Wednesday, September 28, 2016

Congress Nears Plan to Fund Government through the Election

Congressional leadership last night announced an agreement to fund the government through the November election. The plan goes with just days to spare as fiscal year deadline looms at the end of the month.

The tentative deal on a continuing resolution would fund the government until December 9, setting up this Congress to once again come to a spending agreement before a new Congress takes charge next year.

Negotiations between House Speaker Paul Ryan, Senate Majority Leader Mitch McConnell and House Minority Leader Nancy Pelosi led to an agreement to tack on an amendment to the Water Resources Development Act authorizing $170 million in aid for the Flint water crisis. Funding for the on-going water safety crisis in Michigan has been a top priority for Pelosi and Democrats, one which they said was a key component of any deal to fund the government. The House is expected to pass the water bill as soon as today.

Much remains in the air, including ultimate passage of the Flint funding as well as Democratic requests for more Zika funding and how spending is offset, though both sides maintain they are resolute in funding the government before the deadline. "We're not shutting the government down," Pelosi told reporters Tuesday afternoon.

An adjournment resolution in the amendment schedules Congress to leave a day earlier than the original calendar, finishing up the last legislative business on Thursday before returning to their districts until after the election. Congress will resume session on November 11, after the election has taken place but before new Members of Congress are sworn in, for a so-called “lame duck” session.

What do the Quality Award Survey Requirements Mean?

The 2017 Quality Award Intent to Apply process opened last week. While this is not mandatory, it has two important benefits for applicants:

1- The overall application fee is reduced; and

2- Applicants will receive regular emails from Quality Award staff with deadline reminders, tips on applying for the award, and links to exclusive educational webinars.

As potential applicants decide whether or not to submit an Intent to Apply by the November 17th deadline, one of the first questions they ask is whether they meet the Quality Award Survey requirements.

This year, there are a revised set of survey eligibility requirements at each application level that applicants will have to meet. Applicants are encouraged to review all the specific survey eligibility requirements in the respective application packets in detail. Below are some answers to the most common questions that we receive on the survey eligibility requirements.

1- Can I still apply if the center does not meet the survey eligibility requirements?
a. Yes, centers can apply and receive a feedback report even if they do not meet the survey eligibility requirement. They will simply be ineligible to receive the award.

2- Can the center recertify if it does not meet the survey eligibility requirements?
a. If a center submits an application meeting the minimum requirements and fails survey eligibility they will still be able to recertify.

3- How do I calculate the cycle 1 and 2 weighted survey score for the Silver Quality Award and the 3 cycle weighted score for the Gold Quality Award?
a. Review the Guide to Calculate Silver and Gold Weighted Survey Scores

Quality Award staff has developed a resource for applicants to view their current survey eligibility based on the August 24, 2016 Nursing Home Compare release. This can be utilized by applicants to review their current survey eligibility; however, applicants are cautioned as this is preliminary and their survey eligibility will change based on what is available as of the application deadline (January 26, 2017) and award notification.

As always, if you have any questions Quality Award staff can be reached at

Update Your Professional Headshot in Nashville!

The AHCA/NCAL 67th Annual Convention and Expo in Nashville is just around the corner and this year’s convention features a new activity for AHCA/NCAL members. Thanks to the generous support of PointClickCare®, the AHCA/NCAL Long Term Care Career Center, is hosting a Headshot Lounge for AHCA/NCAL member attendees.  

The Headshot Lounge will be open on Monday and Tuesday from 8 a.m. to 4 p.m. in room Jackson F. AHCA/NCAL members are encouraged to drop by the Headshot Lounge to get a free professional headshot. The Long Term Care Career Center’s Headshot Lounge will be a great opportunity to network and get a new personal photo emailed to you to use for your professional needs. 

The Long Term Care Career Center is AHCA/NCAL’s electronic job board dedicated to helping Members find and recruit top LTC professionals. Rates for posting job vacancies are affordable and give prospective employers far greater exposure than local ads and job boards by connecting to a network of more than 330 health care organizations and societies. Employers are also able to post vacancies as they occur and search resumes on the network. 

Of course, the LTC Career Center is always free for job seekers. And, job seekers are using the site! Job postings on the AHCA/NCAL Long Term Care Career Center, average more than 1,600 views a month. 

Now is the perfect time to give the Long Term Care Career Center a try because new users receive 25% off their first posting. Simply enter promo code New25off to receive this special discounted price. 

Employers who utilize the site also receive superior exposure through rotating job listings on AHCA’s home page – the web site where long term care professionals go for news and information. In addition, employers who post vacancies through the center receive bonus rotating listings on the Long Term Care Career Center home page. 

Be sure to stop by the Headshot Lounge in Nashville. We look forward to seeing you there. 

Pat Giorgio Named Recipient of Jan Thayer Pioneer Award

The National Center for Assisted Living (NCAL) has named Patricia (Pat) Giorgio, the president of Evergreen Estates, the 2016 recipient of the Jan Thayer Pioneer Award. With nearly 25 years of experience owning and operating assisted living communities, Giorgio has served in many leadership positions and championed quality improvement through myriad projects and efforts.

NCAL created the Jan Thayer Pioneer Award in 2015 to recognize individuals who have moved the senior care profession forward, positively affecting the lives of those served and those who serve. Recipients must demonstrate dedication, leadership, and considerable contributions to the senior care profession. The award is posthumously named after the first Board Chair of NCAL and assisted living owner and operator Jan Thayer.

“She is one of the rare professionals able to balance the business and human side of this profession with compassion and grace,” wrote nominator Cindy Baddeloo, chief operating officer for the Iowa Health Care Association. “Her efforts to educate, inform, promote quality care, and professional growth have made—and continue to make—an immeasurable difference.”

Additionally, her expertise on assisted living trends, performance measures, bereavement, hospice and LGBT issues has made her a sought after speaker across the country. Giorgio also collaborated with the University of North Carolina and the Center for Excellence in Assisted Living on two community-based participatory research projects. The first was measuring medication errors in assisted living, and the second was developing a toolkit for person-centeredness in assisted living.

Ms. Giorgio will be presented the Pioneer Award during a formal ceremony at the 67th Annual AHCA/NCAL Convention & Expo in Nashville, Tenn. this October.

Twenty-one States File a Legal Challenge Against the Federal Overtime Rule

Sara Rudow

Twenty-one states' attorneys general, the U.S. Chamber of Commerce, and more than 50 other national and Texas business groups filed a legal challenge on Tuesday, September 20th to the federal overtime rule set to take effect on December 1st. The new regulations revise the overtime exemptions for executive, administrative, and professional employees, commonly known as the “white collar” exemptions.

The group is arguing that the Department of Labor (DOL) exceeded its statutory authority in issuing the regulation and violated the Administrative Procedure Act, and holds that the rule will result in increased employment costs that could further impact services and workplace flexibility. The Chamber lawsuit also states that the rule departs from the intent of the Fair Labor Standards Act, that the salary threshold set by the rule is “excessively high,” and that it ignores regional and industry differences. The complaint argues that the salary threshold cannot be updated without a rulemaking process or further input from affected parties. The lawsuit was filed in the U.S. District Court for the Eastern District of Texas.

The full text of the final rule can be found here. For more information, including a memo from ACHA/NCAL’s legal consultant Jackson Lewis and other Department of Labor resources, see the AHCA/NCAL website under Workforce. Members will need their login information to access the memo and other resources.

AHCA/NCAL Research Finds That Nursing Facilities with ANCC Board Certified Nurses Are More Likely to Receive Five Stars on the CMS Quality Rating

New research conducted by AHCA/NCAL found that nursing facilities with at least one RN certified in gerontological nursing by the American Nurses Credentialing Center (ANCC) are more likely to receive a higher star rating on the CMS Quality measure.  The research found that 45 percent of nursing facilities received a 5-Star quality rating as compared to 33 percent nationwide.   

In addition, AHCA/NCAL research found that nursing facilities with at least one ANCC board certified nurse were twice as likely to receive an overall 5-Star rating from CMS and far less likely to receive an overall 1-Star rating.    

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. 

To help increase the number of board certified RNs, AHCA/NCAL’s Gero Nurse Prep program is designed to help RNs prepare for and pass the ANCC gerontological certification exam.  RNs who complete the AHCA/NCAL Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam and receive 30 CEUs.

AHCA/NCAL Gero Nurse Prep is on sale now and each RN registrant can save $100 off his/her Gero Nurse Prep by entering promo code STARS2016 (all caps) at checkout.  That means RNs who are interested can become board certified for less than $1,000 ($590 sale price for AHCA/NCAL Gero Nurse Prep and a separate $395 to take the ANCC exam). 

AHCA/NCAL members seeking to increase their star ratings from CMS are encouraged to examine ANCC certification for their RN leaders.  Watch this video to learn more about AHCA/NCAL Gero Nurse Prep or click on the course preview to get a quick view of this engaging on-line curriculum designed to help RNs pass the ANCC exam. 

Reach for the stars and check out AHCA/NCAL Gero Nurse Prep today.

Remember to enter promo code STARS2016 and save $100 off the registration fee.  The sale ends November 30. 

NCHS Releases New Reports from the 2014 National Study of Long-Term Care Providers

Lindsay B. Schwartz, Ph.D.

The Long-Term Care Statistics Branch at the National Center for Health Statistics (NCHS) released new products from the 2014 wave of the National Study of Long-Term Care Providers (NSLTCP). The new products include the Long-Term Care Providers and Services Users in the United States—State Estimates Supplement: National Study of Long-Term Care Providers, 2013–2014, which includes data on all five long term care sectors (residential care community which includes assisted living, nursing home, home health, adult day services center, and hospice). 

The report covers various characteristics including organization, staffing, services provided, practices such as screenings, and special care (e.g. dementia care). NCHS published information on the use of electronic health records and health information exchange among residential care communities and adult day services centers. Two new QuickStats were published using 2014 NSTLCP data, these new charts compare staffing hours across sectors and one comparing selected services provided across  residential care communities and adult day services centers.

LTC Trend Tracker Introduces New Publication for 2016

LTC Trend Tracker has a new publication that will be sent directly to your email inbox.  This quarterly report will highlight your facility’s progress on Five Star performance, the quality initiative, and help you understand your survey rating and score breakdown.
Check out the new user-friendly design and easy snapshot of data.  The figures and colorful graphics are designed to help improve patient care with tailored tools that will allow your organization to easily monitor hospital readmission rates, staffing, patient dosage, length of stay, spending, and more.  Also, check your competitive standing among other healthcare facilities with instant feedback on your organization’s performance compared to your area.

Join the webinar next Wednesday, October 5th at 2:00 PM Eastern Time to get a sneak preview on what Your Top Line will look like next month. Current, registered users of LTCTT will receive this quarterly report automatically.  You won’t even need to log in. It will be sent directly to the registered user’s inbox.

Are you registered for this web-based tool that is an exclusive benefit to AHCA/NCAL members?  Get your account setup now and you won’t miss out on these easy to view performance targets and results. Please email to get started today.

Tuesday, September 27, 2016

PBJ Requires Hours Worked and Paid!

The deadline for nursing centers to gather and submit Payroll-Based Journal (PBJ) data for the first mandatory quarter is November 14, 2016. As you get ready, it’s important to remember that the system requires the reporting of hours per day and per employee that are worked. It’s also important to keep in mind that the employee must be paid for all of the hours reported.

Here are a few other things to keep in mind: 

1) Are facilities required to report hours paid or hours worked?

  • Facilities (SNF/NF) will report hours paid for services performed onsite for the residents of the facility, with the exception of paid time off (e.g., vacation, sick leave, lunch, etc.). For example, if a salaried employee works 10 hours but is only paid for 8 hours, only 8 hours should be reported
2) I know that only the hours paid for a salaried employee shall be submitted. Can you clarify if I can submit the hours for an extra shift that my salaried employee works, if I pay them a bonus for these additional hours?
  • The hours may be reported under the following conditions: The payment must be directly correlated to the hours worked and must be distinguishable from other payments. (e.g., cannot be a performance-based or holiday bonus). Additionally, the bonus payment must be reasonable compensation for the services provided.
3) When considering reporting, realize that you can report fractions of time as follows.
  • Fractions of time should be reported under the following protocol that converts from minutes to tenths of an hour:
  • 1 to 6 Minutes = 0.1 
  • 7 to 12 Minutes = 0.2 
  • 13 to 18 Minutes = 0.3 
  • 19 to 24 Minutes = 0.4 
  • 25 to 30 Minutes = 0.5 
  • 31 to 36 Minutes = 0.6 
  • 37 to 42 Minutes = 0.7 
  • 43 to 48 Minutes = 0.8 
  • 49 to 54 Minutes = 0.9 
  • 55 to 60 Minutes = 1.0

As always, consult the PBJ Policy Manual, FAQs, etc., for more information. Questions can always be sent to

CMS Issues QAPI Brief: Focus on Adverse Events

Holly Harmon

The Centers for Medicare and Medicaid Services (CMS) has released a Volume 2 QAPI Brief which focuses on adverse events. It includes a list of potentially preventable adverse events and a medication related adverse events case study. 

The last Quality Assurance and Performance Improvement (QAPI) brief was issued in 2013. The next QAPI brief is expected to be on care and infection related adverse events. Reducing Unintended Health Care Outcomes is one of the goals of the AHCA Quality Initiative. Visit the AHCA Quality Initiative site to learn more and to review available resources.