Wednesday, August 5, 2020

Now Available! The NALW 2020 Planning Guide & Product Catalog

Time to start planning for National Assisted Living Week® (September 13-19, 2020) with this year’s Planning Guide and Product Catalog. The planning guide offers ideas to help your residents stay connected, improve your assisted living community, and honor your staff. All suggested activities and official products highlight this year’s theme, “Caring is Essential.” 

The theme recognizes that COVID has been an enormous, unforeseen challenge that has resulted in every person working in long term care to step up and go above and beyond expectations. At a time when the entire profession is doing so much, this year’s NALW theme reflects the hard work and dedication of all the essential caregivers in assisted living facilities across the country.

Some of the suggested activities include: 
  • Celebrate the end of summer with special ice cream deliveries for residents and staff.
  • Organize a family drive-by caravan and live outdoor performances, as well as contests, raffles, and hallway games.
  • Combat social isolation among your residents by encouraging connections with their families and loved ones via outdoor or window visits (depending on your state’s guidelines).
  • Have residents share a special meal together with family or friends via Zoom or FaceTime, and look at photos and reminisce over happy family events. 
  • Encourage loved ones or members of the community to write notes or upload drawings and video messages of support and love for residents and messages of gratitude for staff.
  • Provide lyrics and sheet music for a community hallway singalong.
  • Share your own activity ideas on the NALW Facebook page
The guide also connects providers to this year’s NALW official products, which can also be found in AHCA/NCAL’s online bookstore. Show your support for your staff and residents! 

Looking to create your own materials? The NALW website (www.NALW.org) offers this year’s logo in a variety of formats available for download. Please make sure to follow our logo policy: 

Download the logo in various formats for online use as well as professional print products. You may use the following files, intact, to promote National Assisted Living Week 2020. All other rights, including the creation of derivative works, are reserved by the National Center for Assisted Living. 

Stay tuned for a forthcoming media toolkit to help assisted living providers promote NALW in their community. 

For more information, please visit www.NALW.org.

CMS Issues FY 2021 SNF Final Payment Rule

The Centers for Medicare & Medicaid Services (CMS) today issued the final rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2021 update.   

We are pleased to report that the final rule includes a net market basket increase of 2.2 percent. The final market basket is one tenth lower than the proposed market basket of 2.3 percent due to updated data reflecting substantial changes in the macroeconomic forecast due to COVID-19 CMS estimates that the net market basket update would increase Medicare SNF payments by approximately $750 million in FY 2021.

As we predicted, CMS issued the final rule with few changes in the Patient-Driven Payment Model (PDPM) payment policy section. Updates were limited to nominal additions/deletions of ICD-10 codes used to map the primary reason for SNF stay diagnosis to appropriate PDPM clinical categories from the lists included in the proposed rule. 

The team at AHCA team has developed a summary (member login required) of the payment updates, the SNF value-based purchasing program, and the IMPACT Act quality reporting additions.  

Tuesday, August 4, 2020

AHCA/NCAL Announces a Trio of Exciting General Session Speakers for October’s Virtual Convention & Expo


This year’s Convention & Expo has the right speakers for the times.

On Thursday, October 8, Captain Scott Kelly and presidential historian Doris Kearns Goodwin will kick off convention with messages of recognition and support of the herculean effort each of you have shown throughout the pandemic. 

Captain Kelly is the history-making astronaut, retired U.S. Navy officer, and best-selling author of Endurance: My Year in Space, A Lifetime of Discovery. He understands what it means to “choose to do the hard things.” With awe-inspiring stories from space and personal reflections on leadership, teamwork, and testing limits, Captain Kelly inspires others to believe that they can reach any goal, no matter how ambitious or audacious.



Doris Kearns Goodwin is a world-renowned presidential historian, public speaker and New York Times #1 best-selling author. She was awarded the Pulitzer Prize for No Ordinary Time: Franklin and Eleanor Roosevelt: The Home Front in World War II, and her most recent book, Leadership in Turbulent Times, was published to critical acclaim and became an instant bestseller. The book provides an accessible and essential road map for aspiring and established leaders in every field, and for all of us in our everyday lives. She will offer insights and perspectives applicable to the challenges we face today.




On Thursday October 22, Kindra Hall, President and Chief Storytelling Officer at Steller Collective, will speak on how to better communicate the value of your company, your products, and your individuality through strategic storytelling. A best-selling author and award-winning columnist, her message is sure to resonate and provide inspiration and ideas as you process the difficult and moving events of the past year.







These unique speakers are just three of the many wonderful people who will be making the 2020 Virtual Convention & Expo memorable and meaningful. Find out more about all that’s happening from October 8th through October 31st at AHCAConvention.org. With 24 full days of on-demand and live sessions, you’ll find everything you need and then some.


AHCA/NCAL’s Affordable Online Water Management Training is Ideal for All Building Operations Staff


Skilled nursing and assisted living centers provide care for vulnerable people who can become critically ill when steps are not taken to reduce the risk of waterborne diseases such as Legionnaire’s. Effective water management programs are mandated for nursing facilities by CMS and highly recommended for assisted living facilities by the Centers for Disease Control and Prevention as a best practice.
 
AHCA/NCAL offers an affordable online Water Management Training course that provides long term care staff with information about:  
  • what a water management plan is; 
  • the essential elements of an effective water management program; and, 
  • how nursing and assisted living facilities should develop and maintain comprehensive water management programs. 
The online one-hour training contains five modules and is designed for administrators, building engineers and maintenance department personnel, DONs who have not been trained as Infection Preventionists, and other staff responsible for building operations or infection prevention and control.
 
The per-individual cost for the training is $25 for AHCA/NCAL member facility staff and $65 for non-members. An online final test and certificate of completion are included with each registration.

Make sure your facility is ready to address the threat of water-borne pathogens and external water interruptions by having a thorough and effective water management plan in place. Register for AHCA/NCAL’s Water Management Training today.  

Check Out this 45-Minute Webinar Filled with Helpful Workforce Recruitment and Retention Strategies


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.

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, individuals should e-mail educate@ahca.org with their name and facility contact information

Learn the Fundamentals of Population Health Management through this Exclusive Resource Created for AHCA/NCAL Members


AHCA/NCAL recently launched the first phase of its Population Health Management (PHM) Innovation Lab. Phase I contains free “AHCA/NCAL Member Only” foundational resources designed to introduce AHCA/NCAL assisted living, nursing facility and intermediate care facility members and their staff to the wide array of PHM models available today and in the future. 

Phase I PHM Innovation Lab resources are ideal for familiarizing owners, operators, administrators and LTC managers about the fundamentals of various PHM models and how these models can better serve LTC organizations, residents and families. Members can also access the PHM Innovation Lab resources at: PHMInnovationLab.com

CMS continues to drive the healthcare system to one of value by shifting financial risk to providers through a range of fee-for-service (FFS) and managed care models. PHM is the application of interventions and strategies to improve the health outcomes and manage the costs of a targeted group.  PHM models vary based on the degree of risk, degree to which payments are tied to quality, reliance on data analytics and level of care coordination. Understanding these models is vital in today’s operating environment.

Historically, PHM models have been led by hospitals, health systems, physician groups and large insurance organizations. In recent years, LTC providers (including assisted living) and PAC providers have assumed leadership roles in developing and employing several PHM models. The new environment demands new models, and PHM helps LTC/PAC providers understand and integrate new strategies into SNF and AL buildings by integrating SNF/AL and primary care, enhancing care transitions, and using robust care management models.

PHM models have evolved to address targeted groups of individuals (SNF and AL residents in our case), to improve their health outcomes, and providers can use these models to drive better outcomes, strategies and interventions for handling the COVID-19 crisis. A PHM model, provider led Special Needs Plans (SNPs) can be an important solution in the current COVID-19 environment. With the deployment of on-site nurse practitioners providing primary care at the long term care bedside, costly and potentially dangerous hospital transfers can be avoided. 

The PHM Innovation Lab Phase I contains six different subject area modules with corresponding educational components including webinars and briefs.  
  1. Population Health Management Fundamentals -- Describes the who, what, where, and how of Population Health Management (PHM). It also introduces various PHM models including their specific characteristics, benefits, and implications.  

  2. Accountable Care Organizations -- Provides an overview of the structure, financial model, and regulatory requirements of different ACOs. Types of ACOs covered include Medicare Shared Savings Programs and Next Generation ACOs.  

  3. Bundled Payments -- Provides an overview of the basics of bundled payments (episode-based payments) including what are bundled payments, how they work, and their implications for LTC and PAC providers.  

  4. Emerging Models: Direct Contracting -- Provides a detailed overview of Direct Contracting including types of participants, payment, beneficiary alignment, quality incentives, and a model timeline.  

  5. Managed Care -- Provides an overview of Medicare Advantage/ Provider-led Special Needs Plans (SNPs) and explains how SNPs work, and discusses the implications for LTC and PAC providers.  

  6. Provider Networks --Provides an overview of the why, what, and how of provider-owned integrated care networks and explains the benefits of provider networks.  
Members will need to login with their AHCA/NCAL usernames and passwords to access PHM Innovation Lab materials. For assistance obtaining AHCA/NCAL usernames and passwords, members should e-mail educate@ahca.org with their name and facility contact information.  

Monday, August 3, 2020

Providers May be Due Refunds from Physicians for Some Services Excluded from SNF Consolidated Billing

On July 31, the Centers for Medicare and Medicaid Services (CMS) issued a notice that three new telephone evaluation and management codes were added to the list of physician services excluded from SNF Part A consolidated billing (CB) and therefore payable to the physician by the Medicare Administrative Contractor (MAC). In some cases, the Medicare claims processing edits inaccurately denied the services citing CB, and the physician subsequently billed the SNF instead. This problem edit has been corrected. Provider business offices should review the following details to determine if a refund is due from any physician offices. 

Specifically, the current COVID-19 Public Health Emergency (PHE) does not waive any requirements related to SNF CB; however, CMS added CPT codes 99441, 99442, and 99443, to the list of telehealth codes coverable under the waiver during the PHE. These codes designate three different time increments of telephone evaluation and management service provided by a physician. The physician can bill for these physician services separately under Part B when furnished to a SNF’s Part A resident.

The MACs have been instructed to reprocess claims for CPT codes 99441, 99442 and 99443 with dates of service on or after March 1, 2020, that were denied due to SNF CB edits. Physicians will have their Medicare claims automatically adjusted. If the physician office instead billed the SNF for these services citing CB, they are required to refund the payment to the SNF.

For more information, please visit www.ahcancal.org/coronavirus or email COVID19@ahca.org

Saturday, August 1, 2020

HHS Provider Relief Fund Announcements

On July 31, the U.S. Department of Health and Human Services (HHS) announced three new approaches to securing funding: 
  • The Medicaid allocation application has been extended to August 28, 2020. 
  • For certain Medicare providers, HHS will allow those providers who missed the opportunity to apply for additional funding from the $20 billion portion of the $50 billion Phase 1 Medicare General Distribution. The opportunity to apply will begin on August 10 and will close on August 28. 
Payments for Providers Who Had a Change in Ownership

Also starting the week of August 10, providers who experienced challenges receiving Provider Relief Fund payments due to change in ownership may submit their revenue information, along with documentation proving a change in ownership, for consideration for Provider Relief Fund payment. HHS has said it will accept this information through August 28.

Read the full press release.

Friday, July 31, 2020

CMS Required Training Coming for Additional Provider Relief Funds

The White House announcement last week referred to a COVID-19 training that nursing homes must participate in to qualify and receive additional funding from the Provider Relief Fund. From CMS’ press release:

“In addition, CMS, in partnership with the CDC, is rolling out an online, self-paced, on-demand Nursing Home COVID-19 Training focused on infection control and best practices. The training being offered has 23 educational modules and a scenario-based learning modules that include materials on cohorting strategies and using telehealth in nursing homes to assist facilities as they continue to work to mitigate the virus spread in their facilities. This program supplements training already underway to better equip nursing homes to contain and stop the spread of COVID-19. The training is a requirement for nursing homes to receive the additional funding from the Provider Relief Fund Program. 

“The training will be available to all 15,400 nursing homes nationwide along with specialized technical assistance to nursing homes who have been found to have infection prevention deficiencies in their most recent CMS inspection and had recent COVID-19 cases based upon their data submissions to CDC. A certificate of completion is offered and recognition badges can be downloaded for nursing homes to display on their website.” 

AHCA has confirmed with CMS that this is a new training that has not been launched yet. CMS states it will be COVID-19 scenario-based and is anticipated to be launched before September. AHCA will share more information when it becomes available.  

Thursday, July 30, 2020

Urgent Action Needed - Submit Information on Your Assisted Living Community to HHS

The U.S. Department of Health and Human Services (HHS) is considering a possible distribution of CARES Act Provider Relief Funds to private-pay assisted living/memory care providers that are stand-alone or part of a CCRC, located in the U.S states and territories. NCAL, Argentum, ASHA, and LeadingAge are assisting HHS in an effort to collect the necessary information from these providers through a private, secure data collection portal to help ease a potential future distribution of application funds. At this time, we have no guarantee such a distribution will happen, nor are we aware of an allocation methodology, if such a distribution were to occur. However, providing HHS with this data is an important step forward, and we appreciate your help in being responsive to their request. Providers should submit the relevant data into this portal by Monday, August 3 at 5 pm Eastern Time.

Data Submission Portal Information

Who is eligible to submit information?

We encourage private-pay assisted living and memory care providers that are stand-alone or those part of a CCRCs in the U.S. states and territories to submit their data. Please note that some states may use different terminology (e.g. personal care homes, supportive living facilities, etc.) to describe their licensed assisted living-type providers. All of these providers are encouraged to submit their information. For purposes of this portal, the term licensure also includes assisted living and memory care communities registered or certified by the state. Submitting your data does not guarantee you will receive or be eligible to receive a payment. You do not need to be a member of one of our senior living trade associations to participate in this secure and confidential data-collection effort.
  

What data must be submitted?

  • Name of licensed/registered/certified assisted living and/or memory care community
  • Name of entity that holds the license/registration/certification
  • Address
  • Community license/registration/certification number (some states may not provide a number)
  • Corresponding Tax Identification Number (TIN)
  • Taxpayer ID Number for the filing company
  • Contact information for the person submitting data
  • Include licensed assisted living that is part of a CCRC or a skilled nursing facility (SNF), even if the SNF has already received funding from the Provider Relief Fund.

Where do I submit the data?

All of the above information should be submitted either manually or by uploading a specific file (see instructions for details) in the secure data collection portal . You will need to create an account. Please complete all the fields to ensure your submission will be accepted. Incomplete submissions will likely result in a delay in their inclusion.

What is the deadline to submit data? 

Please submit the requested data into the secure data collection portal by Monday, August 3 at 5 pm ET.

Thank you for your quick action in support of this vital aid to our industry. If you have any questions, please contact us at ncal@ncal.org.