Tuesday, February 19, 2019

AHCA/NCAL Quality Summit: Disruption to Create Change

Jon-Patrick Ewing

Join quality practitioners from around the country at the 2019 AHCA/NCAL Quality Summit. Opening keynote speaker Chris Field, author of Disrupting for Good: Using Passion and Persistence to Create Lasting Change, shares a memorable and motivational message featuring inspirational stories from his book on how passion + persistence = lasting change. From running for mayor as a teenager to breaking multiple Guinness World Records to helping save over a hundred children from slavery, Chris has been disrupting most of his life. Seamlessly weaving his own story with those of other ordinary people who became extraordinary disruptors, Chris offers a clear call to action: anybody, anywhere, can choose to disrupt for good. Chris will end by walking you through his personal Disruption MAP so that you leave both prepared and inspired to disrupt for good in your own job, non-profit, school, neighborhood, and family.

Don’t miss the opportunity to stay at the host hotel and save with AHCA/NCAL discounted rates. The hotel reservation deadline for the Quality Summit is today! You may register for the Quality Summit through March 5. You must be registered for the event before hotel reservations can be made.

Upcoming Independent Owner Leadership Conference Will Help You Compete, Succeed, and Evolve in Ever-Changing Market

Danielle Levitan
The deadline is less than two weeks away!
2019 promises continuous challenges and changes, including the new Payment Driven Payment Model (PDPM).  Don’t go it alone.

Get ideas and insight from experts in the field, get your questions asked and answered, and get inspired at this year’s IO Leadership Conference.

March 20-22, 2019
Marriott Tampa Waterside

Key sessions include:
  • PDPM – learn what you need to know to be ready for the October 1 deadline
  • Workforce Stability – find out how to create successful retention and recruitment programs 
  • Long Term Care Provider Owned Health Plans – discover why a growing number of providers across the country have engaged in population health management initiatives and learn what it can do for you

Earn up to 12.75 CEs. Network with your colleagues. Take in the sun and the warmth of beautiful Tampa, FL.

Learn more, see the complete agenda, and register at IO.ahcancal.org. Receive special savings for first-time attendees and multiple attendees from the same facility.

Advance registration deadline is March 5.
Sponsors as of February 19, 2019:
Cantata Health, CapitalOne, Compass Total Benefit Solutions, Drive DeVilbiss, Ecolab, Evans Senior Investments, Guardian Pharmacy Services, HealthCap, Kronos, MatrixCare, Navigator, Pharmscript, PointClickCare, Prelude, Prime Care Technologies, Reliant Rehabilitation


Train Your Infection Preventionist Now to Meet the CMS November 2019 Requirement

Dave Kyllo

Phase III Requirements of Participation (ROP) take effect November 28, 2019 and mandate that every nursing facility have a designated and specially trained Infection Preventionist who is running a comprehensive infection prevention and control program.  AHCA’s Infection Preventionist Specialized Training (IPCO) program is specifically designed to prepare individuals to effectively implement and manage an Infection Prevention & Control program in nursing facilities.

AHCA’s course is an online, self-study program with 23 hours of training that meets the educational requirements outlined by CMS. It includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term/post-acute care.  It addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control which are fundamental to effectively leading and administering a center’s Infection Prevention & Control program.  

Another reason for nursing facility staff to take the course now is to reduce the risk of receiving the most frequently cited F-Tag in standard nursing facility health inspection surveys under the new survey process is F880 – Infection Prevention & Control.  Since November 2017 when the new infection prevention and control mandates began, more than one-third of surveys conducted across the nation have included a F880 Infection Prevention & Control citation.  The primary change coming this November under Phase III ROP is the designation of a specially trained Infection Preventionist who must work at least part-time at the facility.   

The AHCA training program gets rave reviews with nearly 97 percent of health care professionals who have completed the course recommending IPCO to their colleagues. The registration fee is $450 for AHCA/NCAL members and $650 for non-members.  There are no refunds and no transfers. 

Payment and registration are made online at ahcancalED.  The IPCO course can be accessed here or at: https://educate.ahcancal.org/p/ipco.   Discounted group purchase rates are available for groups of 25 or more.  Those interested in making a group purchase should email AHCA at educate@ahca.org.  

While CMS has announced plans to offer a free infection prevention training course some time in Spring 2019, no specific date has been announced yet.  AHCA/NCAL recommends investing in staff training now rather than waiting to train staff on the requirements that already are in effect.  Facilities will continue to be surveyed on all the new infection prevention and control requirements and the antibiotic stewardship requirements. 

To access ahcancalED and the IPCO course, 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. 

Timely Risk Management Advice from HealthCap®

Dave Kyllo

The winter edition of HealthCap’s quarterly Risk Watch newsletter is chock-full of sound advice for mitigating risks in nursing facility and assisted living settings.  The winter issue explores  facility audit practices, the link between CMS-5 Star ratings and risk, and the impact of ANCC Board certification on gerontological nursing outcomes.

HealthCap is endorsed by AHCA/NCAL and is the premier program solely dedicated to providing liability insurance to senior care communities.  One of the reasons HealthCap gets such great results is its focus on quality care as the foundation of good risk management practices.  HealthCap clients have the fewest liability claims in the industry and HealthCap settles claims for approximately one-half the industry average. 
HealthCap is owned and governed by the senior care providers insured by HealthCap.  AHCA/NCAL members get a bonus advantage by always receiving a 10% discount on their HealthCap premiums.
HealthCap clients also receive:
  • Risk management services that make a financial difference
  • An annual on-site risk consult
  • Unlimited telephone support
  • Accredited in-service education

For more information about HealthCap, email Stephanie Hale at stephanie.hale@chelsearhone.com or call (877) 855-4227. 

Friday, February 15, 2019

Congressman Horsford to Speak at AHCA/NCAL’s ID/DD Hill Fly-in Event Next Month!

Dana Halvorson

AHCA/NCAL’s Intellectual and Developmental Disabilities (ID/DD) Residential Services Providers will be in Washington, D.C., for AHCA/NCAL’s annual Hill Fly-In event on Wednesday, March 6, 2019. Participants will hear from Congressional speakers and others, including Congressman Steven Horsford of Nevada.  The event runs from 8 am – 10:15 am ET.  After the morning event is over, the ID/DD providers will head to Capitol Hill to discuss critical issues, including Medicaid.  If you have any questions relating to this event or would like to attend (it is free to attend, and breakfast and lunch are provided), please don’t hesitate to contact AHCA’s Senior Director of Not for Profit & Constituent Services, Dana Halvorson.   

Wednesday, February 13, 2019

We Want Your Feedback About LTC Trend Tracker


AHCA/NCAL is focused on our mission to improve lives by delivering solutions for quality care, and LTC Trend Tracker is one of those solutions.

If you aren't using LTC Trend Tracker, we would like to know why so we can help you utilize this great member benefit. If you are a using LTC Trend Tracker, we want to hear more about your experience.

Please take this short, online survey by Monday, February 18. It should take less than 10 minutes to complete.

To learn more about this exclusive member benefit, please visit www.LTCTrendTracker.com

Complete the Survey: State of Seniors Housing 2019

Lilly Hummel

NCAL is teaming up, once again, with the American Seniors Housing Association (ASHA), National Investment Center for Seniors Housing & Care (NIC), LeadingAge, and Argentum to issue The State of Seniors Housing, a report on the financial performance data for seniors housing communities. We need your participation in order to provide a representative picture of the industry.

Please download the 2019 State of Seniors Housing Survey (Excel format) and submit completed surveys to colleen.blumenthal@healthtrust.com by close of business Monday, March 18, 2019. Questions about the survey should be directed to Colleen Blumenthal of HealthTrust, LLC at (941) 363-7502 or at her email address noted above.

For owners or managers of multiple properties, please submit data for as many of your properties as is practical. The report will adjust overall results so large portfolios are neither over-represented nor under-represented.

The quality of our industry’s data relates directly to the size and composition of this sample. For the last few years, the State of Seniors Housing has collected data from 1,500 to 2,200 properties annually. If you contributed data for a given property last year, it is particularly important that we obtain information about that property this year also, so that “same-store” industry trends in revenues, costs, and census can be analyzed.

Properties Eligible for Inclusion in Survey
Properties eligible for inclusion in the State of Seniors Housing sample include the following: 
  • For-profit or not-for-profit communities
  • Communities where the majority of units provide Independent Living, including Active Adult 
  • Communities where the majority of units provide Assisted Living services 
  • Communities where the majority of units provide Memory Care 
  • Life Plan Communities/Continuing care retirement communities 
Please do not complete surveys for properties where rates are subsidized, such as Sec. 202 elderly housing.

Benefits of Participating
All organizations that complete surveys will receive a complimentary copy of The State of Seniors Housing 2019, which compiles the survey results for comparisons to your own operations.

As always, the State of Seniors Housing data will be handled with complete confidentiality and the results presented only in the aggregate.

Thank you, in advance, for your participation in this important annual research study. The 2018 State of Seniors Housing publications can be purchased through the AHCA/NCAL Bookstore.

Take Action! Raise Awareness about Careers in the Field of Aging

Careers in Aging Week
March 3-9, 2019
People are living longer, and populations are aging worldwide. The demand for professionals with expertise in long term care is growing rapidly. The U.S. will need between 5.7 million and 6.5 million nurses, nurse aides, home health, and personal care workers to care for the 27 million Americans who will require long term care by 2050. Careers in Aging Week (CIAW), created by the Gerontological Society of America (GSA), is dedicated to bringing greater awareness and visibility to the wide-ranging career opportunities in long term care. During the first full week of March, CIAW is observed annually by businesses, clinics, coalitions, organizations, universities, colleges, and other parties across the world.
  • Participate on social media. Share how you’re celebrating and showcasing careers in aging on social media using the hashtag #CareersInAging19.
    • Share your selfie! Snap a photo of your office, your facility, your clinic, your business, or your classroom. Describe your career in aging using #CareersInAging19.
    • During CIAW, AHCA/NCAL will share resources, graphics, and more on social media. Spread the word by retweeting us on Twitter or sharing our posts on Facebook.
  • Watch “The Information and Tools You Need to Promote Careers in Aging” video. This video, created in partnership with AHCA/NCAL, Argentum, LeadingAge, and GSA, shares a variety of ideas on how to participate. Watch it here.
  • Attend our kick-off webinar. On March 4, hear from caregivers across the country share their story and answer questions about why they work in long term care. Learn about the different roles, opportunities, and benefits that come with a career in aging. Registration coming soon!
  • Celebrate your staff. Host a party to celebrate/thank your staff members, and invite families of staff, residents and their family members. Recognize your staff for accomplishments, like tenure or outstanding customer service.
  • Open your doors to the community. Host a facility tour for local students, parents and teachers to showcase the day to day operations as a long term care professional.
  • Visit your local schools and talk about careers in aging. Informing the next generation about the opportunities in this profession is critical to meet future workforce needs.
  • Participate in job or educational fairs. The overall goal of these events should be to spark the interest of students and give them a sense of what a career in long term care is all about.
  • Plan a community celebration. Community events can be organized by local businesses, Chambers of Commerce, economic development groups and more. Talk to your community partners about how to best organize a celebration.
Visit www.careersinaging.com for more resources and information on how to get involved.

CMS MLN Article – Implementation of the SNF PDPM On October 1, 2019

Dan Ciolek

The Centers for Medicare and Medicaid Services (CMS) recently issued a MLN Matters Article titled “Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM)”.  The article summarizes specific instructions CMS has issued to its Medicare Administrative Contractors (MACs) via Change Request CR 11152 to effectuate changes to the SNF Prospective Payment System (PPS) that are required for the PDPM. These changes were finalized in the FY 2019 SNF PPS Final Rule (83 FR 39162). SNFs billing on Type of Bill (TOB) 21X and hospital swing bed providers billing on TOB 18X, (subject to SNF PPS) will be subject to these requirements. The Effective and Implementation Date are both listed as October 1, 2019.  Make sure your billing staff is aware of these changes.

Currently under the SNF PPS, revenue code 0022 indicates that the claim is being paid under the SNF PPS. This revenue code can appear on a claim as often as necessary to indicate different Health Insurance Prospective Payment System (HIPPS) Rate Code(s) and assessment periods. The HCPCS/Rates field must contain a 5-digit “HIPPS Code”. Currently, the first three positions of the code contain the Resource Utilization Group (RUG) group, and the last two positions of the code contain a 2-digit assessment indicator (AI) code.

PDPM Changes
Under the PDPM, the HIPPS code is structured differently. There are five case-mix adjusted rate components under the revised model:
  • The first position represents the Physical and Occupational Therapy case-mix group.
  • The second position represents the Speech-Language Pathology case-mix group.
  • The third character represents the nursing case-mix group.
  • The fourth character represents the Non-Therapy Ancillary case-mix group.
  • The fifth character represents the AI code.

This also affects the number of potentially valid HIPPS codes under PDPM, as compared to RUG-IV.

PPS Assessment Schedule
The PPS assessment schedule under PDPM is also significantly different from that used under the current case-mix classification system, the RUG Version IV (RUG-IV) model. The only required assessments under PDPM that would produce a HIPPS code would be the 5-day PPS assessment, which follows the same schedule as under the current SNF PPS, and an Interim Payment Assessment (IPA), which may be completed at any point during a PPS stay.

Per Diem Adjustment
Additionally, under PDPM, SNF PPS payments will be reduced according to a prescribed schedule, referred to as the variable per diem adjustment. Under the current SNF PPS, all days within any given RUG during a covered stay are paid at the same per diem rate. Under PDPM, however, the per diem rate for a given day of the SNF PPS stay may be different from the prior day, depending on an adjustment factor that may be applied against the SNF PPS rate connected with the HIPPS code. Moreover, the variable per diem schedule applies only to the Physical Therapy (PT), Occupational Therapy (OT), and Non-Therapy Ancillary (NTA) components of the per diem rate, with different schedules for the PT/OT components than for the NTA component. More details on this may be found in Table 30 of the FY 2019 SNF PPS Final Rule (83 FR 39228). A similar adjustment exists under the Inpatient Psychiatric Facility (IPF) PPS.

Interrupted Stay Policy
PDPM also includes an interrupted stay policy, similar to that which exists in the Inpatient Rehabilitation Facility (IRF) PPS and the Inpatient PPS (IPPS). Specifically, if a patient in a covered Part A SNF stay is discharged from the SNF but returns to the same SNF no more than three consecutive calendar days after having been discharged, then this would be considered a continuation of the same SNF stay. In such cases, no new patient assessments are required and the variable per diem adjustment is not reset. If the patient returns to the same SNF after the 3-day window, or returns to a different SNF, then this would be considered a new PPS stay. The interrupted stay would be recorded on the claim in the same manner as is done for the IRF PPS and IPPS.

AIDS/HIV Patients
As under the current SNF PPS, patients with a “B20” code on the SNF claim, meaning the patient has AIDS/HIV, receive an adjustment factor for their PPS rate. Under PDPM, the adjustment factor is different from that used under the current SNF PPS. Rather than a 128 percent adjustment for the entire PPS per diem rate, the adjustment under PDPM is an increase of 18 percent in the nursing component of the per diem rate and a reclassification under the NTA component to a higher rate category.

Transition to PDPM
With regard to transition between the current SNF PPS and PDPM, CMS anticipates that days paid under RUG-IV would stop on September 30, 2019, and days would be paid under PDPM beginning October 1, 2019. All other adjustment factors, such as adjustments for geographic variation in wage costs, remain the same under PDPM as under the current SNF PPS.

AHCA offers PDPM preparation resources for all members at the AHCA PDPM Resource Center, and for PDPM Academy Workshop registrants at the AHCA PDPM Academy web page. 

Agenda: Skilled Nursing Facilities/Long-Term Care Open Door Forum

Dan Ciolek

The proposed agenda for the next Skilled Nursing Facilities/Long-Term Care Open Door Forum scheduled for Thursday, February 14, 2019 from 2pm-3pmET is as follows below. If you wish to participate, dial 1-800-837-1935. Conference ID: 3693669. Please see the full participation announcement in the Downloads section. Thank you for your continued interest in the CMS Open Door Forums.
Announcements & Updates: