Thursday, December 18, 2014

The Assisted Living Education Track at Quality Symposium

For the second year, AHCA/NCAL has an assisted living education track and intensive at Quality Symposium.  These sessions are specifically aimed at improving quality in assisted living.  The assisted living intensive will be on INTERACT for assisted living.  Participants will learn about the INTERACT tools, how to implement the tools in their community, and how to sustain implementation.  Hear from members about how they are using the National Patient Safety Organization for Assisted Living to improve quality in their assisted living communities.  Ever wonder how well your assisted living community provides person-centered care?   Now you can measure person-centered care in your assisted living community!  Learn about Person-Centeredness Practices in Assisted Living (PC-PAL), a free tool that was developed with assisted living communities to measure person-centered care.  Attend the Quality Improvement Plan session to learn how to develop an improvement plan you can take back to your community and implement.  Partners in the Wisconsin Coalition for Collaborative Excellence in Assisted Living (WCCEAL) will lead a session to discuss this innovative public/private collaborative to improve quality in assisted living.  

Visit the Quality Symposium website to register. The early registration deadline for this event is January 23, 2015.

State Innovation Award Results Are In!

State affiliates are critical partners in AHCA and NCAL’s Quality Initiative endeavor. They help spread the Quality Initiative message to their members through education, communication and one-on-one member interaction, provide AHCA/NCAL with updates and insight on issues of importance at the state level, and work tirelessly on behalf of their members to ensure they have the resources to allow them to provide the best possible care to their residents. To honor their efforts, AHCA recognizes two state affiliates through our annual “Innovation Award,” part of the existing Quality Initiative Recognition Program. This award highlights an affiliate’s unique approach to advancing the Quality Initiative among their membership. 

We are pleased to announce the recipients of this year’s Innovation Award; the California Association of Health Facilities and Care Providers of Minnesota. Congratulations to the staff and members of these two exceptional organizations!

2014 Quality Initiative Recognition Program

This year, 7,700 centers across the country achieved one or more of AHCA/NCAL’s four Quality Initiative goals; this includes 7,435 skilled nursing centers and 298 Assisted Living communities. AHCA goals for skilled nursing care members are safely reduce hospital readmissions within 30 days during a skilled nursing stay by 15 percent; increase staff stability by reducing nursing staff turnover by 15 percent; increase customer satisfaction by having 90 percent of residents and families willing to recommend their center to others; and safely reduce the off-label use of antipsychotics by 15 percent. NCAL goals for assisted living members are safely reduce hospital readmissions by 15 percent; increase staff stability by maintaining nursing staff turnover below 30 percent; increase customer satisfaction to 90 percent; and safely reduce the off-label use of antipsychotics by 15 percent.  

These centers were recognized as part of AHCA/NCAL’s Quality Initiative Recognition Program, a tiered program that recognizes organizations who have achieved one or more of its four Quality Initiative goals.  Centers receive increasing levels of recognition as they achieve more goals, recognized as tiers. A total of 153 skilled nursing centers and 4 Assisted Living communities achieved the Tier IV award, recognizing that they achieved all four goals. All organizations who have been recognized as meeting Quality Initiative goals will be honored at the upcoming Quality Symposium, taking place February 23-25 in Austin, TX.

For more information, please contact

Keep Up The Great Work!

We continue to be very proud of the progress being made across the nation on the Quality Initiative goals. Many of you have been making significant changes in practices that are demonstrated in measurable results.  The most dramatic change can be seen in the reduction of off-label usage of antipsychotic drugs, where the average rate for AHCA members has decreased by 21.1% as of the second quarter of 2014 (the most recent data available). This outpaces the results nationwide, which show a 18.8% decrease for all nursing centers. As of this reporting period, over half (57%) of AHCA member centers had met the quality initiative goal of a 15% reduction since the launch of the Quality Initiative.

On 30-day hospital readmissions, through the second quarter of 2014 we have seen a 14.2% decrease in the average rate for AHCA member centers, with just over half (50.5%) already meeting the 15% reduction target expected by March of 2015. This closely parallels the rate of improvement across all centers nationally, which stands at a 14.3% reduction for this same reporting period. 

We encourage all of you who have been actively “taking the initiative” and in the process changing the lives of the people you serve for the better, to keep up the great work!  Need new ideas, or guidance on your next steps in this journey?  Visit the Quality Initiative Resource Center today!  

The Quality Initiative and Its Impact on Your Overall Business

Everyone has been working hard on the Quality Initiative goals:  1) safely reduce hospital readmissions; 2) increase staff stability; 3) increase customer satisfaction; and 4) safely reduce the off-label use of antipsychotics.  We have seen many examples of success – this is great and continued improvements are important because of changes we are going to experience beginning in 2015.  What are the changes and what do the Quality Initiative goals have to do with them?

Five-Star: (a) Antipsychotic use will be added to the Quality Measure (QM) domain early in 2015; (b) measures for return to hospital and discharge to community will be added to the QM domain later in the year; (c) submission of electronic payroll data will begin on a voluntary basis in 2015; (d) CMS will implement other processes to validate reported staffing information.

IMPACT Act: Data about quality measures, hospitalizations, rehospitalizations, and discharge to community must be reported publicly and made available to consumers when transitioning to long term care.  This data reporting is phased in between October 2017 and October 2019.  Penalties for not meeting the reporting requirements begin in October 2019 and will be a market basket payment penalty of 2 percent.

Value-Based Purchasing: Beginning in October 2018, Medicare payment rates will be based in part on a nursing centers’ performance scores related to an all-condition hospital readmission measure.  This measure must be developed by October 2015.  And by October 2016, an all-condition risk-adjusted potentially preventable hospital readmission rate will be developed. 

These are just three examples of the value of embracing and the Quality Initiative and striving to achieve and sustain the goals.  

Wednesday, December 17, 2014

Senate Concludes Business, Announces New Committee Members

Drew Thies 

The Senate concluded its final session of 2014 Tuesday night, confirming federal nominees and finalizing a tax extender package in what was a more crisis-filled lame duck than many predicted. Party infighting over a spending bill that took the Senate into a weekend session dominated December and forced Members of Congress to stay extra days to conclude legislative business.

Despite the drama, the House passed $1.1 trillion bill late Thursday night with a vote count of 219 – 206. 57 Democrats voted for the budget and were led by the White House—which made personal calls to members—and number two House democrat Rep. Steny Hoyer (D-MD). Democratic Leader Nancy Pelosi (D-CA) and other progressive democrats led the charge against the bill citing controversial campaign finance and financial regulation provisions.

The Senate followed suit, though not without their own hurdles, and passed the spending bill Saturday night, funding all government agencies with the exception of Department of Homeland Security (DHS) through the end of the fiscal year in September. DHS was only funded through the end of February due to Republican concerns over the President’s recent executive action on immigration.

Senators also voted to approve a tax extenders package that allows businesses to claim the Work Opportunity Tax Credit on 2014 returns. The provision gives a credit to businesses that employ veterans and other designated individuals.

The Achieving a Better Life Experience (ABLE) Act was also sent to the President’s desk by the Senate. The act would allow anyone with a disability and their families to save money for education, housing, transportation, employment support and health. Eligible individuals must be severely disabled before turning age 26. AHCA advocates took to the Hill this past March during AHCA’s annual ID/DD conference in D.C. to stress the importance of the ABLE Act to members of congress.

Both parties also announced Senate Committee assignments for the 114th Congress. The assignments are subject to ratification by the party Conferences as well as the full Senate. New Committee Chairs will be selected by a vote of the members of each respective panel and then ratified by the Republican Conference. Those in bold below are new additions to these two important committees.

Reach Your Center’s Performance Excellence Goals in 2015

 Jon Patrick Ewing

Terry Barber
Is your center focused on reaching your quality improvement and performance excellence goals in 2015? Need help, direction or insight regarding the key quality issues that are forefront among long term and post-acute professionals? Now is the time to register for the AHCA/NCAL 7th Annual Quality Symposium: It’s Time to Roar! The symposium is about two months away, but the early registration deadline of January 23, 2015, is fast approaching.

The three-day symposium, occurring February 23-25 in Austin, Texas provides valuable insight, networking and targeted education to help you, your staff and your center excel. This year’s keynote speaker is Terry Barber, the author of The Inspiration Factor. Barber is known as America’s Chief Inspiration Officer. His mission is to equip and empower leaders, companies, and nonprofit organizations to be inspiring from the inside out. His seven proven principles of inspiration have been praised by leaders throughout the U.S., the U.K., and Australia.

The new features of this year’s symposium include: LED (Lead, Engage, and Discuss) Talks, a guided poster gallery, several sponsor supported education sessions with evidence based solutions on quality improvement, as well as, more than 20 concurrent sessions, and an opportunity to earn up to 15.5 CEUs. 

Don’t wait until the new year, register today!

Executive Order on $10.10 Hourly Federal Contractor Minimum Wage, VA Contracts, and VA webinar

Dana Halvorson

On February 12, 2014, President Obama signed Executive Order 13658, Establishing a Minimum Wage for Contractors. The Executive Order raises the hourly minimum wage paid by contractors to workers performing on covered Federal contracts to: (i) $10.10 per hour, beginning January 1, 2015; and (ii) beginning January 1, 2016, and annually thereafter, an amount determined by the Secretary of the Department of Labor (DoL) in accordance with the Order. On October 1, 2014, DOL published the final rule implementing the provisions of Executive Order 13658.

It is long-standing policy that Medicare (Parts A and B) or Medicaid providers are not considered to be federal contractors. However, if a provider currently has VA patients, they are considered to be a federal contractor. AHCA held a webinar with officials from the VA last week on issues impacting those with VA contracts, including the $10.10 issue. The full webinar can be found here. AHCA is awaiting answers from DOL, which has jurisdiction over this issue, on how the $10.10 will impact those with VA contracts or those thinking of entering into a VA contract. As soon as AHCA has information from DOL, which should be this week, AHCA will share it with its membership.

Advancing Excellence and Hallmark Launch New Employee Recognition Program

On Friday, December 12, partners Advancing Excellence in Long-Term Care Collaborative and Hallmark Business Connections launched a new and cost-effective employee recognition program named You Make A Difference.

Designed to help stabilize the average annual nursing home turnover rate of 50%, this innovative resource will provide administrators and senior leaders a tool that’s fun to give and even more fun to receive. It’s been reported that only one-third of employees feel appreciated or engaged. Yet, studies show employee engagement is key to job performance and staff retention.

Furthermore, companies that score in the top 20% for building a recognition-rich culture achieve a 31% lower voluntary turnover rate and engagement scores rise. What’s more, the care of residents will be improved when the same staff attends to them day after day.

 With the You Make A Difference reward and recognition portal, nursing homes can:

 · Order greeting cards and certificates with sincere, thoughtful messages and inspiring visual designs. The certificates can be printed or emailed.

· Easily personalize the award to make the recognition more meaningful.

 · Include a monetary incentive when appropriate. Employees can then redeem the amount for gift cards from hundreds of major national retailers, restaurants, entertainment and travel providers.

Best practices and tips for acknowledging staff and celebrating milestones are also offered as part of the You Make A Difference campaign.

Let your staff know how much you appreciate their accomplishments. You can start now by clicking

Finding & Keeping RNs is an Investment

Finding great RNs and retaining them is an investment every very facility administrator should carefully consider. Once you hire aRN keeping that person highly satisfied in their job is the next challenge. AHCA’s Gero Nurse Prep program provides a solution. Gero Nurse Prep expertly equips RNs to pass the national Gerontological Certification exam:
  • Created expressly to expand the knowledge, skills, competencies, personal and professional growth of registered nurses (RNs) in long-term care facilities.
  • Prepares RNs for attainment of national certification as Gerontological Nurses (credential RN-BC: Registered Nurse-Board Certified) through rigorous testing by the American Nurses Credentialing Center (ANCC).
  • National certification is a badge of quality. It signifies the highest standard of clinical and leadership excellence. And it assures employers, residents and families of quality nursing care.
  • In facilities employing certified RNs, key quality indicators - including patient outcomes, patient satisfaction and RN satisfaction - have shown marked improvement.
  • To date, RNs who've taken the Gero Nurse Prep Course have a 96% exam pass rate. 
Now through December 31, SAVE $100 on each course registration. The online, self-paced course can be completed at any time, but this offer will expire soon so register your RN today.