The Iona Wellness & Art Center, an adult day center in Washington, DC, recently garnered national recognition for adult day services in a segment that aired on National Public Radio. Listen to the informative presentation with Scott Simon. Click here
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National Association of States United for Aging and Disabilities (NASUAD) released the results of a survey administered to Adult Service providers. NASUAD conducted this survey to learn more about the locations, funding sources, and supports that these programs provide to seniors and people with disabilities. The report demonstrates how Adult Services include a wide array of services, including a combination of social and medical supports. The comprehensive nature of Adult Services allows individuals to remain in their communities by ensuring that all of their needs are met in a single location. Consequently, older adults and people with disabilities are able to live in their own homes or the homes of their families without concerns about whether they are receiving adequate nutrition, health care, and socialization supports. Due to some of the locations of Adult Service providers, NASUAD is concerned that new CMS regulations may reduce the number of available providers in the Medicaid program. This would have the unintended consequence of limiting the availability of important health and social services, and would likely result in individuals entering institutional settings.
NADSA’s feedback on the survey tool and assistance with dissemination were instrumental in collecting the information used to generate this report.
Background: NADSA notified its members of the CMS definition released in January 2014 that could jeopardize the future of adult day centers funded by Medicaid. Of greatest concern is the statement “The setting is integrated in, and facilitates the individual’s full access to the greater community, including services in the community, like individuals without disabilities.” Other sections of the Rule state that any setting that resembles an institutional setting by grouping individuals with like conditions, or by being attached or adjacent to an institution, will be presumed to be institutional in nature and will not qualify for Medicaid Waiver funding.
Genworth Financial recently released its 2015 Cost of Care Survey, a report released annually since 2004. Over the past 12 years, Genworth has uncovered several trends in the long term care services landscape. As would be expected, the cost of all types of long term care has steadily risen over the years based on their research. However, the cost of care provided for people living in their homes has risen less than care provided in facilities. The gradual increase in cost for community-based care is good news for many consumers.
According to the 2015 report, the national median daily rate for adult day health is $69, up 5.94% over the 2014 report. Genworth began including adult day health centers in their study in 2008 when the median daily rate was $59 per day. The 2015 report included responses from nearly 1,200 adult day centers via telephone surveys during January and February 2015. Since adult day centers structure rates in a variety of ways, all rates in the Genworth survey were extrapolated to a daily (6-8 hour) rate.
Full results of Genworth’s 2015 Cost of Care Survey, including national and state data tables for care in all 50 states and other useful tools and information is available online at https://www.genworth.com/corporate/about-genworth/industry-expertise/life.html.
On Tuesday night, April 14th, the United States Senate agreed 92-8 with a previously House passed bill to replace the Sustainable Growth Rate (SGR) method of Medicare reimbursement with a new system focused upon “quality, value, and accountability”. Commonly referenced as the “Doc Fix”, the legislation applies primarily to physician reimbursement but includes unrelated items and several nuances that bode well for ADS .
Immediately, the bill does not affect adult day services because they are not direct recipients of Medicare reimbursements. However, additional important goals of the legislation are to link Medicare reimbursements to quality metrics and to encourage better care coordination and chronic care management. These stated goals provide an opening to fortify adult day’s efforts for direct Medicare reimbursement.
Here is a link to the Kaiser Health News report and FAQs about the new legislation, which President Obama said he will sign describing it as “a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs.” http://kaiserhealthnews.org/news/faq-could-congress-be-ready-to-fix-medicare-pay-for-doctors-2/
NADSA Public Policy Advisor
CARF International is conducting a 2015 study to highlight the concept of “Financial Ratios as Performance Indicators” to the field of Adult Day Services. If your organization is an Adult Day Services provider, consider participaticipating in this unique, exciting annual study that began in 2010.
There is no charge for your participation in this study. The goal of this study is to develop financial benchmarks for adult day services and to provide participants in the study with a complimentary summary of financial benchmarking information.
Details related to the financial ratios of each participant in the study will not be disclosed to other organizations. CARF will share the aggregate data analysis with you as a result of your participation.
CARF has partnered with Mr. Jeff Boland, of Reinsel Kuntz Lesher, LLP to assist with the study, and he is required to maintain confidentiality of any information disclosed for the purpose of the study. Jeff is a representative of CARF’s Financial Advisory Panel (FAP) and has presented the results of the last five studies at the NADSA Annual Conferences in 2010-2014. For more information on the FAP’s role related to accreditation, see www.carf.org and type “FAP” in the search field located in the upper left corner of our website.
CARF-CCAC Financial Ratios have been used as operational benchmarks for our accredited Continuing Care Retirement Communities (CCRCs) since the early 1990s. For nineteen years, CARF-CCAC has been collecting data from accredited CCRCs for inclusion in an annual publication titled Financial Ratios & Trend Analysis of CARF-CCAC Accredited Organizations. Historically, benchmarking against financial ratios has been a promising practice for the CCRC field and CARF sees that the Adult Day Services field can likewise benefit from benchmarking. CCRCs rely on this information to enable them to assess trends and make sound financial decisions in varying economic times. Rating agencies, investment bankers and accountants rely on these financial ratios to assess organizational viability when assigning ratings and structuring debt.
CARF sees this initiative as a way to add significant value to accreditation and as a way to share our benchmarking expertise with the adult day services field. For questions, Sue Matthiesen can be reached at either firstname.lastname@example.org or toll-free 866-888-1122, ext. 5006.
How do you participate? If you will participate in this study, please send the following documents by email (email@example.com ), fax (202-587-5009), or mail (1730 Rhode Island Avenue NW, Suite 209, Washington, DC 20036) to Amanda Birch at CARF International by Friday, June 26, 2015:
For your adult day service program’s fiscal year ending in 2014:
- 2015 ADS Indicators Supplemental Handout
- Internal unaudited 2014 fiscal year Financial Statements including Revenue and Expense, Balance Sheet, and Cash Flows or;
- Corporate audit Financial Statements for 2014 fiscal year (if available).
Note: If your financial information is consolidated for a larger organization, please clearly identify the adult day services financials or send a separate report with only the adult day services financial information included.
Please contact Amanda firstname.lastname@example.org with questions about what information is applicable to the study. You are welcome to connect Amanda to the financial staff member at your organization.