The Academy of Senior Health Sciences, Inc. (formerly The Ohio Academy of Nursing Homes, Inc.) seeks to provide public education and awareness initiatives to the long-term care community in Ohio. Our membership represents a true cross-section of the skilled nursing facility profession, from small sole proprietorships to larger Ohio-based multi-facility companies, as well as those businesses that service our industry. Through our public education and awareness efforts, the Academy brings the collective influences of the members together into a single voice on vital issues affecting our profession.
Founded in 1966, the Academy then identified one of its core purposes as "To foster a spirit of goodwill among those persons engaged in the nursing home industry, to promote ethical practices in their relationships with each other, their employees, and the general public to the end that all interests may be served fairly..." Though the organization has undergone several transformations over the years, most notably in 2011, its dedication and commitment to Ohio's most frail and elderly remains the same.
| The Academy Weekly Headlines from 2 Weeks Ago|
The Ohio Department of Medicaid confirmed today that the date for Medicaid Disability Determination Redesign (DDR) is expected to be August 1. CMS has not approved the changes yet; ODM is expecting to be notified in the very near future. The biggest impact on SNFs for the DDR is the elimination of the monthly spend down for individuals who exceed the income limit. Those individuals will have to establish a QIT to retain eligibility. There is a grace period, if approved by CMS, until that person's eligibility re-determination date. Any person that was on spend down during the prior 12 months from August 1 will automatically be enrolled in Medicaid until their re-determination date. For example, if a person has a re-determination date of March 1, 2017, they will not need a QIT until that time to remain eligible. Individuals who have applications pending on or before July 31, 2016 will also fall into that category, meaning they will have more than one year before needing a QIT. Should you establish QITs now? While it usually doesn't hurt to get ahead of the game, it should be noted that CMS has not approved the changes. And these are irrevocable trusts and should not be taken lightly. It may be worthwhile to hold off on establishing the QIT, or at least not depositing funds until we get the okay from CMS. We will let you know when that happens as soon as we are notified. We are also currently working on updating our FAQ document with ODM. We will send that out as soon as it is ready. Until then, if you have any questions or concerns, feel free to contact The Academy.
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OPERS sending letter to SNFs regarding Medicare change
Ohio Public Employee Retirement System (OPERS) has mailed letters to administrators of SNFs that, according to their records, have OPERS Medicare-eligible residents. Per the notification from OPERS:
"The Ohio Public Employees Retirement System has been making significant changes to its health care program for Medicare-eligible retirees. We are sharing this information as you are in contact with one or more OPERS retirees. If these retirees do not take action, their OPERS-sponsored group health care that supplements Medicare will end this month.
OPERS has partnered with OneExchange to administer the OPERS Medicare Connector. OPERS retirees and spouses must select an individual Medicare plan(s) through the OPERS Medicare connector before the end of June 2016. If no action is taken, retirees will no longer have health care coverage that supplements Medicare effective July 1, 2016.
By working with a Licensed Benefit Advisor employed by OneExchange, OPERS retirees and their spouses will be able to select an individual Medicare plan (s) to supplement their Original Medicare coverage which fits their medical, budgetary and lifestyle needs.
Upon enrolling in an individual medical plan with OneExchange, retirees will receive a Health Reimbursement Arrangement (HRA) allowance, which will enable them to seek reimbursement for the eligible medical expenses e.g, insurance premiums, Part A/B payments, copays, coinsurance, etc.
Retirees must enroll in a medical plan through OneExchange in order to receive this HRA allowance. Retirees who enroll in a medical plan through an independent broker are not eligible for the HRA allowance.
Retirees and spouses can call OneExchange at 1-844-287-9945 to schedule their enrollment appointment. Friends, family members, etc. are welcome to participate on the call for additional support.
Retirees and spouses with a Power-of-Attorney do not need to personally participate in the enrollment call. The POA will verbally attest to his or her status, and can participate in the enrollment call without the retiree needing to be on the phone. The POA will not need to provide any documentation to OneExchange prior to that call."
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