Tuesday, January 14, 2020

New Medicare Outpatient Observation Notice (MOON)

Dana Ritchie 

Hospitals and critical access hospitals (CAHs) are required to provide a MOON to Medicare beneficiaries (including Medicare Advantage health plan enrollees) informing them that they are outpatients receiving observation services and are not inpatients of a hospital or CAH.  According to a January 7, 2020, update from the Centers for Medicare & Medicaid Services (CMS), the Office of Management and Budget (OMB) has renewed the MOON (CMS-10611).  The MOON is unchanged from its current version and only the expiration date is different on this renewed notice.  Hospitals are required to use the new MOON beginning April 1, 2020.  Both the previous and new versions of the notice are acceptable for use through March 31, 2020.  The notice, including Spanish versions, are accessible via the following link: https://www.cms.gov/Medicare/Medicare-General-Information/BNI/Downloads/CMS-10611-MOON-Form-English-and-Spanish-Incl-Large-Print.zip.  More information on the MOON can be found on the CMS website. 

2020 Brings You An Unforgettable Independent Owner (IO) Leadership Conference


March 11-13
Grapevine, TX

Register today.

The IO Leadership Conference will dive into hot topics such as:

  • PDPM
  • Workforce Challenges
  • Business Growth
  • Value-based Care
  • Innovation in Building Design
  • Current Food and Senior Dining Trends

You'll walk away with new strategies, new connections, and a new sense of purpose.

Join other owners, operators, or administrators of roughly 10 or fewer facilities at the beautiful Gaylord Texan Resort & Convention Center. You’ll have numerous formal and informal networking opportunities in a beautiful and unique setting. Enjoy lively discussions, get updates on what is happening in Washington, and learn from each other.

Earn up to 13.75 CEs.

Review the agenda and get more details at IO.ahcancal.org.

Register and make your hotel reservations early. Hotel reservations must be made by Friday, February 7, 2020 in order to take advantage of the special AHCA/NCAL group rates.

Sponsors:
Evans Senior Investments, Grace Financial Services, Guardian Pharmacy Services, MatrixCare by ResMed, Reliatn Rehabilitation, srx

Innovative Workforce Strategies Featured in 45-Minute Webinar

Dave Kyllo

AHCA/NCAL offers an instructional webinar titled “Pioneering Solutions to the Workforce Crisis.”  This 45-minute webinar developed in collaboration with PHI delivers practical action steps and strategies assisted living and nursing facilities of all shapes and sizes can take to improve their employee and retention efforts. The webinar also covers ways to improve the hiring process and explains supportive supervision and coaching methods that positively impact employee retention. 

The webinar’s learning objectives include:

  1. Explain the key factors contributing to the workforce shortage
  2. Identify at least 3 strategies to improve employee recruitment
  3. Identify at least 3 strategies to improve employee retention
  4. Explain the impact of supportive supervision on retention

This webinar is part one to a more extensive on-line training for middle managers that will be released in the coming months.  While no CEUs are offered for this webinar, participants can receive a certificate of completion.  The cost of the course is $25 for AHCA/NCAL members and $60 for non-members.

The instructor is Sue Misiorski who served as Vice President of Workforce Innovations for PHI and currently serves as the New England Regional Director of Operations for SageLife.  Starting as a CNA, she later held positions as a DON and VP of Nursing in multi-site skilled nursing homes in New England and has supported the construction of several assisted living and nursing facilities. 

Follow this link to read more about this educational webinar and to register for the course:  https://educate.ahcancal.org/products/pioneering-solutions-to-the-workforce-crisis#tab-product_tab_overview.

To access ahcancalED and the Pioneering Solutions webinar, members will need to login with their AHCA/NCAL usernames and passwords.  For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail update@ahca.org with your name and facility contact information. 

Take a No-Risk Opportunity to Lower Your 2020 Utility Bills with Cleary Energy

Dave Kyllo

Three out of four long term care facilities are being overcharged for one or more of their utilities. Providers don’t receive better service or any other benefit for over paying utility companies. The good news is that putting an end to the overpayments is easy.

Cleary Energy is a AHCA/NCAL preferred provider and has recouped on average 4% to 8% savings on utilities for long term care facility customers. Here are some real life examples of how long term care providers saved:

  • A nursing facility recovered $25,000 in retroactive charges from an electric and gas utility account and the facility will save an additional $7,500 per year going forward.     
  • A nursing facility was overpaying the tariff on their gas account and is now saving $10,000 annually going forward.
  • A Midwest assisted living facility received $5,800 from utility overpayments that Cleary Energy recently found.      

Cleary Energy performs utility bill audits by examining utility, supplier and government charges on utility bills to obtain refunds and/or credits and rate reductions.  Specifically, Cleary Energy audits a facility’s electric, natural gas, propane, heating oil, diesel fuel, water, sewer and telecommunications bills. 

The program is designed to save AHCA/NCAL members significant money on their utility bills without adding new expenses to their budgets.  Cleary Energy guarantees savings or its auditing services are free.  Cleary Energy’s fees are based on facility savings on their utility bills. 

AHCA/NCAL member facilities enter into an audit agreement with Cleary Energy, which is a shared savings agreement that lasts for a period of three years.  If no refund, savings or credits are received, the AHCA/NCAL member facility owes nothing to Cleary Energy for conducting the audit and AHCA/NCAL members will have the peace of mind of knowing that their facilities are not being overcharged for their utilities.   

The process for engaging Cleary Energy to conduct a utility audit is easy.  Most of the information Cleary Energy needs for an audit comes directly from the utilities or suppliers. 

Cleary Energy’s long term care experience sets the company apart with over 40 years of long term care operational experience.  That in-depth knowledge enables Cleary Energy to find the greatest costs savings on utility expenses for AHCA/NCAL members because Cleary Energy knows where to look for savings. 

Take advantage of this unique no-risk opportunity to save on utility costs.  Contact Cleary Energy today in one of the three ways listed below. 

Tuesday, January 7, 2020

AHCA/NCAL Quality Summit Helps You Excel in 2020

Jon-Patrick Ewing

No matter what your focus or interest, we’ve got you covered! Join AHCA/NCAL for the 2020 Quality Summit, March 9-11 at the Gaylord Texan Resort & Convention Center in Grapevine, Texas (centrally located near Dallas/Ft. Worth).

With a program inspired by AHCA/NCAL’s Quality Cabinet and members, the 2020 Quality Summit has a sharper focus on key issues facing long term care, including a full track of education sessions on the Patient Driven Payment Model (PDPM). Come network with your colleagues and receive valuable education while you earn up to 11.5 CEs. At this year’s Summit, national subject matter experts will lead sessions on person-centered care, emergency preparedness, leadership, infection prevention, and more. Attendees will take away strategies to improve clinical, quality, regulatory, and workforce outcomes.

The Summit provides programming for all levels of staff in long term and post-acute care: administrators, DONs/clinical staff, quality managers and directors, assisted living providers and independent owners.

Registration Deadline: February 24, 2020

For registration information and to see our event sponsors, visit: QS.AHCANCAL.ORG

Celebrate the Year of the Nurse by Offering ANCC Board Certification to Your RNs

Dave Kyllo

2020 marks the 200th anniversary of the birth of Florence Nightingale. The World Health Assembly (the governing body of the World Health Organization) declared 2020 the Year of the Nurse and Midwife to recognize the milestone. Organizations around the world are using the occasion to put the spotlight on nurses and the nursing profession.
 
AHCA/NCAL members can put the spotlight on their RNs and improve facility performance by continuing their RNs’ advancement through American Nurses Credentialing Center (ANCC) Board certification in gerontological nursing.   Research conducted by AHCA/NCAL in 2019 found that SNFs with at least one ANCC Board certified RN experienced:

  • Significantly higher SNF Value Based Purchasing scores
  • Fewer survey deficiencies
  • Fewer IJ citations
  • Lower rehospitalization rates
  • Lower rates of off-label use of antipsychotics
  • Higher CMS 5-Star ratings

AHCA/NCAL believes assisted living communities would also experience positive improvements based on the similarities in care offered by both long term care settings. 

The ANCC offers certification in gerontological nursing – the gold standard in demonstrating clinical excellence in geriatric patient care.  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 RNs prepare for the certification exam, AHCA/NCAL offers an online course called Gero Nurse Prep.  RNs who complete the course earn 30 nursing contact hours and experience a 96% pass rate on the ANCC certification exam on the first try.  Gero Nurse Prep students see a whopping 24 percent average increase between their pre- and post-test scores.

Gero Nurse Prep is flexible.  RNs study online at their own pace and have one year from the time they enroll to complete their Gero Nurse Prep coursework. 

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

To learn more about Gero Nurse Prep and ANCC Board certification, watch this video and check out AHCA/NCAL Gero Nurse Prep today.   

Three ACA Taxes Repealed

Special Submission by Nick Cianci

$1.4 trillion in spending was approved in December to fund the government through the rest of the fiscal year and avoid a potential shutdown. The two agreements (H.R. 1158 and H.R. 1865) include nearly $50 billion in new spending. 

Of note to healthcare and parallel industries is H.R. 1865, the Further Consolidated Appropriations Act of 2020, and the full repeal of three taxes included in the Affordable Care Act (ACA). These include the Cadillac Tax, the Health Insurer Tax, and the Medical Device Tax, which were originally levied by Congress to help pay for the ACA.

Actuaries at the Centers for Medicare and Medicaid Services published a report which documented the trends of our nation’s healthcare-spending growth in 2018. The U.S. greatly surpasses most wealthy, comparable countries and continues to trend upward. National health-care spending rose 4.6% from 2017 to 2018 and accounted for 17.7% of last year’s economy.

According to the report, the ACA tax is accountable for most of this increase. The controversy lies in the competing efforts to fund the act and the ultimate effect of raising insurance premiums, hurting the consumer. The ACA taxes have been linked to a rise in the cost of private insurance, which grew 15.3% last year to $164 billion.

In response to these trends, the following three taxes were repealed from the Affordable Care Act.

The Cadillac Tax: The so-called Cadillac Tax was a 40% excise tax on high-cost employer health insurance above certain thresholds. This tax has been permanently repealed, though it never actually took effect.

The Health Insurer Tax: The Health Insurer Tax was based on the insurer’s share of taxable health insurance premium base and is said to have had the most direct impact in spurring the growth of U.S. health-care spending. The fee was implemented in 2014 and had continued to increase annually. Though it was suspended in 2017 and 2019, due to the adverse impact on premiums, the fee will be effective in 2020 and repealed in 2021.

The Medical Device Tax: The Medical Device Tax was in effect between 2013-2015, suspended from 2016-2019, and scheduled to resume in January. This 2.3% excise tax on U.S. medical device revenues has been repealed effective December 31, 2019.

Missing from both spending agreements is any mention of protecting consumers from surprise, out-of-network medical bills after a lengthy congressional effort to create an effective, bipartisan proposal.  Read the final spending package here.

Nick Cianci is President of Compass Total Benefits Solutions and works directly with AHCA/NCAL Insurance Solutions to provide AHCA/NCAL members with employee health benefit options such as the Compass Minimum Essential Coverage plan.  

AHCA ID/DD Congressional Hill Fly-In Event

Dana Ritchie


AHCA’s Intellectual and Developmental Disabilities (ID/DD) Residential Services Providers annual Hill Fly-In event will occur on Wednesday, February 26, 2020, at the AHCA offices in DC. This important event is free to attend.  Breakfast will be provided to registrants. Congressional speakers are being invited, a legislative update will be provided, and Hill visits will follow in the afternoon.  AHCA will provide one-pagers and talking points for registrants to take to the Hill.  If you would like to attend, please contact AHCA’s Senior Director of Not for Profit & Constituent Services, Dana Ritchie, at dritchie@ahca.org. If you have any questions whatsoever, please don’t hesitate to let Dana know.  AHCA hopes to see you at this important event!

Friday, December 20, 2019

Save the Date for Careers in Aging Week

Careers in Aging Week (CIAW) is a national, annual observance created by the Gerontological Society of America (GSA) to raise awareness about the diverse careers available in the field of aging. CIAW will take place on April 19-25, 2020.

CIAW is observed annually by businesses, clinics, coalitions, organizations, universities, colleges, and other parties across the nation. Check out our efforts from last year’s CIAW that include webinars, workforce interviews, and more at www.careersinaging.com. Visit AHCA/NCAL’s Workforce Resource Center for more information on our workforce efforts, and stay tuned for more information on CIAW 2020 coming soon!

Achievers of 2020 AHCA/NCAL Quality Initiative Recognition Program Announced

Kiran Sreenivas

At AHCA/NCAL’s Quality Summit in Grapevine, Texas on March 10, 2020, 9,898 skilled nursing and assisted living member facilities will be recognized for their quality performance over the past two years.

The 2018-2021 AHCA/NCAL Quality Initiative set goals in four key performance areas. Those areas for skilled nursing are hospitalizations, off-label use of antipsychotics, customer satisfaction, and functional outcomes. For assisted living, the areas are hospitalizations, off-label use of antipsychotics, customer satisfaction, and staff stability.


Thirty-nine percent of skilled nursing members achieved 3 or 4 national quality goals. Recognition is tiered from 1 to 4 based on the number of goals achieved. 

You can find your local achievers on the Recognition Program’s webpage.

Highest Performance on Improved Functional Outcomes and Reduced Antipsychotics 

In order to measure improvement, the Initiative uses publicly reported data, such as those found on Nursing Home Compare. All assisted living and all customer satisfaction data is dependent on facilities uploading their metrics to LTC Trend Tracker, AHCA/NCAL’s online data tracking tool, which largely explains the lower achievement percentages on those measures. 

The two skilled nursing focus areas with the most achievers were functional outcomes at 66 percent and antipsychotics at 79 percent. These achievements are possible through hard work, creativity, and strategic operations, such as PruittHealth’s use of consultant pharmacists to lower antipsychotic rates and rewarding high performing nurse aides with a trip to Disney to learn additional skills.  

AHCA/NCAL created the Quality Initiative Recognition Program to honor member facilities for their individual work in achieving national quality goals. The Initiative continues to challenge member providers to meet these measurable targets by March 2021.