Wednesday, September 20, 2017

Get Involved With Hurricane Relief

AHCA/NCAL has launched a web page dedicated to helping the victims of Hurricane Harvey and Hurricane Irma.

Association members can find information about how to contribute to the Heroes of Long Term Care Hurricane Relief Fund, established by the Texas Health Care Association (THCA) Education Fund, for those in Texas.

In addition, a fund is currently in development for Florida's Hurricane victims. Members should stay tuned for more information on how to help the victims of this devastating event. 

Information and resources will be added to the web page as they become available.

Visit the AHCA/NCAL Hurricane Relief webpage here.


Participate in an NCAL Committee!

Katherine Preede

Becoming more involved in NCAL by participating on a committee! Now through October 20, you have the opportunity to nominate yourself to serve on one or more of the following committees: NCAL Quality Committee, NCAL Finance and Policy Committee, NCAL Risk Management Workgroup, and the NCAL Customer Relations Committee

All NCAL members are highly encouraged to participate in this process. In an effort to create diverse and widespread representation, appointments to specific committees may be limited to one participant per state and company. To assist in the process, individuals should choose two committees and rank their selections in order of preference. To submit your nominations, please complete the Survey Monkey. We hope you will take this opportunity to be an active member!

Advanced Registration Deadline Is Tomorrow!

After September 21, on-site registration fees apply, but you may register in-person beginning Sunday, October 15 at 6:45 am in the Mandalay Bay CC Foyer.

Don't miss all the exciting offerings at this year's Convention & Expo. It's the long term and post-acute care event that has everyone talking.

“I look forward to the AHCA/NCAL Conference every year. It helps me to keep my finger on the pulse of national activities, guidelines, and the political landscape of long term elder care.” — Heidi Keeler, Asst. Professor, UNMC

“TERRIFIC. I loved the education, motivation, entertainment, and location. If you haven't attended the annual convention before, you should seriously consider it. Well worth the investment!” — Jeff Christensen, Administrator, Mission at Community Rehab

Join your colleagues from all over the country to:
Network
Earn CEUs
Take part in engaging and timely educational sessions
Discuss the latest tools and trends in the Expo Hall
Strategize with other providers
Get inspired by fantastic speakers

You'll go home energized and excited to tackle your toughest challenges.

Get all the details and register for the convention package

Webinar: HIPAA Regulations and Sharing Sensitive Information about Clients with Dementia

Date/Time: September 27, 2017 from 2-3 p.m. ET

The goal of this web seminar is to review how HIPAA and its Privacy Rule permits the sharing of patient information with family members, friends and caregivers, as well as the components of the HIPAA right-of-access and ways in which it enables individuals and their caregivers to be more involved in their own care.

Participants in this web seminar will be able to:

· Understand how HIPAA permits the sharing of patient information with one’s “personal representative,” family members, friends and caregivers;

· Describe how and when protected health information may be used and shared;

· List the components of the HIPAA access right, including an individual’s ability to direct a copy of their health information to a third party; and,

· Describe how the HIPAA right of access enables individuals and their caregivers to become more involved in their care.

Additional information about this webinar and the registration link can be found here:

http://asaging.org/web-seminars/hipaa-regulations-and-sharing-sensitive-information-about-clients-dementia

For this webinar series, the Administration for Community Living’s National Alzheimer’s and Dementia Resource Center has partnered with the American Society on Aging.

Please note, complimentary CEUs are available through this webinar. In addition, the webinar will be recorded and available for viewing at nadrc.acl.gov.

SNF QRP: Claims-Based Measures Confidential Feedback Report Webinar


SNF QRP: Claims-Based Measures Confidential Feedback Report Webinar 
 
Thursday September 28, 2017
1-2 p.m. Eastern
Click here to register

CMS provides information on the Confidential Feedback Reports for the claims-based measures adopted for the Skilled Nursing Facility Quality Reporting Program (SNF QRP). These reports will be made available to SNFs via providers’ Certification and Survey Provider Enhanced Reporting (CASPER) folders in early October 2017

Information will be presented on the claims-based IMPACT Act measures included in the reports and direct participants to measure specifications.

CMS discusses the following items during this webinar:
  • SNF QRP background
  • Claims-based IMPACT Act measures
  • Confidential feedback report layout
  • Additional resources
  • Next steps
  • Questions & Answers
Audience: SNF providers, health care industry professionals, clinicians, researchers, health IT vendors, and other interested stakeholders

For more information, visit the SNF Quality Reporting Program Training webpage. 
 

The Biggest NCAL Day Ever?

Katherine Preede

Registration deadlines are approaching, and it’s looking like NCAL Day could be one of the most attended yet. Don’t miss out on the fun! Join your assisted living peers for a full day of stimulating education and networking on Sunday, October 15 during AHCA/NCAL’s Convention and Expo.

In its 11th year, NCAL Day will feature keynote speaker, Dr. Rishi Manchanda. A physician and public health innovator, Dr. Manchanda believes in finding the root causes of illness, or looking upstream rather than simply treating the symptoms.



NCAL Day will then offer educational sessions specifically geared towards assisted living providers on a variety of hot topics, including:
  • Empowering LTC Communities to Build a Culture of Improvement
  • Traits of a High Performing Health Care Organization
  • Dementia's Impact on Quality of Life
A panel comprised of a diverse set of assisted living providers will close out the day with a discussion on the latest topics in senior care.

With your ticket to NCAL Day, you are also invited to the NCAL Luncheon and Awards Ceremony where those who touch the lives of residents every day will be honored.

Spend another day in Vegas and get a head start on how to improve your assisted living organization. NCAL Day is a separately ticketed event that you can add on to your registration package.

Get Trained Now! New Antibiotic Stewardship Requirements Take Effect in November


AHCA is ready to help members meet the new Infection Preventionist specialized training requirement finalized by the Centers for Medicare and Medicaid Services (CMS) in the Reform of Requirements of Participation (RoP) for Long Term Care Facilities.  

AHCA’s  Infection Preventionist Specialized Training (IPCO) course provides education for health care professionals who seek to serve as Infection Preventionists and prepares individuals to meet the antibiotic stewardship requirements taking effect in November 2017.   
Even though nursing facilities are not required to have a designated “Infection Preventionist” until November 2019, there are three compelling reasons why it is critical to register for this training now:
  • As of November 28, 2016 nursing facilities are being held accountable to more expansive infection prevention and control federal regulations.
  • Beginning November 28, 2017, the federal requirements for nursing facilities expand further and require that every nursing facility develop and implement an antibiotic stewardship program. This is a new requirement that should be conducted with oversight from specially trained healthcare professionals. 
  • Surveyors nationwide are being trained now to survey for the expanded infection prevention & control and antibiotic stewardship requirements.
The course is an online, self-study program with 23 hours of training that meets the educational requirements outlined by CMS. It includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term and post-acute care.

AHCA’s course addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control that are fundamental to effectively leading and administering successful infection prevention and control programs and antibiotic stewardship programs. Upon successful completion of this program, participants will receive certificates including 23 ANCC contact hours.

The training course registration fee is $450 for AHCA/NCAL members and $650 for non-members.There are no refunds and no transfers. Payment and registration must be made online in ahcancalED.

The IPCO course can be accessed here or at: https://educate.ahcancal.org/p/ipco

Discounted group purchase rates are available for groups of 25 or more. Those interested in making a group purchase should email AHCA at educate@ahca.org.

To access ahcancalED and the IPCO course, members will need to login with their AHCA/NCAL usernames and passwords. For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail update@ahca.org with your name and facility contact information.  

RAISE Family Caregivers Act Introduced in the U.S. House of Representatives



Earlier this year, Senators Susan Collins (R-ME) and Tammy Baldwin (D-WI) re-introduced the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (S. 1028) in the U.S. Senate. Senators Lisa Murkowski (R-AK) and Michael Bennet (D-CO) are original co-sponsors. This legislation, which AHCA/NCAL supports, would implement the federal Commission on Long-Term Care’s bipartisan recommendation that Congress require the development of a national strategy to support family caregivers. The bill would create an advisory body to bring together representatives from the private and public sectors to advise and make recommendations. The strategy would identify specific actions that communities, providers, employers, government, and others can take to recognize and support family caregivers and be updated. Last Congress, the full U.S. Senate considered and passed this legislation. It did not come up for full U.S. House of Representatives’ consideration though before the end of last Congress. On May 11, 2017, the U.S. Senate Committee on Health, Education, Labor & Pensions (HELP) considered and approved this legislation by unanimous voice vote. It now awaits full Senate consideration.

Most recently and last week, a similar version of the RAISE Family Caregivers Act (H.R. 3759) was introduced in the U.S. House by Representatives Harper (R-MS) and Castor (D-FL) with Reps. Lujan Grisham (D-NM) and Stefanik (R-NY) as original cosponsors. It awaits full House consideration. According to AARP, about 40 million family caregivers provide about $470 billion annually in unpaid care to their loved ones. According to the Caregiving in the U.S. 2015 study from the National Alliance for Caregiving and AARP, about 3.7 million family caregivers provide care to a child under age 18 because of a medical, behavioral, or other condition or disability, and 6.5 million family caregivers assist both adults and children.

RTI Releases Report on the Impact of Minimum Wage Increases in Assisted Living


Lindsay Schwartz

The Research Triangle Institute (RTI) International conducted a study which examined the potential impact wage increases would have on assisted living (AL) and continuing care retirement communities (CCRC). RTI researchers examined the impact of raising the hourly minimum wage to $10, $12, and $15 per hour. The report includes the number of AL and CCRC workers who would be impacted by minimum wage increases and the average wage increases per worker, both nationally and in select states.

Researchers also examined the impact to providers, including the average total cost increase in the direct labor costs per worker and across workers. The report found that the average financial impact of a $10 or $12 minimum wage would be 1 percent and 5 percent in total costs, respectively. Overall, a $15 minimum wage would increase provider costs by a roughly 13 percent.

This study was conducted in a partnership between RTI International and the Center for Excellence in Assisted Living (CEAL). NCAL Senior Director of Workforce & Quality Improvement Lindsay Schwartz, Ph.D., is Board Chair of CEAL.

“There is a constant need to attract and retain staff who can provide quality care, and there’s also the challenge of keeping costs affordable for individuals and families who rely on these communities,” said Schwartz.

Take a Free Test Drive of CARES® Online Dementia Training and essentiALZ® Certification Today


Free test drives are available for HealthCare Interactive’s CARES® online dementia care training programs and the Alzheimer’s Association essentiALZ® individual certification programs. CARES® is recommended by the American Health Care Association/National Center for Assisted Living to help reduce the off-label use of anti-psychotics and the online training program is available 24/7.

These online training programs, offered by leaders in the dementia care field, are available to AHCA/NCAL members at a 10 percent discount. 

Use the code AHCA10 at checkout to apply your 10 percent savings off any individual course or site license purchase.

Each program is unique with different video and narrative educational content that teaches the learner about all stages of thinking decline, different approaches, and person-centered care.

To test drive any of the CARES® programs, go to www.hcinteractive.com/testdrive.

The Number of Open LTC Jobs Drops in September


There are 18,814 open jobs posted by direct employers this month in the nursing care facility (including skilled nursing facilities), assisted living, and continuing care retirement community (CCRC) sectors this month according to the latest CEB TalentNeuron statistics.  

The number of open jobs posted nationwide by direct employers decreased by more than 1,600 since August.    

The CEB TalentNeuron statistics also show an estimated 2,101,000 potential candidates in the nation’s workforce whose skills likely match the qualifications being sought by long term care employers. Figures show that 1,855 direct employers are competing for candidates this month – a decrease of more than 200 employers over August figures. The average number of days a job was posted this month decreased by one day to 36 days.   

Finding qualified employees is one of the greatest challenges facing long term care providers. The AHCA/NCAL Long Term Care Career Center is designed to help members be competitive in attracting qualified candidates to fill their health care job vacancies. The LTC Career Center is also fully integrated with Google’s new job search feature “Google for Jobs”, creating even greater exposure for job postings.

Rates for posting job vacancies are affordable and give prospective employers far greater exposure than local ads and job boards by connecting to a network of more than 330 national and state health care organizations and societies. Employers are also able to post vacancies as they occur and search resumes on the network. 

There are two great ways for skilled nursing center and assisted living employers to save on their job postings on the Long Term Care Career Center.  First-time job posters can receive 25 percent off their first posting by entering promo code New25off when they check out.  Employers with multiple positions to fill can purchase three job postings at one time and receive a 20 percent discount on the three postings by entering promo code Bundle20 at check out. 

Of course, the LTC Career Center is always free for job seekers.  And, job seekers are using the site with more than 91,000 searchable resumes on the National Healthcare Career Network this month. Job postings on the AHCA/NCAL Long Term Care Career Center network are averaging more than 1,500 views in September. 

Employers who utilize the site also receive outstanding exposure through rotating job listings on AHCA’s home page – the website where long term care professionals go for news and information.  In addition, employers who post vacancies through the center receive bonus rotating listings on the Long Term Care Career Center  home page.

Be seen nationwide. Check out the LTC Career Center today and remember to use one of the two promo codes to save on your job postings.      

AHCA/NCAL Convention & Expo: Advanced Registration Deadline is Tomorrow!



After September 21, on-site registration fees apply, but you may register in-person beginning Sunday, October 15 at 6:45 am in the Mandalay Bay CC Foyer.   

Don't miss all the exciting offerings at this year's Convention & Expo. It's the long term and post-acute care event that has everyone talking.

 “I look forward to the AHCA/NCAL Conference every year. It helps me to keep my finger on the pulse of national activities, guidelines, and the political landscape of long term elder care.”   — Heidi Keeler, Asst. Professor, UNMC

TERRIFIC.  I loved the education, motivation, entertainment, and location. If you haven't attended the annual convention before, you should seriously consider it. Well worth the investment!” — Jeff Christensen, Administrator, Mission at Community Rehab

Join your colleagues from all over the country to:
  • Network
  • Earn CEUs
  • Take part in engaging and timely educational sessions
  • Discuss the latest tools and trends in the Expo Hall
  • Strategize with other providers
  • Get inspired by fantastic speakers
You'll go home energized and excited to tackle your toughest challenges.

Get all the details and register for the convention package that is right for you.

AHCA/NCAL Announces 2017 Gold National Quality Award Recipients

Today, AHCA/NCAL announced that three long term and post-acute care providers have earned the 2017 Gold – Excellence in Quality Award. The award is the final of three distinct levels possible through the AHCA/NCAL National Quality Award Program, which recognizes organizations nationally that serve as models of excellence in providing high-quality care. 

The 2017 Gold – Excellence in Quality Award recipients are:

  • Inova Loudoun Nursing and Rehabilitation Center; Leesburg, VA
  • Edgemoor Distinct Part Skilled Nursing Facility (DPSNF); Santee, CA
  • The Alverno Health Care Facility; Clinton, IA
Based on the core values and criteria of the nationally recognized Baldrige Performance Excellence Program, the AHCA/NCAL National Quality Award Program challenges member providers to achieve performance excellence through three progressive levels—Bronze, Silver, and Gold. The Gold – Excellence in Quality Award is the most prestigious of the program. At this level, recipients have invested multiple years in mastering and applying the rigorous quality improvement standards of the Baldrige Criteria to achieve superior results in leadership, strategic planning, customer and workforce focus, and operations and knowledge management.

Since the inception of the National Quality Award Program in 1996, only 31 long term and post-acute care providers have achieved this level of quality recognition, apart from this year’s recipients.

AHCA/NCAL announced the recipients of the
 Bronze – Commitment to Quality on June 1 and Silver – Achievement in Quality on July 6. A full list of recipients is available on the AHCA/NCAL Quality Award website here.

The program is sponsored by AHCA/NCAL Associate Business Members: First Quality, NRC Health, and Team TSI Corporation. The awards will be presented during AHCA/NCAL’s 68th Annual Convention and Exposition in Las Vegas, Nevada, October 15-18, 2017


To learn more about the National Quality Award Program, visit the program website here or email qualityaward@ahcancal.org.

Senate Renews Repeal and Replace Efforts


Senate Republicans this week renewed efforts to repeal and replace the Affordable Care Act (ACA), coalescing around a plan championed by Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA).

The legislation, known as Graham-Cassidy, is similar to past attempts to overhaul the health care system in that it sets federal funding restrictions on Medicaid and devolves significant insurance market authority to states.

The plan cuts billions from Medicaid by placing per-capita caps on spending based on population group and reducing the maximum allowable provider tax rates from six percent to four percent.

The Senate only has a limited time frame to vote on the legislation. The reconciliation window that allows the Senate to pass the legislation with a simple 50 vote majority expires at the end of the month.

Though an official Congressional Budget Office score is not out, it is clear this bill would have devastating effects on the long term care profession

AHCA/NCAL is urging all of its members and advocates to call their members of Congress and urge them to oppose this legislation. Advocates can use the Care Advocacy resource to easily locate and contact Members of Congress.

There is also member webinar on Wednesday, September 20 at 5 p.m. Eastern to provide more information about the details of this proposal. Click here to access the webinar.

Monday, September 18, 2017

Submit Your Intent to Apply for the 2018 National Quality Award

The Intent to Apply process for the 2018 AHCA/NCAL National Quality Award application cycle is now open. 

The deadline to submit an Intent to Apply payment is Thursday, November 9th at 8 p.m. Eastern. The Intent to Apply is not mandatory to apply for the Quality Award, but members who submit an Intent to Apply benefit by saving money on their overall application fee and receive weekly tips on submitting a successful application.

Please note the following: 

  • All applicants should read the application packet in full before submitting an Intent to Apply payment. 
  • If your center last received a Bronze or Silver Quality Award in 2015 and has not submitted an application meeting minimum requirements since then, this is your last year to submit an application at the next level. If you do not submit an application this year, you will be considered a past recipient and have to resubmit at the Bronze level if your center chooses to participate again in the program. For more information, please review the recertification policy here.   
  • The National Quality Award website has numerous resources for applicants. Please make sure to visit our website at ahcancal.org/qualityaward to learn about the latest updates to the program. 
If you would like to review your center's award history or have any questions, please feel free to contact us at qualityaward@ahca.org


Wednesday, September 13, 2017

How We Pay Tribute During Assisted Living Week

Scott Tittle

As the executive director of the National Center for Assisted Living, I’m constantly visiting our state affiliates and member companies across the country. Touring assisted living communities is one of my favorite things while I’m out on the road. Seeing how providers are innovating senior care down to the finest details is truly inspiring. But most invigorating is the ability to talk one-on-one with direct caregivers.

You’ll hear a consistent phrase among assisted living staff, “They’re like my family.” This comes from staff at every level; from administrators to housekeeping and maintenance.

Read more on Medline’s blog

Happy National Assisted Living Week


Rachel Reeves

Now through Saturday is the biggest week of the year – National Assisted Living Week! The national observance (which begins each year on National Grandparents Day) honors the individuals served, as well as the individuals who serve, in assisted living and residential care communities across the nation with special activities and events.

Created by NCAL in 1995, NALW this year pays tribute to the close relationships staff and residents form through the theme “Family is Forever.” The theme was inspired by a quote from the famed poet Maya Angelou:

“Family isn’t always blood, it’s the people in your life who want you in theirs: the ones who accept you for who you are, the ones who would do anything to see you smile and who love you no matter what.”

How You Can Celebrate

· Check out our planning guide for activity ideas

· Share your activities and personal stories on social media with the hashtag #NALW

· Follow all the action on NALW’s Facebook page

· Keep track of your activity calendar and collect all photos from the week. You could use them to apply for the National Assisted Living Week Programming Award as part of the NCAL Awards Program in 2018.

AALNA/NCAL Caring Together Webinar: Medication Management


Lindsay Schwartz

Please join the American Assisted Living Nurses Association (AALNA) and National Center for Assisted Living (NCAL) for the third quarter Caring Together Webinar, September 20th 3-4pm Eastern. This webinar will cover topics on best practices for medication management in Assisted Living. The importance of the role of the AL nurse and consultant pharmacist for medication management in assisted living will be discussed. Other topics will include antibiotic stewardship, appropriate use of psychotropic agents, and review of the updated Medication Administration Pocket Guide co-developed d by the Center for Excellence in Assisted Living (CEAL), the American Society of Consultant Pharmacists (ASCP) and MED-PASS. Presenters will be Joan Baird, PharmD, BCGP, FASCP, Director of Pharmacy Practice and Government Affairs with the American Society of Consultant Pharmacists and Loretta Kaes, RN, B-C, C-AL, LNHA, CALA, Director of Quality Improvement and Clinical Services with the Health Care Association of New Jersey. You can pre-register for the webinar here.

Get Your AL Recognized for Improving Quality

Qualityinitiative@ahca.org

The NCAL is pleased to announce the relaunch of the Quality Initiative Recognition Program to honor assisted living members for their individual work in achieving the goals of the NCAL Quality Initiative. All achievers will be recognized at the AHCA/NCAL Quality Summit in New Orleans, March 12-14, 2018.

Eligibility

Member assisted living communities must achieve two or more of the four NCAL Quality Initiative goals. The goals are:

1. Increase staff stability by maintaining nursing and direct care staff turnover below 40%

2. Increase customer satisfaction to 90%

3. Safely reduce hospital readmissions by 15% or achieve a low readmission rate of 5% or less

4. Safely reduce the off-label use of antipsychotics by 15% or achieve a low off-label usage rate of 5% or less

What to Do Next

For assisted living communities, members must submit data for all NCAL goals in LTC Trend Tracker by October 13, 2017. Customer satisfaction vendors can upload data to LTC Trend Tracker on behalf of members. A list of vendors able to upload can be found here.

AHCA/NCAL also encourage members to:

• Check their data on LTC Trend Tracker to see where they stand on each Quality Initiative goal

• Review resources for achieving Quality Initiative goals for assisted living communities

Notification & Assistance

Later this year, achievers will be notified by the AHCA/NCAL Quality Initiative Recognition Program team using the latest available data.

In the meantime, if you need assistance with LTC Trend Tracker, email help@ltctrendtracker.com and be sure to add the email address to your Safe Sender list.

If you are also a skilled nursing provider, your SNF may also be recognized for meeting the goals of the AHCA Quality Initiative. Learn how to participate in the AHCA Quality Initiative Recognition Program.

Implications of the ABLE Act for State Medicaid Programs

Dana Halvorson

According to a September 7, 2017, email update from Medicaid.gov, “the Centers for Medicare & Medicaid Services (CMS) is providing guidance to states on how to treat ‘ABLE’ accounts in Medicaid financial eligibility determinations. The Stephen Beck, Jr., Achieving a Better Life Experience Act of 2014 (the ABLE Act), enacted in 2015, created a program under which people with disabilities can save money for their disability-related expenses in tax-advantaged accounts.  Because disability can serve as a basis for Medicaid eligibility, many individuals who apply for Medicaid on the basis of having a disability may be interested in opening an ABLE account, and this letter provides guidance to states on the treatment of funds in, contributions to, and distributions from an ABLE account for purposes of Medicaid eligibility.” The letter is available here. AHCA supported the passage of the ABLE Act in Congress.   

Trump Signs Government Funding, Debt Ceiling Deal

Drew Thies

President Trump signed a deal that funds the federal government and raises the debt ceiling late last week. The package extends government funding and the borrowing limit to December 8th.

The deal also includes disaster relief for Hurricanes Harvey and Irma, funds flood insurance and aviation programs, and avoids a government shutdown, nearly clearing the deck for must-pass items this month.

Trump surprised many when he announced the deal after meeting with leadership from both parties in the Oval Office last Wednesday. The move went against the wishes of Congressional Republican leadership, who wanted to tie the debt ceiling to reductions in government funding. The legislation advances quickly though both chambers, but relied on help from Democrats to make it to the president’s desk. 90 House Republicans voted against the package.

Lawmakers still must address some key health care items this month. Funding for the Children's Health Insurance Program (CHIP) runs out at the end of September. Additionally, the parliamentary window for Republicans to pass health care reform with only a simple majority in the Senate concludes at the end of the fiscal year, September 30th.

Be Ready to Demonstrate Your Dementia Care Competency to Surveyors: Register for the Intensive AHCA/NCAL Convention Session on Implementing CARES® Online Dementia Training & Alzheimer’s Association EssentiALZ® Certification

Dave Kyllo

Administrators, directors, nurses and other long term care staff interested in quality dementia care are encouraged to register for a facilitated intensive training session led by national CARES® expert, Debbie Richman, to learn how to implement the CMS- and AHCA/NCAL-recommended CARES® online training program within your organization. At the end of the training session, attendees will be eligible for individual Alzheimer’s Association essentiALZ® certification.

This unique learning opportunity at the 68th Annual AHCA/NCAL Convention and Expo in Las Vegas is back this year by popular demand. Attendees will complete the CARES® Dementia Basics curriculum and learn about the training tools, techniques, and activities to implement the CARES® Approach within your organization utilizing the CARES® Classroom Guide™ for Administrators and Educators. 

This session is a great way to help skilled nursing centers develop dementia specific educational programs that can help demonstrate staff competency in quality dementia care as part of the new staff competency assessments that will be required under Phase II of the CMS Requirements of Participation taking effect this November. Specialized training will be one way surveyors will determine if caregivers have the competencies necessary to deliver quality and individualized care.     

The CARES® content video-intensive and includes care vignettes and interviews of real people living with dementia, their families, professional caregivers, and dementia experts (no actors). In addition, this session will offer unique networking opportunities to learn from your dementia care colleagues from across the nation. 

The CARES® Dementia Basics Training is approved for 5.5 Administrator CEUs will be held on Sunday, October 15 from 8 a.m. to 4 p.m. and is a separate ticketed event. The registration fee for this special intensive training is only $199.95.  As an added bonus, attendees will receive a complimentary copy of the CARES® Classroom Guide™ for Administrators and Educators – a $199.95 value – which offsets the entire cost of the session.

Click here to register for the AHCA/NCAL Convention and Expo held October 15 – 18 in Las Vegas.

Statistics Prove It: Gero Nurse Prep Delivers Smarter RNs

Dave Kyllo

AHCA/NCAL Gero Nurse Prep is designed to prepare RNs to take the American Nurses Credentialing Center (ANCC) board certification exam in gerontological nursing. It does that.  RNs who complete the Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam on their first try and they also receive 30 CEUs.

But AHCA/NCAL Gero Nurse Prep does much more. It increases RNs’ knowledge of gerontological nursing practice.  Gero Nurse Prep students see a whopping 23 percentage point increase on average on their pre- and post-test scores.

Attendees at the 68th annual AHCA/NCAL Convention and Expo in Las Vegas will have the opportunity to learn how Gero Nurse Prep and ANCC board certification correlate to improved outcomes in long term care. A one- hour session titled “My RN is Smarter Than Your RN: Case Study Benefits of the Gero Nurse Program” will be held on Tuesday, October 17 and will feature four speakers who will detail how board certification in gerontological nursing is attained and the positive impact certification can have on quality and financial performance.

ANCC is the world’s largest and most prestigious nurse credentialing organization and a subsidiary of the American Nurses Association. Less than one percent of America’s RNs are board certified in gerontological nursing. That means having an ANCC Board certified RN can easily give providers an edge in the marketplace.

To help increase the number of board certified RNs, AHCA/NCAL’s Gero Nurse Prep program is designed to help RNs prepare for and pass the ANCC gerontological certification exam. RNs who are interested can become board certified for less than $1,100 ($690 for AHCA/NCAL Gero Nurse Prep and a separate $395 to take the ANCC exam).

Watch this video to learn more about AHCA/NCAL Gero Nurse Prep or click on the course preview to get a quick view of this engaging on-line curriculum designed to help RNs pass the ANCC exam.

Maximize your nursing strength. Check out AHCA/NCAL Gero Nurse Prep today.

Tuesday, September 12, 2017

OMHA Miami Field Office Hearings Cancelled through September 15

Lilly Hummel

The Office of Medicare Hearings and Appeals (OMHA) has announced that as a result of Hurricane Irma, all hearings from the Miami Field Office are cancelled for the remainder of the week through Friday, September 15. The Medicare hearings will be re-scheduled for a later date when the office resumes normal operations.

CMS Updates SNF Consolidated Billing HCPCS Code List for CY 2018

Dan Ciolek

The Centers for Medicare and Medicaid Services (CMS) published a MLN Matters article titled 2018 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update. The article indicates that Change Request (CR) 10262 makes changes to Healthcare Common Procedure Coding System (HCPCS) codes and Medicare Physician Fee Schedule designations that will be used to revise Common Working File (CWF) edits to allow A/B MACs to make appropriate payments in accordance with policy for SNF CB in Chapter 6, Section 110.4.1 and Chapter 6, Section 20.6 in the “Medicare Claims Processing Manual.”

The Common Working File (CWF) currently has edits in place for claims received for beneficiaries in a Part A covered SNF stay as well as for beneficiaries in a non-covered stay. These edits allow only those services that are excluded from consolidated billing to be separately paid. Barring any delay in the Medicare Physician Fee Schedule, the new code files will be provided to CWF by November 1, 2017.

By the first week in December 2017, new code files will be posted at http://www.cms.gov/SNFConsolidatedBilling/. The files will be applicable to claims with dates of service on or after January 1, 2018, through December 31, 2018. It is important and necessary for the SNF billers to view the “General Explanation of the Major Categories” file located at the bottom of each year’s update in order to understand the Major Categories including additional exclusions not driven by HCPCS codes.

OIG Finds Kansas Did Not Always Verify Correction of Deficiencies of Nursing Homes

Lilly Hummel

As part of a series of state reviews, the Department of Health and Human Services Office of Inspector General (OIG) released a report finding that Kansas did not always verify correction of deficiencies identified during surveys of nursing homes participating in Medicare and Medicaid. Of those nursing homes surveys that OIG reviewed, they found that the state: did not always obtain the nursing homes’ evidence of correction, could not provide sufficient evidence of actions taken by the nursing homes, and did not conduct the required standard survey within 15 months of the previous standard survey. OIG recommended that the state improve its practices for verification, update controls and policies and procedures to ensure that survey system data are protected, and develop a correction plan to ensure consecutive surveys are conducted in a timely basis.

OIG has conducted a similar review of other states. The report found similar deficiencies in Arizona and Washington, while Missouri and Oregon’s verification processes were approved.

Monday, September 11, 2017

Announcing the 2018 Quality Initiative Recognition Program

By qualityinitiative@ahca.org

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) is pleased to announce the relaunch of the Quality Initiative Recognition Program to honor skilled nursing and assisted living members for their individual work in achieving the goals of the AHCA/NCAL Quality Initiative.

Eligibility

For skilled nursing care centers, members must achieve four or more of the AHCA Quality Initiative goals to be eligible for recognition. The goals are:
  1. Decrease turnover rates among nursing staff by 15% from 2015 or achieve/maintain at or less than 40%
  2. Adopt Core-Q customer satisfaction questionnaire and measure and upload data to LTC Trend Tracker
  3. Reduce the number of unintended health care outcomes
  4. Safely reduce the number of hospital readmissions within 30 days during a skilled nursing center stay by 30% from December 2011 or achieve and maintain a low rate of 10%
  5. Improve discharge back to the community by 10% from December 2014 or achieve and maintain a high rate of at least 70%
  6. Improve functional outcomes by 10% from December 2015 or maintain an average rate of improvement of 75%
  7. Safely reduce the off-label use of antipsychotics in long-stay nursing center residents by a total of 30% from December 2011
  8. Safely reduce hospitalizations among long-stay residents by 15% from December 2014 or achieve/ maintain a low rate of 10% or less
For assisted living communities, members must achieve two or more of the four NCAL Quality Initiative goals. The goals are:
  1. Increase staff stability by maintaining nursing and direct care staff turnover below 40%
  2. Increase customer satisfaction to 90%
  3. Safely reduce hospital readmissions by 15% or achieve a low readmission rate of 5% or less
  4. Safely reduce the off-label use of antipsychotics by 15% or achieve a low off-label usage rate of 5% or less
What to Do Next

By October 13, 2017, nursing centers must submit staffing and customer satisfaction data in LTC Trend Tracker. All other data is automatically uploaded by LTC Trend Tracker.  

For assisted living communities, members must submit data for all NCAL goals in LTC Trend Tracker by October 13, 2017.

Customer satisfaction vendors can upload data to LTC Trend Tracker on behalf of members. A list of vendors able to upload can be found here.

AHCA/NCAL also encourage members to:
  • Check their data on LTC Trend Tracker to see where they stand on each Quality Initiative goal
       -AHCA members can also download their quarterly LTC Trend Tracker Top-Line publication
  • Review resources for achieving Quality Initiative goals for nursing centers and assisted living communities.
Notification & Assistance

Later this year, achievers will be notified by the AHCA/NCAL Quality Initiative Recognition Program team using the latest available data. All achievers will be recognized at the AHCA/NCAL Quality Summit in New Orleans, March 12-14, 2018.

For those who need assistance with LTC Trend Tracker, email help@ltctrendtracker.com and be sure to add the email address to your “Safe Sender” list. 


If you have questions about the program, email the team at qualityinitiative@ahca.org.

Emergency Preparedness Surveyor Training Now Available!

Erin Prendergast

On Friday, September 1st, CMS released a memorandum to State Survey Agency Directors announcing that the Emergency Preparedness Training is now available. All surveyors are required to take the training prior to surveying the Emergency Preparedness requirements. Surveying for requirements begins November 15th, 2017.

The online course is now available on the Surveyor Training Website On-Demand. Once in the course catalog for provider training, search “emergency” and the course information will appear. Providers will have continued (ongoing) access to the course, so they can review it anytime. The online training is organized as follows:

Module 1: Emergency Preparedness for Every Emergency 
Lesson 1: Overview of Emergency Preparedness
Lesson 2: Development of the Emergency Preparedness Rule

Module 2: Surveying for Emergency Preparedness 
Lesson 1: Emergency Preparedness Program and Plan
Lesson 2: Policies and Procedures
Lesson 3: Communication Plan
Lesson 4: Training and Testing
Lesson 5: Emergency and Standby Power Systems
Lesson 6: Integrated Health Care Systems
Lesson 7: Transplant Centers and Organ Procurement Organizations

Members are strongly encouraged to review and complete the training as it includes quizzes and exercises to check understanding. The training states to surveyors that the requirements do not prescribe or mandate specific technology or tools nor detailed requirements for how facilities should write emergency plans. The training includes the questions surveyors will ask and how documentation will be reviewed and checked. Links to resources and glossary terms are also included.

The Emergency Preparedness Final Rule was released on Friday, September 16, 2016.  The rule impacts skilled nursing facilities (SNFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), but does not apply to assisted living providers. On June 2, 2017, the Centers for Medicare & Medicaid Services released the Emergency Preparedness Interpretive Guidance (IG), which can be found here. Providers will need to comply with the final rule by November 15th 2017.  Click here for a summary AHCA put together of the IG for your use.

Thursday, September 7, 2017

Convention & Expo: Advance Registration Ends Soon

Jon-Patrick Ewing


If you plan on being in Las Vegas this October, hurry and register now. The advance registration deadline of September 21 is approaching fast. After this deadline on-site registration rates will apply!

The Convention & Expo is the winning deal—four days of top-notch education, national speakers, networking and special events, and an Expo Hall packed with all the best products and services for long term and post-acute care professionals.

When registering, make sure to get your tickets for the Gala Dinner & Show with Huey Lewis and the News. It will be a night you won't forget!

CMS Updates the Medicare Financial Management Manual—Limitation on Recoupment Section

Lilly Hummel

The Centers or Medicare and Medicaid Services (CMS) has issued a revision to the Medicare Financial Management Manual (Publication 100.06), Chapter 3 Medicare Overpayment Manual, Section 200 Limitation on Recoupment. Change Request (CR) 9815 will be effective April 2, 2018 and is the first of four CRs that are forthcoming. Providers should ensure that billing staff are aware of these updates related to the limitation on recovery of certain overpayments. CMS also provided a summary of the revisions.

SNF Review and Correct Report Issue Update from CMS: First Issue Resolved

Holly Harmon

Skilled Nursing Facility (SNF) providers were recently notified of two issues affecting the SNF QRP Review and Correct Reports & Confidential Feedback Reports.

An issue was identified within the SNF Review and Correct Report, if one or more modification records are submitted for a patient stay, the most recent submitted assessment, which was accepted by the Assessment Submission and Processing (ASAP) system on or prior to the submission deadline for quarters one (Q1) and two (Q2) of Calendar Year 2017 (CY2017), was not being used in the measure calculation. CMS reports this issue has now been resolved.

All Quality Measure data has been recalculated for the Review and Correct Report and is now available in the SNF Quality Reporting Program report category in the CASPER Reporting application. Providers are encouraged to request the report to view updated measure results. The updated report should replace versions of the report requested prior to the issue notification.

The second issue that was identified in the technical coding which affected our calculation of one measure contained in the SNF Review and Correct Report related to the measure Application of Percent of LTCH Patients with Admission and Discharge Functional Assessment and a Care Plan that Addresses Function also affected the SNF QRP Confidential Feedback Report (SNF Quality Reporting Program (QRP) Quality Measure Report) is still being resolved and further guidance is forthcoming from CMS.

As a reminder, all data for assessment-based measures required in the SNF QRP in CY2017 will remain open to modifications until May 15, 2018. We anticipate that the data currently “frozen” as of August 15, 2017 to be subject to updates as of mid-September. Another notice will be issued once the Review and Correct Report Q1 2017 SNF QRP data is open again.

Further guidance and timelines has been posted to the SNF Quality Reporting Program Data Submission Deadlines webpage by CMS.

If you have questions concerning this information, please contact the QTSO Help Desk at help@qtso.com or 1 (800) 339-9313.

CMS IMPACT Act Special Open Door Forum on September 28

Dan Ciolek

The Centers for Medicare and Medicaid Services (CMS) has scheduled a Special Open Door Forum (SODF) conference call for September 28, 2017 from 2:00-3:00 PM Eastern.  The SODF will provide information and solicit feedback pertaining to the Improving Medicare Post-Acute Care Transformation Act of 2014 (commonly referred to as the IMPACT Act). This SODF will focus on the goals of the IMPACT Act, update attendees on the RAND contract activities for item development, including pilot test results and plans for the upcoming national field test, and identify opportunities for providers, consumers, stakeholders, researchers, and advocates to become involved over the next year.

CMS invites questions, comments, and ideas from providers, patients, consumers, researchers, and advocates in advance or during the Forum.  Please submit questions, comments, and ideas to: PACQualityInitiative@cms.hhs.gov.
   
Participant Dial-In Number:  1-800-837-1935     Conference ID #: 66557294
Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

The presentation will be posted on the IMPACT Act Downloads and Videos webpage.

Wednesday, September 6, 2017

Hurricane Harvey Update from Mark Parkinson

As I shared in the updates sent last week, employees of Texas' nursing facilities and assisted living communities worked tirelessly and with great sacrifice to keep residents safe as Hurricane Harvey ravaged the Gulf Coast. During the time they were focused on the care and well-being of others, many of the homes of these workers were impacted by the storm's devastation.

The Texas Health Care Association Education Foundation has established the Heroes of Long Term Care Hurricane Relief Fund to assist the employees of our members who were affected by Hurricane Harvey. You can donate today at: https://txhca.org/harvey

Thank you for supporting our members and their employees.

OMHA Miami Field Office Limited Operations Sept 7 and Sept 8

Lilly Hummel

The Office of Medicare Hearings and Appeals (OMHA) has announced that Hurricane Irma will affect operations at the Miami Field Office on Thursday (September 7) and Friday (September 8). A state of emergency has been declared for Miami-Dade County and OMHA has determined that for the safety of the public and employees, the OMHA Miami Field Office will have limited operations on Thursday and Friday. If a provider is participating in a hearing before an Administrative Law Judge in the OMHA Miami Field Office scheduled for those days, please call the Administrative Law Judge’s legal assistant for the status of your hearing. OMHA has instructed providers that if they are unable to contact the legal assistant (for example, the call is answered by a voicemail message system) and they are not contacted prior to the hearing, please assume the Thursday or Friday hearing is not being conducted and will be re-scheduled for a later date. Hearings that are not conducted Thursday or Friday due to the weather event will be re-scheduled when the office resumes normal operations. Providers will receive notification of the re-scheduled hearing date.

Congress Returns for Busy September

Drew Thies



Lawmakers returned to Washington, D.C. this week to tackle numerous must-pass pieces of legislative business over the course of the month.

Key items on the docket include: government funding, raising the debt ceiling, authorizing $7.85 billion in aid for victims of Hurricane Harvey, and reauthorizing children’s health and flood insurance programs. Time is short, however: the House and Senate are only jointly in session 12 days this month.

Congress must deliver a bill to fund the government to the President’s desk on or before September 30th to avert a government shutdown. Treasury Secretary Steven Mnuchin said the deadline for raising is the day prior, September 29th.

Divisions exist on what provisions should be in the bills, as well as what path to take to ensure passage. Republicans who are more conservative on budget issues have in the past demanded spending cuts as part of any debt ceiling increase. Others have indicated they’d like to see the controversial debt ceiling bill be tied to Hurricane relief in order to increase its chances of passage.

In addition to the large budget and fiscal issues facing Congress, lawmakers will also have to address the Children’s Health Insurance Program (CHIP), which expires at the end of the month. Funding for the Federal Aviation Administration and National Flood Insurance Program also expire this month.

The already-full schedule is muddied by recent White House proclamations on immigration policy. This August, President Trump threatened to veto any government funding bill that does not include money for a border wall. Additionally, the President put the onus on Congress to find a legislative solution to the “Deferred Action for Childhood Arrivals” (DACA) program, which will end in six months, according to White House statements this week.

What Happens in Vegas Will Grow Your Business

At AHCA/ NCAL Annual Convention & Expo, your success is our business. We have dedicated Expo Hall hours to build your professional network. Come show your innovative technology that will help provide the best quality care in the industry.

"AHCA Convention allows me the opportunity to seek innovative products, programs and vendor sourcing for our chain efficiently. While allowing for valuable learning sessions from leaders and experts in our field." – 2016 Convention Attendee


New York Times Article on Observation Stays Issue

Dana Halvorson

On September 1, 2017, the New York Times published an article written by Paula Span entitled, “Under ‘Observation,’ Some Hospital Patients Face Big Bills, on the observation stays matter.  The article focuses in on a patients impacted by the issue, and a recent federal court decision (Alexander v. Price) issued on July 31, 2017.  The decision means that Medicare patients could gain the right to appeal placement on “Observation Status” and avoid potentially large out of pocket medical bills.

AHCA/NCAL continues to keep the observation stays issue one of its top advocacy and outreach priorities.  Increasingly, patients have no idea what their status is in a hospital, or the importance of it, which can lead to thousands of dollars in out-of-pocket medical expenses should they need skilled nursing center care following their hospital stay.  In addition to placing a financial burden on seniors and their families, this anomaly in Medicare rules can cause unnecessary spend-down, accelerating the time frame in which seniors will have to turn to programs such as Medicaid to pay for their care.  For more information about the observation stays issue, please visit the AHCA/NCAL website.

Tuesday, September 5, 2017

Get Involved with the AHCA/NCAL National Quality Award Program!

AHCA/NCAL is seeking Examiners for the 2018 AHCA/NCAL National Quality Award program.

Apply to be a Quality Award Examiner Here.

Serving as an Examiner is an incredible opportunity for individuals interested in continuous quality improvement. Examiners experience both personal learning and professional development. Individuals who participate as Examiners have a much better grasp of the criteria and can use that knowledge to improve their organizations and/or submit a National Quality Award application. It is also an excellent networking opportunity; Examiners gain professional contacts throughout the country, and make life-long friendships through the program.

Serving as an Examiner is a serious commitment in respect to both time and impact to the program. Examiners are required to attend a three-day in-person training session before working in teams over a 12-week period to review their assigned applications. Examiners estimate spending 40 to 60 hours reviewing applications, in addition to participating in required weekly conference calls with their teams. The process culminates with a required in-person review session. AHCA covers the travel expenses associated with all required meetings. 

Senior Examiners review the Silver applications while Master Examiners review the Gold applications for the National Quality Award program.

Individuals who are new to serving as an Examiner should apply to serve as a Senior Examiner. For those individuals with 3 or more years of experience as an Examiner, there is also an opportunity to serve as a paid examiner in addition to serving as a volunteer Examiner.

An overview of key dates for Master and Senior Examiners for the 2018 program cycle are available below:

Master Examiner Review Process:
  • Pre-Training Assignment: January 8-February 5, 2018
  • Master Examiner Training: February 12-14, 2018, location TBD
  • Master Examiner (Gold) review period begins: March 1, 2018
  • Master Examiner Review Session: May 21-23, 2018, location TBD
  • Site Visit Period: June 18-July 27, 2018
  • Award Recommendation Meeting: August 6-8, 2018

Senior Examiner Review Process:
  • Pre-Training Assignment: January 8-February 5, 2018
  • Senior Examiner Training: February 14-16, 2018, location TBD
  • Senior Examiner (Silver) review period begins: March 1, 2018
  • Senior Examiner Team Leader Review Session: June 11-13, 2018, location TBD
For more information and to submit an application, please visit the 2018 National Quality Award Examiner website.