Assisted Living Section State of the State

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Assisted Living SectionState of the State

• 9-months ending September 30, 2007

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New OQA Assisted Living Boundaries effective
1-1-2007
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Where are we going?2006 - 2007
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Continue and Expand Collaborations
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Using data to effect positive change
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Proactive Compliance
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Implement HFS 83
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New facility video on Web
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Match resources to workload
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Make more information available on the web
statistics, trends, etc.
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Support and Encourage Innovative
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To have the best staff with the tools and
training to do their job
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Trends Statistics
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Nursing Home FDDsTrend in number of facilities
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Nursing Home FDDsTrend in capacity for
residents
16
Assisted LivingTrend in number of facilities
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Assisted LivingTrend in capacity for residents
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RCACs Certified vs. Registered
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AL vs. LTCTrend in number of facilities
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AL vs LTCTrend in capacity for residents
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New AL vs. Closed AL
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Why Facilities ClosedCY 2006
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Why Facilities Closed9-months ending 09-30-2007
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Post Survey Questionnaire

• 2006 - 172 respondents (39 of total)
• Satisfaction with survey tasks 98.48
• On Site - 4.57
• Knowledgeable - 4.62
• Professional - 4.75
• Respectful - 4.72
• SOD - 4.43
• (1 strongly disagree, 5 strongly agree)

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Survey Results
2006
Sept. 2007
2004
2005
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AL Citations Issued
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(No Transcript)
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CBRF Top 109 months ending 9-30-2007
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Ranking - CBRF Top Citations
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Ranking - CBRF Top Citations
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(No Transcript)
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AFH Top 109 months ending 9-30-2007
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Ranking - AFH Top Citations
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Ranking - AFH Top Citations
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Ranking - RCAC of Citations
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Ranking - RCAC of Citations
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Surveys with Enforcement
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(No Transcript)
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(No Transcript)
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Surveys with Enforcement (505)CY2005
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Surveys with Enforcement (467) CY 2006
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Surveys with Enforcement (427) 9 months Sept.
2007
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of Facilities vs. Enforcement Surveys
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of Facilities vs. Enforcement Surveys
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Sanctions Imposed (966)CY 2005
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Sanctions Imposed (1,039)CY 2006
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Sanctions Imposed (860)9 months Sept. 2007
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Type of SanctionsCY 2005
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Type of SanctionsCY 2006
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Type of Sanctions9 months Sept. 2007
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(No Transcript)
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Ranking - Top Violations with Forfeitures
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Ranking - Top Violations with Forfeitures
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Forfeiture Assessments
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(No Transcript)
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Impending Revocations
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(No Transcript)
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(No Transcript)
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(No Transcript)
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Revocations
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(No Transcript)
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35 Forfeiture Reduction
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Enforcement Action Appealed
2002
2003
2004
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Enforcement Action Appealed
CY 2005
CY 2006
Sept. 2007
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Complaints Received
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Complaints vs Growth
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(No Transcript)
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(No Transcript)
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Complaints ReceivedCY 2005
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Complaints ReceivedCY 2006
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Complaints Received 9 months Sept. 2007
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of Facilities vs. Complaints Received
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of Facilities vs. Complaints Surveys
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Source of ComplaintCY 2005
75
Source of ComplaintCY 2006
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Source of Complaint9 Mo. Sept. 2007
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Ranking Subject areas complaint investigations
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Ranking Subject areas complaint investigations
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Source of Complaint vs Substantiation CY 2005
Source rec. invest. substantiated Anonymous
30 45 Public Official 16 38 Relative/Gua
rdian 19 29 Current Employee 06 65 Former
Employee 11 40 Advocate 09 50 Citizen 0
6 19 Medical 01 50 Resident 02 80
100 43
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Source of Complaint vs Substantiation CY 2006
Source rec. invest. substantiated Anonymous
26 27 Public Official 24 45 Relative/Gua
rdian 19 53 Current Employee 05 53 Former
Employee 11 40 Advocate 05 38 Citizen 0
5 63 Medical 02 31 Resident 03 56
100 43
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(No Transcript)
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(No Transcript)
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(No Transcript)
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Self ReportsCY 2006
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Self Reports9 months Sept. 2007
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(No Transcript)
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(No Transcript)
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Assisted Living Regulatory Activity CY 2005

• Standard Surveys 29
• Initial Surveys 15
• Abbreviated 20
• Other (mostly Complaints) 36

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Assisted Living Regulatory Activity CY 2006

• Standard Surveys 32
• Initial Surveys 17
• Abbreviated 18
• Other (mostly Complaints) 33

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Assisted Living Regulatory Activity Sept. 30,
2007

• Standard Surveys 31
• Initial Surveys 15
• Abbreviated 26
• Other (mostly Complaints) 28

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Abbreviated SurveysCY 2005

• No Deficiency Survey Survey - 60
• Statement of Deficiency - 40

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Abbreviated SurveysCY 2006

• No Deficiency Survey Survey - 66
• Statement of Deficiency - 34

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Abbreviated SurveysSept. 30, 2007

• No Deficiency Survey Survey - 65
• Statement of Deficiency - 35

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Facilities Qualifying for Abbreviated Surveys
CY 2005

• Adult Day Care 64.2
• Adult Family Homes 38.0
• Community Based Residential Facility 35.6
• Residential Care Apartment Complex 42.6
• Statewide 38.2

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Facilities Qualifying for Abbreviated Surveys
CY 2006

• Adult Day Care 68.0
• Adult Family Homes 38.1
• Community Based Residential Facility 38.9
• Residential Care Apartment Complex 50.2
• Statewide 40.5

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Facilities Qualifying for Abbreviated Surveys
09-30-2007

• Adult Day Care 67.3
• Adult Family Homes 38.5
• Community Based Residential Facility 37.5
• Residential Care Apartment Complex 45.9
• Statewide 39.6

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Facilities Qualifying for an Abbreviated Survey
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IN SUMMARY.

• Growth continues especially with AFH and RCAC
  with projected annual growth of approx. 10 in
  each area. More RCAC growth with certified as
  the gap with registered continues to widen
• ICF/MR rebalancing, NH relocation initiative and
  Family Care expansion having direct impact on AL
  growth. AL licensed beds projected to exceed NH
  ICF/MR licensed beds by early 2009
• In addition to overall growth there is
  significant turnover with increases in voluntary
  closures, and Change of Ownership (CHOW)

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IN SUMMARY.

• Fit and Qualified policy having an effect with
  increase of license denials and withdrawn
  applications
• Citations per survey remains flat. Enforcement
  actions are projected to increase with increases
  in surveys with enforcement, increase in
  sanctions and increase in of facilities making
  up enforcement but decreases in revocations, NNA,
  and forfeitures
• BAL continues to refine directed plans of
  correction to help facilities achieve and sustain
  compliance
• Appeals continue to decrease with more providers
  taking 35 reduction of the forfeiture
• CBRF make up higher complaints and enforcement

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IN SUMMARY.

• Despite growth, complaints are projected to
  decrease slightly
• Although CBRF makes up a higher of complaints
  the distribution changed with more moving to AFH
• Complaints continue to come from multiple sources
  with a significant portion coming through
  collaborations with key stakeholders.
• Falls resulting in hospitalization make up 41 of
  self reports received. Resident behavior, police
  intervention and elopements projected to increase
  in both numbers and of total.
• Self reports projected to increase again but when
  investigated rarely result in deficiencies.
• Almost ½ of facilities responding to post survey
  questionnaire utilized the on-line version.
  Approximately 8 were returned. Overall, staff
  of BAL had excellent results.

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IN SUMMARY.

• Majority of assisted living in Wisconsin is very
  good and continues to improve
• Collaboration continues to move the bell curve
  to the right
• More facilities qualifying for abbreviated
  surveys
• For CY 2006 only 16 of facilities make up 100
  of the complaints and only 13 of facilities
  make up 100 of the enforcement action.

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Moving the Bell Curve to the Right...

• Thank You!