Florida Medicaid, Nursing Home, and ALF Legal Updates (May 2023)
DCF Long-Term Care Application Delays and Problems
On May 8, 2023, the Florida Department of Children and Families (DCF), the agency responsible for processing Florida Medicaid Applications, announced the launching of the DCF Long-Term Care Program Inquiry URL. This link only pertains to addressing a limited scope of problems for those applying for the ICP or Medicaid Waiver long-term care programs in Florida.
The form has been set up for certain individuals and providers to send inquiries on pending Medicaid long-term care cases related to:
- incorrect Florida Medicaid benefit approved
- missing Florida Medicaid coverage
- incorrect patient responsibility
- review of cases denied or no action taken between 30-60 days from initial application date
The following entities/individuals may utilize this system:
- Authorized Representative
- Elder Law Attorneys Office
- ADRC / AAA
- Long-Term Care Facility
- Other State Agency
Have ready: the case/application number, and Florida Medicaid applicant / Medicaid recipient's name. Supporting documents cannot be sent via this system, but must go through the MyAccess Account, faxing to: 866-935-7119 / or other DCF fax numbers, or mailing to main ACCESS Center Ocala Address: PO Box 1770, Ocala, FL 34478.
CMS Says Florida Nursing Home Visitation “is Allowed for All Residents at All Times”
On May 8, 2023, CMS revised its September 2020 memorandum in order to align with the ending of the COVID-19 Public Health Emergency. The Centers for Medicare & Medicaid Services confirms:
“Visitation is allowed for all residents at all times.”
For my clients who reside in skilled nursing facilities / nursing homes, note that CMS (i.e. the federal government) confirms that visitors may share a meal with or feed the resident they are visiting (Question 3 in Frequently Asked Questions).
Facilities must allow indoor visitation at all times and for all residents as permitted under the regulations. While previously acceptable during COVID, facilities can no longer limit the frequency and length of visits for residents, the number of visitors, or require advance scheduling of visits.
We have always explained to our clients' families, that you want to make sure someone (you or a hired professional advocate) is visiting your loved one often and at irregular times (day and night).
CMS reiterates its expectation that nursing facilities “adhere to infection prevention and control recommendations in accordance with accepted national standards.”
Read/print the revised CMS Memorandum on Nursing Home Visitation Rights by clicking the link.
Study: Fewer Nurses in Nursing Homes Correlates with More Resident Deaths
“Staffing Shortages, Staffing Hours, and Resident Deaths in U.S. Nursing Homes During the COVID-19 Pandemic” finds that nursing facilities that self-reported nurse staffing shortages in fact had fewer registered nurses, licensed practical nurses, and certified nursing assistants providing care to residents and the result of these nursing shortages was a 10.5% increase in resident deaths, from both COVID-19 and non-COVID-19 causes, during the coronavirus pandemic.
The full study, as published in the Journal of the American Medical Directors Association (JAMDA), can be accessed by clicking the link.
The study, based on national data reported between May 31, 2020 and May 15, 2022, finds that “the quantity and quality of care in NHs may have decreased during the pandemic.” It concludes, “Policies aimed at improving access and quality of care in NHs, especially in times of major health crises such as the COVID-19 pandemic, must consider ways to increase staffing, either through interventions aimed at retaining the existing staff or by attracting additional staff.”
Study: Residents of Medicaid-Funded Assisted Living Facilities with Unaddressed Mental Health Needs
While this study, also published in JAMDA (click link to read full study) was performed in one ALF and with a small sample (13 residents). So, while I am not a scientist, I would think that this study, while worthwhile, likely needs to be repeated with a larger population and likely in multiple different Assisted Living Facilities. However, anecdotally, the results "feel" accurate and
Demographic data and mental health indicators (depression, anxiety, stress, hopelessness) were measured with questionnaires (Center for Epidemiological Studies Depression Scale, Edmonton Symptom Assessment System, Perceived Stress Scale, Beck Hopelessness Survey) and analyzed with descriptive statistics. Interviews were conducted between June and November 2021.
Qualitatively, residents reported barriers to mental health access to address depression, anxiety, and substance use. This was accompanied by concerns surrounding loss of autonomy, mistrust for M-ALF organizational support, isolation and uncertainty about how to receive mental health support.
Mental health interventions and processes are needed to improve mental health access and should prioritize residents’ desire for autonomy and the unique circumstances of living in an Assisted Living Facility