Wednesday, April 26, 2017

AHCA/NCAL Observation Stays Hill Issue Brief Available

Dana Halvorson

Last month, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) commended several members of Congress for reintroducing the Improving Access to Medicare Coverage Act of 2017 (S. 568/H.R. 1421). Introduced on March 8, 2017 by Congressmen Joe Courtney (D-CT) and Glenn “GT” Thompson (R-PA), and Senators Sherrod Brown (D-OH), Susan Collins (R-ME), Bill Nelson (D-FL) and Shelley Moore Capito (R-WV), the legislation ensures that time spent under “observation status” in a hospital counts toward satisfying the three-day inpatient hospital requirement for coverage of skilled nursing care services under Medicare. The Observation Stays Coalition, which consists of over 30 organizations including AHCA/NCAL, fully supports this legislation. The AHCA/NCAL issue brief  is for your use when reaching out to your members of Congress.

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.

Assisted Living Briefing at Congressional Briefing

If you’re an assisted living provider heading to the Hill this June, make sure to get briefed. On the opening day of Congressional Briefing, NCAL will hold an Assisted Living Briefing. An open forum discussion on issues specifically affecting assisted living and a DC update will be the highlight of this meeting. NCAL’s Executive Director Scott Tittle and other legislative staff will prep assisted living providers for their visits with their member of Congress the following day.

Assisted Living Briefing
Monday, June 5
2:30 PM – 3:30 PM
REGISTER NOW

AHCA/NCAL’s Congressional Briefing will be held June 5-6, 2017 at the Hyatt Regency Washington on Capitol Hill. Registration is open now until May 8. There is no registration fee for member providers and associate business members of AHCA/NCAL.

Members are encouraged to set up their own meetings with their members of Congress on Tuesday, June 6. Once you have scheduled a meeting, please tell AHCA/NCAL about your meeting, so we can have materials ready for your visit and if needed, have a lobbyist attend the meeting with you.

Questions? Please email congressionalbriefing@ahca.org.
 

2017 AHCA/NCAL Congressional Briefing



Join your colleagues to hear the latest news from Capitol Hill, share ideas, network, and prepare with AHCA/NCAL to carry your message to your Members of Congress and their staff. Then spend several hours meeting with your Members of Congress in-person. It's the most powerful way to be heard and have an impact.


You can now take advantage of an AHCA/NCAL room rate and save at the Washington Court Hotel on New Jersey Avenue, NW. Deadline: May 8, 2017


Visit CB.ahcancal.org for updates and to see the complete agenda.


The conference registration fee is complimentary to AHCA/NCAL Members and AHCA/NCAL Associate Business Members, and their spouses, and is accepted on a first-come basis.  This year's keynote is Fox News Channel Anchor Bret Baier. Additional speakers and guests will be announced shortly. Register today.

Check Updated LEIE Database




The 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 March 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 health care 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.

New CMS Voluntary Self-Referral Disclosure Form

Dianne De La Mare


The Department of Health of Human Services, Centers for Medicare & Medicaid Services (CMS) has issued a new Self-Referral Disclosure Protocol (SRDP) Form that provides a streamlined and standardized format for disclosing actual or potential violations of the physician self-referral law. The SRDP Form will reduce the burden on providers and suppliers submitting disclosures to the SRDP and facilitate our review of the disclosures. Use of the form is mandatory effective June 1, 2017. Parties submitting self-disclosures to the SRDP are encouraged, but not required, to use the SRDP Form now. Visit the SRDP webpage to learn more.

Measuring Compliance Program Effectiveness Resource Guide




The Department of Health and Human Services, Office of Inspector General (OIG) has released Measuring Compliance Program Effectiveness: A Resource Guide, which is a list of ideas for compliance program implementation, compiled from a day-long discussion with compliance and OIG professionals. The purpose of the list is to give healthcare providers as many ideas as possible, and let the individual provider choose which suggestions fit their individual needs the best.

The ideas fall under the 7 compliance elements
1) standards, policies and procedures
2) compliance program administration
3) screening and evaluation 
4) Communication, education and training on compliance issues
5) monitoring, auditing and internal reporting systems
6) Discipline for non-compliance
7) Investigations and remedial measures.



ahcancalED-Education at Your Fingertips – A Resource for Independent Owners and Not for Profits


Christy Sharp and Dana Halvorson 


With a growing library of webinars, courses, tools and resources, ahcancalED has become a valuable resource to AHCA/NCAL Independent Owners and Not for Profit providers. What makes ahcancalED different from other learning management systems is its customization to the needs of AHCA/NCAL members. From the new Requirements of Participation, to QAPI, to Faith Community Partnerships and QI in Veteran’s Homes, ahcancalED is driven by the information that is of importance to its members. In fact, many use their expertise to create the programs found within it.

In this webinar session, take a tour of ahcancalED, discover some of the programs and rich educational material and how best to navigate through it.  It will be led by Marguerite McLaughlin, Vice President of the Rhode Island Health Care Association. The ahcancalED tool is a helpful resource for all providers, but this webinar is specifically geared towards Not for Profits or Independent Owners. 


You can register for this webinar event here.  If you have any questions regarding the webinar please contact Christy Sharp or Dana Halvorson

Congressional Leadership Negotiates on Government Funding



Leadership in both parties are trying to reach a bipartisan agreement in order to keep the government funded. Members of Congress will need to send a bill to the President’s desk by Friday to avert a government shutdown.

It looked as if Republicans might have to act against the administration in order to come to an agreement that would pass the Senate. Earlier in the week, President Trump called for funding for a border wall between the U.S. and Mexico—a provision that would alienate Democrats—though has since backed off that demand. Any bill would need Democratic help to pass the Senate, as 60 votes are needed to avoid a filibuster.

Democrats have sticking points of their own, with some in Leadership insisting that subsidies relating to the 2010 health care law be included in the agreement. The funding bill could include a provision to provide permanent Obamacare subsidies to help cover costs for low-income Americans and stabilize insurance markets. President Trump has threatened to pull these subsidies to force Democrats to negotiate on health care reform, therefore, some in Leadership want to take Congressional action to prevent such a scenario. If such a provision is not included, Democrats will have to choose to either support a less-than-desirable package or risk a government shutdown.


Congress may pass a short term funding bill, or “continuing resolution,” to keep the government funded at current levels for a few weeks will negotiations on larger sticking points continue.

Nominate Your Champion of Quality By June 9!

Erin Prendergast

Dr. Mor (center) accepts 2016 Champion of Quality Award
Do you know an individual who has made significant national contributions to advancing quality performance in long term and/or post-acute care? Then nominate them today! Nomination forms can be found on Champion of Quality Award page, and must be submitted online by June 9, 2017

Previous recipients, including Dr. Vincent Mor (2016) Dr. Alice Bonner (2015) and Ed McMahon (2014), have demonstrated exemplary achievements in long term and post-acute care, including, but not limited to:

· Leadership in education and advocacy for quality improvements;

· Dedication to performance improvement;

· Significant additions to long term and post-acute care research or interventions, and;

· Initiative in innovation for quality care.

Recipients of the award are not required to be AHCA/NCAL members, but the nomination must be submitted by an individual with an organization that is an AHCA/NCAL member of good standing. In addition, the nomination must demonstrate how the nominee has made a significant impact on a national scale. The recipient will be honored at the 68th AHCA/NCAL Annual Convention ​and Expo​ on Wednesday, October 18, 2017 in Las Vegas, Nevada.

Please contact Erin Prendergast with questions, or visit the Champion of Quality award page for more information.

2017/2018 Future Leaders Training

Christy Sharp


It's time to consider recommending a candidate to your State Executive to participate in the annual “Future Leaders of Long Term Care in America” program. Candidates will be selected for this professional training and mentorship program, which begins at the September 13 - 15 symposium in Washington, D.C. Each state may nominate one person.


The nominees for the 2017/2018 class should be owners and operators who are up and coming leaders in your state. We especially encourage nominees who reflect not only the diversity of AHCA membership in terms of gender, race, ethnicity, and socio-economic backgrounds, but the various constituency groups that comprise AHCA/NCAL – whether that is a rural or urban area, a non-profit or a proprietary facility, or small, independently-owned facilities or regional, multi-facility corporations.

ALL nominations must be submitted by AHCA State Affiliates. Each State Affiliate may submit one nomination. Before contacting your State Association to recommend a candidate for this year’s class of Future Leaders, please discuss the following requirements and responsibilities with your nominee. Future Leaders will be expected to:

  • Attend a three-day training session, which will be held in Washington, DC on September 13 - 15;
  • Complete any assigned reading – typically 4 or 5 books during the year – and be prepared to discuss on conference calls;
  • Participate in a majority of scheduled conference calls and activities, including a graduation event hosted by AHCA/NCAL leadership at the AHCA/NCAL Annual Convention & Expo, which will be held October 7 – 10, 2018 in San Diego, CA; 
  • Demonstrate an interest in working on LTC issues at the national level, which may include participating on AHCA/NCAL workgroups or committees; and
  • Consider active participation in the AHCA PAC and promoting its importance to other members.

Once you have discussed the responsibilities and requirements with your nominee, please contact your State Association with your recommendation. AHCA State Executives will be asked to submit a nomination for one person by June 12, 2017.

Should you have any questions, please contact Christy Sharp at csharp@ahca.org or 202-898-2839.

AHCA/NCAL Gero Nurse Prep Sale Ends this Sunday


Dave Kyllo
Time is running out! The sale on AHCA/NCAL Gero Nurse Prep ends April 30, so this is the last week to save $100 on Gero Nurse Prep registrations for RNs by entering promo code QUALITY17 (all caps) at checkout.  


RNs who are interested in boosting their credentials and expertise 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). 


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 on their first try and receive 30 CEUs. The time to complete for the Gero Nurse Prep program is flexible. RNs have one year to complete the program and the clock does not start ticking until they start begin their coursework.    


AHCA/NCAL Gero Nurse Prep also nets smarter nurses by increasing an RN’s 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.   

The good news for long term care providers does not end there. Having at least one RN who has been certified in gerontological nursing by the ANCC has been correlated to achieve better outcomes in nursing facilities. 

Research conducted by AHCA/NCAL in 2016 found that the rehospitalization rates in skilled nursing centers with at least one RN Board Certified in gerontological nursing by the ANCC consistently have run at least two percentage points lower than the national average since 2011. The facilities were also twice as like to receive a 5-Star rating from CMS. 

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.  


With less than one percent of the nation’s nurses ANCC Board Certified in gerontological nursing, it’s easy to get an edge on your competition through ANCC Board certification. Be more competitive and order Gero Nurse Prep by April 30 to save $100 by entering promo code QUALITY17 (all caps) at checkout.  

CMS Updates SNF Billing Reference Booklet



The Centers for Medicare and Medicaid Services (CMS) recently posted an updated nineteen page Medicare Learning Network SNF Billing Reference booklet. The booklet focuses on fee-for-service Medicare Part A and Part B coverage and billing topics. SNF billers and other interested staff are encouraged to review this updated booklet.


The “Medicare-Covered SNF Stay” section covers skilled services, coverage requirements, Part A benefit exhaustion, benefit period, and communicating with beneficiaries topics. The “SNF Payment” section covers Medicare Part A (including consolidated billing), and Part B. The “SNF Billing Requirements” section offers billing tips, and describes special billing situations such as: readmissions within 30 days, benefits exhausted, no payment billing, expedited review results, non-covered days, and other billing situations. The document also contains a list of resource web pages for additional reference.

Tuesday, April 25, 2017

Delivering What Everybody Loves Through Mood Media

Dave Kyllo

Billy Joel said that “No matter what culture we’re from, everybody loves music.” Members can keep music alive 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).

New! LTC Trend Tracker Features for Account Administrators

help@ltctrendtracker.com

Are you a new account administrator for LTC Trend Tracker? Are you a current account administrator but have some questions on your access? Well not to worry! The LTC Trend Tracker Team is hosting a webinar for all LTC Trend Tracker account administrators to discuss the administration screens and also a live tutorial on new features that only account administrators have access to!

This webinar will be hosted by Gautami Inamdar & Lonnita Belk, managers of LTC Trend Tracker, on Thursday, May 11th at 2:00 PM ET. Registration can be found here. Need some assistance with other areas in LTC Trend Tracker? Our resource center has multiple help documents and how-to videos on all other areas of LTC Trend Tracker at www.ltctrendtracker.com. Need additional assistance? The members of the LTC Trend Tracker team are here to help! Please email help@ltctrendtracker.com with any questions or concerns you have, and they will be sure to respond as soon as possible.

Thursday, April 20, 2017

Updated PBJ Manual Now Available


This week, CMS posted an update of the Payroll Based Journal (PBJ) manual. Highlights of the changes are listed below.
  • Clarified the need for facilities to check the Final File Validation Report.
  • Further clarified that reporting the hire and termination dates are optional.
  • The following positions are now optional
          - Dentists
          - Podiatrists
          - Vocational Service Workers 

Providers are encouraged to go to the CMS PBJ website and download and review the updated PBJ manual and FAQs. Remember that data from January 1 – March 31 2017 must be submitted by May 15th.

Wednesday, April 19, 2017

Jan Thayer Pioneer Award Nominations Open!

Katherine Preede

Nominations are now open for NCAL’s 2017 Jan Thayer Pioneer Award. ​The award recognizes an individual who has moved the senior care profession forward, positively affecting the lives of those served and those who serve. Recipients must demonstrate dedication, leadership and considerable contributions to the senior care profession.

Nominations must be submitted online and include a 500-word or less essay, along with a copy of the candidate’s resume. Nominators must be members of AHCA/NCAL; however, candidates are not required to be members. All nominations must be received by June 9, 2017. The recipient is selected by the NCAL Executive Committee and will be honored at NCAL Day at the AHCA/NCAL Convention & Expo in Las Vegas this October.

The Jan Thayer Pioneer Award is posthumously named after the first Board Chair of NCAL Jan Thayer. A provider for more than 25 years, Thayer owned and operated Riverside Lodge in Grand Island, Nebraska. She also founded and headed up the Excel Development Group, which owned and managed retirement communities throughout the Midwest and employed hundreds.

This is the third year NCAL is honoring an individual in the assisted living profession. The award was bestowed to Pat Giorgio of Evergreen Estates last year.

NCAL Awards Program: 2017 Nominations Open!

 
Nominate a deserving assisted living colleague for an NCAL Award by June 9th! Know of an outstanding assisted living nurse or administrator? Last year, did your community create the best National Assisted Living Week® programming based on the "Keep Connected" theme? Or maybe there is an unlicensed caregiver or someone in the dietary, housekeeping, or maintenance departments who goes above and beyond the call of duty? If you answered yes, then check out NCAL’s 2017 Awards Program. This program gives awards in four categories:
  • Administrator of the Year
  • Nurse of the Year
  • Noble Caregiver in Assisted Living
  • National Assisted Living Week Programming

You must have all components of your application before you can submit a nomination online. To nominate, the following items are required:
  • Administrator and Nurse of the Year nominations - Must have essays and resumes
  • Noble Caregiver in Assisted Living nominations - Must have essays
  • National Assisted Living Week Programming nominations - Must have essay, calendar, and pictures.
Recipients (and one guest) receive a trip to AHCA/NCAL’s 68th Annual Convention & Expo in Las Vegas, October 15-18, 2017. Each will be honored in front of their peers during NCAL Day and the Closing General Session of the Convention.

For more information and to submit a nomination, please visit www.ncal.org/awards. Completed nominations must be submitted no later than Friday, June 9, 2017.

Help recognize those that demonstrate outstanding service!

Updated OMHA Public-Use Forms

Dianne De La Mare


As part of US Department of Health and Human Services (HHS), Office of Medicare Hearings and Appeals (OMHA) continuing implementation of the final rule concerning changes to the Medicare benefit claims appeals process, HHS has updated OMHA forms. See OMHA website for a specific list of new forms and new OMHA numbers.

Tuesday, April 18, 2017

More Than 20,000 Open Positions Posted in LTC Sector in April

Dave Kyllo

There are 20,704 open jobs this month 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. The number of open jobs held relatively steady over the last month.


The CEB TalentNeuron statistics also show an estimated 2,186,000 potential candidates in the nation’s workforce whose skills likely match the qualifications being sought by long term care employers. The pool of available potential candidates has decreased by more than 500,000 since January. Figures show that 2,130 direct employers are competing for candidates in April – a slight increase over March figures.   


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. 


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.


This is the perfect time to give the Long Term Care Career Center a try because new users receive 25% off their first posting. Simply enter promo code New25off to receive this special discounted price. 

Of course, the LTC Career Center is always free for job seekers. And, job seekers are using the site with more than 85,000 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 1,700 views in April. 


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. 


Be seen nationwide. Check out the LTC Career Center today and remember to enter promo code New25off to save 25% on your first job posting.   

Congress Set to Return for Tight Budget Deadline


 Drew Thies

Members of Congress returning to Capitol Hill next week will face a tight budget deadline to come up with a solution for funding the government. The current budget resolution is set to expire April 28th, giving lawmakers only a few days to avert a government shutdown.


Both chambers of Congress are currently out of town for the Easter recess and are scheduled to return April 24th for the Senate, April 25th for the House, just days before the funding deadline. That leaves little time for partisan fighting and deal-making for a budget that will need Democratic support to pass through regular legislative order.

Republicans will need to win over at least 8 Democrats in the Senate to get the 60-vote majority necessary to override a filibuster. A continuation of current spending levels, or continuing resolution, without other policy riders may achieve this goal, but other priorities may come into play.


The Trump administration has indicated that it would like funds to pay for a border wall—a central promise of the Trump campaign. Additionally, some conservative Republicans suggested provisions to limit funding for Planned Parenthood or sanctuary cities. Both these are poison pills for Democrats.


Senate Majority Leader Mitch McConnell (R-Ken.) noted on April 7th that spending bills, “cannot be done by one party alone,” perhaps indicating that the solution will be bipartisan. If the two parties cannot come to a conclusion, Congress will have to address a government shutdown before proceeding on an already crowded list of priorities that includes tax and health care reform.

SNF QRP Quick Reference Guide

Holly Harmon



CMS has released a Quick Reference Guide for centers regarding the SNF Quality Reporting Program (SNF QRP). This guide includes frequently asked questions, information on QRP help desks, and helpful links to additional resources for the QRP. Watch the CMS SNF QRP website for updates. 

SNF QRP Submission Deadline Upcoming

Holly Harmon


The submission deadline for the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) is approaching. Minimum Data Set (MDS) assessment data for October-December (Q4) of calendar year (CY) 2016 are due with this submission deadline. All data must be submitted no later than 11:59 p.m. Pacific Standard Time on May 15, 2017.


View the list of measures required for this deadline on the SNF Quality Reporting Program Measures and Technical Information webpage.


As a reminder, it is recommended that providers run the applicable CMS CASPER validation reports prior to each quarterly reporting deadline to ensure that all required data has been submitted. Providers are also encouraged to verify all facility information prior to submission, including their CCN and facility name. Only successful submissions will count toward your Annual Payment Update requirement. For more information, view the MDS 3.0 Submission, Submission Status, and Final Validation Reports

GAO Shows Improvement Needed to Reduce Improper Billing

Dianne De La Mare

The US Government Accountability Office (GAO) has released a report, Oversight of Efforts to Reduce Improper Billing Needs Improvement, that recommends CMS improve Medicare Administrative Contractor (MAC) oversight by:

1) requiring sufficient detail in MAC reporting to determine the extent to which MACs’ provider education department efforts focus on vulnerable areas;
2) requiring MACs to work together to educate referring providers on proper documentation for DME and home health services; and
3) establishing performance metrics for future probe and educate reviews.

The US Department of Health and Human Services (HHS) has concurred with all of the GAO’s recommendations.

Smarter RNs – Reduced Rehospitalizations – More Stars – What More Could You Ask For?

Dave Kyllo
 

Having at least one RN who has been certified in gerontological nursing by the American Nurses Credentialing Center (ANCC) has been correlated to achieve better outcomes in nursing facilities. 

 
Research conducted by AHCA/NCAL in 2016 found that the rehospitalization rates in skilled nursing centers 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.   The facilities were also twice as like to receive a 5-Star rating from CMS. 


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 complete the AHCA/NCAL Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam on their first try and receive 30 CEUs.

 
AHCA/NCAL Gero Nurse Prep does not stop there.  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.  Those smarter RNs who become ANCC Board certified correlate to the better outcomes found in the AHCA/NCAL research. 


AHCA/NCAL Gero Nurse Prep is on sale now through April 30 and each RN registrant can save $100 off his/her Gero Nurse Prep by entering promo code QUALITY17 (all caps) at checkout.   RNs who are interested in boosting their credentials and expertise 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.   

 
The time to complete for the Gero Nurse Prep program is flexible.  RNs have one year to complete the program and the clock does not start ticking until they start begin their coursework.     

Get an edge on your competition and order now while Gero Nurse Prep is on sale and save $100 by using entering promo code QUALITY17 (all caps) at checkout. 

Register for the 68th Annual AHCA/NCAL Convention & SAVE

meetings@ahca.org

The Mandalay Bay

Reserve Your Room Online and Get $100 Off Registration!

Yes, it’s true! Reserve your room within AHCA/NCAL’s designated hotel block, and you will receive $100 off your registration fee*.


Additional benefits of booking through AHCA/NCAL Housing include:
  •       No full prepayment required for housing reservations
  •       Access to all AHCA/NCAL activities
  •       On-site support from AHCA/NCAL Housing Staff

IMPORTANT NOTE: You must register for the event before you can make a housing reservation.
All registration and housing information, including cancellation policies, can be found online.

*Some restrictions apply. Not all registration packages are eligible for the housing discount.

http://www.AHCAconvention.org or http://www.NCALconvention.org

CMS Post Results of RAC MDS Validation Study of SNF Therapy RUG Claims

Dan Ciolek


In the April 2017 issue of the Medicare Quarterly Provider Compliance Newsletter, the Centers for Medicare and Medicaid Services (CMS) posted results of a Recovery Audit Contractor (RAC) SNF coding validation study. In response to an Office of Inspector General (OIG) report, CMS directed the Recovery Auditor to review claims submitted by SNFs to determine the extent to which the Minimum Data Set (MDS) is accurate and supported by the resident’s medical records. Upon receipt of this requested documentation, the entire benefit period was reviewed to determine the appropriate level of care—not including the determination of medical necessity. The improper payment involved with this review is overpayment.


The review focused on three states, Alabama, Georgia, and Tennessee, and featured a population of 4,276 claims with service dates beginning on October 1, 2010 containing RU, RV, RH, RM, or RU therapy Resource Utilization Groups (RUGs). The audit identified more than $39 million worth of potential overpayments.


Two error codes relate to this study and the reviewed claims:

· No documentation was received to support the RUG billed.
· When documentation was submitted, based on actual evidence in the records, the services the provider billed and the MAC paid were either not performed, or products were not provided, that would support the RUG billed.


The CMS article offers the following guidance on how providers can avoid these problems. 

To verify that the Medicare bill accurately reflects the assessment information, three data items derived from the MDS assessment must be included on the Medicare claim:


Assessment Reference Date (ARD) – The ARD must be reported on the Medicare claim. If an MDS assessment was not completed, the ARD is not used and the claim must be billed at the default rate. CMS has developed mechanisms to link the assessment and billing records.

The RUG IV Group – The RUG group is calculated from the MDS assessment data. The software used to encode and transmit the MDS assessment data calculates the appropriate RUG group.

Health Insurance PPS (HIPPS) Codes – Each Medicare PPS assessment is used to support Medicare Part A payment for a maximum number of days. The HIPPS code must be entered on each claim, and must accurately reflect which assessment is being used to bill the RUG IV group for Medicare reimbursement.

Help Your Shining Stars Shine a Little Brighter by Becoming CARES® Dementia Specialists

Dave Kyllo


You know the shining stars on your frontline caregiving staff. Help those extraordinary individuals shine a little brighter as caregivers by enrolling them in the entire HealthCare Interactive CARES® online dementia care training curriculum (6 courses/32 modules) by earning the CARES® Dementia Specialist™ credential. 


This affordable credential is an excellent way to recognize outstanding performance and position your shining stars to be valued peer mentors for other frontline caregivers. By completing all six training programs, submitting their documentation, passing the required 100-point online exam, and being approved, staff members will be able to use the C.D.S. credential after their name on their name badges and on their business cards.


Those who earn the CARES® Dementia Specialist™ credential will be placed on an international registry of people who earn and hold a current C.D.S. credential. In addition, each will receive an official recognition package that includes a C.D.S. lapel pin, a CARES card, and a frameable certificate. 


The CARES curriculum consists of 32 hours of online video-based person-centered dementia care education. Once activated, staff members will have 10-day access to each of the 5 professional caregiver courses and 30-day access to the CARES Dementia Care for Families program.


The C.D.S. courses include:

· CARES® Dementia Basics™ (4 hours, 4 modules)

· CARES® Dementia-Related Behavior™ (4 hours, 4 modules)

· CARES® End-of-Life Dementia Care™ (5 hours, 5 modules)

· CARES® Dementia Advanced Care™ (6 hours, 6 modules)

· CARES® Activities of Daily Living™ (10 hours, 10 modules)

· CARES® Dementia Care for Families™ (3 hours, 3 modules)


AHCA/NCAL members receive a 10% discount on the $199.95 C.D.S. package by using discount code AHCA10 at checkout! That’s 32 hours of high quality online dementia care training for only $179.95. Take advantage of this outstanding bargain today and remember to use discount code AHCA10 when you checkout. 

Click here to learn more about the CARES Dementia Specialist credential or visit www.hcinteractive.com/CDS

Wednesday, April 12, 2017

2017 Joe Warner Award Winners Announced

Drew Thies
Dirk Anjewierden and Greg Elliot were announced as the 2017 Joe Warner Advocacy Award honorees by AHCA/NCAL. Both Anjewierden and Elliot will accept their awards at the 2017 AHCA/NCAL Congressional Briefing.


Dirk Anjewierden is Executive Director of the Utah Health Care Association in Salt Lake City and acts as the key advocate for both state and federal issues affecting long term and post-acute care in the state.


Greg Elliot is a Vice President at American Medical Facilities Management, based out of West Virginia. Elliot is an integral supporter of skilled nursing and assisted living providers both in West Virginia and in the nation’s capital.


Both Anjewierden and Elliot will be honored at the AHCA/NCAL Congressional Briefing, where attendees can also hear from key voices from Capitol Hill and prepare to advocate in front of Members of Congress on behalf of the patients they serve.


AHCA/NCAL’s Congressional Briefing will be held in Washington, D.C. on June 5th and 6th. The early registration deadline is May 8th, but hotel rooms are already filling fast. Attendees are encouraged to register soon and visit the AHCA/NCAL website for more information.





‘Family is Forever’ Designated as 2017 Theme for National Assisted Living Week

Rachel Reeves
The National Center for Assisted Living (NCAL) today revealed “Family is Forever” as this year’s theme for National Assisted Living Week®. The annual, national observance provides a unique opportunity for residents, their loved ones, staff, volunteers, and surrounding communities to celebrate the individuals served in assisted living and learn more about this sector of long term care. ​​​​​

“Anyone who has spent valuable time in an assisted living community has seen how staff can come to think of their residents like family,” said NCAL Executive Director Scott Tittle. “It takes a special person to work in our profession, and often, caregivers form bonds that can never be broken. This National Assisted Living Week, we want to recognize these amazing individuals who give their heart and soul to their residents, as well as those seniors and individuals with disabilities who leave a lasting imprint on their caregivers.”

Established by NCAL in 1995, National Assisted Living Week (NALW) will be held Sept. 10-16, 2017. This year’s theme is inspired by a quote from the 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.” Assisted living communities across the country are encouraged to organize activities and events during NALW that celebrate these deep connections between staff and residents.

The “Family is Forever” logo is available for download to assisted living communities, stakeholders, and members of the public on the NALW website. In the coming months, NCAL will issue a planning guide and product catalog centered on ways to celebrate “Family is Forever.” Please visit www.NALW.org for updated information and resources.


 

New Video Highlights the CARES® Online Dementia Training Program

Dave Kyllo
 
The American Health Care Association (AHCA), and the National Center for Assisted Living (NCAL) recommend HealthCare Interactive’s CARES® online dementia care training programs and the Alzheimer’s Association’s® essentiALZ® individual certification program to train staff and to use as resources to help reduce the off-label use of antipsychotics.  
 
 
A new video provides an overview of the CARES program. After you review the video, take a test drive of any of the CARES programs to see why the online training program has been so popular with AHCA/NCAL members.  
 
 
All the CARES training programs are available to AHCA/NCAL members at a 10 percent discount. Simply use promo code AHCA10 at checkout to apply your 10 percent savings off any purchase. 
 
 
CARES online training and essentiALZ certification were developed for both professional and family care providers for people living with dementia. The online programs are available 24/7. Each program may be purchased for an individual staff person or single site licenses are available to train and certify all staff for one low price for any or all of the programs. CARES also offers 25-user multiple site licenses.  
 
 
The CARES modules are:
  
CARES® Dementia Basics™ (includes access to the essentiALZ certification exam) 
 
Four modules, four hours with pricing starting at $24.95 for individuals and $999.95 for site licenses. Topics covered: 
 
  • Alzheimer’s and dementia 
  • Understanding behavior
  • Communication 
  • Person-centered care and the CARES® Approach 
 
  CARES® Dementia Advanced Care™ (includes access to the essentiALZ Plus certification exam) 
 
Six modules, six hours with pricing starting at $39.95 for individuals and $1,199.95 for site licenses. Topics covered include the CARES Approach and:
 
  • Making a connection 
  • Eating well 
  • Recognizing pain 
  • Minimizing falls 
  • Rethinking wandering 
  • Minimizing restraints
 
  
CARES® Dementia-Related Behavior™ (includes access to the essentiALZ Plus certification exam) 
 
Four modules, four hours with pricing starting at $24.95 for individuals and $999.95 for site licenses. Topics covered:
 
  •  Introduction to dementia-related behavior
  •  Using the CARES Approach to dementia-related behavior
  •  Breaking down the CARES Approach
  •  Key responses to dementia-related behavior
 
 
CARES® Activities of Daily Living™ (includes access to the essentiALZ Plus certification exam)
Ten modules, ten hours with pricing starting at $49.95 for individuals and $1,399.95 for site licenses. Topics covered:
 
 
· Dementia and the CARES Approach
· Creating meaning in activities of daily living
· Recognizing and managing pain
· Bathing
· Dressing  
· Eating  
· Grooming 
· Mouth care 
· Using the bathroom
· Mobility, transferring, and positioning
 
 
CARES® End-of-Life Dementia Care™ (includes access to the essentiALZ Plus certification exam)
 
Five modules, five hours with pricing starting at $32.95 for individuals and $1,099.95 for site licenses. Topics covered:
 
  • Introduction to End-of-Life Dementia Care
  • The CARES Approach
  • Decision Making at the End of Life
  • Comfort care
  • Emotional and spiritual support
  • Mobility, transferring, and positioning
 
Give CARES a test drive today. For more information, go to www.hcinteractive.com/CARES. Don’t forget to use promo code AHCA10 to receive 10% off your purchase.
 

Calling All High School and College Seniors

Dave Kyllo

It’s Spring and graduation season is just around the corner. The AHCA/NCAL Long Term Care Career Center, is a great resource for nursing students and high school and college seniors who are interested in careers in long term care or health care. Our Center contains a Career Learning Center that includes great resources for creating powerful resumes and acing job interviews. 


The LTC Career Center 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 1,700 views a month. That big number means the LTC Career Center has the jobs people want. 


Creating an account and posting a resume is quick, free and easy! Give a competitive edge to that high school senior, nursing student or college senior you know. Tell them about the LTC Career Center and the free Career Learning Center job seeker resources today and help them land their first health care position.    

Monday, April 10, 2017

The RoP & Baldrige Connection


In October 2016, the Centers for Medicare and Medicaid Services (CMS) published a final rule revising the Medicare and Medicaid Requirements of Participation (RoP) for nursing centers. This represents the first comprehensive revision to the regulations since 1991. The changes to the RoP are significant, and meeting all of the detailed requirements can feel overwhelming. This is why AHCA is encouraging member providers to take a step back and look at the big picture. At its core, the requirements are tied together by three key themes that focus on knowing your residents, your staff, and your center.

While these themes are straightforward, it can be easier said than done. The operations of a nursing center are complex, fast-paced, and demanding. And the requirements add to the burden that staff and management already face. However, successfully incorporating these elements will result in a better environment for staff and residents, as well as more efficient and effective operations.

So how can member centers get there? Through the AHCA/NCAL National Quality Award Program, members can become better prepared to meet the new requirements. The critical component of the Program is its use of the Baldrige Performance Excellence Framework, a nationally recognized method known for improving business performance. By applying the Baldrige criteria, providers are better prepared to meet the RoP.


Click here to read more about the connection between RoP and the Baldrige criteria.


The bottom line is that member centers that meet the demands of the Baldrige Criteria through the Quality Award Program are better prepared to meet the RoPs. The proof of the Programs’ effectiveness lies in the outcomes. AHCA data shows that Gold and Silver recipients have better survey performance, Five-Star Ratings, and rehospitalization rates than other centers in the nation.

AHCA has developed several tools and resources to help members implement the RoPs. For more information about the RoPs and to access these member resources, visit RequirED at https://educate.ahcancal.org/required.

To learn more about the AHCA/NCAL National Quality Award Program, visit ahcancal.org here.

And to learn more about Baldrige, visit nist.gov/Baldrige here.

Have questions? Contact qualityaward@ahca.org.

Smarter is Smarter: 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.


That increased knowledge leads to better facility performance. Research conducted by AHCA/NCAL in 2016 found that nursing facilities with at least one RN certified in gerontological nursing by the ANCC were:

· Twice as likely to receive a 5-Star rating from CMS;

· Consistently had re-hospitalization rates that ran at least two percentage points lower than the national average; and,

· Consistently had off-label antipsychotic usage rates that were three to four percentage points lower than the national average.

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 April 30 and each RN registrant can save $100 off his/her Gero Nurse Prep by entering promo code QUALITY17 (all caps) at checkout. RNs who are interested in boosting their credentials and expertise 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. Get an edge on your competition and order now while Gero Nurse Prep is on sale and save $100 by using entering promo code QUALITY17 (all caps) at checkout.

National Healthcare Decisions Day

nkottkamp@mcguirewoods.com

We all need to be prepared in the event of a health crisis. Having the discussion is easier than most people think, but many of us need a little inspiration or a reminder to do it. This year, National Healthcare Decision Day (NHDD) on April 16th, will become a week long event April 16-22.

Please mark your calendar for April 16 to have a talk with your loved ones. There are all sorts of free resources, including advance directive forms for each of the 50 states and a great short video to get you thinking and talking, on the NHDD website: www.nhdd.org. Additionally, check out social media  Twitter, Facebook, and LinkedIn. Advance care planning is something we ALL should do and encourage others to do, regardless of age or current health. Discussing your wishes can be one of the most important gifts you ever give your loved ones.

The theme for the week will be "It always seems to early, until it's too late."  Join in on the 10th Anniversary of NHDD, as Americans across the country make their future healthcare decisions known to family, friends, and healthcare providers.

Planning for the Week
Sunday (4/16): Prepare
A day to get resources together

Monday (4/17): Start with Yourself
A day to think about your own healthcare decisions

Tuesday (4/18): Family/Friends/Loved Ones
A day to discuss your wishes with others (and learn their wishes)

Wednesday (4/19): Spread the Word
A day to tell others that you've engaged in advance care planning and encourage them to do the same

Thursday (4/20): Facilities Focus
A day for healthcare providers of all sorts to promote advance care planning

Friday (4/21): Professionals Preparedness
A day to ensure that all professionals (healthcare, clergy, legal, and others) understand and can promote advance care planning

Saturday (4/22): Reflection and Readiness
Consider what worked well for NHDD week and file/share your advance care plans so they will be available if needed

The mission of NHDD is to inspire, educate and empower the public and providers about the importance of advance care planning. Learn more at www.nhdd.org.

Medicare SMRC Announces CMS Directed SNF PPS Post-Pay Audit

Dan Ciolek


Strategic Health Solutions, LLC (SHS) is the Centers for Medicare and Medicaid Services (CMS) Supplemental Medical Review Contractor (SMRC) that is charged with conducting nationwide medical review as directed by CMS to address specific agency interests regarding coverage, coding, payment, and billing practices. Recently, the SHS website announced that on March 17, 2017, CMS directed the SMRC to conduct a post-pay audit of SNF PPS claims under project number Y4P0445. SNF providers selected for this audit may receive an Additional Documentation Request (ADR) letter directly from the SMRC contractor instead of the regional MAC.

 Here is an example ADR letter that was posted on the SMRC website. Traditionally, the SMRC audits are limited in scale so providers are not over-burdened with a large number of ADRs, but it is extremely important not to overlook or ignore the ADR requests, as late submission or non-response will result in the initiation of claim adjustments or recoupment by the MACs.  

Contact dciolek@ahca.org if there are questions.




Medicare J5 MAC Announces Pre-Pay Audits for Rehab Ultra High RUGs in IA, KS, MO, NE, National

Dan Ciolek


On April 4, 2017, Wisconsin Physician Services Government Health Administrators (WPS GHA), a Medicare Administrative Contractor (MAC) for the Centers for Medicare and Medicaid Services (CMS), announced that they will be conducting prepayment service specific complex medical reviews of Inpatient SNF services for providers in the J5 Jurisdiction. 


The J5 Jurisdiction encompasses SNFs that submit claims from Iowa, Kansas, Missouri, Nebraska, and other national providers. 


The article states that “A prepay edit will be initiated with reason code 51SNF for J5 claims with dates of service on or after April 1, 2016, meeting the following criteria:

· Original inpatient claims
· Type of bill – 21X
· Containing ultra-high rehabilitation RUGs”


On the WPS GHA website, they state that use data analysis to identify services at risk for potential errors. When the data analysis supports the potential for high risk billing practices within a specific service, a prepayment edit is then initiated to identify potential errors or incorrect billing of the service. The goal of Medical Review is to reduce the claims payment error rate by identifying patterns of inappropriate billing through:

· Identifying patterns of inappropriate billing through data analysis

· Conducting medical review of claims

· Educating providers on identified issues


Please note that while WPS GHA is also the CMS MAC for the J8 Jurisdiction (which covers Indiana and Michigan), AHCA has confirmed that this new audit announcement only applies to providers that submit claims as J5 providers.


Contact dciolek@ahca.org if there are questions.

CoreQ: The Solution for Improving Customer Satisfaction

help@ltctrendtracker.com


CoreQ is the customer satisfaction measure developed by AHCA/NCAL for assisted living residents and families, long-stay skilled nursing residents and families, and short-stay skilled nursing residents. A part of the Association’s metric-based Quality Initiative, CoreQ allows providers to measure overall customer satisfaction with a uniform set of questions.

Has your community or center started using CoreQ? If yes, keep it up! If not, don’t worry, just ask your customer satisfaction vendor to add CoreQ into your survey. Your vendor will take care of the rest by automatically uploading the data to AHCA/NCAL’s LTC Trend Tracker. For a complete list of CoreQ vendors, visit NCAL’s Quality Initiative website here and AHCA’s Quality Initiative website here. After your data is uploaded to LTC Trend Tracker, you can see how your organization is performing and benchmark against selected peer groups.

Have questions? Contact help@ltctrendtracker.com

Friday, April 7, 2017

An Intro to Person-Centered Care

Holly Harmon, RN, MBA, LNHA, FACHCA
AHCA Senior Director of Clinical Services

Person-centered care has become common language across healthcare settings and has a renewed emphasis in the Reform of Requirements of Participation for nursing centers.  So, what is person-centered care, really? 

AHCA members have been leading the way in defining what person-centered care means.  The AHCA Clinical Practice Committee developed the following Principles of Person-Centered Professional Care. 

  • The patient is seen and cared for as a whole person, not compartmentalized into body parts or functions. 
  •  Engagement of the interdisciplinary team is essential to the care and services for the patient according to their individual needs.
  • Person centered care is not task focused, rather it is focused on the person and their needs which is unique for each individual and cannot be accurately reflected in a categorical manner.
  • Quality outcomes are the result of a comprehensive, holistic and individualized dynamic relationship between the direct caregivers, interdisciplinary team, support staff, patient and family.
  • Flexibility in provision of care and services is critical to desired outcomes and requires consideration of both quality of life and quality of care aspects.  

In addition, the Committee developed a framework called Building Prevention Into Every Day Practice which outlines key elements from both an organizational and clinical nature that are critical to successful clinical and organizational outcomes.  One of these elements from an organizational nature is Principles of Person Centered Care.  In the face of a resident’s illnesses and impairments, the primary purpose of care is to support individuals in living as satisfactory and fulfilling a life as possible. It is important to be aware of each individual’s preferences, issues, and risks and tailor recommendations and actions accordingly.  Residents make choices and actively participate in their care planning, which is used as a foundation for everyday person-centered care.  Competent clinical reasoning and effective diagnosis facilitate truly individualized care by enabling interventions tailored to underlying causes.

Another element in the framework of a clinical nature is Individualized Care Approaches Reflected in Care Planning.  This element describes how the care plan results from effective reasoning and problem solving activities based on reliable evidence. It is the blueprint for the activities and interventions related to each individual’s outcomes. Individualized care plan approaches based upon a systematic thought process help the person reach their highest practicable level of function and well-being. Staff must develop and refine the care plan based on analyzing detailed, organized information and in the proper context without discipline-specific or topic-specific “silos.”

These resources provide an understanding of person-centered care concepts and approaches; however, it is important to recognize person-centered care likely means something a little bit different for each person.  The best way to learn what person-centered care means for each person who is served in your center is to ask them, get to know them as a person, and let each person’s strengths and interests breathe life into the care and services provided in your center. 

And be sure to visit the AHCA website here to learn more about Building Prevention Into Every Day Practice.


The Quality Initiative…Let’s Move!

By Kiran Sreenivas, MS, CPHQ
AHCA Senior Research Analyst

While the Let’s Move! campaign was geared towards reducing obesity in children, did you know that some of its basic principles, such as eating healthy and increasing physical activity, apply to the functional outcome improvement work our members are doing with their residents?  

Skilled nursing care providers across the nation are tackling the challenge made by the IMPACT Act and the Centers for Medicare and Medicaid Services (CMS) to improve residents’ self-care and mobility. Using the functional improvement measure added to Nursing Home Compare and the Five-Star Ratings in July 2016, the AHCA/NCAL Quality Initiative set a goal for providers to either achieve a 10% improvement from a baseline rate in the fourth quarter of 2015 or maintain a high-performance rate greater than or equal to 75%.

We now have enough data to examine the progress of providers, and they are doing quite well. Overall, as of September 2016, 46.8% of members have met either the improvement or performance target. Thirty-two percent of members have met the 10% improvement target, while 25% have met the performance greater than or equal to 75% target (see graph below).

Find out how your facility is doing on the functional outcome goal on LTC Trend Tracker, and see the latest national progress for all eight Quality Initiative goals here.