Provider Bulletin | September 2010

Welcome to the September edition of the Provider Bulletin. In this edition you will find useful information about submitting your vacancy list, understanding choking precautions, and upcoming training classes on submitting claims.

Vacancy List Process and Frequently Asked Questions

When you have a residential vacancy, complete the Residential Vacancy Notification form at: www.communitycareinc.org/ForProviders/default.htm.

Email the form to: ResidentialVacancies@communitycareinc.org, fax it to: (414) 342-9306, or mail it to: Community Care 3220 W. Vliet St. Milwaukee, WI 53208.

Complete this form each time you have a vacancy. Email us at ResidentialVacancies@communitycareinc.org once your vacancy is filled so that you can be removed from the list.

The vacancy list goes out weekly to the care managers. We cannot guarantee referrals since we are unable to determine how many members will be seeking placements at any given time.

Frequently Asked Questions

1. What does Accessible Home/Bathroom mean? Accessible refers to wheelchair accessible. A wheelchair accessible entrance and bathroom is what is necessary to classify your home as being able to accept members that utilize a wheelchair.

2. What is "Elopement Risk" mean? Elopement risk refers to a member that may try to leave the home by either wandering or for the purpose of running away. Often times a door alarm(s) are used to alert the provider someone has left the home.

3. When can I expect the vacancy to be filled? We cannot guarantee referrals since we are unable to determine how many members will be seeking placements at any given time.

4. How long does it usually take to fill a vacancy? This depends on the current need for residential placement which can vary from month to month so a timeframe can not be determined.

5. What is the process after I’ve submitted the Residential Vacancy Form? You are placed on our vacancy list. When the team is seeking placement for a member they refer to the vacancy list.

6. Where/to whom does the residential vacancy list go? The vacancy list is available 24 hours a day to all of our teams in all of the counties we serve. The list is also sent out weekly to all of our teams.

7. What is Ambulatory vs. Non Ambulatory? A home that is for ambulatory members is a home that may have stairs or is unable to serve non-ambulatory members. Non ambulatory members are typically individuals that utilize wheelchairs.

8. How often do I need to submit the Residential Vacancy Form? You can submit your vacancy form one time to report your opening.

9. How long will I be on the vacancy list? You will remain on our list until you notify us your vacancy has been filled. You will also be removed from the list if a care manager reports your bed has been filled.

10. Who can I talk to about my facility/home receiving residents? The vacancy list will report this for you. You can also choose to have an open house so that the care managers and RN’s have the opportunity to tour your home.

11. How do I announce my open house? Email your open house information to Residential Vacancies@communitycareinc.org and include:

County location, facility name, size of facility (Number of beds and indicate AFH, CBRF, RCAC), address, date, time, contact name & telephone number, and brief description of your home.

Once we receive the information, we will notify the care teams of your open house. For any questions, email ResidentialVacancies@communitycareinc.org.

The open house information is sent to the care teams located within the county you are located and often times the surrounding counties.

12. What times/days should I have my open house? Typically the best time to have an open house is Monday through Friday between the hours of 9am-4pm. Please give us a one week notice to allow our teams to plan a time to attend.

13. Can I talk to a care manager about my vacancies? Our care managers are very busy serving our members. We ask that you use the vacancy notification process to announce your vacancies and not call the care managers/sites directly to discuss/announce your vacancies.

Choking Precautions

Most of us swallow 1,000 times a day or more without thinking about it, but choking and aspiration pneumonia are among the leading causes of death in adults with developmental disabilities. If you are a provider for any person with any disability (frail elder, physically disabled or developmentally disabled) you should be observant for any difficulties swallowing that person may have.

The following are expectations of providers:

• If a member has any history of swallowing problems, document that clearly and make sure all staff are aware of this.
• Add this information to their Individual Service Plan, educate/train staff on each member’s ISP and the signs and symptoms for staff to watch for and to report, which include:
  • Any gagging, coughing, or choking while eating or drinking.
  • Gurgling or wet voice during eating or swallowing.
  • Swallowing food without chewing it first or swallowing it whole.
  • Repeated respiratory infections and/or pneumonia.
• Anyone with a history of swallowing difficulty or choking issues should be observed continuously during all meals.
• Allow adequate time and minimize distractions during a meal.
• Have members sit upright rather than reclining or lying down while eating or drinking.
• All staff should be trained on how to perform Heimlich Maneuver.
• Call 911 immediately if your efforts to resolve a choking episode are not effective.

Following any choking incident:

• Contact MD and report choking episode and follow directions provided (which may include observation, office visit for X-ray, swallow evaluation etc.)
• Contact Community Care Team and inform of incident within 24 working hours.
• Alert your staff that incident occurred and to watch for any signs of aspiration pneumonia which include:
  • Fever - even a low grade fever (Monitoring temperature twice per day for three days following incident is recommended).
  • Observe for lethargy, lack of appetite, skin flushing and even mild confusion.
  • Listen for labored breathing or coughing with or without exertion.

Report any of these symptoms to MD immediately.

New Adult Family Home Certification Contact Info

Community Care is responsible for completing all aspects of the certification process for 1-2 bed Adult Family Homes. A phone number and email address has been established for you to inquire about AFH certification: 414-902-2482, AFH.Certification@communitycareinc.org

DME/DMS Bench

All DME/DMS providers must submit a current MSRP along with their quote to the IDT team for all miscellaneous items prior to authorization issuance.

For questions regarding this requirement, contact: Tracy.Thompson@communitycareinc.org

Complete Your Residential Summary

We recently sent you an assessment to help us identify the level of care you are able to provide at each of your facilities. Complete the Residential Summary and return it by email to ContractInquiries@communitycareinc.org, fax to 262-446-6707 or mail to:

Community Care, Provider Management, 1801 Dolphin Dr., Waukesha, WI 53186

Need another form? Download one at www.communitycareinc.org/ForProviders.

If you have any questions, call the Provider Hotline at 866-937-2783.

Provider Claims Education Training Schedule

Community Care conducts claims education training to providers on a monthly basis. You are welcome to attend any of the sessions listed below. Current and new non-medical providers are welcome.

Racine County Site | 1220 Mound Avenue, Racine WI 53404 | Third Floor
When: September 17, 2010 | Time: 9:00 to 11:00 a.m. or 1:00 to 3:00 p.m.

Kenosha County Site | 4003 80th Street, Suite 101, Kenosha, WI 53142
When: October 1, 2010 | Time: 9:00 to 11:00 a.m. or 1:00 to 3:00 p.m.

Racine County Site | 1220 Mound Avenue, Racine WI 53404 | Third Floor
When: October 15, 2010 | Time: 9:00 to 11:00 a.m. or 1:00 to 3:00 p.m.

Kenosha County Site | 4003 80th Street, Suite 101, Kenosha, WI 53142
When: October 22, 2010 | Time: 9:00 to 11:00 a.m. or 1:00 to 3:00 p.m.

Additional training sessions will be provided in other counties on future dates. If you have any questions, or would like to sign up for a session, email provider.education@communitycareinc.org.

Evidence of Insurance Declaration

Community Care Network Providers are required to provide Evidence of Insurance Declaration to Community Care at 12-month intervals for all contracted entities. Copies of the following are mandatory:

• General Liability
• Professional or Umbrella Liability
• Worker’s Compensation & Employers Liability Insurance (if three or more employees)
• Vehicle Liability Insurance

If you haven’t already submitted this information for 2010 please do so now. You may submit to:
Community Care, Inc.
Attn: Phyllis Salley
1555 S. Layton Blvd.
Milwaukee, WI 53215

or FAX: 414-383-9346 | EMAIL at Phyllis.Salley@communitycareinc.org

Prevocational and Employment Service Providers

The Department of Health Services (DHS) has developed an on-line Prevocational Definition training that provides additional information on the definition, including guidelines for implementation. The training is in six modules, each approximately 10 minutes long. The training is open to anyone and is accessible via this link: http://www.dhs.wisconsin.gov/LTCare/ProgramOps/Index.htm

Training is found under section “Technical Assistance Series 10-04.” The training also allows for comments and questions to be submitted and responses to the questions will be posted on-line. Providers are strongly encouraged to view this training.

Are You Planning An Open House?

If you are having an open house, we want to hear about it! Email your open house information to Residential Vacancies@communitycareinc.org and include:
• County location
• Facility name
• Size of facility (Number of beds and indicate AFH, CBRF, RCAC)
• Address
• Date
• Time
• Contact name & telephone number
• Brief description of your home

Once we receive the information, we will notify the care teams of your open house. For any questions, email ResidentialVacancies@communitycareinc.org.