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Item P9 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY 7f A OD - ON*' Meeting Date: November 19. 2008 Division: Mayor Pro Tern DiGennaro Bulk Item: Yes No -X- Staff Contact Person: Tamara Lundstrom 289-6000 AGENDA ITEM WORDING: Resolution by the Board of County Commissioners expressing support for a 90 day extension for Key West Convalescent Center allowing time for the center to come into compliance with ARCA and CMS standards, or to transfer the facility to another company, or to relocate the patients to appropriate accommodations in a manner which supports appropriate care for the many severely ill and elderly patients and allows for visitation of family and friends. ITEM BACKGROUND: In November 2008 a team of investigators from Florida's Agency for Health Care Administration (ARCA), conducted an on-sight investigation of the Key West Convalescent Center (KWCC). Based on the investigation, the Centers for Medicare and Medicaid Services' (CMS) regional office in Atlanta issued a letter dated November 7"', 2008, to Key West Convalescent Center. The letter informed the KWCC that as of November 11, 2008 they could no longer accept Medicare of Medicaid patients of be reimbursed for Medicare of Medicaid patients and advised KWCC that all patients had to be removed by December 11,2008. As a result, the center will have no choice bnt to close the facility and to relocate all the patients. There are not enough available beds in the Florida Keys to accommodate all the patients, many will have to be relocated from the Key West area out of the Florida Keys, which will adversely impact the health ofthe patients and the ability of family and friends to visit their loved ones. This Resolution expresses the view of the BOCC that a 90 day extension would be in the public interest of Keys residents who will be unable to locate a facility for their loved ones in the Florida Keys. PREVIOUS RELEVANT BOCC ACTION: NONE CONTRACT/AGREEMENT CHANGES: NONE STAFF RECOMMENDATIONS: BUDGETED: Yes No SOURCE OF FUNDS: AMOUNT PER MONTH N?A OMBlPurchasing _ Risk TOTAL COST: -0- COST TO COUNTY: -0- REVENUE PRODUCING: Not applicable APPROVED BY: County Atty X -NWC Management DOCUMENTATION: Included X AGENDA ITEM # r ..~ Not Required_ DISPosmON: RESOLUTION NO. - 2008 A RESOLUTION OF THE MONROE COUNTY BOARD OF COUNTY COMMISSIONERS EXPRESSING CONCERN ABOUT THE POSSIBLE IMPACT ON MONROE COUNTY'S ELDERLY POPULATION AND THEIR FAMILIES IF THE KEY WEST CONVALESCENT CENTER IS REQUIRED TO CLOSE AND TO TRANSFER PATIENTS AND REQUESTING A 90 DAY EXTENSION TO COMB INTO COMPLIANCE WITH AHCA AND CMS REGULATIONS OR LOCATE ANOTHER FIRM TO TAKE OVER THE OPERATION OF THE CENTER, OR TRANSFER PATIENTS TO ANOTHER FACILITY WHEREAS, a team of investigators from Florida's Agency for Health Care Administration (AHCA) conducted an on-sight investigation of the Key West Convalescent Center (KWCC) and WHEREAS, based on the AHCA investigation, the Centers for Medicare and Medicaid Services' (CMS) regional office in Atlanta issued a letter dated November 7th, 2008, to Key West Convalescent Center. The letter informed the KWCC that as of November 11, 2008 they could no longer accept Medicare of Medicaid patients of be reimbursed for Medicare of Medicaid patients and advised KWCC that all patients had to be removed by December 11, 2008; and WHEREAS, KWCC is presently in negotiations with that ftrm to step in and take over the operation of the center; and WHEREAS, the KWCC has requested a 90 day extension of time to comply, however CMS has denied the extension; and WHEREAS, as a result of the letter from CMS, KWCC will have no choice but to close the facility and to relocate all the patients; WHEREAS, because there are not enough available beds in the Florida Keys to accommodate all the patients residing at KWCC, many will have to be relocated from the Key West area out of the Florida Keys, which will adversely impact the health of the patients and the ability of family and friends to visit their loved ones; and WHEREAS, allowing an extension of time for KWCC to comply with the standards, would allow for KWCC to continue to move toward compliance, transfer ownership to another party, and beneftt the patients and families of current residents; 1 NOW THEREFORE BE IT RESOLVED BY THE BOARD OF COUNTY COIlllIlllISSIONERS OF 1lII0NROE COUNTY, FLORIDA, THAT: Finding or Fact: 1. KWCC houses and cares for many extremely ill and elderly patients. 2. The forced removal of those patients will adversely impact their health and the ability of their families to visit with them and to monitor their heath and welfare. ACTIONS AUTHORIZED: 1. The Board of County Commissioners hereby requests the Florida's Agency for Health Care Administration and Centers for Medicare and Medicaid Services' to allow a ninety (90) day extension on its requirements, as stated in its letter dated November 7th, 2008, and to allow for KWCC to come into compliance with ARCA and CMS standards, to transfer the facility to another company, or to relocate the patients to appropriate accommodations. PASSED AND ADOPTED by the Board of County Co=issioners of Monroe County, Florida, at a regular meeting of said board held on the 19th day of November, 2008. Mayor Mayor Pro Tem Co=issioner Commissioner Co=issioner (Seal) Attest: DANNY L. KOLHAGE, Clerk By: DEPUTY CLERK BOARD OF COUNTY COMMISSlONERS OF MONROE COUNTY, FLORIDA BY: Mayor MONROE COUNTY ATTORNEY ~OVEDASTO~ NATI~ W~SSEL' ASSISTANT CO~TY ATTyRNEY Data II -/ - ~ 2 RANKING MEMBER: COMMITTEE ON FOREIGN AFFAIRS PLEASE RESPOND TO: 2160 RAYBURN HOUSE OFFICE BUILDiNG WASHINGTON, DC 20515-0918 o (202} 225-3931 FAX: (202)225-5620 http;f/wwN.house,gov/ros-lehtinen http://foreignaffairs_house.nov/mif\Qrity!repu bl i ca ns.htm RECEIVED NOV 17 2009 Cltongte~~ of tlJe Wntteb ~tate~ J,)ouse of i\epresfntatibes ILEANA ROS-LEHTINEN 18TH DISTRICT. FLORIDA DISTRICT OFFICE: 8660 W. FLAGLER STREET, #131 MIAMI, Fl33144 (305) 220-3281 FAX.: (305)220-3291 o November 17, 2008 o o MONROE COUNTY: (305)304-7789 MIAMI BEACH AREAS' {3051934-9441 Mr. Kerry N. Weems Acting Administrator Centers for Medicare and Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 Dear Mr. Weems: II would like bring to your attention a matter of grave importance to my Congressional district regarding the Key West Convalescent Center (KWCC) which has been operating in our community for years providing families with essential and life-saving care for their loved ones. Recently, I was informed of a critical situation involving KWCC and Florida's Agency for Health Care Administration (AHCA) and the Centers for Medicare and Medicaid Services (CMS) by constituents of my Congressional district. The possible shutdown of this facility and its impact on the community's elderly population concerns me greatly. .1 request that KWCC be l!iven at least an immediate 90 dav extension and permission to transition to a new firm with time to l!et into compliance with CMS rel!ulations. It was relayed to me that on October 27th and for five additional days through to November I sl, a large team from Florida's Agency for Health Care Administration (AHCA) conducted an on-site investigation of the Key West Convalescent Center. Their evaluation, using a new reporting methodology produced a staggering 175 pages (not the usual 30), which revealed KWCC was not on par with AHCA standard operating procedures. It has been relayed to my office that some AHCA employees actually communicated their apologies to K WCC after the fact, of perhaps, over-zealousness. I wonld appreciate CMS ewe KWCC a chance to respond to tbe AHCA state allegations: while simnltaneonslv workinl! on a buvont and transition that meets CMS compliance. so as to avoid further uunecessarv disruntions to these elders and their devoted familv and friends. On Friday, November 7"' of this month, the Centers for Medicare and Medicaid Services' (CMS) regional office in Atlanta issued a letter to KWCC informing them that they could no longer accept Medicare or Medicaid patients, or be un-reimbursed as of November II, 2008. In addition, they informed KWCC that all patients had to be removed by December 11,2008. As you know, KWCC has located a firm to take over the center and bring them into compliance with all AHCA and CMS regulations. I understand the firm has a history of reliability and experience, and suc:cessfully conducted a similar transition in the Atlanta area. However, it has come to my attention that CMS has summarily rejected this KWCC proposal leaving them 110 other choice but to embark on an immediate move of all 80 patients. PRINTED ON RECYCLED PAPER The patients at KWCC are not only elderly, but in need of a stable environment. The news of their relocation to facilities throughout Florida have not only scared them, but affected their health. It was brought to my attention that many residents were put on anti-depressants as a result. Many health-care professionals feel that some of the 80 elderly patients might die as a result of the move. I am also concerned for the much-loved and respected staff, of nurses and health care professionals, who are scurrying to find work in this unstable economy. I do not want them or their charges disturbed until the agencies decide on a proper and considered course of action. Moving this population is unusual due to the geography of this 127 mile string of islands. The nearest receiving center is in Plantation Key and they can take only 10 of the 80 patients, Homestead perhaps 10 more, leaving the rest to be more than 200 miles from home in Miami, Hialeah, Fort Lauderdale and beyond. I am ioinin!! the constituents of mv district.. alon!! with Florida State Renresentative Ron Saunders, the Mavor and Commissioners of our nation's southernmost city of Kev West.. and the Monroe County Mavor and Board of County Commissioners. in askin!! that CMS !!rant KWCC an immediate 90 day extension so that the transition to a new firm can take nlace. If the residents at KWCC are moved, not only will there be possible negative health conseQuences, but their families will have to deal with the physical ordeal of relocations that might stretch all the way to Jacksonville in some instances. In conclusion, I would like to express my hope that CMS reconsider and grant a 90 day extension to KWCC. I understand and support CMS' role in assuring that those in our community are given the best-quality health-care and treatment. I also know that you can appreciate the uniqueness of this situation and that any resolution must take into account the health and well-being of the residents at KWCC and their families. I would appreciate your consideration in this matter. - e men Member of Congress IRL:gv CC: Ms. Sandra Pace CMS, Atlanta Regional Office Associate Regional Administrator 61 Forsyth Street, SW, Suite 4T20 Atlanta, GA 30303 Representative Ron Saunders Florida House of Representatives 1402 The Capitol 402 South Monroe Street Tallahassee, FL 32399 Key West Mayor & Commissioners 525 Angela Street 2nd Floor Key West, FL 33040 Monroe County Mayor & Commissioners 1100 Simonton Street Key West, FL 33040 Me - HQ/HEAOOUARTERS Fax:850-487.fj240 Nov 10 2008 12:05 P. 01 Privacy Statement: This fa-may include confidential andlor proprietary information, and m-y be used only by the person or entity to which it is addressed. If the reader of this fa- is not the intended recipient or his or her authorized agent, the reader is hereby notified that any disselnination, distribution or copying of this e-mail is prohibited. If you h-ve received this in error, please reply to the sender and delete it :iJrmediately. AGENCY FOR HEALTH CARE ADMINISTRATION Division of Health Quality Assurance 2727 MAHAN DRIVE BUILDING 1, ROOM 170 TALLAHASSEE, FL.32308 FAX (850)487-6240 PHONE (850) 922-2945 The Honorable Larcenia Bullard, Senator The Honorable Ron Saunders, Representative Subject: \)iIne : Rebecca Knapp, Assistant Deputy Secretary, HQA Key West Convalescent Center Nml,Il8 We haVI: been advised that the letter sent via e-mail to your respective offices on Friday could not be opened properly. I am sending a printed copy herewith. This Centers for Medicare and Medicaid letter to Key West Convalescent Center terminates their Medicare and Medicaid participation effective midnight November 11,2008. Should you receive calls from your constituents, please advise that residents in the facility will not be required to leave immediately. The 3D-day period is used for orderly transfer and relocation. lIe - HQ/HEROQURRTERS Fax:850-487-6240 Nov 10 200812:05 P.02 Department of Health & Human Services Centers for Medicare & Medicaid Services 61 Forsyth St., Suite 4T20 Atlanta, Georgia 30303-8909 Referto: 5456.lnvoI.Term. 11.07,08 IMPORT ANT NOTICE - PLEASE READ CARHZULL Y (Receipt of this Notice is Presumed to be November 7, 2008 - Date Notice Faxed) Novemb<::r 7, 2008 Mr. Mark Hmater, Administrator Key West Convalescent Center 5860 West Junior College Road Key West, Florida 33040 Re: Involuntary Termination Notice CMS Certification Number: 10-5456 Dear Mr. Hunter: A facility must meet the pertinent provisions of Sections 1819 and 1919 of the Social Security Act and be in substantial compliance with each of the requirements for long term care facilities, established by the Secretary of Health and Human Services in 42 CFR section 483.1 et sea., in order to qualifY to participate as a skilled nursing facility in the Medicare program and as a nursing facility in the Medicaid program. On November !, 2008, a recertification and life safety code survey was completed at Key West Convalescent Center by the Florida Agency for Healthcare Administration to determine if your facility was in compliance with the Federal requirements for nursir-g homes participating in the Medicare and Medicaid programs. This survey found that yonr facility was not in substantial compliance -vith the participation requirements, and that conditions in your facility constituted immediate jeopardy to residents' health and safety and substandard quality of care. A statement of the deficiencies (CMS-2567) was furnished to you by the Florida Agency for Health Care Administration on November 6,2008. All references to regulatory requirements contained in this letter are found in Title 42, Code of Federal Regulations. t1L- IX HatHt:AUUUAK I i=K-=> t"aX:tl~-LRlI-oL4U NOV W LUUtl"IL:UO 1"""'" U:J Remedie- Imposed: Based upon the November i, 2008 survey, we have determined, in accordance with sections 1819(h) and 1919(h) of the Social Security Act aud the enforcement regulations at 42 Part 488, to impose the following remedies: Discretionarv Termination Your Medicare provider agreement will be terminated at midnight on November 11, 2008, in accordance with 42 CFR 488.456(b) (i) (i) and 42 CFR 489.53. We are required to provide the general public with a notice of impending termination and will publish a notice in yollr local newspaper prior to the effective date of the termination. Medicm'e and Medicaid payments for services rendered to those residents admitted to Key West Convalescent Center before November 11. 2008. will continue to be made for a 30-day period, in order to facilitate the orderly tyansferlrelocation of resident.. The 30-day time interval tor payment is from November 11,2008 through December 11,2008. Discretionarv Denial .ofPavment for New Admissi..ons (l)PNA) Discretionary Denial of Payment for New Admissions is effective November 9, 2008. Please note that any filing of Medicare or Medicaid claims for new admissions after the denial of payment for new admissions (DPNA) is in effect could result in such claims being considered "false" claims under applicable federal statutes and thus potentially subjecting the filing entity to a referral to the appropriate authorities and possibly to the penalties prescribed under such statutes, An exception possibly applies where a timely appeal of the controlling certification/fmding of non -compliance is filed (and remains pending) under 42 C,F.R. Part 498, and where your facility has made arrangements acceptable to your Medicare and Medicaid fiscal intermediaries to submit the claim (or claims) with prominent flagging clearly indicating that the claim(s) is/are being filed not for current payment, but "under protest" and for the sole purpose of preserving a timely filing should the facility prevail on its administrative appeal under 42 C.F.R, Part 498. Civil Monetarv Penal-. (CMP) As a result of your facility's noncompliance as evidenced by the fmdings of the November 1,2008 survey, and in accordance with -eetions 1919 (h) and 1919 (h) of the Social Security Act and the enforcement regulations specified at 42 CFR Part 488, we are imposing a CMP in the amount of $7,050.00 per day, effective September 17, 2008 through November II, 2008, which is the effective date of the involuntary termination remedy described above. CMS will issue a separate written notice specifying the total amount of the CMP remedy, as well as instructions for submitting payment, We considered factors identified at 42 CFR 488.438 (t) in setting the amount of the CMP being imposed for each day of noncompliance. If a hearing is requested, the CMP will not be collected until after it has stopped accruing and a final administrative decision upholdiug its imposition has been made. 2 IVI\... II< HUlHt:TIUUUTIK 1 t:K;:' r-ax:o:>u-ao (-o;,:av I'JOV IV LUUO .IL:UtJ 1-'. va If you would like to waive your right to a hearing, you must do so in writing -vithin 60 calendar days from the date of receipt of this notice. If you waive your right to a hearing in accordance with the requirements specified at 42 CFR 488.436, the amount of the CMP will be reduced by thirty-five percent (35%). In accordance with 42 CFR 488.436, if the facility does not waive its right to a hearir-g, the civil monetary penalty - r-ot reduced by 35 percent. You must submit your waiver request directly to the Regional Office by mail or fax to: Ms. Bridget Winters LTC Certification & Enforcement Branch Centers for Medicare & Medicaid Services Sam Numa Atlanta Federal Center 61 Forsyth St., Suite-TIO Atlanta, Georgia 30303-8909 PH: 404-562-7456 FAX: 404-562-7540 Plan.of Correction t-POC) a. ndlor AUe--ation of Compliance A credible allegation of compliance and/or pac for the deficiencies must be submitted to this office ten (10) calendar days after the facility receives it Form CMS-2567L. Please also submit a copy to the State Survey Agency. Loss of NurseAide Traininl! PrOl!ram (NAooTCEP) Please note that Federal law, as specified in the Social Security Act at sections 1819 (f)(2)(B) and 1919 (f)(2)(B), prohibit approval of nurse aide training and competency evaluation programs offered by or in your facility which within the previous two years has operated under a section 1819 (b)(4)(c)(ii)(ll) or section 1919 (b)(4)(ii) waiver; has been subj cot to an extended or partial extended survey; or has been assessed a civil money penalty of not less than $5,000; or, has been subject to denial of payment, the appointment of a t-mporary manager, termination or, in the case of an emergency, has been closed and/or had its residents transfemld to other facilities. As a result of the exter-ded survey this provision is applicable to your facility and you will receive further notification from the State. Su.b.standard Ou.alit- of Care (S-OC! Your facility's noncompliance with 42 C.F.R. 483.13 and 42 C.F.R. 483.25 has been determined to constitnte Substandard Quality of Care. Sections 1818(g)(5XC) and 1919 (g)(5)(C) of the Social Security Act, as well as implementing regulations at 488.325(h), require that the attending physician of each resident as well as the State Board responsible for licensing the facility's administrator be notified of the SQC. In order to satisfy these notification requirements, you are required to provide the State Survey Agency, within 10 working days of receipt of their November 6, 2008 letter to you, with the name and address of the attending physician for each resident found to have received substandard quality of care. Please note that, in accordance with 488.325(g), your failure to provide this information in a timely fashion will result in termination of participation or the imposition of alternative remedies. HL, l5< HUlHtoALJUUAK I t:K'=> r-ax:tlOU-4l:l (-<:lL4U l'lOV 'I U LUUtl U:Utl 1-". UO Appea) .m. "l!hts If you disagree with our determination that Key West Convalescent Center was not in substantial compliance with Medicare federal participation requirements at 42 C.F.R Part 483 as documented during the November I, 2008 survey previously mentioned in this notice. you or your legal representative may request a hearing before an administrative law judge of the Department of Health and Human Services, Departmental Appeals Board. Procedures govert-ing this process are set out in section 498.40, e-st se--<:-.q. You may appeal the certificettionslfmdings of rtoncompliaxace which led to the enforcement actions, but you cannot appeal the choice of enforcement remedies 42 C.F.R, 488.408(g). Procedures govering t!:tis process are set out in 42 C.F,P, Part 498, gubpart D. A written re<juest for a hearing must be filed no later than sixty (60) calendar days from the date of receipt ofihis letter. Such a request should be directed to: Oliver Ports, Chief, Civil Remedies Division Departmental Appeals Board, MS 6132 330 Independence Avenue, S.W. Cohen Building, Room G-644 Washington, DC 20201 Please send o. copy of your hearing request to the attention of Phyllis King at the address belowartd to the State Survey Agency: Phyllis King LTC Enforcement Branch Centers for Medicare & Medicaid Services Sam Nunn Atlanta Federal Center 61 Forsyth St., Suite 4T20 Atlanta, Georgia 30303-8909 FAX: (404)-562-7540 A request for a hearing should identify the specific issues, and the fmdings of fact and conclusion of law with which you disagree. It should also specify the basis for contettding that the findings and conclusions are incorrect. You may be represented by counsel at a hearing at your own expense. Aoolicat..ion for Readmission Followinfl I......voluntarv Termination: Under the Medicare regulation at 42 C.F.R..- 489.57(a) when a provider agreement i- terminated by CMS, a new agreement will not be accepteduntil it has been detelmined that the reason for the tennination of the agreement has been removed and there is a reasonable assurance that it will not recur. Once terminated, therefore, you must demonstrate through a reasonable assurance period that you can maintain substantial compliance for at least 180 consecutive days. Substantial eomplimaee with the applicable participation requirements at 42 C.ER Part 483 will be verified by surveys conducted at the beginning and end of this period. Additionally, before readmission to the Medicarerrogram, you must demonstrate your ability to comply' with all p.ertinent requirements of Title XVlll 0 the Social Security Act (including your financial ability to provide services required for Medicare participation). You must also establish that you have fialfilled, or made satisfactory arrangements to fulfill, all of the statutory and regulatory responsibilities of your previous provider agreement (including resolution of all outstanding fmanciaI obligations due the Medicare program). 42 C.F.R. ~ 489.57(b). 4 HL: IS< HUlH~UUUAK I t:K:; t-ax:tlOlJ-4tSI-o~4U NOV lU ~UUtll~:U\ r. UO Assuming substantial compliance with partic{patio- requirements is doc,u, me-ted -at, the, beginning and end of the reasonable assurance period, and assun)ing all orner tecteral requirements are met, Medicare certification and reimbursement will begin following the conclusion of the reasonable assurance period in accordance with the terms of 42 C.P.R. ~ 489.13. If you have any questions regarding this matter. please contact Stephanie Davis at (404)-562-7471 or Phyllis King at (404) 562-7456. Ir-formationcan also he fuxed to (404)-562-7450. Sincerely, Sandra M. Pace Associate Regional Administrator Division of Survey and Certification State Survey Agency State Medicaid Agency Fiscal Intermediary Stephanie M. Davis Tina Holloway Howard Lewis AmrAll Mark Halter NOTE TO THE FISCAL INTERMEDIARY This lette:r replaces the CMS-2007, Provider Tie-In Notice