What To Do If Accused of Drug Diversion or Stealing Drugs. Most often employers report nurses and other health care professionals for alleged drug diversion and/or failure to properly document medication administration related to the use of the Pyxis system or other narcotic delivery system. The employer, usually a hospital, relies heavily on the Pyxis printout to document medications that are dispensed. Due to a variety of errors, both human and technological, the Pyxis system or MAR may not properly reflect medications dispensed, administered or wasted. If your employer threatens to report you or calls you into a meeting with supervisory staff and pharmacy staff, do not agree to contact HPRP, IPN or PRN until you consult a professional licensing attorney. Even if you did divert medication you are entitled to a proper defense. If you are asked to provide a drug screen please understand if you refuse, your license will more likely than not be subject to a Summary Suspension or Emergency Suspension Order. A professional licensing attorney can work with you to make sure the facts are thoroughly reviewed and a proper defense is put forth. Often the error is related to a breakdown of hospital procedures or the computer system itself. Often the problem is not diversion but improper documentation. Remember you have options and you need to speak to a professional licensing attorney as soon as possible. Do not give a written statement to anyone without first talking to an attorney. If the police are called, ask to speak to an attorney before giving a verbal or written statement. 2008 NURSING HOME DIVERSION MODERNIZATION GRANT State Of Michigan. The program’s name change from Nursing Home Diversion (NHD). Michigan Nursing Home Diversion Project. Nursing Homes Diversions Modernization Grants Program Subject: Michigan Author: Administratration on. Fast Track and Other Nursing Home Diversion. Michigan's Transitioning Persons from Nursing Homes. Nursing Home Diversion and the Veterans Administration. Michigan Nursing Home Diversion. Nursing Home Grants Michigan. Pennsylvania Transition to Home (PATH): Pennsylvania's Nursing Home Transition Program. U. S. Department of Health and Human Services. Pennsylvania Transition to Home (PATH): Pennsylvania's Nursing Home Transition Program. Steve Eiken and Alexandra Heestand. MEDSTATDecember 2. PDF Version: http: //aspe. PAtrans. pdf (2. 0 PDF pages)This report was prepared under contract #HHS- 1. U. S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long- Term Care Policy (DALTCP) and the MEDSTAT Group. Additional funding was provided by the Center for Medicare and Medicaid Services. For additional information about the study, you may visit the DALTCP home page at http: //aspe. ASPE Project Officer, Gavin Kennedy, at HHS/ASPE/DALTCP, Room 4. E, H. H. Humphrey Building, 2. Independence Avenue, SW, Washington, DC 2. His e- mail address is: Gavin. Kennedy@hhs. gov. This publication is based on research performed under Contract Number 1. Michigan MIP Diversion Programs Keep Your Record Clean I have found that most of the courts in Michigan offer a diversion program. The opinions expressed in this report are those of the authors and do not necessarily reflect the views of ASPE, CMS, or Medstat. The authors gratefully acknowledge the many people in Pennsylvania who generously gave us their time and insights for the preparation of this report. TABLE OF CONTENTSINTRODUCTIONPROGRAM DESCRIPTIONTransition Coordination. Identifying Program Participants. Payment of Up- Front Costs. Coordinating with Nursing Facilities. Obtaining Housing. Obtaining Home and Community- Based Services. PROGRAM RESULTSNEXT STEPSINTERVIEWSNOTESCOMPLETE LIST OF SITE VISIT REPORTSEXHIBITSCHART 1. Planned Distribution of PATH Project Expenses. CHART 2. Type of Disability for PATH Transitioned Consumers. The Centers for Medicare & Medicaid Services (CMS), in association with Office of the Assistant Secretary for Planning and Evaluation (ASPE), sponsored the Nursing Home Transition Demonstration Program to assist states in providing transition options to nursing home residents who wish to move back to the community. CMS and ASPE awarded grants to 1. The Demonstration permitted states to use grant funds for virtually any direct service or administrative item that held promise for assisting nursing home residents' return to the community. The grants provided targeted administrative or service resources to achieve the following objectives: To enhance opportunities for nursing home residents to move into the community by identifying nursing home residents who wish to return to the community and educating them and their families about available alternatives; To overcome the resistance and the barriers that may be in the way of their exercising this choice; and. To develop the necessary infrastructure and supports in the community to permit former nursing home residents to live safely and with dignity in their own homes and communities. This report, which describes an initiative called Pennsylvania Transition to Home (PATH), is one of a series of nine case studies presenting results from the Demonstration. The case studies, along with a final report summarizing results from all these states. Lessons the demonstration states learned during this program are particularly important because CMS awarded a number of Nursing Home Transition grants in 2. Systems Change Grants initiative. During a September 2. Medstat interviewed PATH staff, who are independent contractors for Pennsylvania, as well as Pennsylvania Department on Aging (PDA) staff involved in implementing the project. Medstat also interviewed four consumers who left nursing homes with the help of PATH and staff from three nursing homes that have provided referrals to PATH. After the site visit, Medstat interviewed staff from other organizations involved in PATH: Pennsylvania's Medicaid agency (the Department of Public Welfare), Pennsylvania Protection and Advocacy, and one of the Area Agencies on Aging that provided home and community- based services to PATH consumers. The Commonwealth of Pennsylvania provided additional information for this report through a progress report on the grant available on PDA's Web site. This case study report focuses on three common components of nursing home transition programs: transition coordination or case management to help consumers access housing and services in the community; a fund to pay for the up- front costs consumers may incur as they leave a nursing home, such as a security deposit for an apartment; anda method to identify nursing home residents interested in transition. The report also describes how three challenges common among the demonstration programs- -coordinating with nursing homes, obtaining community housing, and obtaining home and community- based services- -affected PATH, and how program staff addressed these challenges. Finally, the report presents data on the program's results and describes Pennsylvania's subsequent efforts to support nursing facility residents interested in transition. Pennsylvania received a $5. September 2. 00. 0 to fund the PATH program. Pennsylvania received two one- year, no- cost extensions for the grant, which expired in September 2. The state's Intra- Governmental Council on Long Term Care (IGCLTC) oversees the grant and several organizations that participate on the Council serve on the program's advisory group. The IGCLTC comprises three members of the governor's cabinet, four members of the state legislature, and governor- appointed representatives that include consumers, advocates, and providers from different long- term care service sectors. The IGCLTC includes the stakeholders who most affect Pennsylvania's long- term care system. The Secretary of Aging chairs the IGCLTC, and the IGCLTC's Executive Director works for the Pennsylvania Department on Aging (PDA). In its proposal to CMS, the IGCLTC set a goal to transition 9. Since it planned to target older nursing home residents, the IGCLTC selected four contiguous pilot counties from central and eastern Pennsylvania with a relatively high number of nursing home residents age 6. These counties include two mid- size cities, Harrisburg in Dauphin County and Allentown in Lehigh County. The other two counties (Cumberland and Schuylkill Counties) are rural. In early 2. 00. 3, the state added three rural pilot counties from the southwest corner of the state (Fayette, Greene, and Washington). The state hired four independent contractors- -a program manager and three transition coordinators- -to operate the grant. Two transition coordinators serve the original four pilot counties: one serves Dauphin and Cumberland Counties and the other serves Lehigh and Schuylkill Counties. The third transition coordinator serves the southwest Pennsylvania pilot counties. As indicated in Chart 1, Pennsylvania planned to spend almost three- fifths of the grant on transition expenditures: items and services people need to establish a home in the community. An additional 2. 6 percent of the grant was earmarked for staff, and the remaining portion was set aside for state- level administrative and outreach expenses. Pennsylvania had to delay PATH implementation for several months because it had difficulty transferring federal funds from the agency that officially received the grant- -the Medicaid agency, the Department of Public Welfare (DPW)- -to a subcontractor that would serve as the grant's fiscal entity. A fiscal entity was necessary because the IGCLTC did not have legislative authority to spend $5. Before the subcontracting process was complete, the Pennsylvania Department of Aging started the program in May 2. In July 2. 00. 1, DPW contracted with United Disability Services (UDS) to be the PATH fiscal agent. UDS was already the fiscal intermediary for a home and community- based services program for people with disabilities, so it had a record of working with DPW. The project started serving consumers in the original four counties in November 2. Transition Coordination. Pennsylvania hired independent contractors to assist residents who want to transition, believing the traditional civil service hiring processes would be time- consuming and impractical given the short- term nature of the project. The transition coordinators' orientation included meeting with members of the PATH Advisory Committee, which included IGCLTC members and people involved in the pilot areas' long- term care system. These meetings gave the coordinators knowledge about the long- term care system in their service areas and the stakeholders involved in the program. Before serving consumers, the coordinators also met separately with all nursing homes, public housing authorities, and home and community- based services (HCBS) providers in their service area. After learning about a resident who may be interested in transition, a coordinator contacted the consumer's facility to verify the person's name and to learn the person's Medicaid eligibility status. The coordinator met separately with the potential candidate and the nursing facility discharge planner to assess the person's willingness to transition. If the potential candidate indicated that he or she was not interested in PATH, the transition coordinator left a business card and brochure and told the person that he or she may request PATH assistance at any time. During future visits to that facility, the coordinator briefly visited the resident so the person could express interest in transition if the person changed his or her mind. The coordinators assisted all residents interested in transition, regardless of the person's financial status. If the person was not eligible for Medicaid, the coordinator and nursing facility discharge planner worked with the resident to develop a plan to support the person in the community. For Medicaid- eligible participants, the coordinator contacted the local agency that assessed eligibility for the appropriate Medicaid home and community- based services (HCBS) waiver.
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