Wednesday, March 22, 2017

Webinar: New Online Blended Nurse Assistant Training Program

Jon- Patrick Ewing

FREE Webinar! Learn About AHCA’s New Online Blended Nurse Assistant Training Program.

AHCA has just launched a new blended program for training and certifying highly qualified nurse assistants. Using the acclaimed How To Be a Nurse Assistant curriculum, you can now train CNAs with a combination of online study and in-person clinicals without compromising any of the quality you have come to expect from AHCA.

Join us for this free webinar to learn more about the fantastic benefits and cost savings of this program.

 AHCA's New Online Blended Nurse Assistant Training Program
Thursday, April 6, 2017
2:00 PM Eastern Time
You will have the opportunity to ask questions and learn how you can take advantage of this new opportunity.

The webinar will:

· Show you how you can use the blended learning approach to train your staff

· Give a demonstration of the course

· Explain its customizable features as well as the state specific components

Learn how you can utilize and benefit from this latest advancement in nurse assistant education. Sign up for the webinar today. Visit for more information about the online program.

CMS Reminds SNFs How to Prevent Physician Certification Denials

Dan Ciolek

A Centers for Medicare and Medicaid Services (CMS) MLN Connects March 16, 2017 e-newsletter provided the following reminders and educational resources to help SNF providers avoid SNF PPS denials due insufficient physician certification documentation. SNF billing and compliance personnel are encouraged to review the following information.  

“According to the 2015 Comprehensive Error Rate Testing (CERT) Report, the denial rate for Skilled Nursing Facilities (SNFs) increased from 6.9% in 2014 to 11% in 2015 due to missing or incomplete certification/recertification:

· Statement must contain need for skilled services that can only be provided in SNF/swing-bed on a daily basis for a condition patient was treated for in prior hospital stay

· Must include physician’s dated signature (printed name if signature is illegible)

In addition, recertifications should include:

· Expected length of stay

· Explanation if continued need for services is for a condition that arose after SNF admission

· Any plans for home care


· CERT: SNF Certifications and Recertifications MLN Matters® Special Edition Article

· SNF Billing Reference Fact Sheet

· Medicare Fee-For-Service 2014 Improper Payments Report, page 19

· Medicare Fee-For-Service 2015 Improper Payments Report, page 18”

CMS Open Door Forum

Dan Ciolek
 The next Center for Medicare & Medicaid Services (CMS) Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum is scheduled for tomorrow, March 23, 2017 at 2 PM Eastern Time. The conference leaders will be Todd Smith and Jill Darling. 
CMS Open Door Forum
Thursday, March 23, 2017
2:00 PM – 3:00 PM Eastern Time Eastern Time
**This Agenda is Subject to Change**
I. Opening Remarks
Chair – Todd Smith (Center for Medicare)
Moderator – Jill Darling (Office of Communications)
II. Announcements & Updates
III. Open Q&A
The next Open Door Forum is scheduled for Thursday, May 4, 2017.
This Open Door Forum is not intended for the press, and the remarks are not considered on the record. If you are a member of the Press, you may listen in but please refrain from asking questions during the Q & A portion of the call. If you have inquiries, please contact CMS at
If you are unable to join the call tomorrow, CMS Open Door Forums will now be available through Podcasts. Please visit: Please allow a week or so to get it posted.

Open Door Participation Instructions:
This call will be Conference Call Only.

Dial: 1-800-837-1935 & Reference Conference ID: 57682259

If you have any questions please contact CMS directly at:

More Than 20,000 Open Positions Posted in LTC Sector in March

Dave Kyllo

There are 20,588 open jobs this month in the nursing care facility (including SNFs), assisted living, and continuing care retirement community (CCRC) sectors this month according to the latest CEB TalentNeuron statistics. 

The number of open jobs has decreased by 1,300 since January. Correlating to this decrease is a small decline in the number of employers currently competing to fill positions. Slightly more than 2,000 direct employers are competing for candidates in March with the average position being posted for 50 days nationwide. 

Finding qualified employees is one of the greatest challenges facing long term care providers. The AHCA/NCAL Long Term Care Career Center, is designed to help members be competitive in attracting qualified candidates to fill their health care job vacancies. 

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. Job postings on the AHCA/NCAL Long Term Care Career Center network are averaging nearly 1,800 views in March. 

This 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.

Of course, the LTC Career Center is always free for job seekers.  And, job seekers are using the site with more than 84,000 searchable resumes on the National Healthcare Career Network this month.  

Employers who utilize the site also receive outstanding 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 smart and targeted in your search for qualified and talented health care professionals.  Check out the LTC Career Center today and remember to enter promo code New25off to save 25% on your first job posting.   

Interactive Map Matches State Dementia Training Mandates with CARES® Courses

 Dave Kyllo
Health Care Interactive has an interactive U.S. map that shows which CARES dementia training courses fulfill existing state dementia training requirements for various care settings. In states without specific training requirements for certain settings, HCI make recommendations on which training modules would be helpful for staff.

CARES contains six training courses that can be ordered individually or as a group. Bulk on-site licenses are also available. In addition, up to five essentiALZ® certifications from the Alzheimer’s Association can be earned by completing the training modules.

AHCA/NCAL recommends the CARES training program to help safely reduce the off-label use of antipsychotics and the CARES program is also supported by CMS. All AHCA/NCAL members receive a 10% discount on the CARES programs by using the code AHCA10 when ordering. For more information, watch this new short video or go to



ANCC Board Certified Nurses Make a Difference in Reducing Use of Off-Label Antipsychotics

Dave Kyllo

Research conducted by AHCA/NCAL last summer found that the off-label antipsychotic use in skilled nursing centers with at least one RN certified in gerontological nursing by the American Nurses Credentialing Center (ANCC) were an average three to four percent lower than the national average in each quarter calendar years 2012 through 2015. Given the similarities between skilled nursing centers and assisted living communities, it is possible that similar correlations could hold true for assisted settings.

Reducing off-label antipsychotic use is one of the goals in the AHCA/NCAL Quality Initiative. Having RNs who are knowledgeable in gerontological nursing can be a key factor in driving non-pharmacological alternatives in providing quality dementia 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 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 through April 30 and each RN registrant can save $100 off his/her Gero Nurse Prep by entering promo code QUALITY17 (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). 

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. 

AHCA/NCAL Advocates Take the Hill for Medicaid, Survey Issues

 Drew Thies

Over 100 AHCA/NCAL Members are in Washington, D.C. today to advocate for preservation of Medicaid funds and survey reform. As Congress moves forward on health care reform efforts, the fly-in comes at a critical time.

Advocates will focus on opposing efforts to cut Medicaid funding for older adults, individuals with disabilities, and their services. Medicaid already underfunds care in some settings, and superficially only pays 89 cents for every dollar of care delivered in a nursing home. AHCA/NCAL members will urge lawmakers to oppose efforts that reduce funding even further.

Members will also be educating Members of Congress on recent changes at the Centers for Medicare and Medicaid Services (CMS) that have led to a dramatic rise in the issuance of Civil Monetary Penalties (CMPs). Sub-regulatory guidance from CMS has caused skilled nursing facilities (SNFs) to endure financial hardship because of the increasing volume and dollar amount of these CMPs.

Advocates will ask Congress to urge CMS to come up with reasonable solutions that ensure continued quality of care but do not unduly punish SNFs. This surge of CMPs takes place at a time where SNF quality is improving, and even the highest-quality providers are being burdened by these penalties.

Tuesday, March 21, 2017

AHRQ Toolkit Designed to Reduce Urinary Tract Infections in Long-Term Care

AHRQ Online

A new evidence-based toolkit from the Agency for Healthcare Research and Quality (AHRQ) can help long-term care facilities reduce catheter-associated urinary tract infections (CAUTIs). The toolkit is based on the experiences of more than 450 long-term care facilities across the country that participated in an AHRQ-funded project and successfully reduced CAUTI. The new toolkit uses strategies from AHRQ's Comprehensive Unit-based Safety Program (CUSP), which has reduced CAUTI as well as central line-associated bloodstream infections in hospitals.

The toolkit combines clinical interventions and best practices for infection prevention with behavior change elements that promote leadership involvement, improvement in safety culture, teamwork, and communication, and sustainability. Its user-friendly educational modules, guides, and tools can help your facility advance from the "what to do" to the "how to do it.” The modules are customizable to local needs. They include: Using the Comprehensive Long-Term Care Safety Toolkit; Senior Leader Engagement; Staff Empowerment; Teamwork and Communication; Resident and Family Engagement; Sustainability; Indwelling Urinary Catheter Use and Care; and Urine Culturing and Antibiotic Stewardship.

Access the toolkit:

HHS Delays New Mandatory Bundles

James Michel

The Department of Health and Human Services (HHS) this morning issued an interim final rule delaying the effective date of the final rule, "Advancing Care Coordination through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model."

The initial final rule, published on January 3, 2017, implements three new mandatory bundled payment models - coronary artery bypass graft (CABG); acute myocardial infarction (AMI); and surgical hip and femur fracture treatment (SHFFT) - in a variety of healthcare markets across the country. The effective date of the new mandatory EPMs originally was July 1, 2017. The interim final rule issued today delays the effective start-date of the three new EPMs for three months, to October 1, 2017. HHS is seeking comment on the appropriateness of the delay and is specifically requesting feedback on delaying the start-date even further to January 1, 2018. Other components of the original final rule are also delayed to October 1, including the cardiac rehabilitation incentive payment program and modifications to the Comprehensive Care for Joint Replacement (CJR) demonstration.

According to the rule, HHS is delaying the rule "to allow time for additional review, to ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted, and to ensure that in such a case participants have a clear understanding of the governing rules and are not required to take needless compliance steps due to the rule taking effect for a short duration before any potential modifications are effectuated." The rule specifically references the "Regulatory Freeze Pending Review" executive memorandum signed by President Trump on January 20, 2017.

HHS Secretary Tom Price has previously stated his preference for delivery system and payment reform demonstrations that are voluntary as opposed to mandatory. This interim final rule signals that the agency is willing to reconsider its approach to broad, mandatory payment demonstrations.

Comments on the interim final rule will be due April 19th.  AHCA plans to submit comments. Please contact James Michel with any questions or comments on this rule or AHCA's response.

Monday, March 20, 2017

CMS Call on IMPACT Act Implementation - Register Now!

On Wednesday, March 29 from 1:30 - 3 pm Eastern Time, CMS will host a webinar to review its efforts to develop, implement, and maintain standardized Post-Acute Care (PAC) patient assessment data and pilot testing results. As CMS works toward implementing the Improving Medicare Post-Acute Care Transformation (IMPACT) Act that requires changes to the MDS, the RAND Corporation, under contract to CMS, will be working with skilled nursing centers in 14 metropolitan areas this fall to test NEW sections for the MDS.  Representatives on the call will also discuss plans for the upcoming field test.

Be sure to register and join the call if you are in any of the markets below.

The 14 broadly-defined markets include a wide radius around:

  • Boston, MA 
  • Chicago, IL
  • Dallas, TX
  • Durham, NC 
  • Ft. Lauderdale, FL
  • Harrisburg, VA
  • Houston, TX
  • Kansas City, MO
  • Los Angeles, CA
  • Nashville, TN
  • Philadelphia, PA
  • Phoenix, AZ
  • St. Louis, MO
  • San Diego, CA 

To register, visit MLN Connects Event Registration.

For more information, email

NOTE: Registration will close at 12:00 PM Eastern Time on the day of the call or when available space has been filled.