Thursday, April 28, 2016

CMS Releases New Resource Guide for Quality Improvement Tools

Holly Harmon, RN, MBA, LNHA
AHCA Senior Director of Clinical Services

CMS has posted a new Resource Guide for Quality Improvement Tools related to new April 2016 Nursing Home Compare Quality Measures. This guide includes a description and link to multiple tools and resources that are available to centers, including some resources from AHCA. The tools in this guide are sorted into the following five categories:
  • Resources for Systems Approaches to Quality Improvement
  • Resources for Antianxiety or Hypnotic Medication Measure
  • Resources for Mobility Measure (Short Stay or and Long Stay)
  • Resources for Emergency Department Visits and Rehospitalization Measures
  • Resources for Community Discharge Measure
Check out the Resource Guide for Quality Improvement Tools to review and consider using resources that already exist to help centers with quality improvement.

Wednesday, April 27, 2016

Living the Mission: A Day for Not for Profit (NFP) Providers from AHCA/NCAL

Dana Halvorson

AHCA/NCAL’s constituency education program for NFP providers will be held on Tuesday, October 18, in Nashville, TN, and is packed with motivational and educational speakers. The keynote speaker, John O’Leary (pictured), was a curious nine-year-old boy. Playing with fire and gasoline, he created a massive explosion in his garage and was burned on 100% of his body. Given less than 1% chance of survival, John is proof of the power of the human spirit. Using his fire story as a backdrop, John will inspire you to take back your life, see the abundant possibility within your professional and personal challenges, and change the world. Participants will also have the opportunity to hear from other top-notch speakers. More information about this day and where to register can be found here. Registration opened on April 6. If you have any questions, please don’t hesitate to contact AHCA’s Senior Director of Not for Profit & Constituent Services, Dana Halvorson.

President Obama Signs the Older Americans Act Reauthorization Act

Lilly Hummel

On April 19, 2016, President Obama signed the reauthorization of The Older Americans Act (OAA), which promotes the well-being of older individuals by providing services and programs designed to help them live independently in their homes and communities. The Department of Health and Human Services’ Administration on Aging oversees the majority of OAA-funded programs, including supportive services, congregate and home-delivered nutrition services, family caregiver support and the long-term care ombudsman program, among many others. These grants to states and organizations are a critical component of long term services and supports.

DOJ Launches Ten Elder Justice Task Forces

Dianne De La Mare

The Department of Justice (DOJ) has launched 10 regional Elder Justice Task Forces, which bring together federal, state and local prosecutors, law enforcement and agencies that provide services to the elderly to coordinate and enhance efforts to pursue nursing centers that provide substandard care to residents. Participants in the regional tasks forces will include the state Medicaid Fraud Control Units (MFCUs), US Attorneys’ offices, HHS, state Adult Protective Services agencies, Long Term Care Ombudsman programs, and various other law enforcement agencies.

The task forces will focus on protecting nursing center residents from serious abuse, neglect, and other harmful care resulting in “grossly substandard care,” by prosecuting individuals and companies involved in such care. These task forces will play an integral role in DOJ’s future investigation and enforcement activities against nursing centers.

AHCA is monitoring this effort carefully, and will continue to keep the membership informed of any new developments. Read the announcement at

Brown University Survey on Camera Use

Clara Berridge, PhD, MSW
Center for Gerontology and Healthcare Research
Brown University School of Public Health

Researchers at Brown University are conducting a short, 8-question multiple choice national anonymous survey to learn about nursing center and assisted living policies regarding camera use in resident rooms.

As you know, there has been renewed attention in the media on the use of cameras in resident rooms in nursing centers or assisted living facilities. While there is no federal law, some states now have regulations allowing private individuals to install cameras in nursing center resident rooms, and others are considering adopting similar laws. This survey will help estimate how widespread the use of cameras is in resident rooms. It also will help provide information on how requests for cameras are handled by facilities, how staff feel about cameras observing their behavior, and the unintended negative consequences of using cameras in this way.

Please use the attached link to complete this short online survey even if your facility has no policy or doesn’t permit cameras in resident rooms.  They do not collect your name or the name of your facility. They guarantee that your answers are entirely anonymous (e.g., they have no way to link your response to you or your facility). 

Please follow this link to complete this 2-minute online survey:

You can read more information about the survey here.

Senator Flake Introduces Necessary Workers Bill

Drew Thies
Senator Jeff Flake (R-Ariz.) introduced legislation last week that would create a pilot guest working program to address crucial worker shortages.

The Willing Workers and Willing Employers Act (S. 2827) seeks to address the gap between immigrants seeking temporary, seasonal work in the U.S. and those seeking longer stays for highly skilled labor under the H-1B visa and other similar programs.

The American Health Care Association (AHCA)/National Center for Assisted Living (NCAL) applauded the Senator’s efforts in a press release, saying the bill “makes it easier for foreign nurses and other health care workers to get jobs” in a sector that is experiencing a workforce shortage that only grows worse as the country ages.

“Recruiting, training, and retaining caregiving staff are the biggest challenges facing skilled nursing care centers today,” said Clifton J. Porter II, senior vice president of government relations for  AHCA/NCAL.

The program allows for the U.S. to admit workers with less than a bachelor’s degree to do year-round, non-farm work under flexible caps determined by market needs.

AHCA/NCAL members can travel to Washington D.C. to advocate for Sen. Flake’s bill and other issues, such as Medicaid and Observation stays, during the annual Congressional Briefing, May 23rd-24th. Due to increased demand, registration has been extended to April 29th, but slots are filling up fast so those interested are encouraged to register soon.

A long-standing member of the Essential Worker Immigration Coalition (EWIC), AHCA is one of 37 organizations that has worked closely with key Congressional members to shape and draft practical immigration reform legislation.

#ProviderChats on Tuesday, May 10th

Katherine Merullo

On Tuesday, May 10th Provider Magazine will host the next Twitter chat on Elder Care and the Women at 1 PM Eastern Time.    During this hour we will discuss the importance of female caregivers both in the informal and the professional roles.  We will hear from experts who talk about innovative ways to provide care for the working women who are also the family caregivers.  We will also discuss the way the US is managing aging and elder care services and how we compare to others.

There is also the important role that employers play with regard to time off, educational programs and non-financial support that is needed.  This is sure to be an informative discussion with a guest panel of experts to guide us. We will also have nursing staff and providers join the conversation with the expertise from the National Association of Health Care Assistants (NAHCA) and The Evangelical Lutheran Good Samaritan Society

Panelists Include:

Ellen Belk, CDP is president of Keep In Mind Inc., specializing in holistic dementia care solutions and caregiving resources. With more than 15 years of professional dementia care leadership, Belk is known for her operational expertise, executive leadership development, creative activity initiatives and caregiver training.

She authored the 360° Dementia Care Operational Manual™ for professional dementia care partners who seek a comprehensive operational tool that exceeds industry expectations. 
Robin L. Hillier, CPA, STNA, LNHA, RAC-CT, is a health care executive dedicated to post-acute and long term care. Throughout her career she has been involved in all aspects of facility operations, including ownership roles. She is currently the director of reimbursement and quality metrics for Welcome Nursing Home in Oberlin, Ohio; co-owner of Quality Life Services, a home health agency; and president of RLH Consulting, which provides operational and reimbursement consulting to providers of skilled nursing, assisted living and intellectual or developmental disabilities.
Nancy L. Kriseman, L.C.S.W, is a licensed clinical social worker who has worked with older people and their families for over 30 years. Nancy is currently in private practice and presents workshops on caregiving, loss and grief and dementia across the country. As an adjunct faculty member at Kennesaw State University and Mercer University, she taught courses on aging and death and dying. She has published two books, The Mindful Caregiver: Finding Ease in the Caregiving Journey, Feb 2014, Roman and Littlefield publishers & The Caring Spirit Approach to Eldercare: A Training Guide for Professionals and Families 2005 Health Professions Press.
Follow the conversation using #ProviderChats on Twitter and learn about services, programs and ideas to better meet the needs of the female caregiver. Submit your own questions to @ProviderMag or @ahcancal ahead of time or ask during the discussion live.

Webinar: How to Run Reports in LTC Trend Tracker

Christy Sharp

Attention all Independent Owners. On Thursday, June 9 we will host training on How to Run Reports in LTC Trend Tracker and How to Set up your Dashboard. Utilizing the tools within LTC Trend Tracker will help members keep track of progress towards achieving goals of the AHCA/NCAL Quality Initiative and to prepare for mandatory reporting.  There is also a helpful Resource Center with additional guides, videos and help documents to assist you in the program.
LTC Trend Tracker Training 
Thursday, June 9, 2016  
10:00 AM  | Eastern Daylight Time   | 1 hr
Join WebEx meeting

Meeting number: 
731 826 594

Meeting password:

Join by phone
+1-415-655-0003 US TOLL
Access code: 731 826 594

New Measures are Live on Nursing Home Compare!

Holly Harmon, RN, MBA, LNHA
AHCA Senior Director of Clinical Services

The CMS Nursing Home Compare website now includes six new quality measures, four short-stay and two long-stay measures. The measures are:


  • Percentage of short-stay residents who made improvement in function (MDS-based)
  • Percentage of short-stay residents who were successfully discharged to the community (Claims-based)
  • Percentage of short-stay residents who were rehospitalized after a nursing home admission (Claims-based)
  • Percentage of short-stay residents who had an outpatient emergency department visit (Claims-based)
  • Percentage of long-stay residents whose ability to move independently worsened (MDS-based)
  • Percentage of long-stay residents who received an antianxiety or hypnotic medication (MDS-based)
Five of the six new measures (not including antianxiety/hypnotic use) will be added to the Five-Star quality measure component starting in July. Although CMS has not yet announced the specific schedule for when these new measures will affect the Five-Star rating, a phase-in of the measures is expected.

Four key points to consider and explore regarding these changes:

1) Accountability after Discharge - Recognize that three of the new short-stay measures include outcomes after discharge from the center. The three measures are discharge to community, rehospitalization and emergency department use. Traditional discharge planning and assumed release of responsibility after the day of discharge will not position a center for success in this changing healthcare environment. 

What can you do? Evaluate your systems and processes around care transitions and pursue performance improvement opportunities to achieve improved outcomes. 

2) Influence of Short-Stay Outcomes - As the new measures are added to Five-Star starting in July, the quality measure component will be more influenced by quality measure performance for the short-stay population than it has in the history of the Five-Star rating system for nursing centers. Eventually, there will be seven short-stay measures versus three short-stay measures contributing to the Five-Star quality measure component.

What can you do?
Know the person, each individual served in your center from day one. Understand the needs of your short-stay population. Use root cause analysis often to support continuous improvement.

3) Claims Based - This is the first time claims based measures will be used on Nursing Home Compare and eventually the Five-Star Quality Rating System. Hospital claims for Medicare Part A and Medicare Part B are a source of information for the new short-stay claims based measures.

What can you do? Verify that the right systems and processes are in place in your center for timely submission of MDS and claims. Develop channels with local hospitals to foster timely communication and coordination as individual patients and residents move to and from hospitals and nursing centers.

4) Quality Strategy - Pursuing the AHCA Quality Initiative goals position members for success in this changing world where quality and payment are becoming one and successful patient and resident outcomes determine business success.

What can you do?
Embark on the AHCA Quality Initiative today! Explore the Getting Started Guide.

AHCA offers several resources to help members along the journey of quality improvement. Visit LTC Trend Tracker to dig into your data, ahcancalED for online education specifically tailored to post-acute and long term care and AHCA Quality Initiative goals for many resources available to apply into every day practice.

To learn more about what you can do to prepare for upcoming Five-Star changes, click here.

Read more about the CMS additions here and here.

Tuesday, April 26, 2016

Advanced Registration Extended

Come to Congressional Briefing and advocate for the continued funding of Medicaid. Congress is looking for ways to save money so it is a critical time to meet with your Members of Congress and tell them not to reduce provider assessment rates.

During the May 24th morning Congressional Briefing session, AHCA/NCAL will have a panel discussion on best practices for successfully advocating with elected officials. You'll hear from your peers about what has worked for them and learn specific strategies that you can use in your own advocacy efforts.

Reserve your hotel by the April 28th deadline to get the special AHCA/NCAL rate.

Don't miss this opportunity to go to Capitol Hill and use your voice to fight for the quality of care that you are able to provide in your centers. The Advance Registration has been extended until Thursday, April 28. 

See the complete agenda and register for Congressional Briefing today.

The conference registration fee is complimentary to AHCA/NCAL Members and AHCA/NCAL Associate Business Members, and their spouses, and is accepted on a first-come basis. All registrations include continental breakfast, networking lunch, and cocktail reception.

Official Sponsor: Medline
Supporting Sponsors: Navigator, LTC REIT