Wednesday, October 17, 2018

Perception vs. Reality: The Quality Award Program for Assisted Living Providers

Date and Time: 10/19 at 2pm ET 

In a competitive and ever-changing market, assisted living providers must identify ways to stay a step ahead and stand out to potential customers and referral sources. The AHCA/NCAL National Quality Award Program provides the external validation necessary to set yourself apart from the competition. Historically, the Quality Award Program has been perceived as being only for skilled nursing centers. However, more assisted living communities than ever before are applying for and receiving the National Quality Award. In 2018, 114 assisted living centers received the Bronze award, 47 centers received the Silver award and two (the first AL communities) received the Gold award. On this webinar, we will break down the commonly cited barriers preventing assisted living communities from participating in the program and talk about the many free resources available to help assisted living providers succeed. We will also hear from the two 2018 Gold recipient assisted living organizations about their journey, including how they did it and how it benefited their organization. Join us to learn how the Quality Award program can help you succeed!

Learning Objectives:

1. Participants will be able to describe the perceived barriers for assisted living participation in the program and how to overcome them.

2. Participants will be able to summarize the free resources available to help assisted living providers succeed in the program.

3. Participants will discover how participation in the program would benefit their organization.


· Alana Wolfe, National Director of Performance Excellence, Sunrise Senior Living

· Nicolette Merino, Avamere Health Services

· Kimberly Dilg, Executive Director, Sunrise of Gurnee

· Marcia Jackson, RN Administrator, Maine Veterans Home – Machias

Who Should View This Event:

Leadership (i.e. administrator, DON, etc.) at assisted living communities that are members of AHCA/NCAL.

Legislation Introduced to Address CNA Training Program Lock-Outs

Drew Thies

A new bill introduced in the House of Representatives seeks to alleviate the shortage of health care workers by allowing more skilled nursing facilities (SNFs) to train certified nursing assistants (CNAs). The legislation, introduced by Rep. Sean Duffy (R.-Wis.), amends rigid requirements that force SNFs to shut down their CNA training programs for infractions unrelated to care delivery.

The “Nursing Home Workforce Quality Act” modifies the Omnibus Budget Reconciliation Act of 1987 (OBRA) to give CMS greater flexibility in reinstating providers’ training programs. Currently, any infraction that results in a fine of more than $10,000 results in an automatic, two-year suspension of CNA training programs.

The legislation also states that once a deficiency has been remedied, training programs can resume.

SNFs provide CNA training programs for free to combat health care workforce shortages. These are often the only free services of this nature.

CNAs provide for the daily care needs of the 1.3 million frail and elderly Americans receiving SNF care on any given day. Nearly 20% of SNFs nationwide have developed a nurse aide training program.

Take the Online AHCA/NCAL Course Designed to Help You Avoid the Payment Penalties under the CMS Value Based Purchasing Program for SNF Medicare Part A Payments

Dave Kyllo

AHCA/NCAL has launched a new education program designed to help skilled nursing facilities succeed under the new CMS value based purchasing payment program (SNF VBP) that took effect on Monday, October 1, 2018.  The course (Understanding SNF VBP in Detail) contains six modules that provide an in-depth description of each feature of the CMS SNF VBP program along with helpful tools, documents, and primary source references to the program. 

This new training program is intended for nursing home administrators, directors of nursing and any other staff including corporate staff who are responsible for payment models and rehospitalization reduction efforts.   No specific license is required take the course and no contact hours or CEUs are awarded for completing the curriculum.
The training program is specifically designed to help long term care professionals:
  • Understand how CMS calculates the measures, risk adjustment, the facility score and payment adjustment.
  • Use and access the CMS SNF VBP feedback reports and the SNF Performance Score Report.
  • Apply the incentive payment multiplier.
  • Use the SNF VBP prediction calculator to estimate the financial impact different SNFRM rates have on your Part A revenue.
  • Adopt best practices to help either avoid a payment penalty or receive an increase in your Medicare Part A payments.
Possessing a detailed understanding of SNF VBP is critical to operational success.  Starting October 1, 2018, all SNFs will receive a payment adjustment to their SNF Medicare Part A claims ranging from a 2 percent cut to potentially a 1.5 percent increase based on rehospitalization rates in prior years. CMS will recalculate the payment adjustment annually every fiscal year (FY) thereafter for the next ten years.
The registration fee for AHCA’s SNF VBP online course is $25 for AHCA/NCAL members and $65 for nonmembers.

The individual who wants to take the SNF VBP course must login to ahcancalED and register for the course under their individual login.  To access ahcancalED, members will need to login with their AHCA/NCAL usernames and passwords.  For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail with your name and facility contact information. 

Payment is made in ahcancalED upon registration via credit card or check. If paying by check, an order is not complete until the check is received and approved by AHCA staff. You will not have access to the training until approval.  Registrations for SNF VBP cannot be done by another person or under another person’s ahcancalED login.

Know how to succeed under SNF VBP.  Follow this link to register today for Understanding SNF VBP in Detail or go to

$250 Gives Your Job Openings True National Exposure to Health Care Professionals Actively Looking for Their Next Career Moves

Dave Kyllo

Serious health care candidates look for jobs on the national job board network built for health care professionals.  Lead them to your job vacancy through the AHCA/NCAL Long Term Care Career Center.  The LTC Career Center is designed to help members be competitive in attracting qualified candidates to fill their health care positions. 

Rates for posting job vacancies have never been more affordable.  Now through October 31, open positions can be posted on the AHCA/NCAL Long Term Care Career Center for $250 per 30-day posting when employers use promo code FALL100. That’s $100 off the normal low AHCA/NCAL rate of $350 and is the lowest sale price of 2018!

The LTC Career Center gives unprecedented targeted exposure because it connects with the Health Care Career Network by providing visibility on the network’s nearly 300 national and state health care organizations and societies.  The Center is also fully integrated with Google’s job search feature “Google for Jobs” creating greater exposure for job postings.

The $250 for a 30-day posting gives even more value because employers who utilize the AHCA/NCAL Long Term Care Career Center receive free bonus 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 AHCA/NCAL LTC Career Center get extra value through free rotating listings on the Long Term Care Career Center  home page. 

Of course, the LTC Career Center is always free for job seekers and the LTC Career Center features many of the best positions the long term care profession has to offer. 

Make the smart, low cost employee recruitment choice.  Check out the LTC Career Center today and don’t forget to use promo code FALL100 to save $100 on your job postings.  Employers may use the code an unlimited number of times between now and October 31 on any number of postings.   
Call Robin at 866-964-2765 x2736 for more information about posting job vacancies on the LTC Career Center and other discounted job listing packages.   

Want to Lower Your Rehospitalization Rate? Start with Smarter RNs!

Dave Kyllo

AHCA/NCAL Gero Nurse Prep does much more than just prepare RNs to take the American Nurses Credentialing Center (ANCC) board certification exam in gerontological nursing
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.   AHCA/NCAL believes that assisted living settings may experience similar results by increasing their RNs’ gerontological expertise.
Lower rehospitalization rates are key to success under the new CMS Value-Based Purchasing (VBP) program.  CMS is tracking skilled nursing rehospitalization rates for the SNF VBP program and is using those rates to determine Medicare Part A payment levels as of October 1, 2018.

AHCA/NCAL Gero Nurse Prep also 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.
Gero Nurse Prep is on sale!  Save $100 off the regular registration fee now through November 30 by using promo code REALRN18 (all caps).  AHCA/NCAL Gero Nurse Prep provides tremendous value at this AHCA/NCAL member $590 sale price. That’s less than $20 per contact hour for outstanding nursing education that makes a measurable difference on so many fronts.  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. AHCA/NCAL is also hosting a free webinar on November 8 at 2 p.m. EST that will provide a more in depth look at how experienced assisted living and nursing facility RNs can improve outcomes with focused additional gerontological nurse training.  Follow this link to register for the Improving Clinical Outcomes Through Competent Gerontological Nurses. If you need assistance accessing the webinar, please contact

Sign Up Today for This Free Webinar on November 8: Improving Clinical Outcomes Through Competent Gerontological Nurses

Dave Kyllo

Competent RNs are vital to success with the new CMS Skilled Nursing Facility Value Based Purchasing (VBP) program impacting SNF Part A Medicare reimbursements starting October 1, 2018.  It’s also key for nursing facilities to be able to demonstrate that their nursing staff are competent to care for geriatric patients as part of the CMS survey process for nursing facilities. 
Dr. Heidi Keeler, Director, Continuing Nursing Education at the University of Nebraska Medical Center’s College of Nursing, and AHCA/NCAL staff will be presenting a webinar November 8 at 2 p.m. EST discussing the positive impact competent gerontological nurses have on key outcomes, including:
  • Lower re-hospitalization rates
  • Reduced use of off-label anti-psychotics
  • Less use of restraints
  • Higher Overall CMS 5-Star Rating
  • Higher Survey 5-Star Rating
  • Higher Quality-5-Star Rating
The webinar will outline how the AHCA/NCAL Gero Nurse Prep online course thoroughly prepares interested RNs to take the American Nurses Credentialing Center’s (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. 

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.  Gero Nurse Prep students (practicing RNs with at least two years of long term care nursing experience) see a dramatic 24 percent average increase on their pre- and post- course test scores. 

Follow this link to register for the Improving Clinical Outcomes Through Competent Gerontological Nurses free webinar on Thursday, November 8 at 2 p.m. EST.  The webinar will be recorded and archived on ahcancalED for those who cannot attend on November 8.  If you need assistance accessing the webinar, please contact

Tuesday, October 16, 2018

Post-Convention Survey

Jon-Patrick Ewing

Thank you to those who attended the AHCA/NCAL 69th Annual Convention & Expo. Please watch your email for our post-convention survey. Your participation is critical if we are to ensure that the convention and its educational programs continue to meet your needs. As a special thank you for your time, you will be entered for a chance to win $200! Please provide your feedback no later than November 2.

A separate survey will be sent out to exhibitors.

Thank you and mark your calendars for next year’s event in Orlando, FL, October 13-16, 2019.

WPS – The CMS MAC for IA, IN, KS, MI, MO, and NE Announces Part B Therapy Audit Plan for Code 97110

Dan Ciolek

On October 15, WPS Government Health Administrators, the Medicare Administrative Contractor (MAC) for the J5 (Iowa, Kansas, Missouri, and Nebraska) and J8 (Indiana and Michigan) jurisdictions announced a new Targeted Probe and Educate (TPE) Topic:  Outpatient Therapy (CPT Code 97110).  The audit will include a review of medical necessity, correct billing of timed codes and all other therapy codes provided under same plan of care.  Several documentation and other therapy coverage resources are provided on this page.  

Per the WPS website, “CMS has authorized WPS Government Health Administrators (GHA) to conduct the Targeted Probe and Educate (TPE) review process. This is a required process for providers identified by Medical Review. The TPE review process incudes three rounds of prepayment or post-payment probe review with education. If high denial rates continue after three rounds or review, WPS GHA will refer the provider and results to CMS. CMS will determine any additional action, which may include but is not limited to extrapolation, referral to the Unified Program Integrity Contractor (UPIC), and/or referral to the Recovery Audit Contractor (RAC).”
Pre WPS, Providers/Suppliers can expect:
  • WPS GHA will notify providers/suppliers in writing of their selection for the topic or CPT code under review, the data reasons for selection and the review process.
  • Provider/supplier reviews will consist of up to three rounds of prepayment or post-payment TPE claim review. WPS GHA will select the topics for review and the providers to be reviewed based on our current data analysis procedures outlines in CMS Internet-Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual, Chapter 2.
  • WPS GHA may refer providers/suppliers to RAC or UPIC if providers do not respond to ADR requests and submit the requested documentation to WPS GHA.
  • If needed, education will be offered to the provider/supplier throughout the TPE process. Additionally, at the end of each round of claim review WPS GHA will notify the provider/supplier in writing of the results and offer education on identified errors. Providers/suppliers with high error rates will receive on offer for one-on-one education on the specific errors that were identified. The goal for providers/suppliers is to learn from the education and improve the results in the next “round” to a low error category.
  • Providers/suppliers will move to the next round of claim review if the error rate remains at a high level. Providers/suppliers with a continued high denial rate after three rounds of Targeted Probe and Educate reviews will be referred to CMS for possible for further action.
  • Once a provider/supplier has reached an acceptable error rate the provider will be removed from further review. WPS GHA will continue to routinely monitor data on that service/provider.
  • Note: Discontinuation of the review(s) may occur at any time if appropriate improvement is achieved during the review process.
Additional resources related to the TPE audit program including videos, infographics, and a Q&A document are located on the CMS Targeted Probe and Educate webpage.

Time is Running Out! Submit Your Intent to Apply Today!

Erin Prendergast

The deadline to submit your Intent to Apply for the 2019 AHCA/NCAL National Quality Award application cycle is just one month away!

We hope you will take the first step to continue your quality journey this coming year by submitting an Intent to Apply (ITA). The deadline to submit an ITA payment is November 8, 2018 at 8pm EST.

While not mandatory, applicants who submit the Intent to Apply will save money on their overall application fee and receive extra educational resources. No paperwork or application is needed to submit the Intent to Apply.
  • All applicants should read the appropriate application packet in full before submitting an Intent to Apply payment. Application packets for all award levels can be found on the Quality Award website.
  • If your center last received a Bronze or Silver Quality Award in 2016 and has not submitted an application meeting minimum requirements since then, this is your last year to submit an application at the next level. If you do not submit an application this year (meeting minimum requirements), you will be considered a past recipient and have to resubmit at the Bronze level if your center chooses to participate again in the program. For more information, please review the recertification policy here.  
The National Quality Award website has numerous resources for you to continue your Quality Award journey. Please make sure to visit our website at to learn about the latest updates to the program.

If you have any questions, please contact us at

Monday, October 15, 2018

Interested in the 2019 National Quality Award Examiner Program? Join us for a Webinar!

Meghan Karstetter

Join us on Tuesday, October 23 at 12:00 PM EDT for a webinar to review the Quality Award Examiner program. During this one hour webinar, we will review the timeline and process for the 2019 Quality Award review cycle, discuss the different Examiner roles, and answer any questions viewers may have. This webinar will be for both interested examiners and returning examiners. Click here to register today!