closed
• Conditional grant awards signed August 30th
• Complete grant application by February 2014
VETERANSHEALTHADMINISTRATION
3
Grant Program Update
Initial Applications 2014
• VA received 56 initial state applications for
FY2014
•
15 safety projects
•
2 bed replacement projects
•
2 adult day health care
•
7 new construction projects
Reminder: State grant applications may be submitted year round in
grants.gov.
VETERANSHEALTHADMINISTRATION
4
How you can help us !
5
VA’s Landing Page
www.va.gov/aca
VETERANSHEALTHADMINISTRATION
New State Home Survey Contract
• Contract awarded by Geriatrics and Extended Care Operations
office (GEC-Ops) July 31, 2013 to current vendor, Ascellon
Corporation
• Survey Team- Contractor, VAMC Representative, and VAMC
fiscal surveyor
– Conduct all SVH annual, recognition, for cause, and abbreviated
surveys during the base year - August 1, 2013 – July 31, 2014
– If exercised, four option years - August 1, 2014 – July 31, 2018
– The Ascellon Corporation will conduct the clinical & life safety
components of the surveys in State Home, skilled nursing, domiciliary,
& adult day health care facilities
VETERANSHEALTHADMINISTRATION
7
New State Home Survey Contract
(continued)
• The VA Medical Center Representative and the fiscal surveyor
will survey the administrative and fiscal components
• GEC-Ops has oversight of the State Home survey process
• The standards used to survey State Homes will not change;
they will continue using VA State Home Per Diem federal
regulation standards
VETERANSHEALTHADMINISTRATION
8
Types of Surveys
• Annual – Done during the anniversary month of the State Home’s
recognition or agreed upon month by VA and the State Home
• Recognition – A recognition Survey is the VA survey of a State Home used
to determine its compliance with VA standards for the purpose of
recognizing the home as a State Home by VA
– Must be on site 10 business days after official notification and are announced
surveys
VETERANSHEALTHADMINISTRATION
9
Types of Surveys
(continued)
• For Cause -- Survey authorized by GEC- Ops to investigate specific, or a
series of, incidents, complaints, deficiencies, or events that may jeopardize
the health or safety of residents
– covers specific standards related to the event or series of events.
– The scope of standards reviewed for a for cause survey can be expanded, if deemed
necessary by the survey team.
– Must be on site 15 business days after official notification and are unannounced surveys
• Abbreviated – NEW - An Abbreviated Survey is a survey authorized by GEC
Ops to investigate a specific standard or deficiency found during a survey
– Will cover only the specific deficiency found during a survey
– Includes follow up visits to investigate deficiencies found during a previous survey.
– Must be on site 15 business days after official notification and are unannounced surveys
VETERANSHEALTHADMINISTRATION
10
Homeless Programs in SVHs
• VHA workgroup established to address the issue
– Representatives from GEC Operations, Office of General Counsel, Chief
Business Office, Homeless Programs, and Construction and Grants
– Evaluating program requirements to determine how State Homes can
establish homeless programs
• State Home requirements
– Addressing whether the VA recognized beds are needed for the original
intent
– Validating resources are in place to meet the homeless program
requirements
• Program requirements and process for converting State Home
Domiciliary beds are yet to be developed
VETERANSHEALTHADMINISTRATION
11
Newly Recognized State Homes (2013)
• Representing 585 additional beds:
– 470 Nursing Home Beds
– 80 Domiciliary Beds
– 35 Adult Day Health Care Slots
VETERANSHEALTHADMINISTRATION
12
New Home
Addition
Replacement
Pell City, AL
174 NH 80
Dom
Hanson, KY
* Minneapolis, MN
36 additional
NH
** Minneapolis, MN
Black Mountain, NC
* Spring City, PA
Conversion Beds
** 100
NH
* 35
ADHC
100 NH
** Spring City, PA
* 72
NH
**120
NH
Scranton, PA 16 Dom to NH
Chippewa Falls, WI
72 NH
13
State Home Internet Site
• Data Repository of Regulation, Policy and Reports
–
–
–
–
–
–
–
Per Diem Rates
Construction Grant Guidance
Bed Changes
Survey Appeals
Occupancy Reports, authorized beds
Handbooks & Directives
Training
• Link: http://www.nonvacare.va.gov/state-homes.asp
VETERANSHEALTHADMINISTRATION
14
15
General Overview – State Veterans Homes
Total State Home Facilities - 146
– Skilled Nursing Programs - 137 (24,853 beds)
– Domiciliary Programs - 53 (5,865 beds)
– Adult Day Health Care Programs - 2 (85 slots)
• Total Programs – 192
VETERANSHEALTHADMINISTRATION
16
Statistical Updates FY 2012 and YTD 2013
Average Daily
Census
FY 2012
FY 2013 YTD
Nursing Home
Basic
17,797
17,410
Nursing Home
SC Veterans
1,871
2,152
Domiciliary
3,644
3,527
ADHC
21
30
(May 2013)
* Public Law Impact
Data Source: SQL database
State Home Per Diem Program
VETERANSHEALTHADMINISTRATION
17
FY 2013 Year to Date Budget
• FY 2013 Budget - $975,274,023
– Projected Expenditures – $942,570,145
– Average monthly expenditure - $77,040,261
• FY 2014 Budget - $1,070,848,000
VETERANSHEALTHADMINISTRATION
FY 2014 Per Diem Rates
• Rates have been established
• The rates require VHA approval
• Target date for release is September 2013
VETERANSHEALTHADMINISTRATION
19
10-10SH Applications
Accurately and Timely
Program Audits: Improper Payment Elimination
Recovery Improvement Act - IPERIA
– The VHA Office of Finance conducts annual audits for a
variety of programs including the State Home Per Diem
program
– The findings revealed administrative errors which will
require VAMC’s to request applications that were
submitted previously
– Your cooperation to assure that we have a 10-10SH for
every Veteran is greatly appreciated
VETERANSHEALTHADMINISTRATION
20
Timely Per Diem Payments
• We want to ensure your payments are timely
• Implementation of the electronic invoicing requirements have
improved timeliness of monthly invoices
• Timely retroactive payments continue to be a concern for
some State Homes
• Please reach out to the State Home Per Diem office if you are
unable to resolve payment delays with your local VAMC
– Point of Contact - Kelly Schneider Kelly.Schneider2@va.gov or (520)
395-0310
VETERANS HEALTH ADMINISTRATION
21