LTSS Newsletter—May 2019


Upcoming webinar: Changing Tribal Demographics in Post-Acute Care—May 22, 2019
Long-Term Services and Supports

Technical assistance for culturally competent care
May 2019
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Caring for elders affected by trauma

As people age, they are more likely to experience trauma from fall-related injuries and elder abuse, according to SAMHSA. A discussion paper from the National Academy of Medicine describes these common sources of trauma among elders.

The paper also provides a guide of federal programs and services for older adults who have experienced or are at risk of experiencing trauma and discusses promising practices for trauma-informed care.


Trauma-informed care for tribal elders


A recent report from CMS (PDF, 656 KB, 9 pgs.) highlights how tribal long-term care facilities provide person-centered, culturally appropriate care for residents who have experienced trauma.


The CMS LTSS technical assistance (TA) Center also offers resources on addressing elder abuse in Indian Country, as well as helping elders avoid falls.



Medicare covers wellness visits, not routine physicals

A smiling elder

When scheduling elders' medical appointments, caregivers should be aware that word choice matters. Specifically, Medicare fully covers yearly wellness visits, but it does not cover routine physicals.

Focused on preventing disease and disability, wellness visits are opportunities for patients to complete a risk-assessment questionnaire and review their medical history with a health care provider. Patients may also get their blood pressure checked and receive preventive services, such as flu shots.

In contrast, a routine physical involves a physical exam, bloodwork, or other tests. Under Medicare rules, patients pay out of pocket for these services.

Oral health care tips for caregivers

Healthy mouths support elders' overall health in many ways. For example, because elders with healthy mouths can chew well, they can easily eat a variety of healthy foods.


A screen shot of the fact sheet, 'Oral Health and Aging Information for Caregivers: Finding Low-Cost Dental Care,' which features an elder female embracing and elder male

The NIH National Institute of Dental and Craniofacial Research developed a series of fact sheets for caregivers who help someone brush, floss, or visit the dentist. Suggestions range from ways to help elders find low-cost dental care to how to make holding a toothbrush easier.

Planning activities for people with dementia

For people with dementia, planning daily activities can be challenging. The NIH National Institute on Aging offers tips for caregivers on how to help people who have dementia decide how to spend their time and establish routines. Guidance ranges from considerations for planning outings to ways to engage elders in spiritual activities.

Funding opportunities

Grants for grandparents and other surrogate caregivers

Deadline: Wednesday, June 12

The Brookdale Foundation Group's Relatives as Parents Program (RAPP) will provide agencies with seed grants and technical assistance to develop or expand support services for grandparents and other relatives raising children whose biological parents are unable to care for them.


Grants for group respite care for elders with dementia

Deadline: Wednesday, June 26

The Brookdale National Group Respite Program is offering agencies seed grants and technical assistance to develop and implement new, dementia-specific social model day programs. The goal is to provide respite care and supportive services that help elders with memory loss remain in their communities.

Join the conversation on LinkedIn

Want to learn more about or discuss LTSS in Indian Country? Looking to connect with others working in the same field? Join the Tribal Affairs Group on LinkedIn.



Upcoming webinar

Changing Tribal Demographics in Post-Acute Care

Wednesday, May 22

This webinar is organized into two parts: Part I describes changing demographics and services in a rehabilitation hospital. Part 2 describes what these changes look like in skilled nursing facilities.


By the end of the webinar, participants will:


  • Understand the similarities and differences between rehabilitation hospitals and skilled nursing facilities related to lengths of stay and funding
  • Recognize the changing "typical admission," in terms of ages and diagnoses
  • Understand similar care needs and challenges for both types of post-acute care facilities

Have questions for our presenter? Let us know before the webinar by emailing

Register now.


Please note your
location's call-in time:

8 a.m. Hawaii
10 a.m. Alaska
11 a.m. Pacific
11 a.m. Arizona
12 p.m. Mountain
1 p.m. Central
2 p.m. Eastern


Ina Henley 
Divisional Director
Oklahoma Insurance Department

Susan Pourier  
Oglala Sioux Lakota Nursing Home

Joseph Ray 
Executive Director
Native American Independent Living

Tami Reed 
Morning Star Care Center

Dana Schlegel 
Clinical Liaison
Mountain Valley Regional Rehabilitation Hospital




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About the Newsletter

Long-Term Services and Supports Solutions is published monthly by the CMS Division of Tribal Affairs to share information, funding opportunities, and resources with LTSS planners, tribal leaders, and supporters.

Centers for Medicare & Medicaid Services Indian Health Service Administration for Community Living