Wednesday, November 15, 2017

November is a Big Month for Antibiotics


November 13-19 marks U.S. Antibiotic Awareness Week and World Antibiotic Awareness Week. November 28 marks the first day nursing facilities will be surveyed under new Centers for Medicare & Medicaid Services (CMS) antibiotic stewardship program guidelines. 

AHCA is ready to help members meet the new Infection Preventionist specialized training requirement finalized by CMS in the Reform of Requirements of Participation for Long Term Care Facilities. AHCA’s Infection Preventionist Specialized Training (IPCO) course provides education for healthcare professionals who seek to serve as Infection Preventionists and prepares individuals to meet the antibiotic stewardship requirements taking effect in less than two weeks.     

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 were recently trained to survey for the expanded infection prevention & control and antibiotic stewardship requirements. The survey process will be significantly different beginning on November 28.  

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/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.  

New Emergency Preparedness Rules Take Effect Today! Make Sure You’re Ready.


Skilled nursing facilities (SNFs/NFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IID) face new sweeping regulations affecting their emergency preparedness planning beginning on November 15. These requirements include:Annual 
  • Risk Assessment and Emergency Planning
  • Communication Plan
  • Emergency Preparedness Policies and Procedures (must be reviewed annually)
  • Training and Testing

·    AHCA/NCAL is pleased to offer a new tool titled “Emergency Preparedness Program (EPP) Customizable Plan for Long Term Care” that allows facilities to customize compliant plans, including:
  • Emergency Preparedness Program Management Plan
  • Communications Plan
  • Procedures applicable to all hazard responses
  • Incident Command System 
  • Full building Evacuation Plan
  • Emergency Lists
  • Continuity of Operations and Recovery Plan.

AHCA/NCAL members receive exclusive “member only” pricing of $395 for the EPP customizable plan – a savings of $100 off the regular price. The EPP plan from Russell Phillips & Associates includes:
  • An electronic flash drive – Easily add your facility’s information to customize your plan.
  • Hard copy of the documents – Provides hard copy worksheet-style documents of your plan. 
  • Binder with tabs prepared for insertion of customized plan – An invaluable resource that organizes your plan documents.  
  • A crosswalk between the new CMS regulations and the customizable EPP plan manual – This indispensable tool provides a clear-cut detailed comparison that shows how your facility’s EPP plan meets CMS requirements and demonstrates precise compliance to survey agencies and AHJs.  
  • Access to an information-packed 75-minute “how to” webinar conducted by Russell Phillips & Associates.

Be ready for your next survey. Order the customizable EPP plan today through the AHCA/NCAL Bookstore and save $100 off the regular $495 price.   

Bolster Your RNs’ Geriatric Nursing Skills to Reduce Rehospitalizations! Take Advantage of the Gero Nurse Prep Sale


AHCA/NCAL Gero Nurse Prep is on sale now through November 30th and each RN registrant can save $100 off his/her Gero Nurse Prep by entering promo code VBPRN17 (all caps) at checkout. That means RNs who are interested can become board certified for less than $1,000 ($590 sale price for AHCA/NCAL Gero Nurse Prep and a separate $395 to take the American Nurses Credentialing Center {ANCC} exam). 

Hospitals are keeping a close watch on their Medicare beneficiaries to ensure that they are not readmitted within 30 days of discharge, including those hospitalized Medicare beneficiaries who live in skilled nursing and assisted living settings. Well trained RNs can play a critical role in reducing re-hospitalizations. 

Hospitals face having Medicare reimbursements withheld if their re-hospitalization rates are too high. In October 2018, SNFs also will face financial consequences if their rehospitalization rates are too high. Managing rehospitalization rates has become a key part of a successful long term care business strategy in caring for the elderly in an increasingly competitive marketplace.
  
Research conducted by AHCA/NCAL in 2016 found that the rehospitalization rates in nursing facilities with at least one RN certified in gerontological nursing by the ANCC consistently have run at least two percentage points lower than the national average since 2011. AHCA/NCAL believes that assisted living settings may experience similar results by increasing their RNs’ gerontological expertise. 

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 ANCC board certified in gerontological nursing. 

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 complete the AHCA/NCAL Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam and receive 30 CEUs. They also increase their knowledge of gerontological nursing by 20 percent on pre- and post-test scores.

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 online curriculum designed to help RNs pass the ANCC exam.
Outshine your competition by demonstrating your ability to reduce re-hospitalizations.Take advantage of the sale on Gero Nurse Prep and remember to enter promo code VBPRN17 at check out.   

The Number of Open LTC Jobs Dips in November


There are 18,688 open jobs posted by direct employers in the nursing care facility (including skilled nursing facilities - SNFs), assisted living, and continuing care retirement community (CCRC) sectors this month, according to the latest CEB TalentNeuron statistics. That is more than 1,400 fewer posted long term care (LTC) positions than October. 

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 1,769 direct employers are competing for candidates this month – nearly the same number as last month. The average number of days a job was posted this month decreased by two days to 35 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. 

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. 

Of course, the LTC Career Center is always free for job seekers and the LTC Career Center features many of the best positions the long term care profession has to offer. Job seekers are using the site with more than 93,000 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 1,400 views in November.

Join the growing list of high profile employers who use AHCA/NCAL’s premier member resource to find top talent. Check out the LTC Career Center today and remember to use one of the two promo codes to save on your job postings.      

Medicare Part B Therapy Cap Threshold Set at $2,010 for Calendar Year 2018


Recently, the Centers for Medicare & Medicaid Services (CMS) issued a Medicare Learning Network (MLN) Matters article number MM10341 announcing the Medicare Part B outpatient therapy cap values for calendar year (CY) 2018.

The article notes that the annual per-beneficiary benefit limits for physical therapy and speech-language pathology services combined (PT/SLP) is $2,010, while occupational therapy services have a separate $2,010 cap.

While there is currently activity in Congress to repeal the therapy caps before the end of the year, there is no guarantee it will occur. Providers should prepare and make sure that therapy and billing staff are aware of these therapy cap value updates.

Background

The Balanced Budget Act of 1997, P.L. 105-33, Section 4541(c) applies, per beneficiary, annual financial limitations on expenses considered incurred for outpatient therapy services under Medicare Part B, commonly referred to as “therapy caps.” The therapy caps are updated each year based on the Medicare Economic Index. Section 5107 of the Deficit Reduction Act of 2005 required an exceptions process to the therapy caps for reasonable and medically necessary services. The exceptions process for the therapy caps has been continuously extended several times through subsequent legislation. Most recently, Section 202 of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) extended the therapy caps exceptions process through December 31, 2017.

Webinar: Interdisciplinary Care Teams for Older Adults

December 7, 1:30 PM – 2:30 PM EST

Register for the webinar on Interdisciplinary Care Teams for Older Adults organized by CMS Medicare-Medicaid Coordination Office (MMCO), in collaboration with the Lewin Group and the American Geriatrics Society.

This webinar will identify familiar challenges and best practices for Interdisciplinary Care Teams (ICT) working with older adults. Presenters will also address the importance of clinical, psychosocial, long-term care, behavioral, and community-based support for older adults, particularly Medicare/Medicaid beneficiaries.

Participants will learn how to:

• Identify different members of the ICT and how the team’s approach to care may change over time based on the social and health needs of the older adult.

• Describe effective approaches to create high performing teams including clarifying roles of team members and establishing methods of communication and information sharing with the individual, their family, and core team members.

• Demonstrate basic knowledge of strategies to integrate long-term services and supports into care planning and overall team coordination.

• Demonstrate an understanding of how the ICT interacts with the consumer, and if appropriate, their caregiver.

Continuing Medical Education (CME) and Continuing Education (CE) credit is available for this webinar.

Presenters:

• Gwendolyn Graddy-Dansby, M.D., F.A.C.P., Medical Director, PACE Southeast Michigan

• Sandra White, LMSW, ACSW, PACE Southeast Michigan

• Ellen LaSalvia, MSW, LSW, Buckeye Health Plan

Final Webinar: Emergency Preparedness Requirements - Part IV


AHCA, along with guest speakers, has been hosting an ongoing webinar series event this year on the new emergency preparedness final rule impacting skilled nursing facilities (SNFs), nursing facilities (NFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IID).

This final rule is not applicable to assisted living (AL) providers. The rule was released on Friday, September 16, 2016, and can be found here

Providers will need to be in compliance by November 15, 2017.

The final webinar of the series for this year, entitled "Emergency Preparedness Requirements - Part IV", will occur on November 21, 2017.

On Tuesday, November 21, from 2 – 3 PM EST, guest speakers Sarah Baker, Programs Manager from Healthcare Ready and Nicolette A. Louissaint, Ph.D. Executive Director of Healthcare Ready and AHCA will host a webinar on the new emergency preparedness final rule.

The webinar will include an overview of Healthcare Ready and resources available to members, an update on this past hurricane season and best practices learned, and a review of components of the Centers for Medicare & Medicaid Services' (CMS) emergency preparedness rule.

This is the fourth webinar in the four-part webinar series AHCA will hold this year on the emergency preparedness rule. 

You can register here for the webinar.

Registration Now Open for the 2018 Independent Owner (IO) Leadership Conference

Laissez Le Bon Temps Rouler!
Let the Good Times Roll!


Join your colleagues in New Orleans for inspiring speakers, stimulating discussions, and plenty of networking. You’ll walk away with fresh ideas and up to 8.5 CEUs!

Opening General Session
Glenn Van Ekeren of Vetter Health Services will inspire you with strategies for moving your team forward.

Closing General Session
Jessica Cox, the first armless pilot, embodies the spirit of adaptability and provides valuable insights on how to best approach a challenge. Listen to her journey of learning to fly with her feet.  

Education Sessions on Hot Topics like these:
  • ACO partnerships
  • VBP 
  • QRP measures
  • Payment reform
  • Adapting to the changing market place
       
Get all the details and register today.

Deadline: March 2, 2018 

Sponsors as of November 13, 2017:

Participate in the Assisted Living Salary & Benefits Study

Rosanne Zabka, HCS Director of Reports

Hospital & Healthcare Compensation Service (HCS) is conducting its annual Assisted Living/Personal Care Salary & Benefits Study, and they need your help. Assisted living providers are asked to complete the study’s questionnaire by December 4th. The study is published by HCS and supported by NCAL and LeadingAge.

There is no cost to participate in the study. Participants may purchase the results at the reduced price of $175, versus the $350 nonparticipant rate. Publication is scheduled for January 2018.

Questionnaires can be downloaded at: https://www.hhcsinc.com/survey-questionnaires.html

You can notify HCS you intend to submit your data, or request an extension past December 4th by emailing Rich Cioffe, rcioffe@hhcsinc.com.

The report covers management salaries, nonmanagement wages, and fringe benefits. Last year’s report contained data from over 1,300 ALF/Personal Care facilities nationwide.

Salaries and bonus payments will be reported according to unit size, profit type, revenue size, CBSA, state, region, and nationally. Both for-profit and not-for-profit data will be separately covered. Information on 18 fringe benefits will be reported according to region. Percent increases planned for 2018 will be reported for management, nonmanagement, RNs, LPNs, and CNAs.

HCS publishes ten annual compensation studies. Nationally known, the ALF/PCF Report is recognized as the standard for reliable, comprehensive, and affordable compensation data for ALFs/PCFs.

Bolster Your RNs’ Geriatric Nursing Skills to Reduce Rehospitalizations! Take Advantage of the Gero Nurse Prep Sale

Dave Kyllo

AHCA/NCAL Gero Nurse Prep is on sale now through November 30 and each RN registrant can save $100 off his/her Gero Nurse Prep by entering promo code VBPRN17 (all caps) at checkout. That means RNs who are interested can become board certified for less than $1,000 ($590 sale price for AHCA/NCAL Gero Nurse Prep and a separate $395 to take the American Nurses Credentialing Center {ANCC} exam).

Hospitals are keeping a close watch on their Medicare beneficiaries to ensure that they are not readmitted within 30 days of discharge, including those hospitalized Medicare beneficiaries who live in skilled nursing and assisted living settings. Well trained RNs can play a critical role in reducing re-hospitalizations.

Hospitals face having Medicare reimbursements withheld if their re-hospitalization rates are too high. In October 2018, SNFs also will face financial consequences if their re-hospitalization rates are too high. Managing rehospitalization rates has become a key part of a successful long term care business strategy in caring for the elderly in an increasingly competitive marketplace.

Research conducted by AHCA/NCAL in 2016 found that the rehospitalization rates in nursing facilities with at least one RN certified in gerontological nursing by the ANCC consistently have run at least two percentage points lower than the national average since 2011. AHCA/NCAL believes that assisted living settings may experience similar results by increasing their RNs’ gerontological expertise.

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 ANCC board certified in gerontological nursing.

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 complete the AHCA/NCAL Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam and receive 30 CEUs. They also increase their knowledge of gerontological nursing by 20 percent on pre- and post-test scores.

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.

Outshine your competition by demonstrating your ability to reduce re-hospitalizations. Take advantage of the sale on Gero Nurse Prep and remember to enter promo code VBPRN17 at check out.

The Number of Open LTC Jobs Dips in November

Dave Kyllo

There are 18,688 open jobs posted by direct employers in the nursing care facility (including SNFs), assisted living, and continuing care retirement community (CCRC) sectors this month according to the latest CEB TalentNeuron statistics. That is more than 1,400 fewer posted LTC positions than October.

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 1,769 direct employers are competing for candidates this month – nearly the same number as last month. The average number of days a job was posted this month decreased by two days to 35 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% 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% discount on the three postings by entering promo code Bundle20 at check out.

Employers who utilize the site also receive outstanding exposure through rotating job listings on AHCA’s home page – the web site 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.

Of course, the LTC Career Center is always free for job seekers and the LTC Career Center features many of the best positions the long term care profession has to offer. Job seekers are using the site with more than 93,000 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 1,400 views in November.

Join the growing list of high profile employers who use AHCA/NCAL’s premier member resource to find top talent. Check out the LTC Career Center today and remember to use one of the two promo codes to save on your job postings.

Private Activity Bonds and Medical Expense Deduction Provisions in U.S. Congressional Tax Proposals



On November 2, 2017, the Republican leadership of the U.S. House of Representatives introduced the Tax Cuts and Jobs Act. This bill proposes to eliminate the use of private activity and advance refunding bonds beginning on Jan. 1, 2018. 

The elimination of private activity debt instruments would significantly and adversely impact the ability for the majority of our not-for-profit members to fund new construction, infrastructure improvements, acquisitions and other capital expenditures for their operations, including skilled nursing, assisted living centers and many affordable housing projects. For-profit providers would also be impacted.

The Tax Cuts and Jobs Act also includes repealing the medical expense deduction. AHCA/NCAL has recently joined an AARP-led coalition to preserve the medical expense deduction. AHCA/NCAL opposes both the elimination of private activity bonds and the repealing of the medical expense deduction.

On November 9, the Senate Republicans released their own tax reform plan. This plan would preserve private activity bonds, but advance refundings would still be terminated after this year. 

The Senate proposal also preserves the existing medical expense deduction and enhances the standard deduction for the blind and elderly. As work in both chambers continues on the tax reform proposals, AHCA/NCAL will keep its members posted of any relevant updates.       

Monday, November 13, 2017

Help Promote U.S. Antibiotic Awareness Week: November 13 - 17

Holly Harmon


This week (November 13-19) is U.S. Antibiotic Awareness Week!

U.S. Antibiotic Awareness Week (formerly known “Get Smart About Antibiotics Week”) is an annual observance held to raise awareness about antibiotic resistance and the importance of prescribing and using antibiotics appropriately.


According to the CDC, at least two million people become infected with bacteria that are resistant to antibiotics annually in the U.S. More than 23,000 people die from these infections, and many others die from other conditions that have been made more complex as a result of antibiotic-resistant infections.


This week's observance is a critical part of the Center for Disease Control & Prevention's (CDC) efforts to improve antibiotic stewardship in communities, in healthcare facilities, and on the farm in collaboration with state-based programs, nonprofit partners, and for-profit partners. 


You can join CDC and their partners in efforts to combat the spread of antibiotic resistance and improve patient safety by using the following resources:


  • A stakeholder toolkit, which includes key messaging, a press release template, social media posts, and more, can be accessed here.
  • A list of events and activities ideas to be used to to promote this year's observance can be found here.
  • Additional educational materials related to antibiotic prescribing, use, and resistance are available for multiple audiences here.


Members can also sign up for AHCA’s Infection Preventionist Specialized Training (IPCO) course, an online self-study education program for healthcare professionals who seek to serve as Infection Preventionists to prepare to meet the antibiotic stewardship requirements taking effect this month.

The program addresses clinical and organizational systems, as well as processes and cultural aspects of infection prevention and control fundamental to effectively leading and administering successful infection prevention and control programs and antibiotic stewardship programs. 

Members can find out more about the course and register here.

Wednesday, November 8, 2017

Long Term Care Profession Opposes Elimination of Private Activity Bonds in Tax Proposal

AHCA Press Office

Washington, D.C. — The American Health Care Association/National Center for Assisted​ Living (AHCA/NCAL) President and CEO Mark Parkinson today issued the following statement regarding the tax proposal under consideration in the House of Representatives:

“AHCA/NCAL opposes the elimination of private activity bonds, a provision included in H.R. 1, “Tax Cuts and Jobs Act.” Private activity bonds are a critical form of tax-exempt financing which long term care providers utilize to fund new construction, make infrastructure improvements, develop affordable housing and other projects. Should this provision become law, it would severely threaten the ability of providers to make these investments in the future, and would seriously damage operations for long term care providers who deliver critical care for more than one million seniors and people with disabilities.”

CHIP Reauthorization Passes House

Drew Thies

A bill reauthorizing funding for children’s health insurance passed the House late last week. Community Health And Medical Professionals Improve Our Nation (CHAMPION) Act passed Friday by a vote of 242-174, largely along party lines.

The bill reauthorizes funding for the Children's Health Insurance Program (CHIP), which lapsed at the end of October, for an additional five years, but pays for it by cutting provisions of the 2010 health care law—an offset that most Democrats opposed. "Democrats strongly support reauthorization of these programs -- but we reject the way Republicans are paying for them," said Frank Pallone (D-N.J.), ranking member of the House Energy and Commerce Committee.

If Democratic opposition holds, the legislation will stall in the Senate, where a 60-vote super majority is needed to avoid a filibuster. Alternative funding mechanisms may need to be put in place if Republican leadership is to find a bipartisan solution to restore funding to the popular program.

The impasse comes at a time where lawmakers are primarily focused on the high-profile effort to reform the tax code. Republican leadership have said they want to accomplish the task before the end of the year.


AHCA will continue to monitor the CHIP debate and any changes that are made to the offsets as the bill moves through the Senate.

Only 20 Days and Counting…New Antibiotic Stewardship Requirements Take Effect November 28

Dave Kyllo

The American Health Care Association (AHCA) is ready to help members meet the new Infection Preventionist specialized training requirement finalized by CMS in the Reform of Requirements of Participation for Long Term Care Facilities. AHCA’s Infection Preventionist Specialized Training (IPCO) course provides education for healthcare professionals who seek to serve as Infection Preventionists and prepares individuals to meet the antibiotic stewardship requirements taking effect in November.

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 were recently trained to survey for the expanded infection prevention & control and antibiotic stewardship requirements. The survey process will be significantly different beginning on November 28.

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/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.

New Emergency Preparedness Rules Take Effect Next Week! Are you Ready?

Dave Kyllo

Nursing facilities (SNFs/NFs) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) face new sweeping regulations affecting their emergency preparedness planning beginning on November 15.   These requirements include:

  • Annual Risk Assessment and Emergency Planning
  • Communication Plan
  • Emergency Preparedness Policies and Procedures (must be reviewed annually)
  • Training and Testing

AHCA/NCAL is pleased to offer a new tool titled “Emergency Preparedness Program (EPP) Customizable Plan for Long Term Care” that allows facilities to customize compliant plans, including:

  • Emergency Preparedness Program Management Plan
  • Communications Plan
  • Procedures applicable to all hazard responses
  • Incident Command System 
  • Full building Evacuation Plan
  • Emergency Lists
  • Continuity of Operations and Recovery Plan.

AHCA/NCAL members receive exclusive “member only” pricing of $395 for the EPP customizable plan – a savings of $100 off the regular price.   The EPP plan from Russell Phillips & Associates includes:

  • An electronic flash drive – Easily add your facility’s information to customize your plan.
  • Hard copy of the documents – Provides hard copy worksheet-style documents of your plan. 
  • Binder with tabs prepared for insertion of customized plan – An invaluable resource that organizes your plan documents.  
  • A crosswalk between the new CMS regulations and the customizable EPP plan manual – This indispensable tool provides a clear-cut detailed comparison that shows how your facility’s EPP plan meets CMS requirements and demonstrates precise compliance to survey agencies and AHJs.  
  • Access to an information-packed 75-minute “how to” webinar conducted by Russell Phillips & Associates.

Be ready for the November 15 deadline and your next survey.  Order the customizable EPP plan today through the AHCA/NCAL Bookstore and save $100 off the regular $495 price. 

Smarter is Smarter: Gero Nurse Prep Grads Know Gerontological Nursing

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 experienced RNs’ knowledge of gerontological nursing practice.  Gero Nurse Prep students see a whopping 24 percent average increase on their pre- and post-test scores. 

The statistics prove it.  Gero Nurse Prep grads know more about gerontological nursing.    Taking the AHCA/NCAL Gero Nurse Prep course does obligate a RN to sit for the ANCC Board certification exam.  Nurses who only want to increase their knowledge of gerontological nursing practice can simply take the AHCA/NCAL Gero Nurse Prep course and earn 30 CEUs.
  
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. 

AHCA/NCAL Gero Nurse Prep is on sale now through November 30 and each RN registrant can save $100 on his/her Gero Nurse Prep registration by entering promo code VBPRN17 (all caps) at checkout.  That means RNs who are interested can become board certified for less than $1,000 ($590 sale price 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 increase gerontological nursing knowledge and help RNs pass the ANCC exam. 

Strengthen your position in the marketplace through smarter RNs. Take advantage of the sale on Gero Nurse Prep and remember to enter promo code VBPRN17 at check out.   

Updated List of Excluded Individuals and Entities (LEIE) Database File

Lilly Hummel

The US Department of Health and Human Services, Office of Inspector General (OIG) has released its updated List of Excluded Individuals and Entities (LEIE) database file, which reflects all OIG exclusions and reinstatement actions up to, and including, those taken in October, 2017.  This new file is meant to replace the updated LEIE database file available for download last month.  Individuals and entities that have been reinstated to the federal health care programs are not included in this file.  The updated files are posted on OIG’s website at http://www.oig.hhs.gov/exclusions/exclusions_list.asp, and healthcare providers have an “affirmative duty” to check to ensure that excluded individuals are not working in their facilities or face significant fines.  Instructional videos explaining how to use the online database and the downloadable files are available at http://oig.hhs.gov/exclusions/download.asp. Given the penalties and recent government warnings, long term care providers should check the LEIE on a regular basis.

The LTC Career Center Features Amazing Career Opportunities, Tremendous Exposure for Employers and Great Employer Discounts

Dave Kyllo

The AHCA/NCAL Long Term Care Career Center helps employers fill their health care job vacancies.  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 and more than 92,000 searchable resumes.   

The LTC Career Center features many of the best positions available in the long term care profession and is always free for job seekers.  And, job seekers are using the site!  Job postings on the AHCA/NCAL Long Term Care Career Center, average more than 1,400 views a month. 

As a leading employment information resource, the AHCA/NCAL Long Term Care Career Center  has been fully integrated with Google’s new job search feature “Google for Jobs.”  Our partnership with Google’s new initiative will deliver success for AHCA/NCAL members, job seekers and other related employers in the long term care industry

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% 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% discount on the three postings by entering promo code Bundle20 at check out.  Employers who use the site are also able to post vacancies as they occur and search resumes on the network. 

In addition to receiving unique national exposure on a large health care job board network, employers who utilize the site also receive superior exposure through rotating job listings on AHCA’s home page – the web site 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.  View this employer resource and see how easy it is to create an account on the AHCA/NCAL Long Term Care Career Center site.


Check out the prestigious employers and prestigious positions on the LTC Career Center today and take advantage of great savings by using either the New25off promo code to save 25% on your first job posting or the Bundle20 promo code to save on a package of three job postings.     

Tuesday, November 7, 2017

MedPAC Advances Unified Post-Acute Payment System

Carly Sfregola

The Medicare Payment Advisory Commission (MedPAC), a nonpartisan legislative branch agency that provides the U.S. Congress with analysis and policy advice on the Medicare program, met last week to discuss post-acute payment. In response to a Congressional mandate in the IMPACT Act, the Commission has made recommendations of moving to a unified post-acute payment system. Thursday’s meeting featured a discussion on “blending” post-acute payment policy before moving to a fully unified system in 2021. For more details, the presentation slides may be viewed here and for AHCA members, a lengthier summary here

Monday, November 6, 2017

Emergency Preparedness Final Rule Takes Effect this Month



The Emergency Preparedness Final Rule, released September 16, 2016, impacts skilled nursing facilities (SNFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), but does not apply to assisted living providers.  Providers will need to comply with the final rule by November 15, 2017.  In June 2017, the Centers for Medicare & Medicaid Services released the Emergency Preparedness Interpretive Guidance (IG).  AHCA members are highly encouraged to look through the guidance.  Click here for a summary AHCA put together of the IG for your use.  CMS also released the surveyor training to providers, more information can be found in this September memo.  In addition, AHCA has an Emergency Preparedness Final Rule Webinar Series.  Be sure to register for the final webinar in the series, which will be held November 21st from 2- 3pm ET.  Finally, the AHCA Bookstore has added new resources for the rule, to access the bookstore please click here.  Please contact Erin Prendergast (SNF Providers) or Dana Halvorson (ICF/IID Providers) with any questions.

Excellence Has No Limits: Tell Us How You Did It

Urvi Patel

We are currently accepting Poster Session Proposals for the 2018 Quality Summit in New Orleans, March 12-14, 2018.

Tell us how you have employed either a QAPI or Baldrige approach to accomplishing one of the AHCA or NCAL Quality Initiative goals.

Poster Sessions are excellent forums for communicating interventions, new models of service delivery, and innovative research projects. They provide a fun, interactive learning experience. This will be your opportunity to shine and share all of the great things that your center has accomplished. It also providers a wonderful networking opportunity. All poster session participants will receive a certificate of recognition and 4 will be chosen for a special moderated session.

Proposals can be submitted here.

The deadline to submit is November 30th, 2017. Applicants will be notified on December 14th, 2017. For questions, contact Urvi Patel at upatel@ahca.org.

CMS Announces New Low Volume Settlement Option for Medicare Appeals

Lilly Hummel

The Centers for Medicare and Medicaid Services (CMS) has announced a new low volume appeals settlement (LVA) option for providers with appeals pending at the Office of Medicare Hearings and Appeals (OMHA) and the Medicare Appeals Council. This new option is potentially available to providers that have fewer than 500 Medicare Part A or Part B claim appeals pending at both OMHA and the Council, with a total billed amount of $9,000 or less per appeal, in addition to other conditions. CMS will settle eligible appeals at 62% of the net allowed amount. See CMS’ website for additional details about the LVA option, which will be posted in the coming weeks: https://www.cms.gov/Medicare/Appeals-and-Grievances/OrgMedFFSAppeals/Appeals-Settlement-Initiatives/index.html 

Wednesday, November 1, 2017

New Report Reviewing Key Issues in Long-Term Services and Supports Quality


Lilly Hummel

The Kaiser Family Foundation has released a new Report entitled “Key Issues in long-Term Services and Supports Quality”. The issue brief discusses four key issues related to long-term services and supports (LTSS) for Medicaid and Medicare providers, including: regulation of institutional and home and community-based services (HCBS) quality, current status of LTSS, unknown information about LTSS quality, and challenges in LTSS quality oversight. The report emphasizes that state health and social services agencies are primarily responsible for conducting the inspections and other monitoring of LTSS quality for providers such as assisted living communities. HCBS quality measures are being developed, which would support the reporting of more quality data nationally.

AHCA's Parkinson Named Top Lobbyist for 2017

Carly Sfregola

The American Health Care Association and National Center for Assisted Living President and Chief Executive Officer Mark Parkinson was named a Top Lobbyist in 2017. The Hill publishes the top lobbyist list annually and noted the association's efforts to "stand guard against cuts to Medicaid and Medicare." See the full list here.

LTC Facilities with ANCC Board Certified RNs Experience Lower Loss Rates Per Bed

Dave Kyllo

According to analysis conducted by one of the nation’s leading long term care liability insurers, assisted living and skilled nursing centers with at least one RN board certified in gerontological nursing by the American Nurses Credentialing Center (ANCC) experience a lower loss rate per bed than facilities without a Board certified RN. HealthCap, a liability insurer specializing solely on long term care providers, found that facilities with ANCC Board certified RNs averaged a reduction of more than $100 per bed in annual claims.

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 ANCC board certified in gerontological nursing.

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 complete the AHCA/NCAL Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam and receive 30 CEUs.  They also increase their knowledge of gerontological nursing by 20 percent on pre- and post-test scores.

AHCA/NCAL Gero Nurse Prep is on sale now through November 30 and each RN registrant can save $100 off his/her Gero Nurse Prep by entering promo code VBPRN17 (all caps) at checkout.  That means RNs who are interested can become board certified for less than $1,000 ($590 sale price 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.  Take advantage of the sale on Gero Nurse Prep now and remember to enter promo code VBPRN17 at check out. 

HealthCap is endorsed by AHCA/NCAL and is the premier program solely dedicated to providing liability insurance to senior care communities.  HealthCap clients have claim frequency 30 percent lower than the industry and HealthCap settles claims for half the industry average.  AHCA/NCAL members get a bonus advantage by always receiving a 10 percent discount on their HealthCap premiums.

Recent Settlements of False Claims Act Cases

Lilly Hummel

The Department of Justice (DOJ) announced that Catholic Health has agreed to a settlement of $6 million to resolve a qui tam (i.e., whistleblower) lawsuit that its subsidiary, Home and Community Based Care, violated the False Claims Act by submitting false claims to government health care programs. The Western District of New York brought the case, which alleged that services provided at long and short-term skilled nursing care and post-acute care facilities were unreasonable, not medically necessary and unsupported by the medical records. The false claims were related to Ultra High Resource Utilization Group (RUG) levels. As part of the settlement, Catholic Health has agreed to enter into a five-year Corporate Integrity Agreement with the Office of Inspector General (OIG).

Health Services Management Inc. (HSM) has paid $5 million to resolve claims that the company billed the Medicare and Medicaid programs for worthless services and for services that were never provided. The lawsuit, originally brought by a whistleblower, was filed for poor quality of care against Huntsville Health Care Center, a 92-bed nursing home and rehabilitation facility that HSM owned and operated in Texas. As part of the settlement, HSM agreed to enter into a Corporate Integrity Agreement with OIG.

DOJ and OIG have recently settled several other cases that involve post-acute and long-term care providers. For example, the largest for-profit hospice chain has agreed to pay $75 million to resolve a government lawsuit alleging violations of the False Claims Act between 2002 and 2013. The government’s complaint alleged that Vitas, which is now owned by Chemed Corporation, billed for patients who were not terminally ill and thus did not qualify for the Medicare hospice benefit, and submitted false claims for continuous home care services that were not necessary, not actually provided, or not performed in accordance with Medicare requirements. Vitas also entered into a five-year Corporate Integrity Agreement with OIG.

Deliver a Better Resident Experience with Music from Mood Media

Dave Kyllo

Plato said “music gives soul to the universe, wings to the mind, flight to the imagination, and life to everything.” Members can create an inspiring atmosphere in their communities through music offered by Mood Media at AHCA/NCAL “Member Only” discounted rates.

Mood Media offers great musical variety for events or casual common area listening via the internet or streaming, and offers customized commercial free music options that allow facilities to tailor musical selections to meet changing resident preferences.  Mood customers enjoy freedom from music licensing worries on Mood Media’s huge collection of music selections played on Mood Media's portable devices.

Use Mood Media’s music to:


  • Improve the dining experience and set the mood in dining areas as residents gather for meals;
  • Provide a variety of background music in common areas;
  • Create a positive environment for activities; and 
  • Provide musical entertainment for social gatherings and happy hours.


AHCA/NCAL members receive exclusive discounted rates on Mood services and equipment with three-year agreements.  The core music package starts at $29.99 per month or about $1 per day with a three-year agreement.   

For more information about Mood Media’s services, call 800-345-5000 or go to   http://partner.moodmedia.com/ahcancal/ (password: moodpartner).

Bipartisan Framework to Repeal Therapy Caps Announced

Drew Thies

The House Ways and Means and Energy and Commerce Committees announced last week that their members have reached a bipartisan agreement permanently repealing annual limits on Medicare payments for therapy policy. The per-patient limits, commonly referred to as “therapy caps” were an annual nuisance for lawmakers, who previously had to repeal the policy on a yearly basis.

A joint statement from Ways and Means Committee Chairman Kevin Brady (R-TX), Ranking Member Richard Neal (D-MA), Energy and Commerce Committee Chairman Greg Walden (R-OR), and Ranking Member Frank Pallone (D-NJ) praised the agreement as “a major breakthrough” and avoids a similar situation to “the days of SGR patches.”

In 2006, Congress passed an exceptions process allowing patients to exceed the cap based on medical necessity and the temporary legislation has been renewed on a case-by-case basis. The cap was addressed most recently in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and expires on January 1st.

Though the policy framework has been agreed to, lawmakers still do not have agreement on how to offset the package. Negotiations continue as the committees seek to pass legislation before the year-end deadline on the current therapy cap suspension law.

Be Ready for the Phase II Infection Prevention Requirements Taking Effect November 28

Dave Kyllo

The American Health Care Association (AHCA)  is ready to help members meet the new Infection Preventionist specialized training requirement finalized by CMS in the Reform of Requirements of Participation for Long Term Care Facilities. This Infection Preventionist Specialized Training (IPCO) course provides education for healthcare professionals who seek to serve as Infection Preventionists.   Individuals who complete the course will be trained to effectively implement and manage an Infection Prevention and Control Program (including antibiotic stewardship programs) at their nursing facilities.

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 were trained this summer 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. It includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term/post-acute care.  It addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control 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. 

New Emergency Preparedness Rules Take Effect in Two Weeks! Are you Ready?

Dave Kyllo

Nursing facilities (SNFs/NFs) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) face new sweeping regulations affecting their emergency preparedness planning beginning on November 15.   These requirements include:

  • Annual Risk Assessment and Emergency Planning
  • Communication Plan
  • Emergency Preparedness Policies and Procedures (must be reviewed annually)
  • Training and Testing


AHCA/NCAL is pleased to offer a new tool titled “Emergency Preparedness Program (EPP) Customizable Plan for Long Term Care” that allows facilities to customize compliant plans, including:


  • Emergency Preparedness Program Management Plan
  • Communications Plan
  • Procedures applicable to all hazard responses
  • Incident Command System 
  • Full building Evacuation Plan
  • Emergency Lists
  • Continuity of Operations and Recovery Plan.


AHCA/NCAL members receive exclusive “member only” pricing of $395 for the EPP customizable plan – a savings of $100 off the regular price. The EPP plan from Russell Phillips & Associates includes:

  • An electronic flash drive – Easily add your facility’s information to customize your plan.
  • Hard copy of the documents – Provides hard copy worksheet-style documents of your plan. 
  • Binder with tabs prepared for insertion of customized plan – An invaluable resource that organizes your plan documents.  
  • A crosswalk between the new CMS regulations and the customizable EPP plan manual – This indispensable tool provides a clear-cut detailed comparison that shows how your facility’s EPP plan meets CMS requirements and demonstrates precise compliance to survey agencies and AHJs.  
  • Access to an information-packed 75-minute “how to” webinar conducted by Russell Phillips & Associates.


Be ready for the November 15 deadline and your next survey.  Order the customizable EPP plan today through the AHCA/NCAL Bookstore and save $100 off the regular $495 price. 

CMS SNF VBP Call Nov. 16

On Thursday, November 16 from 1:30 to 3 pm ET, learn how the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Program will affect Medicare’s payments to your SNF beginning October 1, 2018, as well as details on how CMS will translate SNF performance scores into value-based incentive payments. CMS will also discuss policies finalized in the FY 2018 final rule.

To register, click here.

A question and answer session follows the presentation; however attendees may email questions in advance to SNFVBPinquiries@cms.hhs.gov with “SNF VBP November NPC” in the subject line. These questions may be addressed during the call or used for other materials following the call.

Tuesday, October 31, 2017

There's Just One Week Left to Submit Your Intent to Apply for the Quality Award Program!

The Quality Award Team

The deadline to submit your Intent to Apply for the 2018 AHCA/NCAL National Quality Award application cycle is just one week away!


Submit the Intent to Apply payment by November 9, 2017 at 8 p.m. Eastern here.

Members who submit an Intent to Apply save money on their overall application fee and receive weekly tips and other resources that support submitting a successful Quality Award application.
  • All applicants should read the appropriate application packet in full before submitting an Intent to Apply payment. Application packets for all award levels can be found on the Quality Award website.
  • 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.  
If you would like to review your center's award history or have any questions, please visit the Quality Award program website or email qualityaward@ahca.org.

You can also view a new video providing an overview of our Quality Award Program here.