Evansville Manor: Skilled Healthcare & Rehabilitation

From the Administrator

October 2016

Welcome to the fall season.  We are already seeing some fall colors arriving.  At the time of this writing, however, the weather has been very nice with temperatures above average.

Along with the autumn season, it is time to provide a couple of reminders to everyone.  For anyone covered by Medicare, remember that the annual open enrollment period for Medicare coverage (traditional Parts A & B), Medicare Advantage Replacement Plans (Part C), and Medicare Part D (medicine & drug coverage) begins October 15th and runs until December 7th.  If you are contemplating a change in any coverage it must be done during this time frame.  

A cautionary note, a number of people have elected a Medicare Replacement "Advantage" Part C plan, which replaces the traditional Medicare Parts A, B, & D.  Although this does provide some of the similar coverages, usually at a reduced monthly premium rate, these Medicare Replacement "Advantage" Part C plans do not provide the identical coverage of traditional Medicare and many insured's are "unpleasantly surprised" at the reduced coverage periods, additional deductible and co-pay differences, as well as somewhat frequent denial of coverage in many instances when the need is deemed necessary and/or could have been covered under traditional Medicare.  Our experience here at Evansville Manor is consistent with reports from others throughout Wisconsin.  Residents and families of those whom we have served have expressed concerns and confusion with Humana and United Health Care policies, among others.

If you have, or contemplate electing coverage of a Medicare Replacement "Advantage" Plan (Part C), be sure that you understand the differences in coverage, and especially, the deductibles and co-pays, as well as the risk of coverage denial, and for coverage following post-acute hospital care.

The other subject for this time of the year is that we are entering the traditional influenza season, beginning about October – November.  By the time you receive this article, it is intended that we will have at least begun the vaccination of all residents and staff.  As we may have a couple of staff members who will not be vaccinated so when the flu is prevalent in the geographic areas of Dane & Rock Counties, they will be required to wear masks when in resident areas.  Similarly, during such times (please take note of the posting of signage in and around the facility) we ask that any unvaccinated visitors mask, covering both the mouth and nose, when in the building.  Of course, we encourage EVERYONE to be vaccinated but we also understand there are a few who cannot be vaccinated due to medical conditions.  As it takes a couple of weeks after vaccination to become effective, it's important to obtain the vaccination now or as soon as possible.  Please remember to wash hands often, use hand sanitizers frequently, cover coughs and sneezes, etc., both for one's own safety but also for our residents, most of whom have compromised health issues.  Your cooperation is very much appreciated.

I apologize for reiterating this several months in a row, but as many of you know, skilled nursing facilities (nursing homes) must be surveyed (inspected) for compliance with state and federal regulations, as well as for Medicare & Medicaid Certifications, on an approximately annual basis.  As it is intended that we can have no expectation of when such surveys occur, the unannounced surveys are scheduled by regulators for 9- 15 months after the previous survey.  However, sometimes they incur "off cycle", weekends, holidays, off hours, etc., just to be more random and surprising for the facility staff.

The reason I share this survey information with you is because it has now been more than 9 months since our last survey and I want to give everyone a "heads up" that we are now in that "survey window" where we can most certainly expect surveyors during these next few months.  When a survey occurs, lasting for about a week, with a number of surveyors, it is very disruptive for staff, but also sometimes for residents and families with whom they wish to interview and discuss matters.  Sometimes residents and families become uncomfortable as much of this is conducted in an investigatory manner.

My purpose in sharing this is to "set your mind at ease".  Although, we don't always agree with the findings, or especially the seriousness of them, our experience is normally quite positive (although it's very rare if nothing is cited during the survey process).  Please feel free to discuss cares and concerns with us, of course, but also with the surveyors, including compliments we hope.  If you have any questions or concerns during the survey process please be sure and let me know.

Enjoy the beautiful fall season that has in my mind come upon me sooner rather than later this month.

Cliff