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 ahcancal.org/qualityaward to learn about the latest updates to the program.

If you have any questions, please contact us at qualityaward@ahca.org.

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!

Secure Your Umbrella License with the Motion Picture Licensing Corporation

Lilly Hummel

AHCA/NCAL and all other leading industry associations have secured member savings on the Umbrella License®, the annual public performance license offered by Motion Picture Licensing Corporation (MPLC). The Umbrella License is the most comprehensive copyright license available for senior living and health care communities and provides annual copyright coverage for over 1,000 motion picture studios and producers. The license includes public performance rights for both major Hollywood studios and independent producers. Once licensed, an unlimited number of movies may be shown. Movies can be secured from any legal source whether rented, purchased, or borrowed via DVD, stream, or download.

If your community currently shows movies or would like to start, please be sure to secure a license to avoid copyright infringement penalties.

As AHCA/NCAL has advised in the past, the 2016 Agreement establishes guidelines for the licensing of motion picture exhibitions in all senior living and health care communities regardless of the level of care provided or the license status of the community. The Agreement states that:
  • All communities, regardless of their type or license status, must obtain licensure for exhibitions of Videos transmitted over a closed circuit television system or in-house channel.
  • All communities, regardless of their type or license status, must obtain licensure for exhibitions of Videos in common areas such as a theater, lounge, or community room. This includes:
    • Affordable housing facilities and units.
    • Assisted living, nursing and rehabilitation facilities and units.
    • Independent living facilities and units.
    • Adult day services centers.
  • Assisted living, nursing and rehabilitation units receive a reduced rate on the license. Minimum fees are waived for campuses that are strictly nursing, assisted living, or rehabilitation.
  • Affordable housing units receive a reduced rate on the license.
  • Members of AHCA/NCAL receive a 10% discount on standard Umbrella License fees.
Please contact MPLC directly at (800) 462-8855 or online at seniorliving.mplc.org for assistance with pricing or to ask any questions about the Umbrella License.

If your senior living community operates assisted living, nursing or rehabilitation units, and held an Umbrella License prior to October 2016, if you have not done so already AHCA/NCAL strongly encourages you to provide MPLC with updated unit counts for the aforementioned units prior to your renewal date. Longstanding licensees are eligible for reduced pricing for any assisted living, nursing, or rehabilitation units/rooms added during this renewal year only. Thereafter, the license requirement remains, but units will be priced at a higher fee.

Please feel free to contact AHCA/NCAL at (202) 842-4444 with any questions about motion picture licensing requirements for long term care providers.

Wednesday, October 10, 2018

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

October 19, 2018
2:00 - 3:00 PM Eastern

In this 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! This webinar will be held on October 19 from 2:00-3:00 pm Eastern. You can register for the webinar and find the recording on ahcancalED.

Monday, October 8, 2018

CMS Rewrites Process for Developing and Updating MAC LCD Policies

Dan Ciolek

In a MLN Matters article released recently, CMS announced significant changes to the process for Medicare Administrative Contractors (MACs) to develop and revise Local Coverage Determination (LCD) policies.  Specifically, Chapter 13 of the Medicare Program Integrity Manual has been rewritten in its entirety with an implementation date of January 8, 2019.  SNF providers are encouraged to review the MLN Matters article for more details.  

Be Seen Like Never Before: Our $250 Sale Price Gets Your Job Posting Connected Nationwide to Nearly 300 Health Care Associations and Professional Societies

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.   

Delivering the Distinct Feeling of Fall with Mood Media

Dave Kyllo

Whether it’s Nat King Cole’s “Autumn Leaves” or The Kinks’ “Autumn Almanac,” members can keep music at the core of fall celebrations 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).

Calling All RNs! Become a Geriatric Nurse Specialist with Gero Nurse Prep

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 whopping 24 percent increase between their pre- and post-course test scores. 

Emily Sample, the MDS Coordinator at Sumner Place in Lincoln, Nebraska agrees.  “The Gerontological Nurse Certification program provided me with the opportunity to grow as a nurse practicing in this area of nursing,” she said.  “It has advanced my knowledge in various areas of the aging process which has helped enhance my critical thinking and problem-solving skills.”
The statistics prove it.  Gero Nurse Prep grads know more about gerontological nursing.    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 earn 30 CEUs, and increase their skills and knowledge of geriatric nursing. 

“I feel this program helped me become more of a ‘specialist’ in geriatric care/nursing,” Sample said.  “The course itself was easy to navigate and I felt it challenged what I already knew about geriatric care forcing me to think more in depth.”

There is also statistical support that facilities with at least one RN with ANCC Board Certification in gerontological nursing have significantly better outcomes in key areas on which nursing facility performance is judged.  AHCA/NCAL research shows these facilities have lower re-hospitalization rates, lower usage of off-label anti-psychotics and are twice as likely to receive a 5-Star CMS rating. 
AHCA/NCAL Gero Nurse Prep is also designed to thoroughly prepare RNs to take the ANCC board certification exam in gerontological nursing.  It does that.  RNs who complete the Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam on their first try.  Sample believes it also makes RNs better nurse leaders. 

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 by having better nurse leaders who are specialists in geriatric care.

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. 

 “I feel what I have learned from the course has helped me become more confident in my practice and decision making as well as a better leader and advocate for this population,” Samples stated.

Watch this video to learn more about the AHCA/NCAL Gero Nurse Prep program that Samples credits with her increased nursing knowledge and leadership skills.