Hurricane Harvey Update

Over the past several days, we have all been watching and reading reports about the devastation caused by Hurricane Harvey in Texas and along the Gulf Coast. In these kinds of situations, we consistently hear of selfless acts by caregivers who prioritize their residents over their own families and personal property. We see our centers and communities step up to help in times of need, making space for residents who need to be evacuated. I am grateful for each and every one of our members and the way we come together in times of need.

The most recent report from Kevin Warren, the President and CEO of the Texas Health Care Association, is that more than 45 nursing facilities and 49 assisted living communities have been successfully evacuated. As flood waters continue to rise, rivers crest, and rain continues in many areas, there are potentially more at risk.

I have received messages from many of you asking how you can help. This week, the Texas Health Care Association is setting up a fund to accept donations that will help provider staff affected by Hurricane Harvey. When we have details about how to donate to the fund, we will share that with you. In the meantime, please continue to keep the providers, their staff, the families, and everyone responding to this crisis in your thoughts.

Sincerely,

Mark Parkinson
President & CEO

NFID Webinar: The Role of Healthcare Professionals in Protecting Older Adults Against Influenza

Webinar Date: Wednesday, September 6, 2017 at 12:00 PM Eastern

Register Here: http://bit.ly/flu-65-webinar

Join National Foundation for Infectious Diseases (NFID) Medical Director, William Schaffner, MD; Martha Gulati, MD, Editor-in-Chief of CardioSmart representing the American College of Cardiology; and Robert H. Hopkins, Jr., MD, Professor of Internal Medicine and Pediatrics at the University of Arkansas for Medical Sciences representing the American College of Physicians, for a panel discussion.

The discussion will focus on the critical role healthcare professionals play in protecting adults age 65 years and older against influenza, the annual burden of influenza on older adults, and safe and effective influenza vaccines specifically developed to protect the 65+ population.

There is no fee to attend the webinar but pre-registration is required. Continuing education credit will not be available for this activity.

House Launches Project Aimed at Medicare Regulation Relief

Drew Thies

The House Ways and Means Health Subcommittee Chairman Pat Tiberi (R-OH) announced a new initiative to identify and modify Medicare regulations that are adversely affecting patient care. The program, “The Medicare Red Tape Relief Project,” will rely on stakeholders and aim to identify opportunities to reduce legislative and regulatory burdens on Medicare providers.

The program “will help members of our committee work hand-in-hand with doctors, nurses, and other health care professionals to identify areas where we can eliminate red tape and burdensome mandates that are driving up costs in the Medicare program,” Chairman Tiberi said in a statement announcing the initiative.

Ways and Means Committee Chairman Kevin Brady (R-TX) applauded the announcement, saying that regulatory relief is of vital importance as more seniors age into the Medicare program and costs continue to rise.

AHCA looks forward to working with Chairman Tiberi toward his goal of identifying unnecessary regulations and improving patient care.

HealthCap’s Focused Risk Management Approach Makes a Difference

Dave Kyllo

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.  

The July issue of Provider magazine featured an article about the importance of proper skin care for bariatric residents written by Angie Szumlinski, Director at HealthCap’s Risk Management Services, and illustrates HealthCap’s depth of knowledge and risk prevention.

Szumlinski outlines several factors that 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. Szumlinski offers more great risk management advice from HealthCap on Angie’s Blog.   

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 percent 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 at stephanie.hale@chelsearhone.com or call 877-855-4227.

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 68^th 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. 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.

A Robust Infection Prevention Program Should Be Part of Your Strategy to Reduce Re-hospitalizations

Dave Kyllo

Re-hospitalizations occur for a myriad of reasons and infections can be one of them.  Infections can wreak havoc on older patients’ health. A comprehensive infection prevention program can help reduce the risk of infections in nursing facilities and the possibilities of patient re-hospitalizations.    

AHCA has developed a 23-hour online training program to educate and train designated Infection Preventionists. Individuals who complete the course will be trained to effectively implement and manage an Infection Prevention and Control Program at their nursing facilities. The program is specifically designed to help nursing facilities meet CMS Requirements of Participation (RoP) related to antibiotic stewardship programs and infection control and prevention programs. 

The Infection Preventionist Specialized Training (IPCO) course is an online, self-study program with 23 hours of training. Nursing facilities are encouraged to register for the IPCO course as part of their overall strategy to reduce re-hospitalizations and meet CMS’ RoP.

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/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 a successful Infection Prevention and Control program. Upon successful completion of this program, participants will receive certificates including 23 American Nurses Credentialing Center (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 or you can access the IPCO course at: https://educate.ahcancal.org/p/ipco. 
• 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 email update@ahca.org with your name and facility contact information.

 Questions about the specialized training should be sent to educate@ahca.org.  

New Quality Award Examiner Webinar Now Available!

Meghan Karstetter

Do you have a passion for quality and/or the AHCA/NCAL National Quality Award Program? Do any of the below benefits appeal to you?

• Networking in the long term care profession 
• Opportunities for professional development
• Education in Baldrige criteria
• Positively impacting long term care performance across the country 
• Earning Continuing Education Units (CEUs)

If your answer was yes to any of the above, the "Serving as an Examiner" webinar is for you! 

Click here to watch the recording now.

During the webinar, AHCA/NCAL staff member Meghan Karstetter and Tammy Kelly, Master Examiner, AHCA/NCAL Quality Award Board of Overseers, will give a background on the National Quality Award program, Examiner roles and Examiner levels. 

The webinar presentation will also provide an overview of the Examiner experience, the Examiner application process, and information on dates to remember for the 2018 National Quality Award cycle. 

Prior to the webinar, we recommend reviewing the Volunteer Examiner role description here, as well as the Paid Examiner role description here.

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

Quality Initiative Series Webinar on Customer Satisfaction

Adrienne Riaz-Khan

Webinar: “Customer Satisfaction: Strive for the Best” - Part 7 Quality Initiative series

  September 20, 2017 – 3:00 pm – 4:00 pm Eastern

Click Here to Register 

How do you ensure your customers are going to be positive about their experience in your nursing center? Is it more important that they are satisfied with their care, that they enjoy themselves while in your center, or that they know you care about them?

Each of the above matters significantly - but there's more to customer satisfaction than that. 

Join this webinar on September 20 with presenter Hari Namboodiri, Regional Vice President for Senior Care Centers in Texas, and acquire key steps you can take right now that will help ensure your residents have the best possible experience in your nursing center. Their positive experiences can result in the best advertising that money can’t buy- word of mouth recommendations.

Hari has been working in health care and long term care since the 1990’s. His commitment to valuing people and making everyone know how important they are is a key driver through all his professional an volunteer work. This webinar will introduce you to Hari’s approach to customer service, customer satisfaction and customer experience.

Hari says, “Let us make a difference in people’s lives, let us live with a purpose.  Let us celebrate and say WOW when we extend a helping hand to people who need to take care of their health.” He emphasizes the need to see what things we can do that are “out of the box” to make a difference in quality of care and quality of life delivery to the individuals living in our nursing centers.

Federal Investigations into Elder Abuse

Lilly Hummel

The Department of Health and Human Services Office of Inspector General (OIG) has released a memo with preliminary results from an ongoing review of potential abuse or neglect of Medicare beneficiaries in skilled nursing facilities (SNFs). OIG determined that CMS has inadequate procedures to ensure that incidents of potential abuse or neglect of Medicare beneficiaries residing in SNFs are identified and reported. The memo contains suggestions for immediate actions that CMS can take to ensure better protection of vulnerable beneficiaries. There will be a forthcoming final report.

The National Association of Attorneys General (NAAG) has announced a new initiative to identify and combat elder abuse. This is separate from the Department of Justice's Elder Justice Task Force, but has similar goals. The focus will likely vary by state depending on each Attorney General’s priorities. 

CMS Announces Nationwide Expansion of Targeted Probe and Educate Medical Review Strategy

Dan Ciolek

 

On August 14, the Centers for Medicare and Medicaid Services (CMS) announced a significant change in direction in their medical review strategy. CMS states they are cognizant of issues of provider burden associated with the traditional medical review process, and have been seeking ways to better target providers that require further education in order to reduce payment errors. What began as a small-scale targeted probe and educate (TPE) pilot with one Medicare administrative contractor (MAC), which was well-received by providers and reduced claim error rates and appeals, is to be expanded nationwide in late 2017.

 

How Targeted Probe and Education (TPE) works

When performing medical review as part of TPE, MACs focus on specific providers/suppliers within the service rather than all provider/suppliers billing a particular service. TPE involves the review of 20 to 40 claims per provider, per item or service, per round, for a total of up to three rounds of review. Each round of 20 to 40 claim reviews is referred to as a probe. This term is intended to convey that the number of claims reviewed is relatively small in comparison with previous provider specific review where the number of claims reviewed for an individual provider may have been much larger. After each round, providers are offered individualized education based on the results of their reviews.

 

MACs will focus only on providers/suppliers who have the highest claim error rates or billing practices that vary significantly out from their peers.

Opportunity for Providers to Implement Corrective Processes 

The TPE review and education process includes a review of 20 to 40 claims followed by one-on-one, provider-specific education to address any errors within the provider’s reviewed claims. Providers/suppliers with moderate and high error rates in the first round of reviews will continue on to a second round of 20 to 40 reviews, followed by additional provider-specific, one-on-one education. Providers/suppliers with high error rates after round two will continue to a third and final round of probe reviews and education (please see the TPE Process Flowchart). In addition to education at the conclusion of each 20 to 40 claim probe review, MACs also educate providers throughout the probe review process, when easily resolved errors are identified, helping the provider to avoid additional similar errors later in the process.

Providers/suppliers with continued high error rates after three rounds of TPE may be referred to CMS for additional action, which may include 100 percent prepay review, extrapolation, referral to a recovery auditor, or other action. Providers/suppliers may be removed from the review process after any of the three rounds of probe review if they demonstrate low error rates or sufficient improvement in error rates, as determined by CMS. 

CMS Announces Emergency Changes to SNF QRP Deadlines Due to SNF QRP Systems Problems

Dan Ciolek

AHCA received notification from the Centers of Medicare and Medicaid Services (CMS) that they are making significant changes to the Skilled Nursing Facility Quality Reporting Program (SNF QRP) reporting deadlines and SNF QRP report availability due to system coding issues. The specific reports impacted are the Review and Correct Report and Confidential Feedback Report that SNFs use to help monitor compliance with Minimum Data Set (MDS) 3.0 assessment-based quality measures, and identify assessments that may need updating.

The following is a summary of the issues and timeline changes:

Problems Identified

• The SNF QRP systems were not properly updating SNF performance when updated assessment records were submitted.
• The SNF QRP systems were improperly calculating the performance of the measure using MDS 3.0 Section GG items titled: Application of Percent of LTCH Patients with Admission and Discharge Functional Assessment and a Care Plan that Addresses Function (NQF#2631).

Data Submission Deadline Extension

• Due to the problems identified, CMS is eliminating the quarterly assessment data submission deadlines for calendar year (CY) 2017 and instead will permit SNFs to submit all CY 2017 SNF QRP assessment data, and any modifications, until May 15, 2018.
• Additionally, CMS will apply this deadline for all quarters of reporting to the Fiscal Year 2019 (FY 2019) annual payment update determinations as well.
• CMS will permit previously submitted Q1 C Y2017 assessment data that have been “frozen” as of August 15, 2017, to be made available for updates as of mid-September 2017.  

Changes in SNF QRP Report Availability and Opportunity to Modify Records 

• Early September, 2017: Review and Correct Reports will be corrected to enable modified records.
• Mid-September, 2017: SNFs will be able to access, view and once again modify Q1 2017 data used in the SNF QRP assessment based quality measures.
• Early December: Updated Review and Correct Reports will include technical updates to the calculation of the measure Application of Percent of LTCH Patients with Admission and Discharge Functional Assessment and a Care Plan that Addresses Function.
• Early December: Release of the SNF QRP Confidential Feedback Reports (SNF QRP QM Reports).

CMS Indicates that they will continue to send follow-up announcements as each of these issues are resolved and further guidance can be given.

Additional information regarding guidance and timelines has been posted to the SNF Quality Reporting Program Data Submission Deadlines webpage.

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

CMS Launches Court-Ordered Jimmo Settlement Agreement Webpage

Dan Ciolek

In January 2013, the Centers of Medicare and Medicaid Services (CMS) entered into a settlement agreement that was intended to assure Medicare coverage rights for beneficiaries that may require skilled nursing or therapy services, but were not expected to improve. The settlement agreement directed CMS to update various policy manuals and provide educational outreach to assure that providers and auditors understood that as long as the professional skills of the therapist or nurse are required, services cannot be denied solely on the lack of improvement in health or function, and that treatment goals of maintenance, or the prevention or delay if decline can be appropriate.  

A recent court decision, supported by an AHCA legal declaration, found CMS non-compliant with the educational campaign component of the settlement agreement. On February 16, 2017, the court ordered CMS to improve their education efforts with specific activities, and to issue a revised maintenance coverage corrective statement (see below) by September 4, 2017.     

In response, on August 23, 2017, CMS published a webpage to provide in one location, access to various public documents related to the Jimmo Settlement Agreement. This webpage provides information and links to the background of the settlement agreement, links to policy and educational resources, and a newly developed Frequently Asked Questions (FAQ) document. 

This coverage policy clarification applies to Medicare Part A, Part B, and Medicare Advantage in an office, facility, or in the beneficiary’s home (including assisted living center). Skilled nursing facility (SNF) nurses, therapists, and billers are encouraged to review this new website.   

Court Ordered Revised Maintenance Coverage Corrective Statement:

The Centers for Medicare & Medicaid Services (CMS) reminds the Medicare community of the Jimmo Settlement Agreement (January 2013), which clarified that the Medicare program covers skilled nursing care and skilled therapy services under Medicare’s skilled nursing facility, home health, and outpatient therapy benefits when a beneficiary needs skilled care in order to maintain function or to prevent or slow decline or deterioration (provided all other coverage criteria are met). Specifically, the Jimmo Settlement Agreement required manual revisions to restate a “maintenance coverage standard” for both skilled nursing and therapy services under these benefits:

Skilled nursing services would be covered where such skilled nursing services are necessary to maintain the patient's current condition or prevent or slow further deterioration so long as the beneficiary requires skilled care for the services to be safely and effectively provided.

Skilled therapy services are covered when an individualized assessment of the patient's clinical condition demonstrates that the specialized judgment, knowledge, and skills of a qualified therapist (“skilled care”) are necessary for the performance of a safe and effective maintenance program.  Such a maintenance program to maintain the patient's current condition or to prevent or slow further deterioration is covered so long as the beneficiary requires skilled care for the safe and effective performance of the program.

The Jimmo Settlement Agreement may reflect a change in practice for those providers, adjudicators, and contractors who may have erroneously believed that the Medicare program covers nursing and therapy services under these benefits only when a beneficiary is expected to improve. The Jimmo Settlement Agreement is consistent with the Medicare program’s regulations governing maintenance nursing and therapy in skilled nursing facilities, home health services, and outpatient therapy (physical, occupational, and speech) and nursing and therapy in inpatient rehabilitation hospitals for beneficiaries who need the level of care that such hospitals provide.

LTC Trend Tracker Users: Check Out Your Quarter 3 Top-Line Publication on September 13!

David Gifford

It’s that time again – your organization’s data has been updated! 

On September 13, LTC Trend Tracker users will receive the latest Your Top-Line publication, produced by LTC Trend Tracker, in their email inboxes. The report will be sent with the subject line LTC Trend Tracker Quarter 3 Publication.

This resource highlights metrics and graphics outlining your facility’s progress on Five-Star performance, the AHCA/NCAL Quality Initiative, and other necessary data to help you achieve your desired goals. The 2017 Quarter 3 edition of Your Top-Line publication will also include each facility’s current Quality Award status, and information regarding the eligibility criteria for all levels of the Quality Award Journey.

Quick tips:

• In order to keep the email from being sent to your clutter or spam folder, be sure to add the email address the report will be sent from, join.support@ltctrendtracker.com, to your Safe Sender list.
• If you misplace the email containing the link to Your Top-Line, don't worry because LTC Trend Tracker keeps these publications saved 

We look forward to continuing to provide Your Top-Line publications on a quarterly basis with your latest benchmarking data! If you have any questions, please email help@ltctrendtracker.com, and add the address to your ‘Safe Sender list’. 

Learn About Improving Performance With LTC Trend Tracker – Register for the Back to School Webinar Today!

Lonnita Belk

LTC Trend Tracker is back in session - we've shared with you how to run reports and upload data into the tool, but what do you do next? How do you use LTC Trend Tracker reports to improve your organization's performance? 

Join the LTC Trend Tracker team for our Back to School webinar to find out more!

September 13, 2017

2:00 pm - 3:00 pm Eastern

Register Here 

During this webinar, Holly Harmon, AHCA Senior Director of Clinical Services, and Lindsay Schwartz, NCAL Senior Director of Workforce and Quality Improvement, will discuss how to utilize your data in LTC Trend Tracker to provide better quality care. 

Specifically, the webinar will cover:

• How to access your data
• Example scenarios and how LTC Trend Tracker data can be helpful. 
• AHCA & NCAL Quality Initiative

What is LTC Trend Tracker?
LTC Trend Tracker is a powerful tool that can help your organization better meet its quality goals. You can monitor your progress on quality measures, Five-Star, AHCA /NCAL Quality Initiative goals, hospital readmission rates, and more. LTC Trend Tracker enables you to you:

• Identify organizational areas for improvement and set your own performance targets.
• Quickly download reports with specific data that engages staff members and area providers.
• Use the Dashboard to evaluate your organization on key metrics in comparison with your peers.
• Benchmark yourself to those of your peers and keep your organization ahead of the curve.

Mark your calendars and register here now!

Questions? Email the LTC Trend Tracker team at help@ltctrendtracker.com.

New Readiness Assessment Tool for Community-Based Organizations on Business Acumen

The Aging and Disability Business Institute [operated by National Association of Area Agencies on Aging (n4a) and a team of partners] has launched a new Readiness Assessment tool, a powerful resource that will help community-based organizations (CBOs) determine their capacity and preparedness for engaging in contractual partnerships with health care payers and providers.

The interactive tool will walk CBOs through seven different modules covering readiness on key topics that impact health care partnerships, including operations, leadership, management, and more.

Learn more about ACL's Business Acumen Initiative to help states and community-based organizations build networks and respond to delivery system changes, including technical assistance, building business capacity for successful contracting with integrated care entities, and developing pathways to sustainability.

Webinar: Identifying and Supporting Dementia Caregivers in Healthcare Settings

September 12, 2:00 PM – 3:00 PM EST

The Administration for Community Living/American Society on Aging will host a webinar on Identifying and Supporting Dementia Caregivers in Healthcare Settings, and define the challenges and benefits of including family caregivers as members of the healthcare team.

Family caregivers are essential for persons living with dementia, but they can often go unnoticed. To provide care and improve outcomes for persons living with dementia, efforts are underway in several healthcare settings to better engage family caregivers in the development of care plans and the delivery of care.

Through this webinar, participants will be able to:

Describe the benefits of improving family caregivers’ representation in the Electronic Health Record (EHR) of persons living with dementia

Discuss multiple ways in which healthcare systems could better identify family caregivers in EHRs and other forms of Health IT

Access tools care managers can use to identify, assess and support family caregivers of people with dementia within healthcare systems

Identify policies that can be leveraged to improve caregiver identification

Complimentary CEU’s are available. Click here to register.

Webinar presenters:

Debra Cherry, Alzheimer’s Greater Los Angeles

Alan B. Stevens, Center for Applied Health Research

Don’t Miss this Special Breakfast Session for Independent Owners

Jon-Patrick Ewing

Registered for convention but haven’t rsvp’d for the Independent Owners Breakfast Session? 

Email your name, title, company name, and e-mail address to Christy Sharp here.

We're looking forward to seeing you in October in Las Vegas and we encourage you to take advantage of the opportunity to attend the invitation-only event.

UPDATES ON ALTERNATIVE PAYMENT MODELS UNDER THE NEW ADMINISTRATION Monday, October 16, 2017 7:30 am - 9:00 am Pacific If you haven’t registered for this year’s Annual Convention & Expo you don’t want to miss this opportunity to network and talk to other IOs. You'll hear from guest speaker Deborah Freeland of CliftonLarsonAllen as she provides an update on current alternative payment models and any new payment models under the new administration.  Learn about the challenges and steps to be taken by providers as they transition from current payment models to alternative models. Get ready to participate in the emerging payment models, and learn from others' successes. This event is included in your Convention & Expo Premium/Full Meeting Package registration but does require that you RSVP. Space is limited.  RSVP today. Event Sponsors:

The AHCA/NCAL Long Term Care Career Center is Part of the New “Google for Jobs” Search Engine

Dave Kyllo

Google has officially tapped into the job search market with the launch of its own job search engine, Google for Jobs. Job seekers that are looking for their next career opportunity now can simply, “Google it.”

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

Here are some of the new benefits:

For Employers…

• Jobs posted to the Long Term Care Career Center are automatically searchable through Google for Jobs, creating even greater exposure. The Google for Jobs application appears before Google’s standard search results, prioritizing your positions over other employers', and job boards and staffing agencies that do not have an established partnership with Google. 
• Provides employers with a new source of active and passive candidate traffic – a unique benefit of posting open positions with the Long Term Care Career Center.
• Alleviates the ongoing challenge of identifying the right candidates to fill open positions by increasing the reach of every job that you post with the Long Term Care Career Center.  

For Job Seekers…

• Streamlines the job search by displaying career opportunities from the Long Term Care Career Center and multiple employment sites in one convenient place.
• Helps more people find work by bringing greater exposure to the outstanding career opportunities in the long term care profession. 
• Increases the likelihood of candidates finding the type of job that they are looking for and cuts down on time that is wasted applying to roles that aren’t a good fit.

Rates for posting job vacancies on the Long Term Care Career Center 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 percent off their first posting by entering promo code New25off when they check out.  
• Employers with multiple positions to fill can purchase three job postings at one time and receive a 20 percent discount on the three postings by entering promo code Bundle20 at check out. Employers who 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 through Google for Jobs, employers who utilize the site also receive superior exposure through rotating job listings on AHCA’s home page, 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.

Extend your reach for highly qualified health care professionals. Check out the Long Term Career Center today or go to www.ltccareercenter.com. 

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. 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. 

Our Gero Nurse Prep program 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 68^th 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, “My RN is Smarter Than Your RN”, will be held on Tuesday, October 17 from 10 to 11 am Pacific and will feature four speakers who will detail how board certification in gerontological nursing is attained and the positive impact that 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 online 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.

CMS Alerts of Issues With SNF QRP Review & Correct Reports

Holly Harmon 

This week, CMS posted a notice on the skilled nursing facility (SNF) quality reporting program (QRP)  website of an issue identified with the SNF Review and Correct Report. Per CMS, if one or more modification records are submitted for a patient stay, the most recent submitted assessment, which was accepted by the Assessment Submission and Processing (ASAP) system on or prior to the submission deadline for quarters 1 and 2 of CY 2017, it is not being used in the measure calculation. 

Therefore, the measure results on the SNF Review and Correct Report are not being updated to reflect any changes in the measure outcomes based on the most recently submitted assessment. This applies to all measures on the SNF Review and Correct Report. Please note that refreshes on the calculations occur on Mondays.

A second issue has been identified in the coding of one measure contained in both the SNF Quality Measure (QM) and Review and Correct Reports that affects the calculation of the measure, Application of Percent of LTCH Patients with Admission and Discharge Functional Assessment and a Care Plan that Addresses Function (NQF#2631). As a result, the data is currently being recalculated and retested for this measure in both reports. The SNF QM report for SNF QRP is not yet available and is anticipated to be released in late fall 2017. 

CMS staff are working to resolve these issues. A follow-up message will be sent by CMS as soon as these are resolved and further guidance can be given.

If you have questions concerning this information, please email the Quality Improvement and Evaluation System (QTSO) Help Desk here or call 1-800-339-9313.

SNFs should continue to review and correct assessments where appropriate. Until this fix is fully implemented by CMS, modification records will not show in the SNF Review and Correct Report.

AHCA will share more information as soon as it becomes available. 

CMS Updates Technical Specifications Table for Reporting SNF QRP Assessment-Based Measures for FY2019

Holly Harmon 

CMS has updated the technical specifications table presenting information in regards to the reporting requirements for the assessment based quality measures that are included in the CMS SNF QRP for FY 2019. 

For more information and to view the table, visit the SNF Quality Reporting Program Measures and Technical Information webpage or here find the table here. 

September is National Preparedness Month - Informative Emergency Preparedness Resources Are Available

Dana Halvorson and Erin Prendergast

September 2017 marks our annual observance of 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. 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 (CMS) 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. 

AHCA has several informative emergency preparedness resources available to you:

• AHCA's Emergency Preparedness Final Rule Webinar Series can be found here.  
• There will be Emergency Preparedness educational sessions at the AHCA/NCAL National Convention in Las Vegas: 
• “A Case Study in the Use of Human Patient Simulator Technology to Enhance Emergency Preparedness Exercises within Long Term Care Facilities" will be held on Monday, October 16, 2017, at 3 pm Pacific. More details on this session can be found here. 
• “Overview and Discussion of the New Emergency Preparedness Requirements” will be held on Tuesday, October 17, 2017 at 10 am Pacific. Click here for more information on this session.
• There will be a Federal Emergency Management Agency (FEMA) Region II Preparedness Webinar Planning for Seniors on Tuesday, September 26 from 12 - 1 pm Eastern. Participants will learn, among other things, about tools and information available that can assist older adults and their caregivers when an emergency strikes. Register here for this free webinar.

Please contact Erin Prendergast (SNF Providers) or Dana Halvorson (ICF/IID Providers) with any questions. 

VA to Revise State Veteran Home Construction Regulations

Dana Halvorson

According to an August 21, 2017, press release from the Department of Veterans Affairs (VA) Secretary Dr. David J. Shulkin, the VA plans to propose changes to regulations for its State Veterans Home Construction Grant Program to make it easier to for states to receive VA funding to construct Veterans homes in rural areas.

State Veterans Homes provide Veterans with nursing home, domiciliary or adult day health care and are owned, operated and managed by state governments. The VA statement notes the following:

“Currently, the construction grant regulations focus on Veteran demographics as well as nursing home and domiciliary bed need within a State, when determining priority group placement based on projected demand for assistance. Unfortunately, this makes it difficult for some rural areas to compete for VA State Home Construction Grants. In highly rural areas, there could be a 500-mile distance from one State Veterans Home to the next, which gives family members limited options when searching for a conveniently located facility for a Veteran family member. By incorporating a consideration for the need of Veterans in rural areas into the ranking priorities for grant applications in the regulations, rural States may find it easier to compete for the limited VA construction grant funding that is available.” 

VA anticipates that the revision of these regulations will be completed by the end of the 2017 calendar year. The updated regulations will be available for public comment.The statement also noted that the VA is working to ensure that the updated regulations go into effect as soon as possible.

CNAs Plan to Visit Lawmakers

Drew Thies

Certified Nursing Assistants (CNAs) are planning to visit Capitol Hill and members of Congress in order to raise awareness about the critical work health care assistants do in long term care facilities.

The National Association of Health Care Assistants (NAHCA) is hosting its annual convention on September 6 to 7 in Washington, D.C., and attendees are not missing the chance to visit important lawmakers while they are in the nation’s capitol. Teaming with AHCA/NCAL, dozens of CNAs and administrators will take their message to Congress in what has already been an eventful year for health care policy.

Attendees from over 20 states all over the country will also receive leadership training and informative talks from leaders in the profession as well as AHCA staff. A rally on Capitol Hill will coincide with the visits to Congress.

CMS Provider Compliance Resources to Prevent Part A SNF PPS Denials

Dan Ciolek

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:

• CERT: SNF Certifications and Recertifications MLN Matters® Special Edition Article
• SNF Billing Reference Fact Sheet
• Medicare Fee-For-Service 2014 Improper Payments Report, page 19
• Medicare Fee-For-Service 2015 Improper Payments Report, page 18

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

Adrienne Riaz-Khan

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