Wednesday, July 26, 2017

Tap the Expertise of Board Certified RNs to Improve Success

Dave Kyllo

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 assisted living settings.

Hospitals face having Medicare reimbursements withheld if their rehospitalization 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 assisted living 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 American Nurses Credentialing Center (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. RNs who are interested can become board certified for less than $1,100 ($690 for AHCA/NCAL Gero Nurse Prep and a separate $395 to take the ANCC exam).

Assisted living providers are encouraged to be proactive in reducing their rehospitalization rates by examining ANCC certification for their RN leaders. 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.

Strengthen your position in the marketplace by demonstrating your geriatric nursing expertise. Check out AHCA/NCAL Gero Nurse Prep today.

Webinar: 2017 HUD Updates on Residential Care Facilities Asset Management


At this webinar, representatives of HUD's Office of Residential Care Facilities (ORCF) will discuss the Section 232 program, which provides mortgage insurance for residential care facilities, including nursing homes, assisted living facilities, and board and care homes. 

In this program, get an overview about programs offered through ORCF, and get detailed information related to a number specific ongoing requirements for borrowers and operators.

Event Date: September 21, 2017 – 2:00pm – 3:00pm (EST)
Registration Link: Click Here

2017 HUD Updates on Residential Care Facilities Asset Management

Learning Objectives:

  • Understand the updated procedures for assuring that Section 232 facilities are in physically sound condition
  • Understand the role of HUD’s Office of Inspector General, and its distinct place within the agency
  • Understand the requirements for changes in participants of residential care facilities that currently have FHA-insured financing.
  • Understand the requirements for changes in collateral of an FHA-insured facility, including capital improvements (and environmental issues associated with those improvements), changes in the number of beds, granting of easements, sale of land or other security.
  • Understand the requirements in connection with taking distributions from the facility's accounts.
  • Understand updated financial reporting and record keeping requirements, including updates on using the Healthcare Portal.
  • Understand the need for, and the means obtaining, HUD approval for secondary loans on a facility.
Speakers:
  • John Hartung, Director, Policy and Risk Analysis Division, Office of Residential Care Facilities, HUD
  • Tim Gruenes, Director, Asset Management and Lender Relations Division, Office of Residential Care Facilities, HUD
  • Phillip Head, Program Analyst, Office of Residential Care Facilities, HUD
  • Rita Dockery, Supervisory Account Executive, Office of Residential Care Facilities
NOTE: We understand that this webinar has been scheduled over the Rosh Hashanah holiday. We sincerely apologize for this scheduling oversight. We will offer a recording of the webinar on ahcancalED. Access to the recording will require that you create an ahcancalED account if you do not have one. Creating an account is free.

MLN Notice on FY 2018 and After Payments SNFs That Do Not Submit Required Quality Data


CMS released a MLN Matters Article last week regarding FY 2018 and after payments for SNFs that do not submit required quality data. Beginning with FY 2018, and each subsequent year, if a SNF does not submit required quality data, their payment rates for the year are reduced by two percentage points for that fiscal year. 

Application of the two percentage reduction may result in an update that is less than 0.0 for a fiscal year and in payment rates for a fiscal year being less than such payment rates for the preceding fiscal year. In addition, reporting-based reductions to the market basket increase factor will not be cumulative; they will only apply for the FY involved.

The initial SNF Quality Reporting Program (QRP) requirement period was quarter 4, 2016, which affects FY 2018 annual payment update. The next SNF QRP requirement period is quarter 1, 2017, through quarter 4, 2017, and will affect FY 2019 annual payment updates.  

Further details on the SNF QRP requirements can be found on the CMS SNF QRP website or by contacting CMS here

Maryruth Butler Named 2017 Champion of Quality Award Recipient

AHCA/NCAL announced Maryruth Butler, MBA, NHA, RCA, yesterday as the 2017 recipient of the Mary K. Ousley Champion of Quality Award for her national impact on quality in long term and post-acute care.
 
Since 2001, Butler has served as the Executive Director of Kindred Nursing and Rehabilitation-Mountain Valley in Kellogg, Idaho, which provides skilled nursing and rehabilitation care for patients and residents. Under Butler’s leadership, Mountain Valley has been recognized with numerous achievements. Through AHCA/NCAL’s National Quality Award Program, the center achieved three progressive levels of awards – Bronze, Silver, and Gold – in 2005, 2007, and 2011, respectively. In 2016, Mountain Valley was the first nursing center to receive the prestigious Malcolm Baldrige National Quality Award, the nation’s highest Presidential honor for sustainable excellence. For eight consecutive years, the center has also achieved an overall five-star rating, the highest possible rating through CMS’ Five-Star Quality Rating System.
 
As a licensed Residential Care Administrator, Butler currently teaches a Residential Care/Assisted Living Administrator course through the Idaho Health Care Association, and conducts presentations across the country on topics such as the Baldrige Performance Excellence Framework and quality improvement.
 
AHCA/NCAL presents the Mary K. Ousley Champion of Quality Award to an individual or organization that has made a significant national contribution to advancing quality performance in the long term care field. Recipients must consistently advocate for quality approaches and demonstrate the ability to educate and advocate for a system’s approach to quality improvement. Recipients also display leadership in the development, promotion, and implementation of quality improvement initiatives that have resulted in measurable improvements in the quality of care and quality of life for individuals in long term care.
 
In 2011, the Friend of Quality Award was renamed the Mary K. Ousley Champion of Quality Award to honor the ongoing legacy and commitment to quality care demonstrated by its namesake, Mary Ousley, a licensed nursing center administrator and nurse who has dedicated her life to quality improvement programs in long term care.

Butler will be presented with the award at AHCA/NCAL’s 68th Annual Convention and Expo in Las Vegas, Nevada, October 15-18, 2017.

CMS Issues SNF QRP: Non-Compliance Letters

Holly Harmon


CMS announced last week that skilled nursing facility (SNFs) have been notified if they were determined to be non-compliant with SNF Quality Reporting Program (QRP) requirements for Quarter 4 of CY 2016, which will affect their FY 2018 Annual Payment Update (APU).  

Non-compliance notifications were placed into providers’ CASPER folders in QIES on July 14, 2017, and also mailed directly to providers. Providers that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59pm PST, August 13, 2017.

CMS advises if you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notification letter and on the SNF Quality Reporting Reconsideration and Exception & Extension webpage.

CMS has advised AHCA that SNFs meeting the SNF QRP requirements will not receive communication confirming their compliance. AHCA continues to advocate for more effective reporting from CMS to SNFs to aid in the understanding and management of SNF QRP.     

Board Certified RNs Can Make a Difference in Reducing Rehospitalization Rates

Dave Kyllo

Research conducted by AHCA/NCAL last year found that the rehospitalization rates in nursing facilities with at least one RN certified in gerontological nursing by the American Nurses Credentialing Center (ANCC) consistently have run at least two percentage points lower than the national average since 2011. Lower rehospitalization rates will be key to success under the new CMS Value-Based Purchasing (VBP) program. 

CMS currently is tracking skilled nursing rehospitalization rates on for the new SNF VBP program. Under the VBP program, claims for services furnished on or after Oct. 1, 2018, will be subject to a two percent withhold. Providers will have the opportunity to get some or all of this money back depending on how well they do in managing hospital readmissions and meeting or exceeding performance standards.

SNFs will be rated on achievement against all other facilities nationally as well as on their own improvement, comparing their rate in 2017 with their previous performance in 2015.  CMS plans to use this metric to determine reimbursement rates in coming fiscal years as well.

The key metric for the program is known as the SNF 30-Day All-Cause Readmission Measure (SNFRM). SNFRM estimates a risk-standardized rate of all-cause, unplanned hospital readmissions of Medicare SNF beneficiaries within 30 days of discharge from their prior acute hospitalization. 

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. 

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 program have a passing rate of 96 percent on the ANCC exam and receive 30 CEUs.  RNs who are interested can become board certified for less than $1,100 ($690 for AHCA/NCAL Gero Nurse Prep and a separate $395 to take the ANCC exam). 

Skilled nursing centers are encouraged to be proactive in reducing their rehospitalization rates by examining ANCC certification for their RN leaders. 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. 
Secure your future for success under the new VBP program. Check out AHCA/NCAL Gero Nurse Prep today!

HealthCap’s Chief Risk Director Offers Sound Advice for Quality Bariatric Skin Care


In case you missed it, the July issue of Provider magazine featured an article written by Angie Szumlinski, Director at HealthCap’s Risk Management Services, about the importance of proper skin care for bariatric residents.

Szumlinski outlines several factors providers should consider when caring for bariatric residents, and provides a practical four-step process for managing skin integrity and reducing care risks for this unique population.

HealthCap is endorsed by AHCA/NCAL and is the premier program solely dedicated to providing liability insurance to senior care communities. HealthCap clients have the fewest liability claims in the industry and HealthCap settles claims for half the industry average. 

HealthCap is owned and governed by the senior care providers insured by HealthCap.  AHCA/NCAL members get a bonus advantage by always receiving a 10% discount on their HealthCap premiums.

HealthCap clients also receive:
  • Risk management services that make a financial difference
  • An annual on-site risk consult
  • Unlimited telephone support
  • Accredited in-service education
  • Access to QA Reader – HealthCap’s innovative risk management service
For more information about HealthCap, email Stephanie Hale here or call (877) 855-4227

AHCA Supports the Veterans Access to Long Term Care and Health Services Act


AHCA applauded the introduction of the Veterans Access to Long Term Care and Health Services Act (S. 1611), legislation introduced last week by Senator John Hoeven (R-ND) and Senator Mike Rounds (R-SD) to expand veterans’ access to health care services.  

S. 1611 would ensure that extended care providers, including nursing center care, could legally enter into VA Provider Agreements, and would only be subject to the same rules and regulations as any other Medicare or Medicaid provider. The ability for qualified providers to enter such agreements would facilitate services for veterans closer to the veterans’ homes and community support structures. Once qualified providers have the ability to enter into VA Provider Agreements, the number of facilities serving veterans will increase in most markets, expanding the options among veterans for nursing center care and home and community-based services. 

Earlier this year, Hoeven secured a commitment from Department of Veterans Affairs (VA) Secretary Dr. David Shulkin to work together on this effort.  Additionally, as a member of the Military Construction and Veterans Affairs Appropriations Committee, Hoeven recently secured a provision in the Fiscal Year 2018 VA funding bill expressing congressional support for allowing non-VA long term care facilities to enter into provider agreements with the VA.  

If you have any questions on this issue, please don’t hesitate to contact AHCA’s Dana Halvorson.  

BCRA Fails, Senate Mulls Options


The Senate failed to pass The Better Care Reconciliation Act (BCRA) hours after opening up debate on the bill Tuesday, tanking Republican efforts to replace the Affordable Care Act (ACA) and overhaul the Medicaid program.

The months-long Republican effort still came up 7 votes short, 43-57, with nine Republicans voting no: Susan Collins (Maine), Tom Cotton (Ark.), Bob Corker (Tenn.), Lindsey Graham (S.C.), Dean Heller (Nev.), Mike Lee (Utah), Jerry Moran (Kan.), Lisa Murkowski (Alaska) and Rand Paul (Ky.). All Democrats opposed the bill.

The BCRA contained massive cuts to Medicaid in the form of both per-capita caps based on a significantly stunted growth rate as well as a cut-and-freeze of the provider assessment program.

The reconciliation process through which the bill moved still leaves options open for Republicans who want to repeal parts of the ACA.

Majority Whip John Cornyn (Texas) indicated Republicans will try to pass a smaller repeal and then potentially move to conference with the House. 

“I’d be happy to have a comprehensive bill that 50-plus senators agree to,” Cornyn said. “But if we can’t, then the idea would be to come up with a core of pieces that 50 of us agree on so we can get to a conference.”

Appetite remains among Republicans to do something on health care, but many are unfamiliar with what the end product will look like. Fifty Republicans voted to open up debate on the legislation, a move that allowed leadership flexibility on what ultimately leaves the Senate floor. Collins and Murkowski voted no on the procedural vote, forcing Vice President Mike Pence to break the tie.

The Senate may move soon to vote on a so-called “skinny” repeal, which targets the provisions of the ACA allowable under the rules of reconciliation. Though no text of such a bill currently exists, it is predicted this would also include a two-year delay to allow lawmakers to come up with a replacement plan.

The skinny repeal may also head to conference with the House, in which members from both chambers will be assigned to come to an agreement.

Wednesday, July 19, 2017

Health Reform Efforts Stymied as Senators Defect

Drew Thies

Several Republican senators announced this week they do not support the party’s current plan to repeal and replace the Affordable Care Act, postponing indefinitely the effort that has consumed Congressional Republicans this year.

Senate Majority Leader Mitch McConnell (R-KY) operated with zero margin for error. He needed 50 of 52 Senate Republicans to vote for the legislation and Senators Susan Collins (R-Maine) and Rand Paul (R-KY) already announced they were not supportive of the legislation.

McConnell, who planned to hold a vote this week, was forced to delay, as Sen. John McCain (R-AZ) had an operation on Saturday, and needed to stay in Arizona to recover. Absent McCain’s vote, the bill would not be able to pass.

Senators Jerry Moran (R-KS) and Mike Lee (R-UT) declared late Monday night that they would not support a procedural measure to bring the Better Care Reconciliation Act (BCRA) to the Senate floor for a vote. Both Moran and Lee issued statements critical of the drafting process, and called for a more open, collaborative repeal and replace effort.

With four solid “no” votes against the bill, McConnell announced “the effort to repeal and immediately replace the failure of Obamacare will not be successful.” He said the next step for the Senate would be to vote to simply repeal the Affordable Care Act, and include a two-year delay for lawmakers to come up with a replacement plan. Similar legislation passed both chambers on reconciliation instructions in 2015, but was vetoed by then-President Obama.

This plan, however, faces an uphill battle. Tuesday morning, Senators Shelley Moore-Capito (R-WV), Lisa Murkowsi (R-AK.), and Susan Collins all announced they will not vote for a procedural motion to bring a simple repeal bill to the floor of the Senate for a vote. Senator Rob Portman (R-OH) also gave indications he will not support such a measure.

McConnell said Tuesday evening that he will hold a vote to proceed to the legislation “early next week;” a vote that will fail unless the opposed Senators change their position. President Trump is meeting with all Republican Senators today and McConnell said the call for a vote was “at the request of the President and Vice President.”

Regardless of the outcome of the vote to repeal the Affordable Care Act, Medicaid cuts to aged and disabled population in the form of per-capita caps are off the table in the Senate for now.

Some Senators said they will begin bipartisan efforts to fix parts of the Affordable Care Act that are not working. Senators Joe Manchin (D-WV) and Mike Rounds (R-SD) announced they are beginning a group of former governors who are now in the Senate to look for pragmatic solutions. AHCA continues to monitor health care reform efforts as they move forward.

AHCA/NCAL Convention: Early Bird Savings End Friday

Jon-Patrick Ewing

Make your plans now and enjoy savings on the registration package that is right for you. Don't miss out on all the unique events taking place at Convention. We'll help you make sense of the current long term care environment and all its complexities. In addition to sorting through and discussing the very latest happenings in Washington, D.C., you can earn CEUs in education sessions on a wide variety of key topics. See the full schedule and start making plans. The early bird registration ends this Friday! We hope to see you in Las Vegas.

Free Resource Helps Find, Learn About Care



There could come a time when you or a loved one will require additional care. There are a lot of important choices to make. How do you even begin planning? Who can provide the right kind of care? How do you pay for care? It can be overwhelming to plan for the future. Wherever you may be in your planning, the Care Kit Builder, a free resource from CareConversations.org can help guide you. Just by answering a few questions, the Care Kit Builder will create a personalized, interactive toolkit to help you prepare for the future.

The Care Kit Builder asks six easy questions to help determine the best resources for your care needs. It won’t require looking up any medical records or log in information. It will ask who you are planning for and what types of assistance you are requesting. It will then personalize your toolkit for care option you wish to learn about in that state.

If you or a loved one could benefit from some expert planning assistance, access this free Care Kit Builder today.

CareConversations.org provides expert knowledge, guidance, and insights into the care planning process. You can also find a care center near you and learn more about the different care options available.

Department of Labor Intends to Rescind “Persuader Rule”

Lilly Hummel

The Department of Labor recently submitted a notice of proposed rulemaking intended to rescind what is known as the “persuader rule.” The rule would have required employers to publicly disclose certain relationships with labor relations consultants, including the identity of any outside attorneys or consultants that may affect employees’ rights to engage in protected activity, the terms of any such engagement, and the activities to be performed by the attorney or consultant. Companies had reported concern that the rule would test the limitations of the attorney-client privilege and the privacy of consultant relationships protected by the Labor-Management Reporting and Disclosure Act (LMRDA). Rescinding the rule would not affect the disclosure requirements currently in effect. In November 2016, a federal court stopped the rule from being implemented, so it has never been enforced. Comments on the proposed rescission are due August 11, 2017.

Tuesday, July 18, 2017

HHS OIG Announces Charges for Medicare and Medicaid Fraud Schemes

Lilly Hummel

The Department of Health and Human Services Office of Inspector General (OIG), along with state and federal law enforcement, announced charges against more than 400 defendants for fraud schemes involving about $1.3 billion in false billings to Medicare and Medicaid. OIG also issued exclusion notices to 295 doctors, nurses, and other providers based on conduct related to opioid diversion and abuse.

Social Security Board of Trustees Releases 2017 Annual Report to Congress

Dana Halvorson

On July 13, 2017, the Social Security Board of Trustees released its annual report quantifying the long-term financial status of the Social Security trust funds.  More details, including the 2017 Trustee Report, can be found in this press release. The release notes that the combined asset reserves of the Old-Age and Survivors Insurance, and Disability Insurance (OASDI) Trust Funds are projected to become depleted in 2034, the same as projected last year, with 77 percent of benefits payable at that time. The DI Trust Fund will become depleted in 2028, extended from last year’s estimate of 2023, with 93 percent of benefits still payable.

U.S. Senate Report Language Includes Support for VA Provider Agreements

Dana Halvorson

Thanks to Senator John Hoeven (R-ND), the fiscal year (FY) 2018 Military Construction, Veterans Affairs, and Related Agencies Appropriation Bill that was printed on July 13, 2017, includes language in support of VA provider agreements. The language, found on page 69 of the report, specifically notes that the Committee on Appropriations supports enabling the VA to enter into provider agreements with non-VA long-term care providers, including skilled nursing facilities, in lieu of the current onerous Federal contracting requirements. While this is not bill language (in statute), it certainly sends a strong message to the Administration. On July 13, the full Senate Appropriations Committee approved the bill and report by voice vote.  It now goes to the full U.S. Senate for consideration.

As you may know from previous American Health Care Association (AHCA) correspondence, Medicare (Parts A and B) or Medicaid providers are not considered to be federal contractors.  However, if a provider currently has VA patients and a VA contract, they are considered to be a federal contractor. The Office of Federal Contracting Compliance Programs (OFCCP) has administered onerous reporting requirements and regulations, which have dissuaded nursing care centers from admitting VA patients.  This limits the care available to veterans needing long term care in their local communities. AHCA has been advocating for VA provider agreements that would make the VA requirements for providers the same as they are for the Centers for Medicare and Medicaid Services (CMS) and waives the OFCCP federal contracting requirements.  AHCA will continue to work with Congressional champions, like Senator Hoeven, and the VA and others to get VA provider agreements across the finish line, and to take those with VA contracts out of the scope of being deemed a federal contractor.

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

Dave Kyllo

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

These on-line training programs, offered by leaders in the dementia care field, are available to AHCA/NCAL members at a 10 percent discount. Use the code AHCA10 at checkout to apply your 10 percent savings off any individual course or site license purchase.

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

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

The Number of Open LTC Jobs Increases in July

Dave Kyllo


There are 21,273 open jobs posted by direct employers 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 posted nationwide by direct employers increased by more than 1,200 this month after holding relatively steady over the three previous months.

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 1,951 direct employers are competing for candidates in July – virtually the same number as in June. The average number of days a job was posted this month held steady in July at 37.  

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.

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.

Of course, the LTC Career Center is always free for job seekers. And, job seekers are using the site with more than 89,000 searchable resumes on the National Healthcare Career Network this month.   Job postings on the AHCA/NCAL Long Term Care Career Center network are averaging 1,660 views in July.

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 use one of the two promo codes to save on your job postings.    

Wednesday, July 12, 2017

Senate Delays August Recess

Drew Thies

Senate Majority Leader Mitch McConnell announced Tuesday that he will keep the chamber in session for the first two weeks of August. The Senate was originally scheduled to begin its annual month-long recess starting on July 31.

McConnell said in a statement that the Senate needs the extra time to address the annual defense authorization measure and many open positions in the administration that require Senate confirmation.

The move could give Republicans time to coalesce around a plan to repeal and replace the Affordable Care Act, though McConnell indicated that he wants a vote on health care legislation as soon as next week. A revised version of the legislation is slated for release Thursday.

AHCA/NCAL advocates are still urged to call their Senators and let them know that the draft bill released in June would be harmful to the long term care profession. AHCA/NCAL has an online advocacy portal and encourages all members to continue to contact lawmakers.

Tuesday, July 11, 2017

CMS Seeks More Volunteer SNFs for PAC Data Collection Study – Upcoming Informational Webinars

Dan Ciolek

CMS is working with the RAND Corporation and its partners to implement the Standardized Patient Assessment Data Project. The goal of the project is to develop and test standardized assessment-based data elements across the PAC settings for purposes of complying with the requirements of the IMPACT Act of 2014. The project is being conducted over three years, from October 2015 – September 2018. PAC providers are being asked to assist with field data collection to test the standardized data elements for reliability, validity and ease of use in all four PAC settings (HHAs, IRFs, LTCHs, and SNFs). Patient assessment data element development and testing will focus on the following clinical domains as outlined in the IMPACT Act:

Cognitive Status
Mental Status (e.g., mood)
Medical Conditions (e.g., pain)
Impairments (e.g., incontinence and sensory impairments)
Other clinical topics (e.g., care preferences and medication reconciliation)

If interested, below is information about informational webinars coming up this month.  Each webinar lasts about 20 minutes and provides an opportunity for questions.

July 13 at 11am EST:  Event address for attendees: https://abtassociates.webex.com/abtassociates/onstage/g.php?MTID=e140283399b010ca575c957f8c1831816
o Call 1-415-655-0002
o Access code: 647 437 900

July 18 2:30pm EST: Event address for attendees: https://abtassociates.webex.com/abtassociates/onstage/g.php?MTID=efab6c0614adcf28ad834495eaf627626
o Call 1-415-655-0002

o Access code: 649 352 033

My RN is Smarter Than Your RN: Gero Nurse Prep Delivers Smarter RNs

Dave Kyllo



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

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

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

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

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

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

Maximize your nursing strength. Check out AHCA/NCAL Gero Nurse Prep today and plan to attend the “My RN is Smarter Than Your RN” educational session at convention this October.

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

Dave Kyllo


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

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

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

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

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

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

Registration Now Open for July 25 RoP Medicare Learning Network Call


CMS will hold a Medicare Learning Network LTC National Provider Call call on July 25, 2017, from 1:30 to 3:00 p.m. Eastern.
CMS will be reviewing information about the revised Interpretive Guidance for Phases 1 and 2 and the new Survey Process, both of which go into effect on November 28, 2017

To register and obtain information regarding the call, click here. For additional information and to access call materials prior to the event, click here.

CMS is also soliciting questions in advance of the call. Please send your questions to NHSurveyDevelopment@cms.hhs.gov

Friday, July 7, 2017

AHCA/NCAL Announces 2017 Silver National Quality Award Recipients

Yesterday, AHCA/NCAL announced the names of the 191 skilled nursing care centers and assisted living communities in 43 states that have earned the 2017 Silver - Achievement in Quality Award. The award is the second of three distinctions possible through the AHCA/NCAL National Quality Award Program, which recognizes providers across the nation that have demonstrated their commitment to improving quality of care for residents and patients in long term and post-acute care centers and communities.

Based on the core values and criteria of the nationally recognized Baldrige Performance Excellence Program, which is also the foundation of the metric-based AHCA/NCAL Quality Initiative, the Association’s Quality Award program challenges member providers to achieve performance excellence through three progressive levels—Bronze, Silver, and Gold. Members at the Silver award level develop and demonstrate effective approaches that help improve performance and quality outcomes.

This year’s Silver recipients can now advance in developing approaches that meet the criteria required for the Gold – Excellence in Quality Award. On June 1, the Association announced the honorees of the Bronze - Commitment to Quality Award. A full list of Silver and Bronze recipients is available on the AHCA/NCAL Quality Award website here. Gold award recipients will be announced later this summer.

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

For more information about the Quality Award Program, download the program overview here or visit the program website here.

Wednesday, July 5, 2017

Three Reasons Why Nursing Facilities Should Train Their Infection Preventionists Now

Dave Kyllo

AHCA is ready to help members meet the new Infection Preventionist Specialized Training requirement finalized by the Centers for Medicare & Medicaid Services in the reform of Requirements of Participation for long term care facilities. The self-study Infection Preventionist Specialized Training (IPCO) online course provides 23 hours of training and 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 are being trained this summer to survey for the expanded infection prevention and control and antibiotic stewardship requirements.

The IPCO course includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term and post-acute care. 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 hereDiscounted group purchase rates are available for groups of 25 or more.  Those interested in making a group purchase should email AHCA here.   


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

Two Great Options for Saving on Your Job Postings on the LTC Career Center

Dave Kyllo

The AHCA/NCAL Long Term Care Career Center helps members 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 88,000 searchable resumes.

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 new employer resource and see how easy it is to create an account on the AHCA/NCAL Long Term Care Career Center site.

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.

Extend your reach for the health care stars. Check out 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.

Mood Media Has the Right Tunes to Set the Right Tone

Dave Kyllo

Billy Joel said that “No matter what culture we’re from, everybody loves music.” Members can create an upbeat 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.


AHCA Submits Comments on CMS PAC Cross Setting Standardized Assessment Data


On June 26, 2017, AHCA submitted comments to the RAND Corporation, which is the Centers for Medicare & Medicaid Services (CMS) contractor tasked with developing and maintaining standardized resident assessment data elements to comply with the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act).
Prior to the submission of AHCA's comments, on April 26, 2017, CMS posted a data element specifications document for public comment on their Quality Measures Public Comment web pageThis data specifications document requested public feedback regarding 39 different items/item sets within the following categories: 
1) Cognitive Function and Mental Status
2) Medical Conditions – Continence
3) Medical Conditions – Pain, Impairments of Hearing and Vision
4) Medication Reconciliation
5) Care Preferences
6) Patient-Reported Outcomes Measurement Information System (PROMIS) domains of sleep disturbance, fatigue, social roles and activities, and global health. 
These proposed data elements are currently being tested, and if determined feasible, reliable, and valid for post-acute care settings by CMS, they would be proposed through future rule-making and comment period to be used in patient assessment instruments in skilled nursing facilities (SNFs), home health agencies, inpatient rehabilitation facilities, and long term care hospitals. The items, if adopted as soon as next year, would be added to replace items in the SNF Prospective Payment System Minimum Data Set 3.0 admission and discharge assessments.

For further information, please contact Dan Ciolek.       

Early Bird Registration Ends July 21


Jon-Patrick Ewing

If you still haven’t registered for the AHCA/NCAL 68th Annual Convention & Expo, do it today! Register before July 21 for maximum savings!
The Convention & Expo is a great value for our members and consists of four days of unparalleled education, national speakers, networking and special events. We host an Expo Hall packed with all the best products and services for long term and post-acute care professionals.
When registering, make sure to get your tickets for the Gala Dinner & Show with the Grammy-Award winning Huey Lewis and the News
We hope you join us for a night you won't forget! Less than three weeks remain before the early bird deadline ends, so don’t delay and register today!

Senate Continues Work on Repeal and Replace


Drew Thies

Senate Republicans are working to find a compromise on a plan to repeal and replace the Affordable Care Act.

Senate Majority Leader Mitch McConnell (R-KY) was forced last week to delay a vote on the “Better Care Reconciliation Act,” the chamber’s first draft of replacement legislation.

Republican leadership faces a tight deadline. Both the House and Senate are out of session for the Fourth of July work week and return for only three legislative weeks before the month-long August recess.

Several Republican senators expressed concerns with the discussion draft; some conservative members said they wanted to see it do more to repeal the Affordable Care Act, while others were concerned the policy went too far in cutting Medicaid and other health care services.

The Senate bill differs significantly from the House bill on the issue of Medicaid funding for long term care services. The Senate bill both changes the per-capita growth rate for aged and disabled population, and reduces provider taxes. The changes to the bill are estimated to cut federal Medicaid funding by 20 percent in 2025 and cut an average of $100,000 per building in states that use the provider tax program.


AHCA/NCAL advocates are still encouraged to call their senators and let them know that this bill would be harmful to the long term care profession. AHCA/NCAL has an online advocacy portal and encourages all members to continue to contact lawmakers.