Evansville Manor: Skilled Healthcare & Rehabilitation

From the Administrator

November 2017

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.  Perhaps we had fall in August and are now having summer in September.

Along with the autumn season, it is time to provide a couple of reminders to everyone.  For anyone covered by Medicare, remember the annual open enrollment period for Medicare coverage (traditional Parts A & B), Medicare Advantage replacement Plans (Part C), and Medicare Part D, medicines and drugs, 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.

As I mentioned last month, for us here at Evansville Manor, this year, because of the timing of the last state and federal survey (inspection), July brought with it the beginning of what we commonly refer to as our "survey window".   It might be a little early to address the issue of our "annual" recertification survey by the Department of Quality Assurance (DQA) of the Wisconsin Department of Health Services (DHS), but this year our "window" for this event runs from July 11th to January 11th, although they have occasionally been known to survey outside the regulatory imposed dates.  An inspection survey by Wisconsin Health Officials for licensure, Federal Medicaid, and Medicare Certifications is required to be completed within 9 – 15 months from the date of the last survey. This is a "wide window" during a significant time frame in order to assure that it will be a "surprise" visit and so that a facility does not operate or staff differently in preparation for their inspection. Because the dates are unknown, I will include this information each month until survey so that newer residents, family members, and staff are similarly aware. For those who might see this information duplicated, I apologize in advance for my redundancy.

I always like to include this survey information in our newsletter for residents and family members (and also for staff) so they are aware of these surveyor visits. Surveyors not only include interviews and observation of the care and treatment of all of the residents but also include contacting and interviewing a number of resident family members. I want to encourage everyone to be open and comfortable with them during the survey process. It is a time when staff is put in very stressful situations, especially since the occasion is completely unplanned and requires significant time consumption while they are still attempting to provide care during the course of their normal duties. Please make allowances for their ability to timely respond during survey times.

The survey process normally takes the best part of a week with multiple surveyors that might even change from day to day. Subsequent survey paperwork will usually take another week or two with any applicable noted requirements that might involve our need to take corrective action.  All of this and the results of the survey are always shared with everyone.  Documents of the prior survey last November are located in the facility lobby.

Have a great month as we progress toward a beautiful Wisconsin autumn this month.

Cliff