Monday, August 21, 2017

CMS Provider Compliance Resources to Prevent Part A SNF PPS Denials


This week, the Centers for Medicare & Medicaid Services (CMS) Medicare Learning Network (MLN) Connects newsletter provided the following information and resource links for skilled nursing facilities (SNFs) to help prevent errors that commonly result in SNF Part A Prospective Payment System (PPS) payment denials:

According to the 2015 Comprehensive Error Rate Testing (CERT) Report, the denial rate for SNFs increased from 6.9 percent in 2014 to 11 percent in 2015 due to missing or incomplete certification/recertification:
      • Statement must contain need for skilled services that can only be provided in SNF/swing-bed on a daily basis for a condition patient was treated for in prior hospital stay
      • Must include physician’s dated signature (printed name if signature is illegible)

In addition, recertifications should include:
      • Expected length of stay
      • Explanation if continued need for services is for a condition that arose after SNF admission
      • Any plans for home care

Resources:


Friday, August 18, 2017

Webinar: Preparing for the New Survey Process and RoP Phase 2


Webinar:Preparing for the New Survey Process and Requirements of Participation Phase 2
Date: September 25, 2017 – 1:00 pm – 2:00 pm Eastern 
Register Here

November 28, 2017 is a significant date for all nursing centers. That date marks the following:

(1) The implementation of Phase 2 of the Requirements of Participation (RoP)
(2) All new F-Tag numbers
(3) New interpretive guidance, and 
(4) A brand-new annual survey process. 

As a result, providers might be feeling anxious and overwhelmed.This webinar will provide information on what to expect in the new survey process; updates on materials available from the Centers for Medicare & Medicaid Services (CMS), AHCA tools and resources available to help you understand and implement new Phase 2 requirements such as the Facility Assessment, and guidance on how to access AHCA's tools and resources.

Learning Objectives:
1. Participants will review key elements of the new survey process and be prepared for the changes that will be implemented on November 28, 2017.

2. Participants will learn about tools and materials available from AHCA to help centers implement Phase 2 requirements and will understand how to access these resources on ahcancalED. 

3. Participants will understand the importance of using a framework focused on the intent and purpose of the requirements to help centers navigate successfully through these changes.

Speakers:
Sara Rudow, Director of Regulatory Services, AHCA
David Gifford, Sr. VP, Quality and Regulatory Affairs, AHCA
Bobbie Vailes, Manager ahcancalED, AHCA

Wednesday, August 16, 2017

Webinar: The Importance of Collaboration between Nurses and Environmental Services

August 21, 1:00 PM – 2:00 PM EDT

The Centers for Disease Control and Prevention (CDC) and the American Nurses Association invite you to register for a free webinar to learn how collaboration between nurses and environmental services prevents and reduces the spread of healthcare-associated infections. The speakers will cover the application of standards, guidelines, best practices, and established processes in infection control.

Breaches in cleaning and disinfection practices in the healthcare settings can be a significant factor in the transmission of healthcare-associated infections. Preventing contamination between the environment and patients is critical to breaking the chain of infection.

This webinar is hosted by members of the Nursing Infection Control Education (NICE) Network, including the Oncology Nursing Society, the National Association of Directors of Nursing Administration, and the American Association of Colleges of Nursing.

Therapy Professionals: Convention Offers Special Half-Day Program Just for You



SUNDAY, OCTOBER 15


Interdisciplinary Rehabilitation of Complex Patients in a
Value-Based Payment Environment

Hosted by:
AHCA and National Association for the Support of Long Term Care (NASL)

Back for a fourth year, AHCA and NASL bring you this important half-day session featuring the most current information on achieving outcomes and managing costs.

Beginning with a networking coffee reception, this targeted event will focus on:
·         Interdisciplinary approaches to assess the rehabilitation potential of complex patients
·         Strategies to more effectively restore function for those with restoration potential
·         Strategies to transition to skilled and non-skilled maintenance programs for individuals when functional improvement is no longer a realistic outcome

This is a separate ticketed event and must be purchased in addition to any convention registration package. If you have not yet registered for this year’s Convention & Expo, register today. The deadline is September 21.

If you have already registered for convention but would like to add the Rehab Therapy Program, go to registration, click Edit Registration, and sign in with your e-mail address. Then edit your registration package.

See you in Las Vegas!


Sponsors:

Encore Rehabilitation

Aegis, Affirma, CEU 360, Consonus, Genesis, Therapy Management Corp, Rehabcare, and ONR

Don’t Gamble With Your Business



At AHCA/ NCAL Annual Convention & Expo, you’ll have two amazing days to build your professional network. It’s time you hit the networking jackpot. Come show your innovative technology that will help provide the best quality care in the industry.


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

Sen. Murkowski Visits AHCA Member Facility

Drew Thies

Senator Lisa Murkowski (R-Alaska) visited Prestige Care and Rehabilitation Center in Anchorage last week to hear from residents and speak about health care reform. Sen. Murkowski was one of three Republicans who voted against a bill to repeal and replace the Affordable Care Act, also known as Obamacare, late last month.

Sen. Murkowski highlighted the growing population of seniors in Alaska and spoke to their unique needs. She said that while she agrees health care reform efforts need to continue, the legislation brought to the floor in the Senate in July would have harmed Alaska’s seniors.

Sen. Murkowski stood alongside Sen. Susan Collins (R-Maine) as the only two members of the Republican party to oppose opening debate on repeal and replace efforts. Versions of this legislation would have cut billions from Medicaid funding for long term care services.

Both the Senate and House are in recess through the rest of the month and it is a great time for lawmakers to visit providers to learn more about long term and post-acute care. AHCA members who would like help coordinating a facility tour, are encouraged to contact Matt Smyth, AHCA’s Senior Director of Grassroots and Membership Advocacy at msmyth@ahca.org.


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.

The Number of Open LTC Jobs Dips Slightly in August

Dave Kyllo

There are 20,492 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 decreased slightly since July.

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 2,065 direct employers are competing for candidates in July – an increase of slightly more than 100 employers.  The average number of days a job was posted this month held steady 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.  The LTC Career Center is also fully integrated with Google’s new job search feature “Google for Jobs” creating even greater exposure for job postings.

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

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

Of course, the LTC Career Center is always free for job seekers.  And, job seekers are using the site with more than 90,000 searchable resumes on the National Healthcare Career Network this month.   Job postings on the AHCA/NCAL Long Term Care Career Center network are averaging more than 1,500 views in August.

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.    

Three Reasons Why Nursing Facilities Should Train Their Infection Preventionists Now

Dave Kyllo

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

Even though nursing facilities are not required to have a designated “Infection Preventionist” until November 2019, there are three compelling reasons why it is critical to register for this training now:

  • As of November 28, 2016 nursing facilities are being held accountable to more expansive infection prevention and control federal regulations. 
  • Beginning November 28, 2017, the federal requirements for nursing facilities expand further and require that every nursing facility develop and implement an antibiotic stewardship program. This is a new requirement that should be conducted with oversight from specially trained healthcare professionals. 
  • Surveyors nationwide are being trained this summer to survey for the expanded infection prevention & control and antibiotic stewardship requirements.

The course is an online, self-study program with 23 hours of training. It includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term/post-acute care.  It addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control that are fundamental to effectively leading and administering successful infection prevention and control programs and antibiotic stewardship programs.   Upon successful completion of this program, participants will receive certificates including 23 ANCC contact hours.

The training course registration fee is $450 for AHCA/NCAL members and $650 for non-members.  There are no refunds and no transfers.  Payment and registration must be made online in ahcancalED. The IPCO course can be accessed here or at: https://educate.ahcancal.org/p/ipco.  

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

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


Monday, August 14, 2017

CMS Posts Updated Part B Therapy Coding Scrutiny Starting January 2018

Dan Ciolek

Recently, the Centers of Medicare and Medicaid Services (CMS) posted a MLN Matters article (MM10176) titled “Updated Editing of Always Therapy Services -MCS.”  The article, intended for providers of Part B therapy services, identifies outpatient therapy procedures that must always be accompanied by a discipline-specific therapy modifier (GP = physical therapy, GO = occupational therapy, and GN = speech-language pathology services).

CMS also notes that per CR10176 instructions, they are requiring the Medicare Administrative Contractors (MACs) to update their claims-processing systems edits, as follows for services furnished on or after January 1, 2018:


  • MACs will return/reject claims which contain an “always therapy” procedure code, but do not also contain the appropriate discipline-specific therapy modifier of GN, GO, or GP. 
  • MACs will also return/reject claims if any service line on the claim contains more than one occurrence of a GN, GO, or GP therapy modifier. 
  • MACs who are returning/rejecting such claims will use Group Code CO and Claim Adjustment Reason Code (CARC) 4 on the related remittance advice.


The complete code list that this policy will apply to in CY 2018 will be posted later this year on the CMS Annual Therapy Update web page at https://www.cms.gov/Medicare/Billing/TherapyServices/AnnualTherapyUpdate.html.

In addition, while many of these codes can be used by any of the three therapy disciplines, CMS notes that several “always therapy” codes have been identified as discipline-specific – requiring the GN modifier for six codes, the GO modifier for four codes, and the GP modifier for four codes, as illustrated in Tables 1-3 below.

AHCA recommends that SNF billers review this guidance.  If you have questions, contact Dan Ciolek, AHCA Associate Vice President, Therapy Advocacy.


Table 1: Codes Requiring the “GN” Therapy Modifier
Code
CPT Short Descriptor
Therapy Modifier Required
92521
Evaluation of speech fluency
GN
92522
Evaluate speech production
GN
92523
Speech sound lang comprehend
GN
92524
Behavral quality analys voice
GN
92597
Oral speech device eval
GN
92607
Ex for speech device rx 1hr
GN

Table 2: Codes Requiring the “GO” Therapy Modifier (NEW CODES for 2018)
Code
CPT Short Descriptor
Therapy Modifier Required
97165
Ot eval low complex 30 min
GO
97166
Ot eval mod complex 45 min
GO
97167
Ot eval high complex 60 min
GO
97168
Ot re-eval est plan care
GO

Table 3: Codes Requiring the “GP” Therapy Modifier (NEW CODES for 2018)

Code
CPT Short Descriptor
Therapy Modifier Required
97161
Pt eval low complex 20 min
GP
97162
Pt eval mod complex 30 min
GP
97163
Pt eval high complex 45 min
GP
97164
Pt re-eval est plan care
GP

AHCA/NCAL Submits Testimony to Congress Regarding Part B Therapy Caps

Dan Ciolek

On July 20, 2017, AHCA/NCAL submitted written testimony for a hearing titled “Examining Bipartisan Legislation to Improve the Medicare Program” conducted by the U.S. House Energy and Commerce Committee, Subcommittee on Health.  The AHCA/NCAL comments focused on a discussion draft of proposed legislation related to the Part B therapy caps exceptions and targeted medical review processes that will expire at the end of December.  Without Congressional action this year , beneficiaries would not be able to receive covered therapy services above the cap limits per year (currently $1,980 for PT/SLP and $1,980 for OT).  AHCA/NCAL has been working with a broad coalition of providers and consumers to repeal the therapy caps, and in the testimony, encouraged Congress to act this year to assure continued beneficiary access.

The following is an excerpt from the five page AHCA/NCAL testimony:

AHCA/NCAL appreciates that the Congress has previously responded to providers and beneficiaries, and has mitigated many therapy cap beneficiary access concerns by extending a cap exceptions process on numerous occasions, and is proposing to do so again with this discussion draft bill. We applaud your attention to addressing this important issue by considering another extension to the current exceptions process policy, which would at least protect the status-quo. However, we ask that the Health Committee consider whether the time is right to consider developing a permanent solution to repeal the therapy caps. We believe that a permanent solution should:

• Ensure timely and uninterrupted beneficiary access to outpatient therapy, 
• Build upon the program integrity success of the current targeted review program established by the MACRA provisions, 
• Align outpatient therapy data collection efforts with IMPACT Act provisions, and 
• Align outpatient therapy policy with various person-centered value-based payment models. 
 
You can find the entire AHCA/NCAL written testimony here.  Contact Dan Ciolek, AHCA Associate Vice-President, Therapy Advocacy, for questions related to the therapy caps.

LED Lights: Do You Use Them in Your Skilled Nursing Center?


Do you use special "tunable" light-emitting diode (LED) lights at your skilled nursing center? Brown University's Center for Long-Term Care Quality & Innovation (Q&I Center) would like to know.

The Q&I Center, which the Brown University School of Public Health established in partnership with the AHCA in 2014 to help find innovative ways to improve quality of care in skilled nursing centers across the country, is looking to identify centers that have installed, or are planning to install, a specific kind of LED light.

Over the past few years, LED lighting technology has rapidly evolved. New tunable LED lights can be pre-programmed to change in color temperature and intensity over the course of the day and night in a cycle that is similar to the natural cycle of day and night light. 

In fact, some preliminary evidence suggest that these lights may benefit center residents, particularly those with Alzheimer's disease, as well as staff. The Q&I Center is partnering with the Center of Design for an Aging Society to evaluate the impact of these lights on resident outcomes.

If any of your centers have tunable LED lights installed, or plan to install tunable LED lights, please email Rosa Baier here by September 15 to learn more about including your center/s in an evaluation of the impact of these lights. 

Wednesday, August 9, 2017

Webinar: The Home- and Community- Based Services (HCBS) Quality Measure Development


August 16, 2:00 PM - 3:00 PM EST

The Home and Community- Based Services (HCBS) Quality Measure Development webinar is the third event in ACL's HCBS quality informational webinar series. Agenda items will include discussion of the importance of quality measurement, how measures are developed, and the progress made through measure development. The webinar will conclude with a brief question and answer session. 

Join ACL to learn about the progress made in quality measure development.

Presenters:

· Heather Menne, Administration for Community Living
· Alexandra Bonardi, Human Services Research Institute
· Brian Abery, University of Minnesota Research Rehabilitation Training Center

Please register online for the webinar.


Congress in Recess

Carly Sfregola

The United States Congress is in recess until September 5, 2017, when the lawmakers will return to Washington, D.C.  While Members of Congress are at home in their districts, AHCA advocates are encourage to reach out. This is a great time to build personal relationships with lawmakers.

Reforms to the Medicaid program will continue to be discussed and proposed in Congress, so we must continue to educate lawmakers on the value of this program to our residents. Brush up on our talking points here.

One of the most valuable educational tools we have is our facilities. Invite your Representative or Senator to come and tour your facility in the next few weeks and read our Steps to a Successful Facility Tour resource. If you’d like help arranging a facility tour, then please contact Matt Smyth, Senior Director, Grassroots & Member Advocacy, at:  202-898-2817 or msmyth@ahca.org for assistance.

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).

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 90,000 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 1,500 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.    

CMS Corrects Nearly Three Year Long Error in SNF Consolidated Billing File – If Impacted Notify MAC to Reprocess Claims

Dan Ciolek

The Centers for Medicare and Medicaid Services (CMS) recently released MLN Matters Article MM10163 titled “October Quarterly Update to 2017 Annual Update of HCPCS Codes Used for SNF CB Enforcement. CMS indicates that Change Request (CR) 10163 provides updates to the lists of Healthcare Common Procedure Coding System (HCPCS) codes that are subject to the Consolidated Billing (CB) provision of the SNF Prospective Payment System (PPS). The CR corrects an error impacting certain claims with dates of service on or after January 1, 2015, that Medicare mistakenly denied rejected prior to implementation of CR10163. Make sure your billing staffs are aware of these changes to determine if there is a need to submit a reprocessing request to your Medicare Administrative Contractor (MAC).

Background:
CR10163 alerts providers that CMS periodically updates the lists of HCPCS codes that are excluded from the CB provision of the SNF PPS. Services excluded from SNF PPS and CB may be paid to providers, other than SNFs, for beneficiaries, even when in a SNF stay. Services not appearing on the exclusion lists submitted on claims to MACs will not be paid by Medicare to any providers other than a SNF.

For non-therapy services, SNF CB applies only when the services are furnished to a SNF resident during a covered Part A stay; however, SNF CB applies to physical and occupational therapies and speech-language pathology services whenever they are furnished to a SNF resident, regardless of whether Part A covers the stay. In order to assure proper payment in all settings, Medicare systems must edit for services provided to SNF beneficiaries both included and excluded from SNF CB. The updated lists for institutional and professional billing are available at http://www.cms.gov/Medicare/Billing/SNFConsolidatedBilling/index.html.

Certain radiation therapy codes are included as services that are not subject to SNF CB. These codes can be submitted globally (no modifier), professional component only (modifier 26), or technical component only (modifier TC).

When the codes listed below are submitted globally or just for the technical component, the claims are being rejected by Medicare's Common Working File (CWF). That is to say, they are not allowed to pay separately outside of the consolidated payment that is made to the SNF.

When submitted with the 26 modifier for just the professional component, the claims have been allowed to pay. The following are the allowable HCPCS codes: 77014, 77750, 77761, 77762, 77763, 77776, 77777, 77778, 77785, 77786, 77787, 77789, 77790, 77799, 79005, 79101, and 79445.

This error is occurring because the codes were not added by CMS to the appropriate coding lists with the 2015, 2016, and 2017 SNF CB Annual Updates. CR10163 corrects this error. Therefore, when brought to their attention, your MAC will reprocess claims with dates of service on or after January 1, 2015, that were erroneously denied/rejected.

Are You Ready: Nutrition and Phase II LTC Requirements of Participation with the New Survey Process

Adrienne Riaz-Khan

The new Phase II LTC Requirements of Participation (ROP) and Survey Process effective November 28, 2017 are fast approaching, and integrating food, nutrition and dining are integral components for success. This informative webinar will present key nutrition related areas in the Centers for Medicare & Medicaid Services (CMS) revised Requirements for Participation for Medicare and Medicaid-certified nursing facilities and the new Survey Process. An overview of the most current information, tools and resources will be presented such as the Phase II State Operations Manual (SOM) Appendix PP FTags with surveyor Interpretive Guidance, the new computer-based LTC Survey System, and use Critical Element Pathways.

Registration Link: https://educate.ahcancal.org/products/are-you-ready-nutrition-and-phase-ii-ltc-requirements-of-participation-with-the-new-survey-process

Presenter: Brenda Richardson, MA, RDN, LD, CD, FAND

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

Lilly Hummel

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

A Framework for Successful Clinical Outcomes Series Available on ahcancalED

Bobbie Vailes

The Association’s Clinical Practice Committee designed a framework series that outlines guiding elements such as individualized care approaches, effective transitions of care, QAPI concepts, safety, risk management, team-based care, and diagnostic quality. Care providers that use these resources can more effectively apply knowledge through organizational approaches and clinical care that leads to optimal patient outcomes and quality of life.

Visit www.educate.ahcancal.org to access Building Prevention into Every Day Practice: A Framework for Successful Clinical Outcomes Series.

We hope you find this Series useful to your practice to improve lives of the individuals who stay and live in centers across the nation.

Monday, August 7, 2017

Register for the 2018 Quality Award- New Applicant Overview Webinar


Join the Quality Award program staff in this new applicant webinar to learn about program benefits, the criteria and application process for the Bronze award level. The Quality Award team will also announce dates for the 2018 program cycle, recommend helpful AHCA/NCAL resources, and facilitate a question and answer session.

Date: Tuesday, August 22, 2017 - 12:00-1:00 pm Eastern
Registration: Click Here to Register

Prior to the webinar, we recommend reviewing the 2018 Bronze Application Packet, which is now available on the Quality Award website here

To learn more about the National Quality Award Program, please visit our website or submit questions to qualityaward@ahca.org

About AHCA/NCAL's National Quality Award Program:
The AHCA/NCAL National Quality Award Program, based on the Baldrige Performance Excellence Framework, recognizes long term and post-acute care member centers and communities nationally that strive for improved quality care. Since 2007, the program has recognized almost 5,000 awards in organizations across all 50 states.


Friday, August 4, 2017

September is National Preparedness Month


September 2017 marks, among other observances, National Preparedness Month.  National Preparedness Month will focus on planning, with an overarching theme “Disasters Don’t Plan Ahead. You Can.” The goal of this month is to increase the overall number of individuals, families, and communities that engage in preparedness actions at home, work, businesses, school, and places of worship.  That being said, it is important to note that Emergency Preparedness Final Rule was released on Friday, September 16, 2016.  The rule impacts skilled nursing facilities (SNFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), but does not apply to assisted living providers. 

On June 2, 2017, the Centers for Medicare & Medicaid Services released the Emergency Preparedness Interpretive Guidance (IG), which can be found here.  AHCA members are highly encouraged to look through the IG.  Providers will need to comply with the final rule by November 2017.  Click here for a summary AHCA put together of the IG for your use.  Finally, AHCA has an Emergency Preparedness Final Rule Webinar Series that can be found here.  Please contact Erin Prendergast (SNF Providers) or Dana Halvorson (ICF/IID Providers) with any questions.


Wednesday, August 2, 2017

NALW 2017 Media Toolkit Now Available

Rachel Reeves

Get noticed this National Assisted Living Week! There is no better time to showcase your unique residents, your dedicated staff, your contributions to the larger community, and the home you create for those needing long term care. Check out the NALW Media Toolkit for ideas on how to spread the word. Download sample materials and tips at www.nalw.org.

This September 10-16, invite a local reporter to your big event, send out a press release highlighting your community’s unique programs, or send a letter to the editor sharing your AL community’s family-like atmosphere.

You can also encourage local government officials to officially declare NALW in your city, county or state. Offer them the sample proclamation and invite them to hold an official signing event at your assisted living community (and invite local media to attend!).

The media toolkit also includes sample social media posts, so you can engage with the public directly. Share pictures or videos of your activities, unique stories, or to recognize amazing staff. (Note: be sure to read up AHCA/NCAL’s best practices for social media promotion while protecting the privacy and dignity of your residents and staff.)

Use the hashtag #NALW to contribute to the national conversation. You don’t even have to wait until NALW. Share activity ideas and connect with your fellow assisted living caregivers on the NALW Facebook page.

Still figuring out how to commemorate NALW? Consult the NALW Planning Guide and Product Catalog for activity ideas and products to help you celebrate in style.

AHCA/NCAL Announces 2017 Award Recipients


Last week, AHCA/NCAL announced the recipients for the 2017 AHCA/NCAL Awards program. Each year, AHCA/NCAL recognizes the men and women who selflessly care for individuals in long term and post-acute care centers, Intellectual and Developmental Disabilities (ID/DD) residences, and assisted living communities. Honorees demonstrate selflessness, compassion, and strive to enhance the lives of seniors and individuals with disabilities in their communities.
 
The 2017 AHCA/NCAL Awards recipients are:
  • Hero of the Year- Intellectual and Developmental Disabilities: Cathy Gray, Cedarcrest Center for Children with Disabilities, Keene, N.H
  • Not for Profit Program of the Year: Trinity Oaks Health and Rehab Life Enrichment, Trinity Oaks Health and Rehab, Salisbury, N.C.
  • Not for Profit Trustee Award: Peter Miesburger, Maine Veterans’ Home, Augusta, Maine
  • Adult Volunteer of the Year: Mike Howard, Harlan Health and Rehabilitation Center, Ky.
  • Group Volunteer of the Year: Bryant Parkview Care Center Auxiliary, Bryant Parkview Care Center, Bryant, S.D.
  • Young Adult Volunteer of the Year: Luke Flippo, Diversicare of Amory, Amory, Miss.
The Hero of the Year award recognizes an individual who works or volunteers in an ICF/IID facility or HCBS Waiver Homes and has shown commitment and dedication to serving people with ID/DD.
 
The Not for Profit Program of the Year award highlights a specific program that adds value to the care of individuals within a community.
 
The Not for Profit Trustee award honors a not for profit trustee committed to faithfully carrying out functions of the board and dedicated to improving the lives of frail and vulnerable individuals.
 
The Volunteer of the Year program seeks to honor a young adult (under 19), an adult, and a group organization that have served in a volunteer capacity for more than one year and have made a positive contribution to residents and staff of a care center.

Award recipients will be honored at the AHCA/NCAL 68th Annual Convention in Las Vegas on October 18, 2017. To learn more about the Awards program, visit the website here.

Webinar: Bundled Payment: Where Do We Go from Here?


Tuesday, August 29, 2017 – 2:00 p.m. Eastern 


Registration is now open! This webinar will provide an update on the AHCA's current thinking and strategy regarding CMS’ various bundled payment programs. 

James Michel, AHCA's Senior Director, Medicare Reimbursement & Policy, will describe AHCA members’ early experience with the various bundled payment programs and how those experiences are informing ongoing work to advocate for bundled payment models that are workable for skilled nursing providers. 

Additionally, attendees will learn about the current policy landscape and what we know so far about how the new administration views bundled payment programs, what action policymakers could take in the short- and long-term, and the likely fate of ongoing demonstrations. Finally, AHCA will discuss current research efforts to advance a PAC bundled payment proposal to CMS and an overview of the tools and resources available to Association members.

In order to access the webinar you will need an ahcancalED account. If you have not already done so, please take a few moments to create one prior to the date of the webinar.  Registration is easy. After you click the link in the webinar title, you will see a green box in the upper right corner of your screen. If you have an account (it is the same login information that you would use to access the AHCA website) – click 'Log in now'. If you need assistance with your password – please email educate@ahca.org. If you need to create an account, click 'Register' and follow the few simple prompts.

The webinar is free to members.There are no CEUs offered. The webinar will be recorded and archived for those members that cannot join live on August 29 at 2:00 p.m. Eastern. 

Health Care Vote Fails on Senate Floor


Republican efforts to repeal and replace the Affordable Care Act (ACA) were dealt a stunning blow last week as several options to reform the health care system failed to garner the votes necessary for passage. Senator John McCain (Ariz.) joined with Sens. Lisa Murkowski (Alaska), Susan Collins (Maine) and all Democrats to defeat the so-called “skinny repeal” early Friday morning.

Senate Majority Leader Mitch McConnell brought several options to the Senate floor with the hopes that one could gain enough votes to pass the chamber and potentially set up a conference with the House. Ultimately, neither the Better Care Reconciliation Act, past attempts to repeal and replace the 2010 health care law, nor the more recent Health Care Freedom Act, also known as skinny repeal, could find the votes.

McCain was at the center of deliberations from the beginning. The Senator announced he was diagnosed with brain cancer after emergency surgery to remove a blood clot from above his eye. The surgery and the diagnosis grounded McCain in Arizona, delaying the vote, after which Senator Jerry Moran (Kan.) and Mike Lee (Utah) announced opposition to the Better Care Reconciliation Act, forcing McConnell to go back to the drawing board.

McCain then made an unscheduled trip back to Washington in order to open up debate on health care legislation, a move that made many assume McConnell may have had enough support to pass a repeal and replace plan. Republicans could only afford to lose one vote on the motion, as Collins and Murkowski were firmly against any stated Republican options. McCain gave an impassioned speech on the Senate floor urging the body to return to regular order, but voted for the motion to proceed to the bill.

While McCain voted for previous iterations of repeal and replace efforts over the course of debate on the bill, defections among other Republicans meant that no single plan gained enough support to pass.

Court Certifies Nationwide Class in “Observation Status” Case


The Center for Medicare Advocacy recently released a press statement on a federal court decision (Alexander v. Price) issued on July 31, 2017. The decision means that Medicare patients could gain the right to appeal placement on “Observation Status” and avoid potentially large out-of-pocket medical bills.  

In addition to being represented by attorneys from the Center for Medicare Advocacy, the class is also represented by attorneys from Justice in Aging and from the law firm of Wilson Sonsini Goodrich & Rosati. The court had previously allowed the case to proceed in a decision issued in February 2017. 

For more information about the observation stays issue, please visit the AHCA/NCAL website

Register for the Intensive AHCA/NCAL Convention Session on Implementing CARES® Online Dementia Training & Alzheimer’s Association EssentiALZ® Certification


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 (RoP) 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. PST 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.