Thursday, December 18, 2014

Free Clinical Practice Webinar Series from AHCA/NCAL


The Clinical Practice Committee designed a series of free webinars focused on various areas of clinical practice that support the AHCA/NCAL Quality Initiative goals to safely reduce hospital readmissions and the off-label use of antipsychotic medications.  The Series is now complete and the webinars are available on demand so they can be viewed at all hours. 

The Clinical Practice Series offers webinars useful to all members in the interdisciplinary team including three part reducing rehospitalizations, eight part falls management & prevention, two part antipsychotic medication management & reduction, and considerations for end of life care.  Click here to view the flyer with more details.  Visit the AHCA/NCAL website to access these webinars.

Quality Award Application Deadlines


The National Quality Award program recognizes high-performing long term and post-acute care centers across the nation based on the Baldrige Performance Excellence criteria. The program is open exclusively to AHCA/NCAL member centers.  Since its inception, the program has recognized more than 3,000 member centers with an award. Applicants may apply for three levels of awards: Bronze, Silver and Gold, each with its own distinct rigors and requirements for quality and performance excellence.

If you are new to the program, it’s not too late to apply! The Bronze application can be completed in a short period of time using the Bronze Criteria Series as a resource. Not sure if you are interested? Check out the top five reasons to participate in the program:

Five Reasons to Apply
  1. Adopt a Proven Framework for Performance Excellence: The Baldrige criteria are a proven framework for comprehensive quality management to enhance organizational success.
  2. Measurable Outcomes: AHCA research shows that centers that achieve the Silver and Gold award are significantly more likely to have fewer survey deficiencies, better quality measures and higher satisfaction scores than the national average.
  3. Peer Feedback: All eligible applicants receive customized feedback to help improve performance in the application and the organization.
  4. Prepare for QAPI: The Bronze criteria are aligned with the Quality Assurance Performance Improvement (QAPI) requirements forthcoming from CMS. Quality Award participants will be ahead of the curve in complying with this new requirement. 
  5. National Recognition: The Quality Award is a great way to showcase your center’s commitment to continuous quality improvement and resulting success. Recipients are featured in a national press release and receive assistance in promoting this accomplishment.


If you are interested in applying for the program, there are two key deadlines to note:

  • January 29, 2015– Bronze Application Deadline (mandatory)
  • February 12, 2015–Silver and Gold Application Deadline (mandatory)


All deadlines are at 8 p.m. Eastern

Missed the Quality Award Intent to Apply Deadline? Don’t worry; you can still submit a Quality Award Application.

LTC Trend Tracker Webinar Series

help@ltctrendtracker.com

If you have questions about how to use the new LTC Trend Tracker, join our Friday webinar sessions beginning January 9, 2015.  The LTC Trend Tracker team will be available to answer your questions on how to build reports, how to use LTC Trend Tracker and other general questions.   Please register for one of the sessions below:


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 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. 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.  

  •  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. 


  • 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.  


Centers receive increasing levels of recognition as they achieve more goals, referred to 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 QualityInitiative@ahca.org.


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 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

dpace@aeltcc.org


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 AELTCC.org

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.   

Tuesday, December 16, 2014

2015 Independent Owner (IO) Leadership Conference Offers Unique Networking Opportunities

Christy Sharp

As you look ahead to the New Year and set new goals, consider the IO Leadership Conference.
 
 
March 11-13, 2015
Westin Beach Resort & Spa
Fort Lauderdale, Florida
Registration is now open, and it’s an opportunity you can’t afford to miss.

 “AHCA’s Independent Owner Conference is the only forum where I can discuss challenges I am facing owner to owner.”
—Kelley Rice-Schild

So mark your calendars and register today!
 
We've revised the format so that all sessions at the IO Leadership Conference are now in the popular Town Hall format. You'll hear more from each other, share ideas, and engage in lively, facilitated discussions. Additional networking and social opportunities include a reception on Wednesday evening, and a networking lunch and spectacular dinner on Thursday, all in the relaxing atmosphere of a gorgeous beach-side resort.

This year’s theme is How To Survive Medicaid Managed Care As an Independent Owner. You can earn up to 11.75 CEUs and take part in a range of education sessions.

Don't miss this unique opportunity to gather with your peers. Visit io.ahcancal.org to see the complete agenda and register.

Enjoy special savings opportunities when you register early, or if you are attending for the first time. The deadline is February 9, 2015.
Sponsors as of 12/15/2014: eHealth Data Solutions, Kronos, matrixcare, Mueller Prost, and PointRight.

2015 Healthcare Observances Calendar is Online

Katherine Merullo

A handy look at 2015 for all the monthly, weekly and daily healthcare observances has been posted to the AHCA website.  If you're interested in finding out when certain celebrations or recognitions occur, this is the document to use for all your planning needs.

If there is a relevant celebration that is not on this calendar, please let us know.  Many of the fall dates have not been determined yet but will be sorted out in the new year.

Also, AHCA is always interested in hearing about how you recognize and celebrate.  Please share your ideas on Facebook with a story and an image.

NCAL Wins National Award for LGBT In-Service Training

Lindsay Schwartz 

NCAL was a winner in the 23rd annual National Mature Media Awards Program. “Better Serving the Lesbian, Gay, Bisexual, and Transgender (LGBT) Populations in Long Term Care” received a Bronze Award for Staff/In-service Training for its design, content, creativity, and relevance to the senior market.

The training program was offered at the 2013 NCAL Spring Conference, as well as around the country at numerous state affiliate conferences.

The training program begins with a background on the terminology used among LGBT community and provides a short history on the struggles and advancements of LGBT individuals. 

For instance, it points out that the Gay Liberation movement started in the late 1960’s. Until 1973, homosexuality was classified as a psychiatric disorder by the American Psychiatric Association.

The NCAL training program offers things caregivers can do for LGBT residents in assisted living communities. Specifically, it advocates ongoing education and sensitivity training to increase cultural competency.

For example, the training encourages staff to be accepting of each resident’s loved ones. For LGBT residents, this means visitation should not be denied to their spouses, partners, or families of choice (a circle of friends who are like family).

Additionally, NCAL’s education program teaches caregivers to approach residents on their terms. Some LGBT residents may be comfortable being out with their caregivers, while others may prefer to only tell those with whom they are close.

NCAL encourages staff training to avoid discussions on whether homosexuality is right or wrong. “The goal of training is to convey that staff are to provide quality care to all residents, and sexual orientation should not change this,” the educational program says.

Improving care to the LGBT population should be an effort for the inevitable future. The Equal Rights Center in Washington, D.C., estimates that the number of LGBT Americans 65 and older to double from 3 million to 6 million by 2030.

The presentation is a member benefit, available for download from the NCAL website. If you are interested in having the in-service training presented at your upcoming conference, please contact Lindsay Schwartz: lschwartz@ncal.org.

Updated 2015 Medicare Part B Therapy Physician Fee Schedule File Posted on AHCA Website

Dan Ciolek

Thanks to the efforts of Tony Marshall, the Senior Director of Reimbursement for the Florida Health Care Association, AHCA is now able to post the updated 2015 Medicare Part B Fee Schedule that applies to Part B therapy services for the period from January 1 through March 31, 2015 here.

  Included in this file are tables related to Part B therapy services, including the continuation of the multiple procedure payment reduction (MPPR) policy.

The following provides additional background and guidance regarding how to read and use the file:

The 2015 (January through March) therapy fees for each CPT/HCPCS Code in each geographic area are provided in the Excel spreadsheet. This document has four worksheets containing the following information:

 1. The 2015 Medicare Part B Fee Schedule (Part B Fees) for Outpatient Rehabilitation for each Carrier and Locality.

 2. The 2015 Medicare Part B MPPR Fee Schedule (MPPR) for “Always Therapy” Services (50% MPPR Factor). 

3. The 2015 Relative Value Units (RVUs) for each Outpatient Rehabilitation Therapy Code.

4. The 2015 Geographic Practice Cost Indices (GPCI) by Medicare Carrier and Locality.

The final Part B Fee Schedule amounts are calculated as follows:

 (( A1 x B1) + (A2 x B2) + (A3 x B3)) x Conversion Factor (Part B Fees), and

 (( A1 x B1) + ((A2 x B2) x (1-MPPR Factor)) + (A3 x B3)) x Conversion Factor (MPPR Part B Fees), where: 

A1 = Physician Work RVU
A2 = Non-Facility Practice Expense RVU
A3 = Malpractice RVU
B1 = Work GPCI
B2 = Practice Expense GPCI
B3 = Malpractice GPCI

Conversion Factor = $35.8013

MPPR Factor = 50%

Please note that the fees reflect all changes included in the CY 2015 Medicare Physician Fee Schedule Final Rule published in the Federal Register on November 13, 2014. The fee schedule also reflects legislation (Section 101 of the Pathway for SGR Reform Act of 2013 and Sections 101 and 102 of the Protecting Access to Medicare Act of 2014) which provided for a one-half percent (0.5%) update to the Medicare Physician Fee Schedule effective January 1, 2014, a zero percent (0.0%) update for services provided January 1, 2015 through March 31, 2015, and extended the 1.0 Work GPCI floor through March 31, 2015. After March 31, 2015, the standard calculation of the Medicare Physician Fee Schedule under the SGR formula will apply which is expected to result in a reduction to payment rates of 21.2 percent for the remainder of CY 2015. (CMS notes in the Final Rule that they will continue to work with Congress to develop a long-term solution to fix this untenable situation.)


The outpatient therapy beneficiary cap for CY 2015 is $1,940 for physical therapy and speech-language pathology combined, and $1,940 for occupational therapy. Section 103 of the Protecting Access to Medicare Act of 2014 extended the therapy caps exceptions process through March 31, 2015. The current MMR policies and procedures remain in effect until March 31, 2015 pending further legislation.

 The final rule also continues the multiple procedure payment reduction (MPPR) policy for “always therapy” services. The MPPR policy required, effective April 1, 2013, a 50 percent reduction to be applied to the practice expense component of payment for the second and subsequent “always therapy” service(s) that are furnished to a single patient by a single provider on one date of service (including services furnished in different sessions or in different therapy disciplines). The MPPR worksheet lists those “always therapy” services subject to the MPPR policy and the reduced fee payment amounts.

An overview of the Physician Fee Schedule Payment Policies may be found on the CMS website and an overview of skilled nursing facility consolidated billing and annual updates can be found here. Additional state-specific details for 2015 can be found online.

Additional schedules will be provided before the April 1, 2015 rate changes and/or following further legislation.

CMS issues proposed rule related to resident rights

Lyn Bentley


On Friday, December 12, 2014, CMS issued a proposed rule entitled: Medicare and Medicaid Program; Revisions to Certain Patient’s Rights Conditions of Participation and Conditions for Coverage.

The provisions of the rule apply to:

Ambulatory Surgical Centers
Hospices
Hospitals
Long-Term Care Facilities (SNFs and NFs)
Community Mental Health Centers

The changes are consistent with the Supreme Court decision in United States v. Windsor, 570 U.S.12, 133 S.Ct. 2675 (2013), which found the Defense of Marriage Act unconstitutional. The proposed changes impact portions of Resident Rights at §483.10 and Preadmission Screening and resident Review (PASSR) Evaluation Criteria at §483.128. Essentially, the same-sex spouse of a resident must be afforded treatment equal to that afforded to an opposite-sex spouse if the marriage was valid in the jurisdiction in which it was celebrated. Similarly, in the PASSR regulations, same-sex spouses are recognized and treated as an opposite-sex spouse if the marriage was valid in the jurisdiction in which it was celebrated, relative to participation in the PASSR review.

Comments are due by 5 p.m. on February 10, 2015. AHCA will submit comments. If you have comments that you would like to be considered for inclusion in AHCA’s comments, please send them to Lyn Bentley no later than January 27, 2015.

Friday, December 12, 2014

State of the States Clearinghouse – Identify Key Medicaid and Medicare Data That Impacts Your State

Abigail Horn


The AHCA/NCAL State of the States Clearinghouse, an online AHCA/NCAL resource launched earlier this fall, provides members with access to key Medicaid and Medicare information.

DID YOU KNOW?

The Medicaid Reimbursement for Nursing Centers section of the clearinghouse provides information on:

· State-specific Medicaid rates, costs, and shortfalls; 

· Provider tax rates; 

· State Medicaid payment structure; and 

· Medicaid payment of Medicare coinsurance policy information.



Please visit the AHCA Medicaid Page to learn more about this resource and to access other AHCA members-only Medicaid resources. ​​The State of the States Clearinghouse is your one-stop shop for key Medicaid and Medicare information impacting the long term care profession.


 

Thursday, December 11, 2014

Refreshed LTC Trend Tracker Proving to Be Valuable Resource

help@LTCTrendTracker.com
 
The new and improved online platform for LTC Trend TrackerSM – launched at the AHCA Annual Convention this fall – is transforming how skilled nursing providers maximize their quality improvement efforts and operational performance.

Available exclusively to AHCA members, LTC Trend Tracker allows providers to access extensive CMS data on skilled nursing centers, as well as compare themselves to their peers. This more modern, user-friendly version gives more information up-front, allows the creation of custom reports and offers additional options in choosing peer comparisons. Members can access information such as exclusive, in-house measures that provide insight on hospital readmissions and discharges to the community. It also allows skilled nursing organizations to examine ongoing quality improvement efforts. 

Members not yet signed up for LTC Trend Tracker should utilize this exclusive member benefit and register today. For any questions, please contact the LTC Trend Tracker team

Tuesday, December 9, 2014

Emerging Nutrition Issues Webinar Series – Part I: The 2014 NPUAP/EPUAP/PPPIA Guidelines for Nutrition in Prevention and Management of Pressure Ulcers

Adrienne Riaz-Khan

Long Term Care Nutrition Experts, Brenda Richardson, MA, RDN, CD, LD, FAND, along with Past Director/President of the National Pressure Ulcer Advisory Panel, Mary Ellen Posthauer, RDN, CD, LD, FAND will present a webinar focused on the 2014 EPUAP and PPPIA international guidelines for nutrition in prevention and management of pressure ulcers. This webinar will be the first in a three-part series in 2015 on emerging nutrition issues impacting he long term care profession. In this webinar, learn more about evidence-based recommendations for nutrition screening, assessment, and care planning along with specific recommendations related to energy , protein, hydration, vitamins and, minerals.
Learning Objectives:

· Understand the impact of pressure ulcers on the quality of life for our aging population.
· Identify the 2014 “evidence-based international guidelines” for nutrition from NPUAP/EPUAP/PPPIA
· Define practical nutrition strategies for preventing and healing pressure ulcers.

Webinar: Update on VA Contracts, VA Provider Agreements and $10.10 Wage Increase

Dana Halvorson

On Thursday, December 11, 2014 from 11:00am - 12:30pm Eastern Time, you will have the opportunity to get your pressing questions answered on issues impacting you as a VA contractor.

Presenters include:

• Daniel J. Schoeps
Director, Purchased Long Term Services and Supports
Geriatrics and Extended Care
VA Central Office

• Patrick O'Keefe
Program Analyst (NRCPDS)
US Department of Veterans Affairs

The registration link for this free webinar event for AHCA members can be found here. Please be sure to register if you plan to attend. If you have any questions whatsoever relating to this, feel free to contact AHCA's Senior Director of Not for Profit & Constituent Services, Dana Halvorson.

Medicare Anti-Fraud Legislation Introduced in House

Drew Thies 

House Ways & Means chair Kevin Brady (R, TX) and ranking member Jim McDermott (D, WA) introduced the “Protecting the Integrity of Medicare Act,” a wide-ranging bill which seeks to limit Medicare and Social Security fraud.

The bill, introduced December 2, was released in draft for by Rep. Brady in August and contains a number of provisions, including modifying Medicare cards, setting up outreach and education efforts for contractors, renewal of MAC contracts, preventing prescription drug abuse under Medicare Part D, modification of home health surety bonds, and expanding the Comprehensive Error Rate Testing (CERT) program. 

The bill, while bipartisan, is not without its critics. Even Rep. McDermott has expressed some concern. “Although I continue to have reservations regarding certain provisions, I have agreed to join in this effort because I believe that the American people deserve a collaborative approach to this nonpartisan issue,” he said in a statement.

It is unlikely the bill will move until Congress returns for a new session in January. AHCA will continue to monitor the bill’s status as we progress into 2015.

Register Now for the White House Conference on Aging Webinar

 Drew Thies

The White House Conference on Aging will begin its webinar series Thursday, December 11th with a session discussing the opportunities and challenges of healthy aging.

The webinar entitled “21st Century Challenge for Healthy Aging: Balancing Living Well with the Reality of Multiple Chronic Conditions,” will begin at 4:00 PM EDT and will feature both White House and Health and Human services staff, as well as aging experts from medical and academic backgrounds.

Registration for the event is required but still open. Register here to participate.

The White House Conference on aging is a once-a-decade event featuring multiple seminars and panels which serve to guide health policy in the White House, Federal agencies, and Congress. AHCA already has had members participate in preliminary planning for this important conference and we look forward to our continued involvement as the official conference draws nearer.

7th Annual AHCA/NCAL Quality Symposium: It's Time to Roar!

Jon-Patrick Ewing

Come join like-minded quality professionals in long term and post-acute care at the 7th Annual AHCA/NCAL Quality Symposium: It’s Time to Roar! Register today and mark this off your holiday to do list! Held in Austin, Texas, February 23-25, this unique event offers a variety learning and interactive sessions: intensives, new LED (Lead, Engage, and Discuss) Talks, guided poster gallery, several sponsor supported education session with evidence based solutions on quality improvement, and more than 20 concurrent sessions over three days. Plus an opportunity to earn up to 15.5 CEUs.

For a complete schedule, list of speakers, sponsors, network events, and hotel and travel, visit our official Quality Symposium website for details.

The early registration deadline for this event is January 23, 2015.



OSHA Issues New Requirements for Occupational Injury & Illness Reporting

Lyn Bentley

Effective January 1, 2015, employers must report an expanded list of injuries to OSHA and revises the requirements for when an employer must report work-related hospitalizations. The final rule also provides additional avenues for how to report to OSHA and more clearly identifies the information that must be reported to OSHA.

Under the final rule, all employers, including all nursing home facilities and assisted living facilities, are required to report all fatalities, inpatient hospitalizations, amputations, and losses of an eye.

The specifications under the final rule can be found here.

Newly Developed Toolkit to Increase Influenza Vaccination among Healthcare Personnel in Long Term Care

Holly Harmon


The long-term care toolkit for increasing influenza vaccination among healthcare personnel in long term care settings – developed by the HHS National Vaccine Program Office (NVPO) and available on the CDC website – is the first of its kind. This toolkit was developed because workers in long-term care centers are vaccinated at a much lower rate than that of healthcare personnel in general (63.0% versus 75.2%, according to CDC data for the 2013-2014 flu season). Trends show there have been increases in vaccine coverage within all occupational settings over the past few seasons, with the exception of long-term care. 

Within the toolkit are a number of resources intended to help long-term care centers, agency, or corporation owners and administrators provide access to influenza vaccination for their workforce and to help any employer of workers in long-term care understand the importance of influenza vaccination for their employees. In it you’ll find resources for increasing influenza vaccination among healthcare personnel in long-term care settings as well as data and other information. Increasing vaccination rates among long-term care personnel—including doctors, nurses, nursing assistants or nursing aides, home health aides, personal care aides, and others who do not have direct resident care, such as clerical, dietary, housekeeping, and volunteers, will help to reduce influenza-related illness and its potentially serious consequences. Visit the CDC website for more information. 

OFCCP Releases Final Rule Prohibiting LGBT Discrimination in Government Contracting

Dana Halvorson

According to a December 4, 2014, email alert from Ford & Harrison, LLP, the Office of Federal Contract Compliance Programs (OFCCP) has released its final rule implementing Executive Order 13672, signed by President Obama on July 21, 2014, which prohibits federal contractors from discriminating against individuals on the basis of sexual orientation or gender identity. The OFCCP has published a list of Frequently Asked Questions regarding the rule, which are available here. The rule will be effective 120 days from its publication in the Federal Register and will apply to federal contracts entered into or modified after the effective date. You can read the full Ford & Harrison, LLP, legal alert here.

As previously noted, 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. It is important to note that under the VA Provider agreement proposed rule AHCA has been working to finalize, providers would not be considered federal contractors, and would therefore not have to follow complex federal contracting and reporting rules. AHCA is currently awaiting the release of the final rule, and will keep its members posted on any updates relating to this matter.

Influenza Update from CDC

Holly Harmon 
 
The CDC announced that influenza A (H3N2) viruses have been detected most frequently and have been detected in almost all states. There tend to be more severe seasons when H3N2 viruses predominate. About half of the H3N2s that have been analyzed since October are different from the H3N2 virus that is included in this season’s flu vaccine. They are different enough that the CDC is concerned protection from vaccination against these drifted H3N2 viruses may be reduced. CDC continues to recommend:
  •   Flu vaccination as the best way to protect against the flu. Vaccination may provide partial protection against the drifted viruses and should better protect against other non-drifted flu viruses that may circulate this season, including influenza B viruses
  • Antiviral medications as an important second line of defense against the flu. Treatment with antiviral drugs is especially important for people at high risk of serious flu complications or people who are very sick with flu. It's especially important to get antiviral medicines quickly – as they work best when started within two days of the beginning of flu symptoms.
  • Everyday actions like covering your cough, staying away from sick people, and washing your hands often. If you get the flu, stay home from work or school. If you are sick, do not go near other people so that you don't make them sick too.
Click here to read the CDC Health Advisory.

RNs Gain a Competitive Advantage in Your Career

Jon-Patrick Ewing

From now until the end of the year, AHCA/NCAL’s Gero Nurse Prep program is offering a $100 savings on all course registrations. Gain a competitive advantage in your career, be ready for all kinds of geriatric nursing challenges, and get the tools you need to provide superior care.

Gero Nurse Prep is a self-paced online course that prepares RNs to pass the gerontological certification exam by the American Nurses Credentialing Center.

Visit the official Gero Nurse Prep website to learn more about the program and its benefits for staff, residents, and organizations.

Whether you're an RN ready to advance your career or an administrator wanting to raise the level of care at your center, Gero Nurse Prep has what you need. Don’t let this great opportunity pass you buy. Sign up yourself or a member of your staff today. Offer ends December 31, 2014.

Wednesday, December 3, 2014

HOUSE SET TO VOTE ON APPROVAL OF ABLE ACT

Drew Thies

The House will vote tonight for passage of the bipartisan Achieving a Better Life Experience (ABLE) Act (bill text, summary), legislation that focuses on easing the financial burden of those living with intellectual and developmental disabilities and their families.

The ABLE Act would help more individuals with disabilities work, save and live independently without losing access to Medicaid and Supplemental Security Income (SSI). States would have the option to establish an ABLE program, under which eligible individuals with disabilities could start an ABLE account, modeled after current Section 529 savings accounts. 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. 85 percent of Congress supports the bill--380 House cosponsors and 74 Senate cosponsors--including leadership in both parties.

A vote in the Senate during the lame duck session may be scheduled if the House approves the legislation, which they are expected to do by a wide margin.

The bipartisan effort to pass the ABLE Act has been overshadowed by larger fights in the Lame Duck session over how to respond to President Obama’s recent executive action on immigration and tax break extensions that have proved controversial. AHCA will continue to monitor and respond to legislation in the expected final two weeks of this Congressional session.

Tuesday, December 2, 2014

Fraud and Abuse Prevention Toolkit

Dianne De La Mare


AHCA/NCAL is pleased to release the Fraud and Abuse Prevention Toolkit, posted on AHCA/NCAL website, which was prepared by Reed Smith attorneys, Susan Edwards and Carol Loepere. It was reviewed by AHCA’s Legal Committee and edited by AHCA Public Affairs staff, Tom Burke.

This Toolkit will help AHCA/NCAL membership untangle the complex web of federal and state agencies, regulations and laws related to fraud and abuse. Although the Toolkit focuses on nursing care centers (NCCs); much of the information within also applies to other settings, such as assisted living communities (ALCs) and centers for individuals with intellectual and developmental disabilities (ID/DD). In all of those settings, for example, the federal anti-kickback and Stark laws will apply (e.g., those laws are relevant to all health care programs including both the Medicare and Medicaid).

Please note, the Toolkit will help AHCA/NCAL membership better understand the legal environment they operate within.  However, it is not a Compliance Program or Compliance Plan. Instead, this Toolkit was specifically developed to help members improve their compliance with federal fraud and abuse laws and regulations.

To obtain a copy of the Toolkit go to http://www.ahcancal.org/facility_operations/integrity/Pages/default.aspx.

Please contact Dianne De La Mare at ddmare@ahca.org if you have any questions.

ICD-10 Team Preparation: Are you Ready?

Dianne De La Mare

Please join us on Friday, December 5, 2014, 2:00PM, Eastern Time, for the first webinar in a 2-part series entitled, ICD-10 Team Preparation: Are you Ready?, with HCPro expert, Diane L. Brown, BA, CPRA, where you will learn:

 · Diagnosis Coding Basics
· Scope of ICD-10 Implementation
· Managing ICD-10 Transition Issues


The overall purpose of this webinar is to assist SNFs in understanding the ICD-10 basics, as well as some of the specifics of coding in the LTC environment. Although the Centers for Medicare & Medicaid Services (CMS) has provided numerous training sessions to hospitals and physicians over the last several years; it has not provided any specific ICD-10 training to SNF organizations and staff. Now is the time for SNFs to prepare for the ICD-10 system; and it involves planning, calculating the scope of work, determining timing and the learning “curve,” and securing an adequate budget to accomplish the task. Recognizing the consequences of and improving the choices SNFs make as we approach the ICD-10 transition is the focus of this webinar. Some SNFs may have already begun the preparation process; but some still have some work to do to meet the new transition deadline of Oct. 1, 2015.

This webinar will prove invaluable to those of you looking for concrete ICD-10 direction and instruction now. REGISTER NOW at http://webinars.ahcancal.org/session.php?id=14943.
 

Mark your calendar now for Thursday December 11, 2014, at 2:00PM, Eastern Time, when we have scheduled the second webinar in this series, Is Your ICD-10 Coding Accurate? Diane Brown will again be leading this discussion; but this time the discussion will focus on:

· ICD-10 Official Coding Guidelines
· Using the Index and Tables
· Selecting Proper Code from the Index

REGISTER NOW at http://webinars.ahcancal.org/session.php?id=14944.

Prior to each webinar, we encourage you to go on AHCA’s website at http://www.ahcapublications.org/ProductDetails.asp?ProductCode=8296 and purchase ICD-10 Essentials for Long-Term Care: Your Guide to Preparation and Implementation, by Karen L. Fabrizion, RHIA, CPRA. This manual will help greatly as you listen and participate in the upcoming AHCA webinars.

OIG 2014 Top Management & Performance Challenges

Dianne De La Mare

The US Department of Health and Human Services, Office of Inspector General (OIG) has released its annual summary of the agencies most significant management and performance challenges. The OIG has identified ten challenges where it believes either HHS has had vulnerabilities over recent years or that it believes that HHS will face in the future.

Specifically, OIG identifies: 1) Implementing, operating and overseeing the health insurance marketplaces; 2) Ensuring appropriate Use of prescription drugs in Medicare and Medicaid; 3) Protecting an expanding Medicaid program from fraud, waste and abuse; 4) Fighting waste and fraud and Promoting value in Medicare Parts A and B; 5) Ensuring quality in nursing home, hospice and Home- and Community-Based Care; 6) The meaningful and secure exchange and use of electronic health information; 7) Effectively operating public HHS programs to best serve program beneficiaries; 8) Ensuring effective financial and administrative management; 9) Protecting HHS grants and contract funds from fraud, waste and abuse; and 10) Ensuring the safety of food, drugs and medical devices.

To obtain a full copy of the OIG report go to http://oig.hhs.gov/reports-and-publications/top-challenges/2014/.





CMS Instruction on Prepayment ADRs Released

Dianne De La Mare


The US Department of Health and Human Services, Center for Medicare & Medicaid Services (CMS) has released a revised Medicare Learning Network (MLN) Matters article, New Timeframe for Response to Additional Documentation Requests, which instructs Medicare Administrative Contractors (MACs) and Zone Program Integrity Contractors (ZPICs) to notify providers that they must submit their prepayment Additional Documentation Requests (ADRs) within 45 calendar dates from the initial MAC/ZPIC request date.

MACs and ZPICs also must notify providers that failure to respond to a prepayment review ADR within the 45-day timeframe will result in a denial of the claim. The effective date is April 1, 2015.

CMS review contractors (MACs, ZPICs, Recovery Auditors, etc.) are not always able to make a determination on a claim based solely on the information on the claim. In those instances, CMS review contractors will solicit documentation from the provider or supplier by issuing an ADR. CMS review contractors are authorized to collect medical documentation.

The ADR requirements must notify the provider that: 1) no payment will be made to the provider if they have not furnished the information requested in an ADR; and 2) when requesting documentation for a prepayment review; MACs and ZPICs must notify providers that the requested documentation must be submitted within 45 calendar days of the request, or providers claim will be denied.

To obtain the complete copy of the MLN article go to http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8583.pdf.

SHOP Marketplace Webinar Series

Dana Halvorson


According to a November 25, 2014, email alert from the HealthCare.gov Team, the Centers for Medicare and Medicaid Services (CMS) is offering a webinar series for small business employers, agents, brokers and other interested stakeholders, about important changes in the Small Business Health Options Program (SHOP).

SHOP was created in the Affordable Care Act, and is a new way for small businesses to buy health insurance for their employees. The presentation will focus on the federally-run SHOP Marketplace and subject matter experts will be on hand to take questions following the presentation. The webinar will be offered every Tuesday, 2:00 to 3:00 p.m. ET from December 2, 2014, through February 24, 2015, (except December 23 and 30). The full 2014-2015 SHOP webinar schedule and registration details can be found here.

More information on SHOP for employers can be found on the HealthCare.gov site


 

 

Submit Your Quality Award Application today!

Urvi Patel


The Quality Award program recognizes high-performing long term and post-acute care centers across the nation. The program sets rigorous standards for quality based on the Baldrige Performance Excellence criteria.

The National Quality Award Program is open exclusively to AHCA/NCAL member centers. Since its inception, the program has recognized more than 3,000 member centers with an award.

Applicants may apply for three levels of awards: Bronze, Silver and Gold. Each level has its own distinct rigors and requirements for quality and performance excellence.


Five Reasons to Apply
1. Adopt a Proven Framework for Performance Excellence: The Baldrige criteria are a proven framework for comprehensive quality management to enhance organizational success.

2. Measurable Outcomes: AHCA research shows that centers that achieve the Silver and Gold award are significantly more likely to have fewer survey deficiencies, better quality measures and higher satisfaction scores than the national average.

3. Peer Feedback: All eligible applicants receive customized feedback to help improve performance in the application and the organization.

4. Prepare for QAPI: The Bronze criteria are aligned with the Quality Assurance Performance Improvement (QAPI) requirements forthcoming from CMS. Quality Award participants will be ahead of the curve in complying with this new requirement.

5. Garner National Recognition: The Quality Award is a great way to showcase your center’s commitment to continuous quality improvement and resulting success. Recipients are featured in a national press release and receive assistance in promoting this accomplishment.

If you are interested in applying for the program, there are two key deadlines to note:

• January 29, 2015– Bronze Application Deadline (mandatory)

• February 12, 2015–Silver and Gold Application Deadline (mandatory)

Missed the Quality Award Intent to Apply Deadline? Don’t worry, you can still submit a Quality Award Application.

Stay on Track with the NCAL Spring Conference!

Katherine Preede


Did your waist band expand over the Thanksgiving holiday? Give yourself the opportunity to expand professionally as well by attending the 2015 NCAL Spring Conference!


With the opportunity to earn up to 10.5 CEUs, this must-attend event features the latest from experts in the assisted living profession and provides multiple networking opportunities with peers from across the country.

With the theme Thriving in a New Health Care Environment, the NCAL Spring Conference features two distinct tracks: Tools and Strategies that each bring focused and tangible information to participants. 

· The Tools track includes educational sessions on dementia care, risk management, quality improvement, opening a new communities and helping residents achieve a higher quality of life. 

· The Strategies track features emergency preparedness, staff stability and leadership training, how to utilize customer satisfaction data, preventing burnout, care transitions and the future of virtual senior care.

Join us March 9-11, 2015 at the Westin Beach Resort & Spa in Fort Lauderdale, Florida. 

Register TODAY and save $125 off the on-site registration rate! Also consider registering for the AHCA/NCAL Independent Owner Leadership Conference, occurring immediately after this event, March 11-13, 2015, and save on registration fees for both conferences.

This Year’s 2015 Independent Owner (IO) Leadership Conference To Focus on Medicaid Managed Care

Christy Sharp


Registration is now open for the 2015 IO Leadership Conference.

March 11-13, 2015
Westin Beach Resort & Spa
Fort Lauderdale, Florida

This year’s theme is How To Survive Medicaid Managed Care As an Independent Owner.
Earn up to 11.75 CEUs and take part in a range of education sessions including:

 • The Future of Health Care Policy

 • Managed Care Market Place

• Medicaid Managed Long Term Care Services and Supports (MLTSS) Contracting

• Positioning for Success in an MLTSS Environment

• Quality and Payment: The Growing Overlap

• Transformation: Cost-effectively Retrofit Aging Buildings for Person-centered Care

• Seven Deadly Sins That Are Sabotaging Your Social Media Efforts

We've revised the format so that all sessions at the IO Leadership Conference are now in the popular Town Hall format. You'll hear more from each other, share ideas, and engage in lively, facilitated discussions. Don't miss this unique opportunity to gather with your peers in beautiful, sunny Fort Lauderdale.

Visit io.ahcancal.org to see the complete agenda and register.

 Enjoy special savings opportunities when you register early, or if you are attending for the first time. The deadline is February 9, 2015.

Sponsors as of 11/11/2014: eHealth Data Solutions, Kronos, matrixcare, PointRight.

CMS Issues Long-Awaited ACO Version 2.0 Proposed Rule

James Michel

This week CMS issued a proposed rule calling for the first overhaul of the Medicare Shared Savings Program (MSSP) Accountable Care Organization (ACO) program since it was first established in 2011. According to a fact sheet developed by CMS:

 “The proposed rule addresses proposed changes to several program areas including beneficiary assignment, data sharing, available risk models, eligibility requirements, participation agreement renewals, and compliance and monitoring. Additionally, the proposed rule seeks comment on issues related to financial benchmarking and waivers for program and other payment rules.”

Of particular interest is CMS’ request for input regarding the application of a waiver of the three-day stay rule for all Medicare ACOs. Over the coming weeks AHCA will be analyzing the 429-page rule in anticipation of submitting comments to CMS by early February. Please email James if you are interested in providing input to these comments.

To access the proposed rule, click here.

 To access the CMS announcement on the rule, click here.