NASUA, which represents the nation’s 56 officially designated state and territorial agencies on aging, has announced a name change. Those in the professional aging community know this organization well, so don’t get confused when you start seeing “NASUAD” in place of NASUA. The name change is consistent with a national movement to bring disability resources into the umbrella of state agencies on aging. The thought process behind this push is that doing so more accurately represents long-term care services in its totality, that such services are not restricted to our elders. Their press release states:

In keeping with its mission to design, improve, and sustain state systems delivering home and community based services and supports for the elderly and individuals with disabilities, the NASUA membership voted overwhelmingly in support of a proposal to change the name of the association to the National Association of States United for Aging and Disabilities, NASUAD.

The change was made, in part, to accurately reflect the evolving role of state aging agencies in the delivery and administration of long term services and supports, and to streamline the coordination and provision of these services across the continuum of care.

When first established through the Older Americans Act (OAA), state units on aging were primarily responsible for the administration of OAA services within the aging network. Recently, federal legislation, increased reliance on additional funding sources, and the economic downturn have dramatically impacted and increased the scope of services states are called upon to provide, and their ability to do so. As the need for long-term services has expanded, so has the role of the state aging agency, with nearly 65 percent of the states serving both seniors and individuals with disabilities as of October, 2009. James Toews, NASUA Vice President and Assistant Director of the Oregon Department of Human Services, Seniors and People with Physical Disabilities, recognizes the significance of the name change, saying, “This is a pivotal time in our nation’s history. As an organization, we are looking forward to working with members of the aging and disability communities to emphasize the importance of a comprehensive long-term care system.” NASUA’s Executive Director, Martha Roherty, echoes these sentiments, “We welcome collaboration with our partners in the aging and disability communities as we work to further strengthen relationships at the national, state and local levels.”

This transition will be phased-in over the coming months. In the interim, please visit www.nasua.org for additional information.

Updated with July, 2010 changes!

Elder Guru is offering the Minimum Data Sets (MDS) 3.0 Coding Manual for sale to assist clinical assessors, MDS coordinators, long-term care administrators, and others. The MDS 3.0 will be the successor to the MDS 2.0 and it will take effect in October 2010. The coding manual Elder Guru is offering represents Chapter 3 of the Center for Medicare and Medicaid Services’ Resident Assessment Instrument (RAI) manual, but with large, easy-to-read print and improved pagination for faster reference. The manual contains 400 pages of step-by-step instructions for completing the MDS 3.0.

Click Here to Purchase the MDS 3.0 Coding Manual

The MDS is a federally required, standardized clinical assessment form used for all residents in a Medicare and Medicaid certified nursing facility regardless of their payment source. The form is intended to develop a comprehensive look at each resident’s functional abilities and health problems for the purpose of developing a comprehensive care plan for the resident. The MDS is typically completed by a registered nurse in consultation with others as part of the larger Resident Assessment Instrument (RAI).

The information within the MDS is submitted by nursing facilities to the state in which they operate, which then goes to the federal database at the Centers for Medicare and Medicaid Services. The data is used to help determine a facility’s quality indicators and quality measurement reports, which are then made available to the public for view.

The MDS 2.0 was criticized because it failed to account for information derived from resident interviews, and concerns were raised about the form’s data quality and validity. The MDS 3.0 was developed to address these concerns, improve reliability and usefulness.

The Brown University Center for Gerontology and Healthcare Research has launched a new nursing home comparison website designed for professional nursing home researches, but which is readily accessible to consumers, advocates and administrators. Whereas the Medicare Nursing Home Comparison site compares survey data collected from each state, Brown University’s new site, LTCfocus.org, supported in part by the National Institute on Aging, crunches data from a variety of sources:

• State Policy Data – Brown University research team survey
• Online Survey Certification and Reporting system (OSCAR) – administrative data collected by the Centers for Medicare and Medicaid Services
• Minimum Data Set (MDS) – resident level data related to clinical and functional status
• Area Resource File (ARF) – a national county level health resources database maintained by the Health Resources and Services Administration
• Residential History File – a data resources developed at Brown University that tracks individuals as they move across the long-term care system

It’s an interactive database that lets the user create tables and charts to compare information about individual nursing homes, counties, states, etc. There is a wide range of variables accessible for comparison allowing greater research capabilities. Those variables include:

• for-profit versus non-profit organizational structure
• bed capacity
• percentage of Medicare and Medicaid approved beds
• Alzheimer’s specific units
• occupancy rates
• age ranges
• resident gender and race statistics
• staffing levels
• MDS quality measures
• resident admission sources (home or hospital)
• 30-day re-hospitalization rates

According to the LTCfocus.org site:

These data will allow researchers to examine the relationship between state policies and local market forces and the quality of long-term care. Researchers can use this website to examine care processes and resident outcomes within the context of their local markets and regulatory practices. Policymakers can use the information to shape state and local guidelines, policies, and regulations that promote high-quality, cost-effective, equitable care to older Americans.

They have plans to add additional information about other sectors of the long-term care industry at a future date.

Individuals looking to use the database to compare local nursing homes for purposes of long-term care decision making will find the site a bit cumbersome to navigate, but the savvy user should have no problem. The more likely impact for consumer-level decision making will be the downstream effects improved information sharing made available to policy makers and elder advocates. Consumers will likely still find Medicare’s Nursing Home Comparison site to be the most useful and straightforward. Contacting their Long-Term Care Ombudsman Program (contact information available through the Resources by State page) is an even consumer-friendlier method to gather information on area nursing homes.

Sooner after learning about a new documentary focusing on LGBT discrimination in long-term care and health care settings, I heard about Kathleen Sebelius, Secretary of a Department of Health and Human Services, announcing the award of a new, 3-year $900,000 grant to Services and Advocacy for Lesbian, Gay, Bisexual and Transgender Elders (SAGE) for the creation of the first national resource center on LGBT aging.

SAGE began advocacy work in 1978 when it was incorporated as the Senior Action in a Gay Environment. SAGE bills itself as the largest and oldest non-profit agency serving the needs of this population group. They are forming a partnership to administer the grant with 10 organizations having different areas of expertise on aging issues. Those organizations include:

1. PHI – an elder care training resource
2. National Association of Area Agencies on Aging
3. National Institute of Senior Centers
4. American Society on Aging
5. Brookdale Center for Health Aging and Longevity
6. Centerlink (the national association of LGBT community centers)
7. GRIOT Circle
8. FORGE Transgender Aging Network
9. Third Sector New England/The LGBT Aging Project
10. Openhouse

The creation of The National Technical Assistance Resource Center for LGBT Elders is intended to help create services and supports for aging LGBT people. The Center will offer trainings and educational tools to agencies across all 50 states. One such tool will be a comprehensive, web-based resource for web-based trainings and information. From the press release:

Assistant Secretary for Aging Kathy Greenlee explained: “AoA frequently turns to national organizations to support the Aging Network in their efforts to work with specific minority populations that are traditionally underserved.  In the past, AoA has funded national organizations to provide technical assistance on providing supports and services to African Americans, Hispanic Americans, Asian and Pacific Islander Americans and Native Americans.  With the full support of the current Administration, we now recognize that LGBT older adults also represent a community with unique needs that must be addressed.”

The National Council on Aging (NCOA), a non-profit service and advocacy organization in Washington, D.C., established a valuable web resource in 2001 for elders, their caregivers and aging professionals to connect older persons with resources and programs that help pay for prescription drug costs, health care expenses, utility bills and other basic needs. Since that time the site has helped millions of people find savings and assistance. Watch their public service announcement on the site:

There are often state and federal resources available to help that older people and professionals are unaware of. Navigating those services and programs, let alone staying on top of what the qualification requirements are, is a full-time job onto itself. The NCOA’s site, BenefitsCheckUp, holds an up-to-date database of more than 1,750 public and private benefits programs across all 50 states. These programs help with:

• Prescription drugs
• Food and Nutrition
• Energy assistance
• Financial services
• Legal assistance
• Health care
• Social Security
• Housing
• Tax relief
• In-home care
• Transportation
• Employment

The site connects elders with services through online questionnaires that determine what services and programs an individual may qualify for. Staff persons at Area Agencies on Aging and other senior service organizations use this site to assist elders looking for help, but so long as someone has basic internet skills, the site can be easily navigated by the individual him/herself.

Check BenefitsCheckUp to see if you or the one you care for is receiving all of the help he/she qualifies for.

Nina Tumosa, Professor of Internal Medicine at Saint Louis University, gave me different versions of the Saint Louis University Mental Status exam (SLUMS), each in a different language. I converted the files into pdf documents available for download.

Unfamiliar with the SLUMS exam? Read about it here.

Download the SLUMS Exam in:

• Chinese
• Deutsch
• English
• French
• Hebrew
• Romanian
• Portuguese
• Spanish

Download the SLUMS Instructions in English.