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Exam Code: NAB-NHA Practice exam 2023 by team
NAB-NHA Nursing Home Administrator (NAB)

Required Activity Areas:

The AIT Program should be based on the five domains of practice, which are covered in the various departments found in a long term care facility. The tool presents

the departments as modules and rotations; it is through these departments/modules
that the program should be designed, so that the individual AIT can meet an appropriate and tailored amount of time in each of the domains as appropriate. These modules include:

• Administration

• Human Resources

• Nursing

• Business Office/Financial Management

• Diet

• Rehabilitation

• Medical Records

• Activities

• Social Services/Admissions

• Housekeeping/Laundry

• Environmental Management/ Maintenance

A. Quality of Care/Nursing

1. Develop a rounding sheet with the administrator and director of nursing that is
resident- centered; initiate implementation.

2. Observe nurse peer review on administration of medications.

3. With director of nursing, ensure medications are not expired.

4. Develop resident satisfaction surveys and make recommendations for implementation as necessary.
B. Rehabilitation

1. Organize and implement a follow-up program for discharged residents
to the community.

2. Develop audit for equipment inventory and complete audit; report.

C. Medical/Resident Records

1. Conduct admission audit of current in-house resident population, analyze data
and report. Assist with recommendations, as needed.

2. Conduct audit of flu vaccination response variables, analyze data and report.
Assist with recommendations, as needed.

3. Conduct audit of admission and annual required vaccines, analyze data and
report. Assist with recommendations, as needed.

4. Conduct medical records audit with appropriate staff.

D. Activities

1. Develop and implement a volunteer program

2. Develop/enhance Life Enrichment/Person Centered Care program

a.Interview residents and families and analyze information to ensure that
desired activities are planned and implemented as necessary

b.Working with Directors of Activities and other personnel as needed, help
develop in-service for Life Enrichment/Person Centered Care; assist appropriate staff with delivering in-services.

E. Social Services/Admission

1. Conduct an audit of admissions documents (per regulations and organization
policy), analyze and report.

2. Complete an audit of resident preferences, such as time to eat, rise and retire,
bath/showers, time of therapy, etc. Make recommendations as necessary

3. Develop and implement an outreach program that communicates regularly with
residents and/or families post discharge.

F. Dietary

1. Develop a questionnaire for residents related to dietary satisfaction including
variables such as taste, temperature, timeliness, presentation, etc; implement,
analyze and report; make recommendations.

2. Meet with the dietician and dietary manager to learn how menus are developed,
followed, and implemented; conduct an audit to confirm residents are receiving
correct foods, drinks and adaptive devices.

3. Understand nutritionally compromised concerns and how weights are monitored.

4. Audit purchasing and storage of dietary supplies and food; report to dietary
manager and administrator.

5. Audit to ensure foods are served and maintained at proper temperatures and in
accordance with the Food Code.

G. Housekeeping/Laundry

1. Conduct weekly audits, evaluating such variables as dust, floors, toilet, showers
of designated public areas; track, trend and report accordingly.

2. Audit resident rooms for housekeeping variables;track, trend and report

3. Audit residents to determine if laundry is clean and received promptly.

4. Audit infection control, safety and cross contamination procedures and make
recommendations as necessary.

5. Follow the linen distribution system from soiled to clean and report accordingly.

6. Observe resident clothing management

II. Possible Activities/Assignments related to Domain 20: Human Resources

A. Conduct an employee file audit per regulations and organizational policy.

B. Collect annual turnover rates for last few years, and develop a strategic plan
with activities, timeframes, etc. for identified changes.

C. Develop an employee satisfaction questionnaire, administer it and analyze
data;develop a subsequent plan.

D. Develop, organize and implement several employee activities.

E. Track absentee information, such as shift, day of week, reason, frequency;

analyze and report the findings.

F. Audit external health care providers (e.g., physicians, dentists, podiatrists)
to determine current licenses, liability insurance, etc.; analyze and report the

G. Study and analyze recruiting plans/staffing patterns and offer ideas to
improve current processes to ensure that the needs of the residents cared
for are met.

H. Review and understand the facilitys employee handbook to ensure accuracy
and that all federal/state guidelines are followed and make recommendations
as necessary.

I. Review and evaluate payroll plans, compensation plans, and benefit packages

J. Participate in a complete employee hiring and orientation process ( interview,
background check, etc.).

K. Conduct a staff meeting and an in-service training program.

L. Participate in a disciplinary/grievance procedure and an employee
counseling session.

M. Understand and have knowledge of National Labor Relations Board (NRLB)
as it relates to the facility.

N. Review and evaluate the unemployment compensation record of the facility
and attend an unemployment compensation hearing as necessary.

O. Review and report on ways to encourage and support professional development of team members.

III.Possible Activities/Assignments related to Domain 30: Finance

A. Assist the administrator with all budget (capital, cash, operating, etc.) development and submission.

B. Understand and assist with accounts payable processing.

C. Analyze and understand how aged accounts work.

D. Understand the facilitys bad debt and write-off policy; determine avenues
for improvement.

E. Understand triple-check systems for private pay and all third party payors.

F. Describe and review regularly produced financial reports to determine if fiscal
issues have arisen and make recommendations as necessary

G. Review and describe the chart of accounts, bookkeeping procedures,
income and expense statements and balance sheets; make
recommendations as necessary.

H. Understand the financial audit process utilized by third party payors to ensure
billings are in accordance with services provided.

I. Analyze and understand third party payor cost reporting systems.

IV. Possible Activities/Assignments related to Domain 40: Environment

A. Audit preventative maintenance logs per regulations and company policy;track
and trend such variables as time of day, season, staff member, etc.

B. Audit resident rooms, utilizing audit tools to evaluate such items as electrical
outlet plates, call bells, water temperatures and beds; track, trend and report

C. Review emergency generator and life safety regulatory requirements according
to state, local, and federal laws specific to your building(s) and prepare a compliance report.Conduct audit of past year of the log; develop/revise preventative

maintenance log with maintenance supervisor.

D. Conduct an audit of the past years log; develop and/or revise preventative
maintenance logs with the maintenance supervisor.

E. Assist the administrator and maintenance supervisor with developing and
implementing an emergency plan.

F. Develop a rounding sheet with the administrator and maintenance supervisor
that is environmental and safety centered; initiate its implementation.

G. Audit Log Out/Tag Out procedures to ensure compliance.

V. Possible Activities/Assignments related to Domain 50: Management
& Leadership

A. Review policy and procedure manuals to determine if they are appropriate
and timely, per regulations and organization policy and make recommendations for change as necessary.

B. Develop and assist the administrator with an annual strategic planning

C. Review current internal and external contracts and agreements for accuracy,
efficiency and timeliness; organize and make recommendations as necessary.

D. Review and become comfortable with federal regulations and state specific
regulations; assist with educating department leaders, if needed.

E. Assist with writing a Plan of Correction and/or identified regulatory violations.

F. Review and update the facilitys organizational chart and job descriptions.

G. Review short-term and long-term goals of the organization for appropriateness.

H. Study the bylaws/mission statement/vision of the governing body and how
decisions and policies are made within the organization. Analyze the authority
throughout the facility.

I. Plan and attend internal and external meetings and prepare reports for the
organization, as necessary.

J. Review the facility marketing plan and make recommendations for change as
necessary based upon facility dynamics and community needs.

K. Review and understand the facilitys media publicity efforts, including (but not
limited to) writing news releases, facility publications, newsletters, etc.

L. Organize and write a report to include competitive information, such as
description of services and amenities, survey history, CMS 5-Star rating and
community involvement.

M. Review the facilitys corporate compliance program to ensure all appropriate
rules and regulations are followed.

N. Review and describe how the facilitys risk management program minimizes
legal liability.

O. Review and analyze facilitys information management system, including
technology, to ensure safeguards are in place to provide resident confidentiality, data security, social media, cell phones, etc.

P. Review and analyze the facilitys quality improvement programs.

Q. Review the facilitys customer satisfaction program, including resident relations initiatives, reception/concierge duties and resident/family surveys.

R. Transitional Care: understanding the various regional lines of service and how
they relate, as well as initiatives to ensure continuous delivery of safe and
quality care as consumers transition between the different lines of service.

Nursing Home Administrator (NAB)
Certification-Board Administrator health
Killexams : Certification-Board Administrator health - BingNews Search results Killexams : Certification-Board Administrator health - BingNews Killexams : Stockton Earns National Certification for Home Care and Hospice

GIRARD, Ohio — Amy Stockton, administrator at Windsor Home Health, recently earned the designation of Certified Executive for Home Care and Hospice. This certification program was offered through the Ohio Health Care Association.

Stockton passed the National Association of Long-Term Care Administrator Board’s Home and Community-Based Services Examination to earn the designation. She is one of only 86 Ohio executives achieve this national certification.

The comprehensive certification program is designed to elevate the skills and professionalism of executives in home care, hospice and community-based services by combining national competency standards with Ohio’s comprehensive state-specific training. The training course is a combination of interactive classroom training, guided self-study, and hands-on clinical learning.

Following the four-day course, candidates must complete the NAB examination to earn the Certified Executive for Home Care and Hospice designation.

Stockton has worked at Windsor Home Health for 18 months. She has an exceptional record of assisting with a start-up home health care agency as well as almost a decade of experience in home health care ranging from pediatrics to geriatrics.

Copyright 2023 The Business Journal, Youngstown, Ohio.

Fri, 11 Aug 2023 09:10:00 -0500 en-US text/html
Killexams : Mayor Brandon Johnson fires health Commissioner Allison Arwady day after health board asks him to keep her in her post No result found, try new keyword!Chicago’s top public health official, who led the city through the COVID-19 pandemic, was let go by Mayor Brandon Johnson on Friday, city officials confirmed. Department of Public Health Commissioner ... Fri, 11 Aug 2023 04:01:00 -0500 en-us text/html Killexams : LGB People Are Suffering With Their Mental Health

Source: Susan-lu4esm/ Pixabay

This past June, the Substance Abuse and Mental Health Services Administration (SAMHSA) released an exhaustive survey report on the mental health status of the lesbian, gay, and bisexual (LGB) communities during 2021 and 2022.

Let's discuss those findings (they’re dire). I will also provide some solutions and resources that may be helpful if you belong to one of these groups.

Before we get to the report, first this: Whoever you are and whoever you love, you deserve to be content and to feel like you belong—because you do. You don’t need me or anyone else to tell you that, but I wanted to all the same. Hopefully, it provides at least some small comfort.

The SAMHSA Survey Results

By way of context, the researchers say this in the report’s introduction: “Sexual minorities [such as lesbian women, gay men, and bisexuals] experience unique stressors that can contribute to adverse substance use and mental health outcomes.” This reality “can be further compounded by the experience of being female or a person of color.”

These survey findings stood out to me:

  • Bisexual females were six times more likely to have attempted suicides in the previous year than their straight peers.
  • Bisexual males were three times more likely to be dealing with a serious mental illness in the previous year than their straight peers.
  • One in seven lesbian women experienced a major depressive episode in the last year.
  • One in three gay males reported a substance use disorder in the past year, while one in four lesbian females also did so.

As you can see, the report makes for depressing reading—but it’s important to know what’s happening. To my mind, we all need to be aware of what’s going on, and do what we can to help, including simply talking about it.

Finding LGBTQ+-Affirming Therapy

Before I list a few search engines that can help you find a therapist that specializes in LGBTQ+ communities, please know that these experts aren’t your only options. The vast majority of respected, fully licensed mental health and addiction treatment centers maintain an open-door policy for helping straight people, LGBTQ+ people, and everyone in between.

That said, if it’s a priority for you to find a treatment tailored to LGBTQ+ individuals, consider contacting one of the resources listed below:

  • Association of LGBTQ+ Psychiatrists:
  • The Human Rights Campaign’s Healthcare Equity Index Map:
  • LGBTQ+ Healthcare Directory:
  • Mental Health Match:
  • Pride Counseling:
  • Psychology Today:
  • The Trevor Project:

SMART Recovery May Work Best

During my time in the addiction treatment field, I have found that some LBGTQ+ people—and certainly others as well—are not always comfortable with the religious messaging in traditional 12-step groups, like AA and NA. (For example, step 3 in the AA tradition states that we “made a decision to turn our will and our lives over to the care of God as we understood Him.”

A latest study published in the journal Families in Society found evidence that the SMART Recovery program may be a good option for people looking for a non-religious option.

The “SMART” part of the term stands for Self-Management and Recovery Training, a therapeutic strategy of moving away from addictive substances and negative behaviors to a life of positive self-regard and an openness to change.

To be clear, many LGBTQ+ clients do great with 12-step programs. But you may want to consider SMART Recovery as well. It’s simply another option that may feel more self-empowering and offer a better fit.

Reach Out For Help: It’s There For You

A lot of people—by no means just LGBTQ+ folks—are hesitant to seek care for their mental health or substance use. If you’re reluctant to call, ask a family member or friend to do it for you.

Whoever makes the initial contact, consider the brief, helpful script below. It makes it easier to know what to say:

  • My identity/sexual orientation is ______. What experience do you have working with people like me?
  • What experience do you have with the LGBTQ+ community?
  • Do you have any specific training or certifications that relate to working with LGBTQ+ clients?

If the provider doesn’t answer these questions to your satisfaction, consider another provider. (It isn’t your job to educate people on these issues.)

Final Thoughts

Please know this: LGBTQ+ people are not inherently prone to greater levels of mental illness, higher suicide risk, or increased substance use. Those things happen as a reaction to how LGBTQ+ people are treated and stigmatized by others.

To which I say: Stay strong, be confident in who you are, don’t let the uninformed frame your reality, and yes, seek mental health help without hesitation when you need it.

To find a therapist, visit the Psychology Today Therapy Directory.

Wed, 16 Aug 2023 06:09:00 -0500 en text/html
Killexams : Health care professionals: Names to Know

Access Sports Medicine & Orthopaedics welcomes Deborah Pacik, MD, MPH

Deborah Pacik, MD

EXETER — Access Sports Medicine & Orthopaedics welcomes Deborah Pacik, MD, to their practice.

Dr. Pacik has a specialty in physical medicine and rehabilitation with a sub-specialty in sports medicine and interventional spine. In her practice, she focuses on the diagnosis and treatment of musculoskeletal pain, including joints such as the shoulders, elbows, hips, and knees, as well as back pain. Her areas of expertise include regenerative medicine, such as platelet rich-plasma (PRP), shockwave treatments, micro-fragmented adipose tissue (MFAT), and prolotherapy for tendon and joint problems. She has extensive training in ultrasound-guided musculoskeletal diagnosis and injections and fluoroscopically guided spine injections. In addition, she is an experienced acupuncturist.

Dr. Pacik graduated from the University of Connecticut School of Medicine in Farmington, Conn., followed by a residency in Physical Medicine & Rehabilitation at Montefiore Medical Center/Einstein College of Medicine. She completed her fellowship in Sports Medicine and Interventional Spine at Mount Sinai in New York City. Prior to medical school, she received her Master of Acupuncture from the New England School of Acupuncture and was one of the first acupuncturists practicing in New Hampshire.

Her professional affiliations include the Interventional Orthobiologics Foundation, Spine Intervention Society, American Academy of Physical Medicine & Rehabilitation (AAPM&R), National Certification Commission for Acupuncture and Oriental Medicine, American College of Sports Medicine, and the American Medical Society for Sports Medicine. She has published on regenerative medicine and the impact of exercise on COVID severity.

Having grown up in Goffstown and then did medical training throughout the Northeast, she is excited to return to N.H., bringing her knowledge and experience to patients with musculoskeletal and back pain. Her primary interest is keeping people active at all stages of life, from the elite to the recreational athlete. She enjoys cross-country skiing, downhill skiing, and trail running.

Dr. Pacik will be accepting new patients at the Exeter location of Access Sports Medicine & Orthopaedics in August 2023. To make an appointment with Dr. Pacik, please call Access Sports Medicine & Orthopaedics at 603-775-7575 or visit

Lamprey Health Care appoints Susan Durkin as Co-CEO

Susan Durkin

NEWMARKET – The Lamprey Health Care Board of Directors voted to adopt a Co-CEO structure for their leadership team. Susan Durkin has been appointed Co-CEO of Lamprey Health Care, sharing the leadership responsibility for Lamprey Health Care with Gregory White.

Durkin joined Lamprey Health Care in 2018 as Chief of Clinical Services. She is a Registered Nurse with 25 years of experience in nursing and administration. Focusing primarily on community health, she has extensive experience leading teams in program development, operations, quality, and risk management. She has a particular interest in developing services for vulnerable populations.

Durkin has a Master of Science degree in Organizational leadership from the University of Colorado at Boulder, a Bachelor of Arts degree in Sociology from College of the Holy Cross, and an Associate of Science degree in Nursing from Rivier University.

“I am excited about this opportunity,” said Susan Durkin. “While working at Lamprey Health Care, I have seen incredible resiliency, innovation, and most of all, teamwork. Together we have added to both the depth and scope of our services, and connected to our communities in new ways by providing care inside a shelter, in community mental health centers, and at mobile locations throughout our regions. We have added specialized programs within primary care that meet the needs of our patients. I see this as just the beginning. I look forward to hearing from our communities about their needs and working with our team to assure that our services not only meet those needs, but are delivered in a way that fosters diversity, equity, and inclusion for all. Our employees are our most valuable asset and I look forward to supporting them in carrying out our mission.”

“The appointment of Sue Durkin as Co-CEO will maintain Lamprey Health Care’s position as one of the finest Community Health Centers in the country. Our Board is very excited about this new chapter. Lamprey Health Care was founded in 1971 and is one of the first community health centers in the country. We are a leader in the field, and as Lamprey has done in the past, we seek new ways to Boost the quality of care to better serve our patients, employees, and our community,” said Frank Goodspeed, Chair of the Lamprey Health Care Board of Directors.

While each Co-CEO will share many responsibilities, it also allows each each to focus on their respective areas of expertise. White who has served as Chief Executive Officer since 2013 commented on the new leadership approach. “While this may be unconventional, it is becoming more common. It allows us to optimize our ability to achieve more, to deliver a higher-level of care for our patients, support for our staff and to set ourselves apart from those around us. I truly feel invigorated by this opportunity to have clinical representation, and perspective melded and balanced with finance into a partnered leadership of the organization.”

This article originally appeared on Portsmouth Herald: Health care professionals: Names to Know

Wed, 16 Aug 2023 05:57:00 -0500 en-US text/html
Killexams : Hospital ratings reflect urban bias, administrators say

Small-town hospitals may suffer from low rating scores and payment penalties due to urban bias by organizations such as LeapFrog and Centers for Medicare and Medicaid Services, area health care administrators say.

James Berry, CEO of Northeastern Health System, said the general method in which all hospitals are measured is the evaluation of public and discrete data from the federal government.

LeapFrog, a nonprofit watchdog organization, collects data from hospitals and generates a quality-of-care rating.

Berry said LeapFrog has proprietary performance criteria used to assign a letter safety grade.

“LeapFrog performance measurements and letter grades are biased toward large, tertiary hospitals in urban areas,” said Berry. “They echo the belief that critical and/or subspecialty care should only occur in large urban hospitals, and all rural communities should transfer complex patients for care because it is ‘appropriate and safe’.”

NHS received a “D” grade from Leapfrog Hospital Safety Grade in spring 2023. According to the report, under the category “Practices to Prevent Errors,” all six subcategories were rated as “Hospital Performs Worse Than Average.” The same was reported on the subcategories under “Doctors, Nurses & Hospital Staff.”

Hospital Compare, formed to do the ratings for CMS, grades the services given by hospitals certified by Medicare/Medicaid. Penalties were established by the federal government under the Affordable Care Act, enacted in March 2010.

Under programs set up by the ACA, the federal government cuts payments to hospitals that have high rates of readmissions and those with the highest numbers of infections and patient injuries. CMS imposes penalties from 1% and up to no more than 3%.

According to Brian Woodliff, NHS chief executive and strategy officer, said disincentives for Medicare range from 0% to 3%, based on CMS’ campaign to reduce the frequency of hospital readmissions by applying financial disincentives.

“Ninety-three percent of all hospitals have received a reduction in their reimbursement since the program began in 2013,” said Woodliff. “NHS received one-eleventh of 1% reduction in 2022.”

NHS received 2 stars for the overall category from Hospital Compare, and also for patient survey rating. This information is located on

“Medicare doesn’t typically pay 100% of medical costs for the beneficiary,” said Woodliff. “Generally speaking, CMS reimbursement is about 35% of the charges from the providers. The new Medicare advantage plans pay providers even less.”

NHS scored better than other competitors such as Massachusetts General Hospital, a teaching hospital for Harvard University, and competitors in Tulsa, said Woodliff.

“Northeastern Health System views the campaign evaluation as one of many quality indicators,” said Woodliff.

Other rural hospitals in the area are also subjected to Hospital Compare’s low ratings. Wagoner Community Hospital garnered 2 stars, and Sequoyah County-City of Sallisaw Hospital Authority earned 3 stars overall.

Three rural hospitals earned a much higher rating: Memorial Hospital in Stilwell, with a 5 star rating; and Hillcrest Hospital in Pryor and Claremore both received 4 stars overall.

The overall star rating is based on how well a hospital performs across different areas. The five measure groups include: mortality, safety of care, readmission, patient experience, and effectiveness of care.

Patient survey ratings measure patients’ experiences during a hospital stay. Recently discharged patients are asked about their experience with staff communication, responsiveness, and cleanliness and quietness of the hospital.

Subcategories under the doctors, nurses and staff category, are: effective leadership to prevent errors, enough qualified nurses, specially trained doctors to care for ICU patients, communication with doctors and nurses, and responsiveness of hospital staff.

Berry explained the biases he says are held by LeapFrog.

“LeapFrog’s standard measure for an effective Intensive Care Unit, equates appropriate treatment as only under the supervision of a critical care specialty physician,” said Berry. “All day, every day – otherwise [LeapFrog rates] the care provided is substandard hospital care for critical patients.”

NHS employs only one pulmonologist/critical care specialist in Tahlequah, Dr. Creticus P. Marak, who provides 10 to 12 shifts of 12 hours per month in the ICU, due to physician scarcity.

Another consideration by LeapFrog is the percentage of registered nurses with bachelor’s degrees in nursing, and surgical competence.

“My 30 years in health care have taught me that it’s not the education that counts, but the passion to help ‘people get better’,” said Berry. “Fewer people in rural areas have advanced education, including RNs. NHS disagrees with LeapFrog’s philosophical position but has no outlet for discussion.”

All surgeons at NHS are board-certified, said Berry. LeapFrog establishes procedural competence based upon the number of procedures completed per year.

“This is LeapFrog’s urban bias,” said Berry. “It has a medical social media bully pulpit. They publish your grade. There is no option for appeal or room for discussion. Like a Google opinion, the power resides with the evaluator.”

Berry believes NHS will have a better LeapFrog rating for 2024.

What’s next

The second article, which will publish in the Aug. 23 edition, will focus on W.W. Hastings Hospital and other nearby hospitals.

Fri, 18 Aug 2023 03:22:00 -0500 en text/html
Killexams : Bolstering health care’s core

With Erin Schumaker

Driving the Day

FUNDING FOR NURSING WORKFORCE — The Department of Health and Human Services announced it will award more than $100 million to grow the nursing workforce Wednesday, POLITICO’s Daniel Payne reports.

It’s the latest step to address a nationwide shortage of health professionals.

The funding will go to programs to train registered nurses, nurse practitioners, certified nurse midwives and nurse faculty — with some money going toward efforts to offer advanced certifications to those already working as nurses.

“We’re doing this because we got marching orders,” HHS Secretary Xavier Becerra told reporters during a call. “We got marching orders directly from President Biden.”

Why it matters: The U.S. faces a large and growing shortage of health care workers, particularly those who provide primary care.

The administration and Congress continue to work on policies to increase the workforce of nurses, doctors, therapists and other health professionals. Some lawmakers have said the issue is among their top health care priorities for the year.

The details: The awards will go to three main priorities, Carole Johnson, who heads Health Resources and Services Administration, said.

HHS will grant:

— Nearly $65 million to train nurses to deliver primary care through advanced nursing education and nurse practitioner residency and fellowship programs

— About $26 million to recruit and support more nursing faculty to train a larger workforce

— Almost $9 million to support licensed practical nurses’ training to become registered nurses

What’s next? The newly announced program is part of a larger HHS workforce initiative, which spans the agency, from the CDC to the Substance Abuse and Mental Health Services Administration, according to Angela Ramirez, HHS deputy chief of staff.

WELCOME TO FRIDAY PULSE. If you need a weekend watch, the romance movie “Red, White and Royal Blue” is now out on Prime Video, and we hear that POLITICO gets a mention. As always, send your tips, scoops and feedback to [email protected] and [email protected] and follow along @_BenLeonard and @ChelseaCirruzzo.

TODAY ON OUR PULSE CHECK PODCAST, host Alice Miranda Ollstein talks with POLITICO’s White House correspondent Adam Cancryn about the millions of Medicaid beneficiaries being dropped from the program as a result of the expiration of a pandemic policy meant to prevent vulnerable people from losing their health coverage — and how this change comes at the worst time for President Joe Biden.


INSIDE THE PRIVATE WHITE HOUSE MEDICAID MEETING — Neera Tanden, President Joe Biden’s domestic policy council director, met Wednesday with several health advocacy groups to address concerns over mounting Medicaid coverage losses, three people familiar with the matter told POLITICO’s Adam Cancryn and Megan Messerly.

The closed-door session was aimed at reassuring advocates that the issue remains a top priority for the White House amid simmering frustration over the administration’s reluctance to take stronger action against states that are drastically winnowing their Medicaid populations.

More than 4 million people have lost coverage overall since April, most of whom were terminated for paperwork reasons.

Tanden, along with Domestic Policy Council aides Christen Linke Young and Jessica Schubel, walked through the administration’s strategy, emphasizing that officials are making progress behind the scenes despite the ongoing coverage losses, the people familiar with the matter said.

Still, the administration, on the same day, took a first step toward the kind of forceful action long sought by health groups, quietly publishing letters detailing which states are falling short of federal standards for their Medicaid renewal processes.

A White House spokesperson confirmed the meeting, saying in a statement that it represented “just one of many that have taken place over the course of months to discuss the work underway to ensure Medicaid enrollees stay covered or are reconnected to other coverage options.”

At the Agencies

PACT ACT SCRUTINIZED — The chairs of the House and Senate Veterans’ Affairs Committees, Rep. Mike Bost (R-Ill.) and Sen. Jon Tester (D-Mont.), are concerned about error messages thousands of veterans received when filing online for benefits under the PACT Act, Ben reports.

What happened: The VA had launched a major push to encourage veterans to file or submit an intent to file before Wednesday so their benefits could be backdated a year. A tech glitch due to high demand affected about 5,600 veterans in trying to file for backdated disability benefits under the legislation that expanded health care benefits for veterans exposed to toxins like burn pits.

Bost noted he was encouraged to hear that the VA still honored the backdate for veterans affected. The VA said in a statement that it’s logged all the filings and no veterans will miss out on benefits because of the issues. The agency announced Thursday it was extending the deadline until Monday, Aug. 14.

“VA’s failure to anticipate and prepare for the increased volume of submissions as the PACT Act deadline approached is unacceptable, given that the situation was easily foreseeable,” Bost said in a statement, arguing the VA took too long to address the issues.

Tester is also thinking about long phone-call wait times for veterans, which the VA said it’s working to decrease, saying there has been an unusually high number of calls.

“We continue to work on these issues and will not rest until they are fully resolved,” the VA said.

Further scrutiny: The news of the issues surfaced as the National Academies of Sciences, Engineering, and Medicine released a report Thursday on the VA’s benefit decisionmaking process. The report found that the process was “reasonable and logical” but said it should be more transparent, and without setting forward standards, inconsistencies could occur during decisionmaking.

VA spokesperson Gary Kunich said the agency will “thoroughly review” the recommendations.

TRACKING HEAT-RELATED CALLS — HHS’ climate change and health equity office launched a new national dashboard this week that tracks heat-related illnesses as heat waves hit parts of the country.

Federal officials hope state and local officials can use the dashboard, which draws from heat-related emergency calls at the county and state levels, to help shape heat-mitigation strategies. The dashboard also displays the average time it took emergency services to reach a patient, how many patients were transported to a facility and how many died. It also provides a breakdown by age, race, gender and whether they are in a rural, suburban or urban area.

Children, older adults, communities of color and lower-income communities are most vulnerable to extreme heat, HHS says, which means climate change and rising heat can worsen health outcomes for those groups.

What the dashboard found: The national rate of heat-related emergency calls has climbed since 2018. Nearly half of states — mainly concentrated in the South and Mid-West — had a higher-than-average number of emergency calls related to heat between July 6 and Aug. 4.

The dashboard will be updated weekly.

At the White House

FUNDING ASKS FOR OVERDOSE EPIDEMIC — The White House is asking Congress for an additional $350 million for its overdose epidemic response.

The funding, made in a supplemental budget request Thursday, would go toward SAMHSA to:

— Provide grants to states and territories through its State Opioid Response Grant program, which provides medical screenings, educational programming, treatment referrals and behavioral services to people in treatment,

— Award $50 million to the Indian Health Service for substance use treatment and prevention services

The administration requested additional funding for the Department of Justice and Department of Homeland Security, totaling $800 million among the three departments to reduce the supply of illegal fentanyl and expand addiction care.

House Speaker Kevin McCarthy’s (R-Calif.) office didn’t respond to a request for comment on the funding requests.

The budget request came on the same day Secretary of State Antony Blinken and Mexican Foreign Secretary Alicia Bárcena met to outline plans to combat the flow of illegal fentanyl coming into the U.S.

Bárcena told reporters Mexico plans to digitally monitor precursor chemicals for fentanyl that are brought across the U.S. border and then generate a database of substances to ensure they’re traceable.

Names in the News

Mike Loftus, director for pharmacy services at Mercy Health System, and Dr. Adrian Moran, chief medical officer at Aurora St. Luke’s Medical Center, have been elected to the 340B Health Board of Directors.

What We're Reading

The Associated Press reports on the record number of suicides reported in 2022.

Kaiser Health News reports on how Montana lawmakers passed an anti-abortion measure similar to one voters had already rejected.

The New York Times reports that human research trials at the New York Psychiatric Institute at Columbia have been paused while regulators review whether protocols were violated.

Fri, 11 Aug 2023 02:11:00 -0500 en text/html
Killexams : The Doctor Won't See You Now

Pittman is a health workforce researcher and an expert in health policy and management. Chen is a pediatrician, health workforce researcher, and an expert in health policy and management.

Patients are increasingly alarmed by the health workforce shortages delaying care, reducing access, and in some cases harming patient safety and quality of care.

Policymakers usually rely on provider counts to estimate and address shortage areas. However, we know that not all providers accept all types of insurance.

More specifically, the greatest shortfall of available providers is experienced by some of the poorest and sickest among us. Nearly 94 million people are covered by Medicaid, and secret shopper studies and physician reported surveys show that doctors are less likely to accept patients with Medicaid compared to those with private insurance or even Medicare.

We know that simply having health insurance is not enough; we also need more healthcare providers willing to see Medicaid patients.

Newly available Medicaid claims data (T-MSIS) now allow us to systematically track providers that serve Medicaid patients, as well as those that don't. The data on primary care providers is displayed on our Medicaid Primary Care Workforce Tracker, where consumers can view trends over time, by specialty type, at a national, state, and county level.

As we report in the forefront section of the journal Health Affairs, the Tracker reveals a mix of good and bad news for Medicaid patients across the nation. In 2019, the percent of primary care physicians who provided any appreciable care to Medicaid patients -- seeing just 11 or more patients over the year -- ranged from 84% in Wisconsin to as low as 61% in New Jersey, suggesting the variability in state Medicaid policies matters a great deal.

Overall, the number of any type of primary care provider who saw Medicaid patients rose 13% from 2016 to 2019. However, advanced practice nurses and physician assistants made up 95% of the increase. The increase in physicians was only 1%, and the number of ob/gyns seeing Medicaid patients actually dropped 2.5% over the 3-year period, with 24 states losing ob/gyns accepting Medicaid over this period.

In 2019, 44% of U.S. counties had no Medicaid ob/gyns at all. Given that access to pre- and post-natal care can prevent life-threatening complications, this statistic translates to women dying in childbirth and other shameful health outcomes.

Thirteen states also saw a loss of Medicaid family medicine physicians, 21 states saw a loss of Medicaid internal medicine physicians, and 11 states saw a loss of Medicaid pediatricians.

There are many reasons healthcare providers and practices refuse or limit Medicaid patients. Across the U.S., state Medicaid programs pay on average 72% the rate of Medicare, and on top of the low pay, many providers cite other barriers to participation including loads of paperwork.

The federal government does require states to establish access standards for Medicaid managed care programs. However, enforcement by state agencies is variable and historically, there has been little oversight by CMS.

In 2020, CMS issued a rule requiring states to develop quantitative network adequacy standards. Earlier this year, the Biden-Harris administration proposed new rules to establish national standards for appointment wait times and to require states to conduct secret shopper surveys to verify state compliance. These are important steps forward, but will require vigilance to ensure enforcement.

Overall health workforce shortages also limit the number of providers Medicaid may draw from. These shortages are only getting worse due to burnout and moral injury. In communities with too few resources, there are too few healthcare providers. It's always those with the least who suffer the most.

During the COVID-19 pandemic, health workforce programs saw increasing investments. Programs like the National Health Service Corps -- which places primary care and mental health providers in underserved settings in exchange for loan repayment -- and the Teaching Health Centers program -- which supports community-based physician and dental residency training programs -- received American Rescue Plan Act funding. The federal government and states passed emergency policies to support telehealth and to allow advanced practice nurses and physician assistants to practice at their full scope. However, with the end of the COVID-19 public health emergency and the latest debt ceiling deal claw-back of unspent COVID relief funds, these programs are at risk again.

Among the lessons of COVID-19 is the importance of caring for America's essential workers who keep our society functioning. These workers are often poorly paid and therefore rely on programs like Medicaid. It was also this population that (on top of pre-existing disparities) faced the brunt of COVID illness and death.

To ensure access to healthcare for women, children, essential workers and others, we need more providers willing to see Medicaid patients. Policymakers can help make that happen with better pay and a reduction in the administrative burdens associated with the program.

Such action would be a small price to pay for a healthier population -- and a much stronger workforce.

Patricia Pittman, PhD, is the director of the Fitzhugh Mullan Institute for Health Workforce Equity, which is based at the George Washington University Milken Institute School of Public Health, and a professor of health policy and management. Candice Chen, MD, MPH, is a member of the Mullan Institute, and an associate professor of health policy and management at the George Washington University and a board-certified pediatrician.

Mon, 14 Aug 2023 11:21:00 -0500 en text/html
Killexams : Cano Health Appoints Mark Kent Permanent Chief Executive Officer No result found, try new keyword!Mr. Kent immediately joins Board of Directors, replacing Dr. Marlow Hernandez who has stepped down ... Mon, 21 Aug 2023 00:11:00 -0500 en-US text/html Killexams : Fitwel Accelerates Global Adoption Of Healthy Building Certification At Scale Announces New Champions, Partners, & Providers No result found, try new keyword!Leading insurance, real estate, financial services, and sustainability companies commit to health at scale. NEW YORK, Aug. 16, 2023 /PRNew ... Wed, 16 Aug 2023 01:09:00 -0500 Killexams : Alpine school board approves lower property tax rate than residents feared

Frustrated residents packed Alpine School District’s boardroom Tuesday evening, thinking they would see a 19% increase in their property tax rates.

“I’m a retired individual on a fixed income, and many people are like that,” one resident said. “Having this big of a tax increase is kind of difficult to take.”

Others suggested the district make funding cuts elsewhere to come up with the needed money.

“Many homes, many people are having to tighten their budget and figure out how to come up with better solutions,” another resident said. “I suggest that the school board do this. Tighten your belts. Figure out where you can come up with better solutions, just as all the rest of us are. Increasing a tax directly to the people isn’t the best way to do this.”

But after nearly four hours of emotional speeches from 44 individuals, their worries were set to ease — at least a bit. Alpine’s school board approved a rate that is actually 3.6% lower than last year’s.

It amounts to a 7.8% increase.

Under the new rate, many property owners might actually see a decrease in taxes, said Rob Smith, business administrator for Alpine.

“Many property holders, if their values stayed relatively the same last year versus this year ... they will pay less in property taxes,” Smith said.

However, if a property’s value significantly increased over the past year, taxes will, too, Smith said.

Why were residents concerned about a 19% increase?

Tuesday’s meeting, called a truth-in-taxation hearing, is a step required under Utah law if school districts — or any taxing entity — want to generate more revenue, which they can do by increasing local property taxes.

Generally, property tax rates in Utah are based on the amount of tax dollars collected the previous year. This means that as property values rise, taxing entities can only collect as much revenue as was generated the year before.

Tax rates are forced downward to keep revenue streams the same year to year. That adjusted rate is known as the “certified rate.”

If school districts want to change the certified rate, they must hold a hearing. The first step in that process is notifying the public.

Districts must calculate and disclose the “worst-case” scenario, meaning they must publish the “maximum rate” they could charge under state law, along with the certified rate.

In Alpine’s case, its certified rate for the coming year would have been .005118 on the taxable value of property. The maximum rate is .005818 this year.

And those two rates were what residents were seeing on their notices.

“What we’re recommending, which is different from your tax notice, is .005518 not .005818, which is what was in the tax notice,” Smith said. “That shows the 19% that many of you referenced tonight.”

Last year’s rate was .005724, Smith said.

“If I look at what was last year’s rate versus what we’re recommending the board consider, that rate is less than what it was last year,” Smith said. “It’s more than what the certified rate is. So, I’m not here to say that there is not increased taxes.”

(Rick Egan | The Salt Lake Tribune) Rob Smith explains a few points, during the Alpine School District Truth in Taxation Hearing, on Tuesday, Aug. 8, 2023.

What will the tax increase fund?

The new rate will generate an estimated $21.6 million in additional annual revenue, even though the rate is lower than last year.

This is because over the last two years, the value of Utah County houses have skyrocketed. In 2020, the median home value was roughly $390,000, according to Zillow. Now, it’s nearly $500,000 — a 28% increase.

The district intends to use approximately $4 million of the additional tax revenue to supplement programs and services that were previously funded by COVID-19 relief dollars.

Alpine spent roughly $60 million of pandemic funding on support services, the majority of which went to students with special needs. But now that the funding has run out, the district hopes to maintain its level of service.

“Our special ed funding is insufficient to provide the supports we need for many of our most at-risk students academically,” Smith said in a previous interview with The Salt Lake Tribune. “So, part of this revenue is to provide additional paraprofessional supports in all of our special ed classrooms, self-contained schools [and] transition programs.”

The remaining dollars will fund the district’s school nursing contract with the Utah County Department of Health, a 2% base salary increase for teachers and new construction.

Residents accuse the board of ‘backlash’

Though the board did not approve a 19% tax increase, comments by the public highlighted the severe impact of inflation and mounting financial burdens.

“I have a concern because my taxes for the last seven years have gone up a bit,” said resident Kim College through tears. “I’m also retired. I also am on a medication that costs $6,000. I can’t do it any more.”

Many speakers echoed College’s sentiments. “We can’t afford this,” they pleaded with the board.

Some called taxes “evil,” while others criticized the salaries of the district’s highest-paid administrators, Superintendent Shane Farnsworth and Smith. Each made more than $310,000 in 2022, according to public records.

(Rick Egan | The Salt Lake Tribune) Thomas Cook makes a statement during the Alpine School District Truth in Taxation Hearing, on Tuesday, Aug. 8, 2023.

“You need to tighten your belts,” said resident Thomas Cook. “You need to do a little soul searching when you come to this vote and realize that you got people out here and across this county that are tired of losing their homes. This is not about cheating kids out of funding. This is about fiscal responsibility on y’all’s part.”

Others said the district should “cut back” on diversity, equity and inclusion-focused programs and “stick with the basics” like reading, writing and arithmetic.

However, some expressed their support.

“I do support this tax increase,” said resident Emma Wilson. “I am willing to pay my share and to pay more so that my children and the future of this school district have a good education.”

Alpine is currently exploring new school boundaries and more school closures after a proposed $600 million bond failed to pass with voters in 2022. The funds would have gone toward building new schools and repairing old ones with significant seismic needs.

Board members have attributed recent school closures — and possible future consolidations — in part to the failure of that bond.

In July, the board voted to close two elementary schools — Valley View and Sharon elementaries — despite a lawsuit and scrutiny by Utah lawmakers over whether the district followed school closure laws. The lawsuit has since been dropped.

At Tuesday’s meeting, several residents said they felt the tax increase was a form of retaliation for voting down the bond.

One resident described it as “coming in the back door” to make up for the lost funds.

But Briawna Hugh, a teacher at Willowcreek Middle School in Lehi, said the revenue generated by the tax increase is needed because her class sizes are becoming unmanageably large.

(Rick Egan | The Salt Lake Tribune) Briawna Hugh makes a statement during the Alpine School District Truth in Taxation Hearing, on Tuesday, Aug. 8, 2023.

“We didn’t pass the bond,” Hugh said. “I know that goes to buildings, and it goes to capital needs. But when we are taking out money from other pots to address capital needs, we’re missing out on a lot of money.”

Board members respond

Board members countered the criticisms before their vote.

“The kids we have now are not living in the same world that I lived in when I was a school or you lived in when you were in school,” said board member Stacy Bateman. “So I appreciate the desire for reading, writing and arithmetic, but that is no longer what cuts it in our world.”

(Rick Egan | The Salt Lake Tribune) Board member Stacy Bateman makes a statement during the Alpine School District Truth in Taxation Hearing, on Tuesday, Aug. 8, 2023.

Board member Ada Wilson said she sympathizes with those on fixed incomes during a time when inflation is so high, but the district is feeling the pains of it as well.

“I find it kind of hard to fathom because we have made efforts to tighten our belts,” Wilson said. “And this process of school closures is one that’s going to be happening not just in our school district but throughout the state as we face the changing demographics of our communities. And I find it hard to understand how you can ask us to keep small schools open and not raise your taxes because that’s what it takes.”

She said what she heard from residents on Tuesday is a symptom of decisions by Utah legislators to cut income tax and funnel public money for education into private schools through vouchers.

Wilson called on residents to help by speaking with their legislators and advocating for increased public education spending.

“They are not being responsive in the ways that count,” Wilson said. “And I just want you to know that what they’re doing is pushing boards like us to raise taxes on people like you.”

Wed, 09 Aug 2023 23:53:00 -0500 en text/html
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