December 2004
Hi !
Presidents Message
MN-DONA Board Goals 2004-2005
CMS Protocol Related to Pressure Ulcers
Mission Statement
MN-DONA's Nursing Director of the Year for 2004 is Juli Miller
MN-DONA's DON of the Year Nominees
Nominations Sought
Survey Says
District I Report - Cheryl Sjodin
District II Report - Nikki Boder
District III Report - Pat Perryman
District IV Report - Joyce Hawkinson
District V Report - Julie Turnberg
District VI Report - Verla Halland
District VII Report - Joy Hellen
Committee Reports - Scholarship Education Committee Meeting 10/13/04
Committee Reports - Legislative October 13, 2004
MDH Staff Education September 28th and 29th
Stratis Health Nursing Home and Home Health Stakeholder Meeting Report
On-site Hearing
Addressing the Under Diagnosed Hearing Loss of Long Term Care Facility Residents
Scholarship Winners
Scholarship Thank You Letters
MN-DONA Gold Patron Members
MN-DONA Silver Patron Members
New Members
Renewing Members
Calendar
Contact Information
Presidents Message
November 21st, 2004
It seems impossible that more than a month has gone by since our annual fall
conference and what a great conference it was. Our thanks again to the planning
committee for all their hard work in putting the conference together. In January, they
will begin the process all over again in preparation for our 2005 get together. I want to
personally thank everyone again for all your expressions of congratulations on being
named the MN-DONA DON of the year. It is indeed a wonderful honor and one that
means a great deal to me. MN-DONA is a special organization made up of very special
people who are devoted to the care of the elderly and I am honored also to serve as your
current president.
Recently, there have been several issues and questions that have been brought to the board's
attention. This past week, I visited with Mary Absolon of the MDH regarding these items.
The following are the questions and answers plus some other general information.
- A facility recently had an annual survey after only 7 months-the question being regarding
the 9-15 month survey window. According to Mary, the 15 months still stands, however
CMS states that the average of all surveys in the state needs to be 12 months so some could
be earlier like the 7 month one. Their fiscal year begins October 1st so that starts the new
cycle for surveys. I did mention to her that their own survey team members still quote the
9-15 month window, and she stated she would be reminding them that this is not a correct
statement. Least everyone starts to worry earlier due to this, remember that the average
needs to be 12 months so most surveys will not be that early. - Brenda Fisher has now taken over as supervisor of the St. Cloud team. Vernice is still with
the department in another capacity. Marj Meeker from the metro team will be the supervisor
of the newly created statewide team that will be made up of a variety of personal including an
OT, PT, and Pharmacist if all goes as they plan. This group will be based in St. Cloud but will
be available to survey in all areas of the state as the need arises. - CMS has released the new pressure ulcer protocol dated November 12th, 2004. MN-DONA
has been invited to serve on a committee that will be reviewing the protocols before their
implementation. If after reviewing the new information, please contact Nicki Boder or myself
with any concerns or questions as one of us will be sitting in on the discussion. Please review
Mary's bulletin, which follows this article.
A question was asked regarding the testing and training of TMA's. I have attached the state
rule that pertains to TMA's. In discussion with Mary, according to her information and
review of the rule, after a LPN student has taken their medication administration course
and has passed according to the programs criteria, they do not need to take the TMA test
or class that is offered through customized training. If they are in a four-year program
and have taken medication administration but have not completed a NA/R training program,
they would not be able to use that class for becoming a TMA. Please review rule 4658.1360
for complete language.
4658.1360 ADMINISTRATION OF MEDICATIONS BY UNLICENSED PERSONNEL.
Subpart 1. Authorization. The director of nursing services may delegate medication
administration to unlicensed personnel according to Minnesota Statutes, sections 148.171,
subdivision 15, and 148.262, subdivision 7.
Subp. 2. Training. Unlicensed nursing personnel who administer medications in a nursing
home must:
A. have completed a nursing assistant training program approved by the department; and
B. have completed a standardized medication administration training program for
unlicensed personnel in nursing homes which is offered through a Minnesota postsecondary
educational institution that includes, at a minimum, instruction on the following:
(1) the complete procedure of checking the resident's medication record;
(2) preparation of the medication for administration;
(3) administration of the medication to the resident;
(4) assisting residents with self-administration as necessary;
(5) documentation after administration of the date, time, dosage, and method of
administration of all medications, or the reason for not administering the medication
as ordered, and the signature of the nurse or authorized person who administered and observed
the same; and
(6) the type of information regarding medication administration reportable to a nurse.
Subp. 3. Documentation of training course. A nursing home must keep written
documentation verifying completion of the required course by all unlicensed nursing
personnel administering medications.
Subp. 4. Medication administration. A person who completes the required training course,
and has been delegated the responsibility, may administer medication, whether oral,
suppository, eye drops, ear drops, inhalant, or topical, if:
A. the medications are regularly scheduled; and
B. in the case of pro re nata (PRN) medications, the administration of the medication is
authorized by a nurse or reported to a nurse within a time period that is specified by
nursing home policy prior to the administration.
STAT AUTH: MS s 144A.04; 144A.08; 256B.431
HIST: 20 SR 303; L 1999 c 172 s 18
Current as of 11/25/03
- A new informational bulletin 04-18 has recently come out in regards to writing
acceptable plans of correction. The informational bulletin of 95-2 no longer applies.
In light of our discussion regarding cross referencing and writing proper plans of
correction, please be sure and refer to this as you respond to your 2567. - A facility that was recently surveyed was asked to give to the surveyors their call
light log that their system produces. We had discussed with Mike Tripple and David
Giese at our July board meeting what their feeling was in regards to whether this
information could be requested and used by the survey team. When I recently checked
with Mike, this had not been discussed on the state level. We will attempt to get a ruling
on this. At present, the thought is that this is an internal QI tool and should not be shared
unless you feel it would be beneficial in regards to a complaint or possible deficiency. We
will let you know by email when a decision has been made.
Hopefully you will find this information helpful as you continue on your valuable but stressful
work. As the holiday season approaches, please take time to be good to yourself and renew
whatever that is important to you that you might have lost in your very busy life as a DON or
ADON this past year.
HAPPY HOLIDAYS AND NEW YEAR TO ALL
Juli Miller, MN-DONA President
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MN-DONA Board Goals 2004-2005
1. STRENGTHEN OUR ORGANIZATION PEER TO PEER NETWORKING AND
COMMITTEE INVOLVEMENT.
- Provide networking opportunities at each MN-DONA event: Spring Conference,
Fall Conference and District Meetings.
- Each committee meeting agenda will include discussion on how to increase participation
and how to supplement communication electronic via web site.
- Publicity committee to establish mechanism to seek member input on their needs to
strengthen our effectiveness of events and meetings.
2. CONTINUE TO BE LEGISLATIVELY ACTIVE TO PROVIDE AN AWARENESS
AND SUPPORT OF LONG TERM CARE SERVICES.
- Collaborate with other organizations to provide a united coalition.
- Actively encourage members to participate in MN-DONA Day at the Capitol.
3. ENHANCE EDUCATIONAL OPPORTUNITIES AND INFORMATION TO ENABLE
MEMBERS TO PROMOTE STANDARDS OF EXCELLENCE IN CARE DELIVERY.
- Spring and Fall conference will provide educational opportunities according to our mission:
" To Provide Leadership Excellence in the LTC Director."
- Build on relationship with MDH and other organizations to focus on quality improvement.
- Explore collaboration with Wisconsin DON Council to provide educational "Road Shows"
for our members.
4. MAINTAIN VIABILITY OF ORGANIZATION
- Collaborate and enhance relationship of service provider.
- Retain and increase MN-DONA membership, including patrons.
- Financial stability.
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CMS Protocol Related to Pressure Ulcers
Enclosed is the CMS protocol related to pressure ulcers which was released by CMS on Nov. 12, 2004.
http://www.cms.hhs.gov/manuals/pm_trans/R4SOM.pdf
MDH will not implement these new protocols until after joint training has taken place. This training
program will be developed in consultation with representatives from nursing home provider associations,
health care professionals, advocacy organizations and staff from the Department and from Stratis Health.
CMS has indicated the protocols are effective Nov. 12, 2004, however MDH will use the protocols only
after joint training has taken place. As a reminder, MDH currently surveys for pressure ulcers and this
process evaluates assessment, care planning and outcomes. This process will, of course, continue.
As a reminder, there has been statewide training in Minnesota during the past year by Stratis
Health on issues relating to pressure sores and facilities should review this information.
There has also been a CMS video this summer on pressure sores which can be reviewed on line.
Notice was provided on the MDH website to access this August, 2004 training session.
See website:
Both of the above provided up to date of clinical information relating to pressure ulcers
and homes need to review this information.
Nursing homes should also review their own quality indicators to identify where they
stand, conduct root cause analysis and implement appropriate actions.
MDH strongly urges that nursing homes review the new pressure ulcer protocols to
assure that appropriate clinical treatment of pressure sores is provided.
MDH is committed to working with interested parties to identify the extent of training
prior to implementation.
If you have questions, please feel free to contact me.
Thank you and I look forward to working together with you on this activity.
Mary Absolon
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Mission Statement
in the Long Term Care Director of Nursing.
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MN-DONA's Nursing Director of the Year for 2004 is Juli Miller
On Wednesday October 13, 2004 the MNDONA Nursing Director of the Year was
presented to Julie Miller, MN-DONA President, Director of Nursing at Dassell Lakeside
Community Home.
Juli has been Director of Nursing at Lakeside since 1996. Letters nomination her for the
award include the following comments: She is involved with the politics, policy and
finances because she cares. She is a leader, a doer, a get involved type of person, an
advocate, and a friend. She is a hands on DON, not only in her capacity as an RN, but in
all aspects of the residents lives. Her consideration and sensitivity is not only seen by her
interactions with residents, but also with families as well. She provides comfort and
understanding at times of crisis, extending whatever help is needed, both personally and
by the staff, especially in end of life situations when thoughtfulness is so important."
Her Administrator says:
"She has been an anchor or port in the storm in a crazy business. She has taken many
phone calls from other Directors at their wits end, looking for some sort of support in
a world that seems often to be nothing but one crisis after another. She had a dream,
She wanted to take the MN-DONA organization and make it something of a powerhouse
in Minnesota. She and a handful of the MN-DONA faithful not only started out on that
quest, they conquered. They put MN-DONA in the Bd room at M & Care Providers.
They put MN-DONA in the Commissioner of Health Cabinet. They put Mike, Mary, and
David from the Survey & Compliance Division of Health Department at the MN-DONA
Board Table. They put MN-DONA in the "to be interviewed" list for the State's audit of
survey compliance environment."
Congratulations Juli and Thank you.
Jeneva Bellefeuille Presents Juli Miller the DON of the Year Award
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MN-DONA's DON of the Year Nominees
Along with Juli there were five other Nursing Directors nominated. The following are
excerpts from their nomination letters:
Maureen Greden, Three Links Care Center, Northfield. She is a professional and personal
role model to many as she daily goes about her work of making sure that others share her
passion of respectful, dignified care of the Elderly.
Sue Larson, Sholom Home East, St. Paul. Sue's long term service at our facility speaks to
her dedication and commitment to Minnesota elderly. She is trusted, respected and looked
upon for advice from other management staff.
Judy Larson, Bethesda-Pleasantview, Willmar. In the face of adversity, plaques, surveyors,
staff shortages, locusts, personal tragedy and a host of other yucky thins that would drive
most others from the field Judy hangs in there as a strong advocate for long term care.
Fran Fronczak, Lyngblomsten Care Center, St. Paul. Fran leads by example. She is exhaustive
in her drive to raise the bar for resident care and employee knowledge.
Kelly Danielson, Moorhead Healthcare Center, Moorhead. She has been willing to use her
skills and talents with the experience and single minded focus to make our facility the best it
can be, to provide the beat service possible to our residents and families and to make it the
employee of choice in our community.
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Nominations Sought
Isn't it great that the elections are over and we don't have to listen to any more campaign
ads and speeches? While we know who the President of the United States is, MN-DONA
members have the opportunity to choose a new President-Elect for our state's organization.
We are also seeking a Treasurer. And, if you belong to an odd-numbered district (1,3,5,7),
you have the chance to nominate someone for District Director.
Any MN-DONA member who is currently employed as a DON or ADON may hold an
office in our organization. The terms for all offices are two years. The President-Elect serves
two years in that position, then assumes the President's office for two years, and then is the
Advisor to the Board for two years.
MN-DONA Board meetings are usually held in St. Cloud, and board members are reimbursed
for mileage and travel expenses, per our policy. This is a great opportunity to be involved
at the state and local level.
Call for Nominations are being mailed out by Best Meetings to general membership. We have
extended the deadline for nominations into January, to allow all districts to meet and discuss
this important event.
If you have questions about what responsibilities there are for each office, you can refer to
your membership directory, where there is a copy of the constitution. If you'd like to "sit in"
on a board meeting, or talk with a board member, please contact Pat Oss at patoss@juhlent.com
or phone 320-354-6056.
MN-DONA's strength depends on the participation of its members, both at the committee level
as well as the board level. Get involved!
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Survey Says
At the Fall Conference, MN-DONA members were asked to complete a data gathering
survey. The survey was regarding the qualification of members and MN-DONA both at
the board level as well as at the district level. Seventy-two surveys were fully completed.
The first question asked was "Should the membership expand to include nurse managers,
care coordinators, etc.?" The results were 35 yes and 37 no. The second question was
"should the membership expand to assisted livings and their directors of nursing?" The
results were 26 yes and 46 no. The board reviewed the survey and the results. The board
has decided at this time not to pursue any changes in the constitution and by-laws.
Thank you to all the members that returned their surveys.
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District I Report - Cheryl Sjodin
Our district has been meeting every other month at the Fireside Grill and Patio in Bagley,
Minnesota at 12:30 pm for lunch and a meeting to follow. Our attendance has ranged from
8 to 10 directors. Our next meeting is January 13th at 12:30 pm at the same location. We
plan to set dates for the 2005 meetings at that time. We will also be electing our new
District I leader by the Spring of 2005.
The MDH survey process is usually our main topic. We also appreciate having the network
of support to assist us in our roles as Directors of Long Term Care facilities. We encourage
new and seasoned directors to join our group. We definitely believe that we give support to
each other, learn from, and grow with the knowledge shared by our peers.
Resident census varies from full capacity to 6-8 beds open in our area facilities. Several facilities
have laid away beds.
We would like the opportunity to make an impact on our legislators for the benefit of our
residents, staff, and communities. We plan to voice our concerns at the Capitol on
March 10th, 2005.
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District II Report - Nikki Boder
Fall Conference has come and gone and I, for one, am ready for another break. As usual,
the Fall Conference was a great time for networking and relaxation. Thanks to the Fall
Conference committee for all of their hard work in putting on a great conference!
District two has been meeting every other month in conjunction with the AGNE group.
The meeting is the third Friday of the month at 12:30 pm. It is held at Blackwoods in
Proctor. Our topics focus on the survey process, staffing and other issues that crop up
in the course of a day. Everyone is welcome to come and listen and share!
I am looking to see if anyone is interested in hosting a District Two northern meeting.
If you are, please contact Nikki Boder.
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District III Report - Pat Perryman
Our District has met every other month. We decided at our October Fall Conference
meeting that starting the first of the year we would change our day that we meet to the
second Thursday of the month and we would have our meetings at the Pioneer Home
in Fergus Falls, MN. Hopefully we will be able to get other members to our meetings
that were not able to come when they were held on Tuesday.
Our meetings mainly consist of networking among the members and sharing of information.
We set up a list of current members that are willing to be mentors for new DON'S in our
District. District III continues to plan the Fall Conference, and we will be meeting in January
to begin planning next years conference. Our next meeting is January 13, 2005 at Pioneer
Home in Fergus Fall, MN.
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District IV Report - Joyce Hawkinson
We met Wed November 26th at Old Chicago in St. Cloud ay 12 noon. There were 26
members present. Nancy Kollmann and Sandy Stang presented information on the
National Geriatric Conference held in Las Vegas. Nancy is interested in starting a
Minnesota chapter. This could involve all the aspects of Geriatric care staff. She will
continue to pursue the information needed to start up the chapter. The membership
would be at a very low cost to us and we would not have to be members of the National
chapter only the Minnesota board members. The CMDON and the NGC would remain
separate identities but come all together for the Gerentologic workshop in September.
Every one had census problems except one of the group. Many challenges dealing with
remodeling, case audits, recovering from state surveys and the aftermath. It seems that
we are just done with one survey, the revisit or the 2nd revisit and then we start all over
again. It is very frustrating to many and there was much discussion. One question was on
how to manage a resident with safety issues and falls when the home has documented
every possible intervention? How to Care plan this issue and inform all parties involved
that all has been tried and we don't know where to turn?
We are still looking for the perfect individualized toileting care plan.
FYI when a resident is in your facility, beware of other appointments (laser eye surgery)
that family or another MD has scheduled that the COST becomes yours!!!
Most of the facilities plan those appointments after the Medicare A stay if they do not
qualify the Medicare A criteria. Many MDs will tell the resident or family that while mom
is in the nursing home we will get all these tests (etc) done.
As of October 1, 2004 there are new guidelines and we should visit that website
Our speaker was Laura Dahl Pokes RN, CWOCN she gave us website for:
- Perspectives (free CECs) www.perspectivesinnursing.org
- Kennedy Terminal Ulcer www.kennedyterminalUlcer.com (very interesting
info on ulcers that seem to appear within hours no matter what we do) - The Wound Ostomy Continence Nursing Society www.wocn.org
meeting is December 1st and we are asked to bring a $10.00 Toy for Tots gift.
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District V Report - Julie Turnberg
It was fun to meet as a larger group during a round table at the Fall Conference. At that
time, we decided to have a joint meeting of all district 5 members on May 19, 2005 at
12 N at the Wooden Nichol in Marshall. Mark your calendars now!
On November 18, twelve DONs met at Pizza Ranch in Montevideo. We welcomed
our newest member, Jennifer Parker from Belview. She and some other newcomers
received welcome packets to acquaint them with MN-DONA and our district. We wish
Joe Garvey (Belview) the best in his new endeavors and Marlene Polejewski (Minneota)
in her retirement as DON.
Our agenda included the discussion of bath aides, MN-DONA conference topics, hydration
tracking forms, DON job descriptions and recent survey results. We always make sure we
have time for round robin.
Our next District 5 (PrairieLand Directors) meeting will be January 20, 2005 at Pizza Ranch,
Montevideo at 1:00 pm.
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District VI Report - Verla Halland
District VI is a large located in south east Minnesota. District VI is divided unofficially
into three area support groups.
At the very Southeast corner near and around the Rochester area, we have a group that
meets the 2nd Wednesday of the month at 12:30 PM. The next scheduled meeting of this
group is 12-8-04 at Broadstreet in Rochester. The last meeting held by this group was held
October 27, 2004 at the Country Buffet in Rochester and they had Gail Sheriden, Vice
President of Health Services for Tealwood speak. Gail shared trends and findings of recent
surveys. Another pattern that was noted was "deficiencies being issued on re-survey". Other
topics discussed by the group were, the service in facilities of IVs, policies, and staff training.
Linda Anderson DON at Charter House in Rochester is the MN-DONA contact person.
(507-266-7946) (anderson.linda3@mayo.edu) .
To the east of District VI in the Faribault, Kenyon and Northfield area a DON support group
meets at 7:15 AM the first Wednesday of every month. The site alternates between Faribault
and Northfield. This group meets to review problems, surveys and give each other support. It
is a great time to get together and share information and frustrations. The December 1 meeting
was held at Wimpy's in Faribault. The January meeting will be January 5 at 7:15 AM in Northfield.
Please contact Maureen Greden DON at Three Links Care Center, Northfield for more
information. (507-664-820)(mgreden@deskmedia.com).
District VI west area meets the second Wednesday of January, March, May, July, September, and
November. This meeting takes place in New Ulm at the Holiday Inn and begins at 12:00 PM.
This group also includes the staff development persons from the area. We lunch together and
then break into separate groups. Surveys, RUGS and audits are shared. We have a round table
discussion time for sharing of support and concerns. Contact person is Verla Halland DON at St.
John Lutheran Home, Springfield (507-723-3200) (verla@springfield-sanborn.net).
We would love to have our southeast area represented on the board by more than the District VI
leader please consider being on a committee and/or running for an open office. Thank-you!
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District VII Report - Joy Hellen
Well, Thanksgiving and Christmas are just around the corner and I am looking forward
to the great time visiting family and friends, eating the mouth-watering dinners and then….
loading up on desert while enjoying the much anticipated football games!!! As you all head
out, or have family coming here for the upcoming holiday season, I hope you have safe
traveling and wonderful visitation.
Fall Conference was GREAT!!!!! A huge thank you to the Fall Conference Planning Committee-
they put a lot of work into the planning of the conference. The turnout at the District 7
roundtable at fall conference was terrific and we shared a lot of good ideas. To those that were
unable to attend or were unable to hear, here is a brief summary of the discussion: it was
suggested that the 4 area groups get together for a joint meeting a couple times a year, there
was a lot of discussion about the area meetings- some requested more educational speakers while
others didn't want speakers at all but preferred to just network with each other, and discussed
sending out a notice about a certain topic for discussion at each meeting so people could bring
policies and forms to share with each other. All great ideas! Watch for more discussion at your
next area meetings.
District 7 has 4 different area groups that meet in Brooklyn Center, Bloomington, Chaska, and
St. Paul every other month.
Upcoming Meetings:
- Area 1 (North Metro) Hilton, Brooklyn Center: January 13
- Area 2 (East Metro) Michaels Holiday Inn, St. Paul: January 13
- Area 3 (South Metro) Thunderbird Hotel, Bloomington: January 18
- Area 4 (West Metro) Embers, Chaska: January 19
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Committee Reports - Scholarship Education Committee Meeting 10/13/04
Due to the overwhelming number of applications for scholarships this year it was decided
to have Best Meetings staff help us by eliminating from the packets, those applications
that do not meet the criteria or follow the application process.
Every year the committee reviews the scholarship application to make it as clear as possible.
The application again this year will exhibit a few changes.
Sponsors for 2004 scholarships were:
MN-DONA $2000.00
Omnicare $1000.00
McKesson $500.00
Elim Preferred $500.00
Thrifty White $500.00
PharMerica $500.00
Saunders $250.00
Anonymous Donor $100.00
The members of this committee plan to meet in a telephone meeting to plan the
Spring Education component.
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Committee Reports - Legislative October 13, 2004
We made introductions and reviewed the committee responsibilities and goals.
Darla Pallow agreed to represent MN-DONA at the MHHA Government Affairs
Steering Committee meetings. We are still looking for a member from a Care Provider
home to represent MNDONA at a similar Care Provider's Committee.
Day at the Capital
- Will be held on Thursday, March 10, 2005.
- We will meet at Lake Ridge in Roseville. A light breakfast will be served. Joy will
check with Pharmerica to see if they will again sponsor this. - We will extend our time at Lake Ridge to give us more time to discuss the issues.
We will have speakers from MHHA(Cheryl) and Care Providers (Joy), who will also go
over issues and talking points. - During the last 15 - 20 minutes at Lake Ridge, we will meet as districts to coordinate
who we will see at the Capital and also to mentor first timers. - We do not plan to have a speaker at the Capital. This will give more time to visit with
the Legislators. - A bus will again come from the north on I94 and we will try a bus from the west on
Highway 212. There will be no bus from the south as there was no interest. - We will meet at the Capital at 2:30 PM to debrief. Judy will arrange for the room.
- We discussed several ways to make MN-DONA stand out and decided on a button with
the MN-DONA logo on it. Joy will check with Pharmerica about sponsoring this. - We will not reserve a block of rooms at a hotel close to Lake Ridge, but will list two on
the mail out brochure. - We will check with Elim (Judy) and McKesson (Darla) about sponsoring the busses.
- Our committee will have a conference call on January 12, 2005 at 1:00 PM to go over details
and discuss talking points. - The cost will again be $35/ person.
- Laurie Stee stated her representative says be understands the financial concerns, but would
like to know how the finances affect residents, families and staff. He'd like to hear stories.
We will contact MHHA, Care Providers and the LTC Imperative to suggest questions. The
hope is to put these on the website (MN-DONA) and be brought to the district meeting. DON
can then collect stories to bring with them on March 10, 2005. - We also talked about the pros and cons of bringing staff from our facilities at a cost of $10.00
each to testify to legislators about how the finances affect them.
Respectfully submitted,
Judy Dahl
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MDH Staff Education September 28th and 29th
Stratis Health presented for the first day. The presentation was on the QIO role and
perspective in health care quality improvement. Stratis provided history on their
organization. Specific to the nursing home, Stratis presented on the two initiatives:
pressure ulcers and pain. Stratis also described the two new initiatives for the nursing
homes: UTI and immunizations. For home health care Stratis discussed OBQI
(outcome based quality improvement) and for the hospital they discussed quality
improvement support. Stratis also discussed the difference between quality assurance
vs. quality improvement.
The morning of the second day was spent on MDS and what is a significant change.
The second day was also spent on staff motivation and conflict resolution. Paddles Up!
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Stratis Health Nursing Home and Home Health Stakeholder Meeting Report
Overview of Meeting
- Discussed the mediation/case review process that Stratis offers beneficiaries and
providers. The first case did not end with an agreement. Was between a nursing
home and family. - Fast track appeals for Medicare plus choice. Stratis will provide an answer to non-
coverage before there is provider liability. Stratis has done 84 since January with
the majority being nursing homes. 82 they agreed with the non-coverage and 2 were
overturned. Stratis completes the review within 24 hours. Most often it was therapy
that was reviewed. Process will continue to other Medicare groups. The ruling has
been delayed and has not been published. Expected implementation date of Spring/
early Summer. The beneficiary still has other appeal/reconsideration processes they
can use even after the fast track. No answer to the question of being able to bill the
beneficiary after initial fast track review completed. - The liaison support is completed for the nursing home technical assistance group.
Stratis will continue to provide technical support and will go on-site to the group as needed. - Mike Tripple reviewed the new CMS bulletin regarding pressure ulcers. Stated it has been
in the works for three to four years and appeared. As of the meeting, there had been no
official notice of the release. MDH will not be implementing until the process of education
has been completed. MDH encourages the providers to use the web cast from CMS. There
most likely will be joint training between surveyors and providers. Expect implementation
early 2005. Just an FYI: there is a severe backlog of protocols at CMS. No ideas as to what
is coming out and when. - Patsy Riley discussed the 8th scope of their contract. Stratis is waiting for the final draft. For
the 7th scope, Stratis did well with the clinical indicators in the nursing homes, more difficulty
with home health due to the low number of Medicare clients. CMS has two new requirements
for QIOs. The first is the nursing home pilot (culture change) and the second is small clinics
using electronic records. She also discussed CMS using indicators for payments for performance.
QIO continues to be measured by indicators. CMS expects providers to be 100%. The culture
change has 22 states working on it with 5 in Minnesota. Brief discussion held regarding culture
changes and survey process.
Needs/Ideas for MNDONA participation
- Follow the fast track appeal process and can a provider bill once the decision has been made.
- Pressure Ulcer Education
Nikki Boder
November 30, 2004
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On-site Hearing
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Addressing the Under Diagnosed Hearing Loss of Long Term Care Facility Residents
According to a study conducted by the American Medical Association (*Journal of
American Medical Association, Vol 289, No. 15), "hearing loss in the elderly is easily
treated but often under diagnosed by doctors who in some cases wrongly consider it
an inevitable part of aging."
The most common cause of deafness in older adults, the study continues, is nerve
damage, which "is not reversible but can be substantially improved with hearing aids…"
The study also revealed that, "only 25% of patients with treatable hearing loss actually
receive hearing aids…"
What can be done for residents?
Has it been more than a year since a resident's file has been updated? If so, it's time for
an annual hearing examination. Audiological evaluations can reliably detect hearing loss
and monitor known hearing impairment.
Consider these situations, which may have affected a resident over the past year:
- In the past year, a resident's medications may have changed
- A resident may have had noticeable weight gain or loss, and the shape of their ear may
have changed which affects his/her hearing - A resident may have impacted cerumen that should be removed
- If a resident currently wears hearing aids, he/she may need a thorough cleaning to
make sure the instruments are working properly
Make sure your residents have regular hearing examinations. Audiological evaluations can
reliably detect hearing loss, and licensed audiologists are trained to recognize changes in
hearing. There may be a misconception in your facility. You should know that an annual
hearing examination does not mean that a resident will need hearing instruments. A third
party should always be involved (such as a resident's attending physician, licensed social
worker and/or family members) regarding the results of a hearing evaluation so your resident
can be sure he/she is not being "sold" anything.
Hearing loss in elderly people is the third most prevalent chronic condition in the older
population. Help make a difference in the hearing health of your residents by referring them
for annual hearing evaluations and hearing aid maintenance.
Marni Johnson, M.A. FAAA, CCC-A, is an audiologist with On-Site Hearing Services, Inc.
in Edina. She may be reached at 952-929-2060, or at
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Scholarship Winners
The purpose of the MN-DONA scholarships is to further the education of a member of MN-
DONA or a person sponsored by a MN-DONA member, focusing on furthering education that
will benefit long term care.
To be eligible for and receive a MN-DONA scholarship award, the applicant must be pursuing
nursing course work that will benefit long term care. The scholarship award must be used for
tuition and books. And scholarship recipients may re-apply on a yearly basis.
Each year our Patron Members are invited to sponsor scholarships. Seven companies did just
that this year! We received 47 applications for scholarships. The Scholarship/Education
Committee members individually reviewed the applications and ranked the applications.
The totals are then calculated and awards determined.
Saunders Associates sponsored our first scholarship for $250 and an additional $100 from an
anonymous sponsor for a total of $350 was presented to June Knick who is an LPN at
Hutchinson Area HealthCare/Burns Manor Nursing Home in Hutchinson. June is pursuing her
RN degree at South Central College in Mankato. She is sponsored by Pam Wolling, Director of
Nursing at Hutchinson Area HealthCare/Burns Manor Nursing Home.
Omnicare Minnesota sponsored a $500 scholarship presented to Caroline LaHoud. Caroline is
employed as a Certified Nursing Assistant at Lakeshore Lutheran Home in Duluth. She has
worked in long-term care for eight plus years and is pursuing her LPN at Lake Superior College.
Caroline is sponsored by Brenda Marshall, Director of Nursing at Lakeshore Lutheran Home.
McKesson HBOC sponsored a $500 scholarship presented to Valerie Annette Peterson a
NAR at The Lutheran Home in Belle Plaine. Valerie has worked in long term for two and a half
years and is pursuing her LPN at Hennepin Technical College in Eden Prairie. Wendy Newman,
Director of Nursing at the Lutheran Home in Belle Plain is Valerie's sponsor.
PharMerica sponsored a $500 scholarship presented to Crystal Kilsdonk who is a NAR at Lakeshore
Lutheran Home in Duluth. Crystal has worked in long-term care for seven months. She is pursuing
her RN degree at Lake Superior College in Duluth Technical College. Crystal is sponsored by Brenda
Marshall, Director of Nursing at Lakeshore Lutheran Home.
Elim Preferred Services sponsored a $500 and is awarded to Anne Major, RN, case manager at
Minnewaska Lutheran Home in Starbuck. Anne has worked in long term care for two years and is
pursuing her BSN at Minnesota State University, Moorhead. Anne is sponsored by Karen Johnson,
Director of Nursing at Minnewaska Lutheran Home.
Omnicare Minnesota sponsored a $500 scholarship awarded to Jennifer Larion. Jennifer is a Nursing
Assistant Registered at Knute Nelson Memorial Home in Alexandria. She has worked in long term
care for three plus years and is pursuing her LPN degree at the Alexandria Technical College. Linda
Bergerud sponsored her.
Thrifty White Pharmacy Services sponsored a $500 and presented to Heidi Thooft. Heidi is a NAR at
Tyler Healthcare Center in Tyler. She has worked in long term care for three years. She is pursuing
her BSN at Augustana College in Sioux Falls, South Dakota. Dorothy Erickson, Director of Nursing at
Tyler Healthcare Center is Heidi's sponsor.
Each year MN-DONA gives four $500 scholarships. Our first MN-DONA scholarship was
presented to Amanda Pankan who is a Nursing Assistant Certified at Cambridge Health Care
Center in Cambridge. She has worked in long term care for nine years and is pursuing her RN at
Cambridge Community College/Anoka Ramsey. Sybil Donelan, Director of Nursing at
Cambridge Health Care Center sponsored Amanda.
The second MN-DONA scholarship for $500 was presented to Constance Quistorff who is a RN at
Community Memorial Home in Osakis. Connie worked as an LPN and is now and RN at
Community Memorial Home. Connie recently completed her associate degree program and
passed the RN examination in May of this year. She plans to continue working full-time and
take online courses from Minnesota State University, Moorhead while pursing her BSN. Connie
is sponsored by Marsha Paulson, DON at Community Memorial Home.
The next MN-DONA scholarship for $500 is presented to Rosebella Payne who has worked in
long term care for fifteen years. The last seven years Rosebella has worked as an LPN at Jones-
Harrison Residence in Minneapolis. She is pursuing her Associate Degree in Nursing from
North Hennepin County College in the Weekend Mobility Program. Phyllis Mensah, Assistant
Director of Nursing at Jones-Harrison Residence sponsored Rosebella.
Our final MN-DONA scholarship is the Jean Cosgriff Scholarship for $500 and usually
presented to a MN-DONA member who is pursuing further nursing education. However, we
didn't receive any applications that qualified for this award, so the MN-DONA Board decided to
extend one more $500 scholarship. The winner is Shantel Pattison, a Certified Nursing Assistant at
Sunrise Manor Nursing Home in Tyler. Shantel is enrolled at Minnesota West Community and
Technical College in Pipestone for her LPN degree. She has worked in long term care for over
nine years. Dorothy Erickson, Director of Nursing at Tyler Healthcare Center where Sunrise Manor
is attached to the hospital sponsored Shantel's application
That completes our scholarships for 2004. Congratulations to all our scholarship award winners and
thank you to all our sponsors!
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Scholarship Thank You Letters
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MN-DONA Gold Patron Members
MN-DONA GOLD PATRON MEMBERS |
| Accu-Med Services, Inc. Mike Hengehold 200 Technecenter Drive Milford, OH 45150 (P) 800-777-9141 (F) 513-831-1370 mhengehold@accu-med.com AstraZeneca Care Alliance Pharmacy Care Providers of MN DMS Imaging, Inc. Elim Preferred Services | First Quality Products SteveWherry 11130 Xylon Ave. S. Bloomington, MN 55438 (P) 800.227.3551 ext 4933 (F) 952.829.7123 swherry@firstquality.com Gulf South Medical McKesson Medical-Surgical Merwin LTC Pharmacy Minnesota Health & Housing Alliance | Omnicare Minnesota Dawn Tuttle 5534 Lakeland Ave. N. Minneapolis, MN 55429 (P) 763.259.0188 (F) 763.259.0179 dawn.tuttle@omnicare.com On-Site Care, LLC Saunders Associates SMT Health Systems Thrifty White Pharmacy Services |
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MN-DONA Silver Patron Members
MN-DONA SILVER PATRON MEMBERS |
| Apple Tree Dental Jayne Cernohous 8960 Springbrook Dr. # 150 Minneapolis, MN 55433-5810 (P) 763.784.7570 (F) 763.784.5978 jcernohous@appletreedental.org Arjo, Inc. Bristol Myers Squibb CliniShield CMA An IdeacomPartner ColoPlast Corp Health Care Consultants of MN, PA | Healthcare Documentation & Delevopment, Inc. Marnie Braun 301 South 8th Street Po Box 325 Henderson, MN 56044 (P)507.248.3310 (F)507.248.3321 mbraun@healthcareacademy.comHuntleigh Healthcare Eric Langlee 7142 Shady Oak Rd. Eden Prairie, MN 55344 (P) 800-223-1218, x 479 (F) 952-829-7090 elanglee@huntleighhealth.com Hypoguard Midland Hospital Supply Paper Pak Products Peart & Associates, Inc. PharMerica | Preferred Choice Pharmacy Bill Appel 900 Long Lake Road #150 New Brighton, MN 55112 (P) 651.636.3919 (F) 651.582.0299 bill.appel@bhshealth.org Professional Portable X-Ray, Inc. Promedica, Inc. SCA Personal Care Inc. Smith & Nephew- Wound Management Division Span America Innovative Solutions The College Network Voigt, Jenson & Klegon Law Firm |
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New Members
WELCOME NEW MEMBERS! MN-DONA would like to welcome the following new members who |
Katie Busch ADON, Nurse Manager St. Gertrude's Health & Rehab Center Shakopee MN Lynette Engbarth RN, DNS Good Samaritan Communities Pipestone MN Christie Gallagher RN,C, DON MVHC - Gardenview Nursing Home LeSueur MN Cheryl Gravelle DON Maranatha Senior Living Community Brooklyn Center MN Kathy Hahn RN, DON Lake Crystal Health Care Center Lake Crystal MN Nancy Hess RN, DON Anoka Care Center Anoka MN Rita Iverson DON, LTC Manager Mille Lacs Health System Onamia MN Linda Johnson ADON Mercy Hospital & Health Care Center Moose Lake MN Collette Lynch RN Janesville Nursing Home Janesville MN Anne Major ADON Knute Nelson Memorial Home Alexandria MN Angela Mott DON St. Peter Community Health Care Center St. Peter MN Lisa Muelken ADON, Nurse Manager St. Gertrude's Health & Rehab Center Shakopee MN Jennifer Parker RN,C Parkview Home Belview MN Karen Peppel RN/Resident Care Coordinator Bridges Medical Services Ada MN Renae Peterson DON Albert Lea Good Samaritan Center Albert Lea MN Margo Simmonds RN, DON Colonial Manor Lakefield MN Joan Stumpf RN, DON St. Mary's Home St. Paul MN Marjean Wolff RN, DON Greenbush Nursing Home Greenbush MN Rhonda Yochem Director of Resident Care Pipestone Cty M.C./Ashton Care Ctr Pipestone MN |
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Renewing Members
Thanks for supporting the efforts of MN-DONA by renewing your membership. The following people renewed during the months of September, October and November. | ||
Karen Amdahl Kimberly Anderson Toni Bandow Gayle Bauer Betty Behnken Lois Boerboom Lisa Boje Irmgard Boyer Toni Brogren Judy Buck Grace Burkinshaw Sharon Carlson Pauline Collova Deborah Comeau Mary Ann Cooper Susan Diekmann Sybil Donelan Leah Erickson Dorothy Erickson Chester Fishel | Jane Goebel Cheryl Harms Melissa Heesch Tammy Heimer Carroll Hoehn Karen Hopman Dawn Huelsman Janet Ingersoll Lisa Kalla Clellie Kiecker Nancy Kollman Ann Krause Chris Kuhn Doreen Langlois Brenda Liker Wendy Lonetto Julie Ann Manley-Hartje Gretchen Murr Melodie Myers Kathleen Nasr | Phyllis Nelson Caroljean Newell Lori Olson Caroline Owens Kathy Palattao Marna Palmen Patricia Perryman Debb Pongratz Jan Riewer Mary Ann Schneidermann Sue Schwartz Nelson Sue Simon Alice Smith Sandy Stang Laurie Stee Patti Tackmann Jonathan Torralba Julie Turnberg Marie Wolf |
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Calendar
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
| Nov 28 | Nov 29 | Nov 30 | Dec 1 District VI Fairbault, Kenyon and Northfield District 4, Saint Cloud Group | Dec 2 | Dec 3 | Dec 4 |
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
| Dec 5 | Dec 6 | Dec 7 | Dec 8 District VI Southwest | Dec 9 | Dec 10 | Dec 11 |
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
| Dec 12 | Dec 13 | Dec 14 | Dec 15 Board Meeting | Dec 16 | Dec 17 | Dec 18 |
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
| Jan 2 | Jan 3 | Jan 4 | Jan 5 District VI in Fairbault Kenyon and Northfield | Jan 6 | Jan 7 | Jan 8 |
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
| Jan 9 | Jan 10 | Jan 11 | Jan 12 District VI West Area | Jan 13 Distrcit 3 | Jan 14 | Jan 15 |
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
| Feb 6 | Feb 7 | Feb 8 | Feb 9 Board Meeting | Feb 10 | Feb 11 | Feb 12 |
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
| Mar 6 | Mar 7 | Mar 8 | Mar 9 District VI West Area | Mar 10 Distrcit 3 | Mar 11 | Mar 12 |
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
| Mar 13 | Mar 14 | Mar 15 | Mar 16 Board Meeting | Mar 17 | Mar 18 | Mar 19 |
Sunday | Monday | Tuesday | Wednesday | Thursday | Friday | Saturday |
| Apr 3 | Apr 4 | Apr 5 | Apr 6 | Apr 7 Spring Conference and Annual Meeting | Apr 8 Spring Conference and Annual Meeting Board Meeting | Apr 9 |
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Contact Information
Minnesota Directors of Nursing Administration/LTCc/o Best Meetings, Inc.
2626 East 82nd St, Suite 270
Bloomington, MN 55425
Phone: 952-858-8875
Phone: 800-958-8875
Fax: 952-858-8950
Email:
or visit our website at:
www.mndona.org
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