Tuesday, August 14, 2018

AHCA Disappointed with Proposed Tax Rule

Drew Thies

The American Health Care Association (AHCA) expressed disappointment last week concerning an Internal Revenue Service (IRS) proposed rule relating to the tax status of skilled nursing providers.

The proposed rule stipulates that skilled nursing facilities (SNFs) cannot take advantage of some of the tax deductions in the 2017 tax law because of their status as "specified service trade or businesses.”

The Trump administration’s signature tax law allows passthrough entities like limited liability corporations, partnerships, S corporations, and sole proprietors to deduct 20% of their "qualified business income” but only if they are not a specified service business.

AHCA CEO and President Mark Parkinson said “[t]he rule is inconsistent with Congressional intent” and that [t]he intent of the law was to provide tax cuts to job creators and those willing to put capital into the economy.”

AHCA will “submit comments and will forcefully advocate our position” and “go to the Hill and seek legislative relief” if necessary, Parkinson continued.

The rule is part of the regular notice of proposed rulemaking (NPRM) process, is not final, and will become law after stakeholders weigh-in and the IRS codifies it. Comments are due by October 1st.

Monday, August 13, 2018

2018 Gold Quality Award Recipients Announced

Last week, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) announced that two skilled nursing care centers and two assisted living communities have earned the 2018 Gold – Excellence in Quality Award. The award is the final of three distinct levels possible through the AHCA/NCAL National Quality Award Program, which recognizes organizations nationally that serve as models of excellence in providing high-quality care.

The 2018 Gold – Excellence in Quality Award recipients are:
• Comer Health and Rehabilitation; Comer, Georgia
• Holly Heights Nursing Center; Denver, Colorado
• Maine Veterans Home - Machias; Machias, Maine
• Sunrise of Gurnee; Gurnee, Illinois

Maine Veterans Home – Machias and Sunrise of Gurnee are the first free-standing assisted living communities to ever attain the Gold – Excellence in Quality Award in the history of the program.

Based on the core values and criteria of the nationally recognized Baldrige Performance Excellence Program, the AHCA/NCAL National Quality Award Program challenges member providers to achieve performance excellence through three progressive levels—Bronze, Silver, and Gold. The Gold – Excellence in Quality Award is the most prestigious of the program. At this level, recipients have invested multiple years in mastering and applying the rigorous quality improvement standards of the Baldrige Criteria to achieve superior results in leadership, strategic planning, customer and workforce focus, and operations and knowledge management.

Since the inception of the National Quality Award Program in 1996, only 34 long term and post-acute care providers—excluding this year’s recipients—have achieved this level of quality recognition.

AHCA/NCAL announced the recipients of the Bronze – Commitment to Quality on May 31 and Silver – Achievement in Quality on June 28. A full list of recipients is available on the AHCA/NCAL Quality Award website here.

The program is sponsored by the following AHCA/NCAL Associate Business Members: First Quality, NRC Health, and Team TSI Corporation. The awards will be presented to recipients during AHCA/NCAL’s 69th Annual Convention & Expo in San Diego, California, October 7-10, 2018.

Wednesday, August 8, 2018

Special Session on New Payment Model at Convention

Jon-Patrick Ewing

The Patient-Driven Payment Model (PDPM) is now final with implementation scheduled for October 2019. Register for the AHCA/NCAL Convention and receive the answers to your implementation questions during a four-hour intensive session: Replacing RUGs - CMS' New SNF Payment System & How to Get Ready.

The intensive will be held on Sunday, October 7 and repeated on Wednesday, October 10. AHCA's educational approach to PDPM will be to offer a holistic picture of how PDPM impacts SNFs and will incorporate PDPM interactions with:
  • Requirements of Participation
  • Survey and Licensure
  • SNF Rehospitalization Measure Value-Based Purchasing
  • IMPACT Act Quality Reporting Program
  • Other payers' (Medicare Advantage and Medicaid) and their probable responses to PDPM
In addition to in-depth training on the PDPM final rule, a members-only tool kit will be introduced that will contain the core competencies framework and a readiness review tool that will help you track your operational readiness for PDPM. The intensive will also cover data gathered from 12 companies testing impacts of PDPM and provide hospital and discharge pattern data that could be helpful in member markets. Finally, a panel discussion of AHCA members will discuss opportunities and potential pitfalls for SNFs as they consider operational changes necessary to be successful under PDPM.
Attendance at the PDPM Intensive: Due to proprietary information, attendance at the PDPM intensive sessions (Sunday at 1:00 pm and Wednesday at 10:30 am) is limited to SNF providers only. No other attendee types will be permitted inside the session rooms. If attending the Sunday intensive, you must pick up your convention badge at registration prior to attending the session.

Advance registration continues through September 21, after this date on-site rates apply.

Medicare Advantage Plans Allowed to Negotiate Drug Prices

Drew Thies

Under a new policy announced by the Trump administration, insurers which offer Medicare Advantage plans will be able to directly negotiate with drugmakers in an effort to reduce prices.

The Centers for Medicare and Medicaid Services (CMS) said Medicare Advantage plans will be allowed to require that patients first try certain lower-cost drugs before moving to a more expensive alternative if the first treatment is not effective.

Until now, insurers were not able to negotiate prices under Medicare Part B and Part D, which are administered in a hospital or doctor’s office. In 2017, Medicare Advantage plans spent $11.9 billion on Medicare Part B drugs.

Secretary of Health and Human Services Alex Azar said, "By allowing Medicare Advantage plans to negotiate for physician-administered drugs like private-sector insurers already do, we can drive down prices for some of the most expensive drugs seniors use."

According to CMS Administrator Seema Verma plans will be required to pass on to patients more than half of the savings generated from the negotiations. Patients can receive benefits in the form of gift cards and other rewards programs.

Smarter RNs Are Key to Fewer Rehospitalizations. Fewer Rehospitalizations Are Key to Future SNF Reimbursements.

Dave Kyllo

It increases experienced RNs’ knowledge of gerontological nursing practice. Gero Nurse Prep students see a dramatic 24 percent average increase on their pre- and post-test scores.

Those specially trained RNs can net tangible results. Research conducted by AHCA/NCAL in 2016 found that the rehospitalization rates in nursing facilities with at least one RN certified in gerontological nursing by the ANCC consistently have run at least two percentage points lower than the national average since 2011.  
Lower rehospitalization rates will be key to success under the CMS Value-Based Purchasing (VBP) program. CMS is tracking skilled nursing rehospitalization rates on for the SNF VBP program. Under the VBP program, claims for services furnished on or after Oct. 1, 2018, will be subject to a 2 percent withhold. Providers will have the opportunity to get some or all of this money back depending on how well they do in managing hospital readmissions and meeting or exceeding performance standards.
 The key metric for the program is known as the SNF 30-Day All-Cause Readmission Measure (SNFRM). SNFRM estimates a risk-standardized rate of all-cause, unplanned hospital readmissions of Medicare SNF beneficiaries within 30 days of discharge from their prior acute hospitalization.

AHCA/NCAL Gero Nurse Prep thoroughly prepares interested RNs to take the ANCC Board certification exam in gerontological nursing. RNs who complete the Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam on their first try.

ANCC is the world’s largest and most prestigious nurse credentialing organization and a subsidiary of the American Nurses Association. Less than one percent of America’s RNs are board certified in gerontological nursing. That means having an ANCC Board certified RN can easily give providers an edge in the marketplace.

Taking the AHCA/NCAL Gero Nurse Prep course does not obligate a RN to sit for the ANCC Board certification exam. Registered nurses who are interested in increasing their knowledge of gerontological nursing practice can simply complete the AHCA/NCAL Gero Nurse Prep course receive 30 nursing contact hours, and increase their skills and knowledge of geriatric nursing.

AHCA/NCAL Gero Nurse Prep is affordable and provides value at the $690 AHCA/NCAL member price.  That’s $23 per contact hour for outstanding nursing education that makes a measurable difference in an RN’s knowledge of gerontological nursing. For RNs interested in pursuing Board certification through ANCC, there is an additional and separate cost of $395.

Watch this video to learn more about AHCA/NCAL Gero Nurse Prep.  Check out AHCA/NCAL Gero Nurse Prep today.

Delivering What Everybody Loves Through Mood Media

Dave Kyllo

Billy Joel said that “No matter what culture we’re from, everybody loves music.” Members can keep music alive in their communities through music offered by Mood Media at AHCA/NCAL “Member Only” discounted rates.

Mood Media offers great musical variety for events or casual common area listening via the internet or streaming, and offers customized commercial free music options that allow facilities to tailor musical selections to meet changing resident preferences. Mood customers enjoy freedom from music licensing worries on Mood Media’s huge collection of music selections played on Mood Media‘s portable devices.

Use Mood Media’s music to:

· Improve the dining experience and set the mood in dining areas as residents gather for meals;

· Provide a variety of background music in common areas;

· Create a positive environment for activities; and

· Provide musical entertainment for social gatherings and happy hours.

AHCA/NCAL members receive exclusive discounted rates on Mood services and equipment with three-year agreements. The core music package starts at $29.99 per month or about $1 per day with a three-year agreement.

For more information about Mood Media’s services, call 800-345-5000 or go to http://partner.moodmedia.com/ahcancal/ (password: moodpartner).

Check Out the Affordable Health Benefit Plan Built to Help AHCA/NCAL Members Recruit and Retain Frontline Staff

AHCA/NCAL Insurance Solutions now offers a minimum essential coverage health plan to members.  The new plan was developed by Compass Total Benefit Solutions and offers two new affordable options for providing many of the health insurance benefits that are important to long term care employees.  
The new plans feature affordable premiums and co-pays for valued and commonly used services, including prescriptions, physician visits and free unlimited 24/7 access to TELADOC.  The Compass 1 plan costs about $1 per hour for a full-time employee or $161 per month.  The Compass 2 plan costs $182 per month.  The Compass 2 plan costs a little more because it includes higher indemnity payments for hospitalizations. Here’s the rate schedule:

  Monthly Premiums
Compass 1
Compass 2
EE & Spouse
EE & Children

The plan was designed with long term care staff members in mind to help those employees who cannot afford Affordable Care Act (ACA) compliant plan premiums or the high deductibles associated with many ACA plans.  Even though traditional ACA compliant plans are classified as “affordable,” they are not an option that many long term care employees can afford.   
Employers decide the level of contribution for plan expenses for coverage for employees, their spouses, their children or family coverage.  Employers can pay all the costs, share the costs with employees, or have employees pay for coverage completely as a voluntary option.  Or LTC employers can increase their employer contribution over time based on an employee’s length of service.  Both plans are flexible. In addition, employers have options such as covering all the costs for employee coverage but having the employee pay the premiums for their spouse and/or children.  
While this new AHCA/NCAL Insurance Solutions plan satisfies all 71 benefits required under the Affordable Care Act, it is not a fully compliant ACA plan.  It is considered a minimum essential coverage (MEC) plan and should be offered alongside a traditional ACA compliant plan to avoid any ACA employer penalties.  
There is no additional underwriting for the Compass plan and no mandatory wait periods for new employees to join the Compass MEC plans.  Any wait periods are determined by the employer.  There is a minimum of five employees that must be enrolled to offer the plan to employees. 
The ability to offer a health insurance plan at little to no cost to employees allows AHCA/NCAL members to market their facilities as superior employers in comparison to competing employers.   This plan is much less expensive to an employer compared to a traditional employee health benefit plan and costs far less than the expense of an employee who turns over.
Read this Q&A document for more information about Compass plans for AHCA/NCAL members. Versions of the Compass Plan are available in all 50 states. Changes to the Hospital Indemnity benefit vary based on state approvals. To see what's available in your state, please

contact Nick Cianci at 202-898-2841 or Dave Kyllo at 202-898-6312 or email ahcainsurancesolutions@ahca.org.

Tuesday, August 7, 2018

Quality Award Criteria Video Series Now Available!

Now that the 2019 National Quality Award Applications have been released, be sure to watch the Criteria series for each award level—Bronze, Silver and Gold—available on ahcancalED!

As a reminder, these series are updated to reflect changes in the Criteria each year, so even if you have viewed the series previously, you will want to view it again this year.

The Bronze Series
  • The Bronze Series is a sequential set of videos that was developed to help applicants understand and meet the demands of each question of the Bronze criteria. Each video is less than 10 minutes! 
The Silver Series
  • The Silver Series is a 5-part video series that covers the Criteria questions asked in the Silver Award application; the Organizational Profile, the basic and select overall item requirements within the seven Baldrige categories. 
The Gold Series
  • The Gold Series is a 5-part video series covering the Criteria questions asked in the Gold Award. The Criteria for this Award comes directly from the 2017-2018 Baldrige Excellence Framework in its entirety. You should purchase a copy of the Framework here before beginning the series.
Tips and Tricks:
  • All three Criteria series can serve as a team building experience for your staff. We suggest that you form an application team that views the videos together and then complete the responses to the Criteria as a team effort. This will result in a better application, a greater understanding of the foundational elements of quality in your center, and enhanced excitement as your center engages in the program.
  • The Criteria questions are interdependent, and responses often build on what has previously been written in other responses.

Want to learn more about the Criteria?
  • State Affiliates often offer classroom-style Criteria workshops for the Bronze and Silver level. Consider reaching out to your state affiliate for more information.
  • Attend this year’s Convention and participate in the Quality Award Sessions and Criteria Intensives offered throughout the event. 
If you have questions on how to sign into ahcancalEd, please reach out to educate@ahca.org for your credentials. If you have questions regarding the Quality Awards, please reach out to qualityaward@ahca.org

Thursday, August 2, 2018

2019 Quality Award Applications Available NOW! Get Started Today!

The National Quality Award Program is pleased to announce that the 2019 application packets are now available online. In addition, the 2019 program calendar and submission checklist have been posted to each award level page. 
This is an opportunity to show residents, family members and the community-at-large your organization's commitment to continuous quality improvement, and to establish recognition on a national level. Get ready to begin your journey today!
Please visit the Bronze, Silver or Gold application pages to download application materials specific to your respective award level to learn how your center should begin preparing. New for 2019, is our Gold criteria series , which is already available on ahcancalED. The Bronze and Silver criteria series will be available next week on ahcancalED
The Quality Award Program is also proud to introduce the Quality Award Portal, a new online application and payment portal. You may visit this portal starting now to get an early start on your application and submit your Intent-to-Apply. 
As a reminder, all applicants should read the application packet in full before submitting an intent-to-apply payment. 
**Important Dates to Remember**
November 8, 2018 - Intent to Apply Deadline
January 31, 2019 - Application Deadline
All deadlines are at 8 pm EST

If you have any questions, please email qualityaward@ahca.org. We look forward to seeing your application in 2019!

Quality Award Team Staff

P.S. If you are interested in serving as a Quality Award Examiner, the application is also available! Visit our Examiner webpage to learn more and apply today. 

Wednesday, August 1, 2018

JFNA Webinar: Trauma, Hoarding, and Home Safety: Person-Centered, Trauma-Informed Interventions for Older Adults

Thursday, August 9, 2018, 1:00 PM - 2:15 PM EDT

Webinar attendees will learn about the relationship between trauma and hoarding, as well as the unique issues that older adults who have experienced trauma face in terms of home safety and hoarding. It will address how to determine the difference between a cluttered home and a hoarding situation, and what case managers should do when they encounter an older adult living in unsafe condition. The webinar will address ways to ensure that the homes of older adults who have experienced trauma are safe in a person-centered, trauma-informed way. It will highlight inexpensive changes that can be made in terms of products available and teachable techniques. Finally, it will cover what to tell occupational therapists, contractors, and mental health service providers who specialize in hoarding about older adults who have experienced trauma, so they are prepared to work with your clients.

Registration is required by August 7 to attend this event. All registrants will receive the webinar information via email on August 8.


Leah Bergen is the Project Manager at The Jewish Federations of North America’s Center for Advancing Holocaust Survivor Care.
With a thesis focused on Post Traumatic Stress Disorder and a doctoral degree in Psychology from University College London, Dr. Chia-Ying Chou has worked with over 100 individuals with Hoarding Disorder. She is currently developing a Compassion Focused Therapy treatment protocol, tailored for individuals suffering from Hoarding Disorder. Dr. Chou's clinical and research interests fall in the intersection between trauma and hoarding.
Amy Neuman is Program Manager of Holocaust Survivor Services in Aviv Older Adult Services at JF&CS Atlanta.
Andrew Sever, MS, OTR/L, ECHM, CAPS, CEAC is a licensed occupational therapist who has specialized in healthcare for seniors.

Learn more about the Center for Advancing Holocaust Survivor Care