Monthly Archives: September 2011

15 April 2015

“Doc Fix” Bodes Well for ADS

Posted April 15, 2015 in blog in News in Public Policy

On Tuesday night, April 14th, the United States Senate agreed 92-8 with a previously House passed bill to replace the Sustainable Growth Rate (SGR) method of Medicare reimbursement with a new system focused upon “quality, value, and accountability”. Commonly referenced as the “Doc Fix”, the legislation applies primarily to physician reimbursement but includes unrelated items and several nuances that bode well for ADS .

Immediately, the bill does not affect adult day services because they are not direct recipients of Medicare reimbursements. However, additional important goals of the legislation are to link Medicare reimbursements to quality metrics and to encourage better care coordination and chronic care management. These stated goals provide an opening to fortify adult day’s efforts for direct Medicare reimbursement.

Here is a link to the Kaiser Health News report and FAQs about the new legislation, which President Obama said he will sign describing it as “a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs.”

Roy Afflerbach
NADSA Public Policy Advisor

31 March 2015

Participate in 2015 Adult Day Services Financial Benchmarking Study

Posted March 31, 2015 in Research

CARF International is conducting a 2015 study to highlight the concept of “Financial Ratios as Performance Indicators” to the field of Adult Day Services. If your organization is an Adult Day Services provider, consider participaticipating in this unique, exciting annual study that began in 2010.


There is no charge for your participation in this study.  The goal of this study is to develop financial benchmarks for adult day services and to provide participants in the study with a complimentary summary of financial benchmarking information.


Details related to the financial ratios of each participant in the study will not be disclosed to other organizations. CARF will share the aggregate data analysis with you as a result of your participation.


CARF has partnered with Mr. Jeff Boland, of Reinsel Kuntz Lesher, LLP to assist with the study, and he is required to maintain confidentiality of any information disclosed for the purpose of the study. Jeff is a representative of CARF’s Financial Advisory Panel (FAP) and has presented the results of the last five studies at the NADSA Annual Conferences in 2010-2014.  For more information on the FAP’s role related to accreditation, see and type “FAP” in the search field located in the upper left corner of our website.


CARF-CCAC Financial Ratios have been used as operational benchmarks for our accredited Continuing Care Retirement Communities (CCRCs) since the early 1990s. For nineteen years, CARF-CCAC has been collecting data from accredited CCRCs for inclusion in an annual publication titled Financial Ratios & Trend Analysis of CARF-CCAC Accredited Organizations. Historically, benchmarking against financial ratios has been a promising practice for the CCRC field and CARF sees that the Adult Day Services field can likewise benefit from benchmarking. CCRCs rely on this information to enable them to assess trends and make sound financial decisions in varying economic times. Rating agencies, investment bankers and accountants rely on these financial ratios to assess organizational viability when assigning ratings and structuring debt.


CARF sees this initiative as a way to add significant value to accreditation and as a way to share our benchmarking expertise with the adult day services field. For questions, Sue Matthiesen can be reached at either or toll-free 866-888-1122, ext. 5006.



How do you participate? If you will participate in this study, please send the following documents by email ( ), fax (202-587-5009), or mail (1730 Rhode Island Avenue NW, Suite 209, Washington, DC 20036) to Amanda Birch at CARF International by Friday, June 26, 2015:

For your adult day service program’s fiscal year ending in 2014:

  • 2015 ADS Indicators Supplemental Handout
  • Internal unaudited 2014 fiscal year Financial Statements including Revenue and Expense, Balance Sheet, and Cash Flows or;
  • Corporate audit Financial Statements for 2014 fiscal year (if available).

Note: If your financial information is consolidated for a larger organization, please clearly identify the adult day services financials or send a separate report with only the adult day services financial information included.



Please contact Amanda with questions about what information is applicable to the study. You are welcome to connect Amanda to the financial staff member at your organization.

19 March 2015

S.704 Offers Medicare Opportunities for ADS

Posted March 19, 2015 in blog in News in Public Policy

New Senate Republican Bill Offers Medicare Opportunities for ADS

                   ADS Included as a Medicare Option–

On March 11, Senators Chuck Grassley (R-IA) and Ben Cardin (D-MD) introduced S.704, which proposes to establish a Community Based Institutional Special Needs Plan (CBI-SNP) demonstration program to target home and community based care to eligible Medicare only beneficiaries. The bill was referred to the Committee on Finance, upon which both Grassley and Cardin serve.

In his press release, Senator Grassley noted that HCBS services are less expensive than institutional care and that the plans would tailor services to the beneficiaries specific needs. Most importantly, Adult Day Care Services are specifically included as one of the Medicare options in a bill sponsored by a member of the new Senate Republican majority.

Senator Grassley further stated, “One estimate shows four-year savings of nearly $60 million for a demonstration of 5,000 Medicare members by postponing or preventing hospitalization and institutionalization” [emphasis added]. Although only a limited demonstration proposal, this bill offers an opportunity for ADS to fit legislatively into Medicare as an institutional option and the Senator’s words mirror NADSA’s focus of Modernizing Medicare With ADS for Cost Avoidance!

Now is the time to contact your Senator to ask him/her to co-sponsor and support passage of S. 704 with the continued inclusion of ADS!!

 In short, this is the closest NADSA has come to legislatively fitting ADS into the tent of Medicare. We cannot allow this opportunity to pass!

Here is a link to Senator Grassley’s full statement:;

And a link to the full text of the bill:

Roy Afflerbach

NADSA Public Policy Advisor

12 March 2015

CMS Has Announced Additional HCBS Rule Guidance

Posted March 12, 2015 in News in Public Policy in Resources / Providers

The Centers for Medicare & Medicaid Services (CMS) recently updated portions of the CMCS Home and Community-Based Services (HCBS) Toolkit.  Updated versions (Version 1.0) of the HCBS Basic Element Review Tool for Statewide Transition Plans and the HCBS Content Review Tool for Statewide Transition Plans are now available. This information is part of the CMS ongoing effort to assist states in meeting regulatory requirements for residential and non-residential home and community-based settings.

The full HCBS toolkit, including the updated portions, is available online at

Providers may find it helpful to review the information and examples CMS is providing for state administrators.

Roy Afflerbach, NADSA Public Policy Advisor

28 January 2015

Join Adult Day Services Advocates in Washington, DC on May 4-5, 2015

Posted January 28, 2015 in Events in Public Policy

Join adult day services supporters in for the fourth annual National Adult Day Services Association Capitol Hill Day in Washington, D.C., May 4-5, 2015. 

May 4, 2015   6:00pm Join us on Monday evening for networking. We will be gathering to meet each other, share ideas, dine together, prepare for legislative meetings. Dinner is included in registration fee.  (Hilton Alexandria-Old Town)

May 5, 2015

7:30 – 9:00 am  Breakfast, Public Policy Education Session (Hilton Alexandria-Old Town)

10:00 am – until  Congressional Hill visits-NADSA will provide assistance with scheduling meetings with Congressional staff/members of Congress for registrations received before April 6, 2015.

Event Registration (Includes Monday dinner, Tuesday breakfast, leave-behind packets for legislative visits, one round-trip Metro Pass for legislative visits, assistance scheduling legislative visits for registrants before April 6.  Does not include costs for lodging or transportation)

Register for the National Adult Day Services Association Capitol Hill Day

in the NADSA online store at

 Hotel Arrangements:

Hilton Alexandria-Old Town, 1767 King Street,  Alexandria, VA

A limited number of rooms has been reserved at the Hilton Alexandria-Old Town.  The special room rate will be available until April 3, 2015, or until the room block is sold out, whichever comes first. Indicate your affiliation with NADSA to receive the reduced room rate.

RESERVATIONS:  Click the link to register online at National Adult Day Services Association or call 1-800-HILTONS (1-800-445-8667)


Located in the historic, vibrant King Street neighborhood, the Hilton Alexandria Old Town hotel, which was renovated in April 2014, is one of the most convenient hotels in Alexandria, VA for business and leisure travelers visiting Washington, DC. Downtown DC attractions and government buildings are minutes away by Metro. After a long day exploring DC, reinvigorate with a workout in the fitness center.

Learn more at 2015 National Adult Day Services Capitol Hill Event

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