Monday, October 16, 2017

AHCA/NCAL Annual Convention Kicks Off in Las Vegas

This week, The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) welcomed more than 2,700 long term and post-acute care providers and 1,500 vendor partners to the Association’s 68th Annual Convention and Expo at The Mandalay Bay Convention Center in Las Vegas, Nevada. 

Monday morning, AHCA/NCAL President and CEO Mark Parkinson described the challenges providers have faced in 2017. He also celebrated those heroes who stepped up to protect patients and residents during the recent natural disasters, including hurricanes Harvey and Irma.

The keynote address was delivered by Jim Collins, author, expert, and futurist in the field of Demography and Generational Marketing. He is author of the best-selling books Good to Great and Built to Last. In addition to his work in the business sector, Jim has passion for learning and teaching in the social sectors, including education, health care, government, faith-based organizations, social ventures, and cause-driven non-profits.

Tomorrow, the Association will honor long term and post-acute care providers who have been changing lives and making a difference in the profession through the National Quality Award Program. This year, more than 700 member centers and communities were recognized with a Quality Award, including 520 Bronze, 196 Silver and an elite group of three at the Gold level. 

On Wednesday, convention attendees will hear from Closing General Session keynote speaker, Mike Rayburn. Rayburn is a two-time TEDx Talk presenter, an entrepreneur, and Hall of Fame speaker who uses his world-class guitar playing skills and comedy to teach innovation and performance to corporations worldwide.

The 68th Annual AHCA/NCAL Convention runs through Wednesday, October 18.

Sunday, October 15, 2017

Update: SNF Review and Correct Report & Confidential Feedback Report Issues


The Centers for Medicare & Medicaid Services (CMS) recently notified skilled nursing facility (SNF) providers that all data for assessment-based measures required for the SNF Quality Reporting Program (QRP) in CY2017 would remain open to modifications until May 15, 2018, and that SNFs would be notified when the Q1 2017 data that was "frozen" as of August 15, 2017 would be open and subject to updates again.

Please be advised that the submission deadline for Q3 2017 data has been modified to May 15, 2018. The SNF Review and Correct Report has been updated to reflect that both Q1 and Q2 2017 are "open". Data for all measures for Q1 2017 have been recalculated for any assessment records that have been received since the original Q1 2017 submission deadline of August 15, 2017.  

The SNF Review and Correct report is available in the SNF QRP report category in the CASPER Reporting application. Providers are encouraged to request the report to view updated measure results. The updated report should replace versions of the report previously requested.

Please note that when the report is run for more than one quarter, the reporting quarters are now displaying in random order, rather than being displayed in descending order (newest reporting quarter to oldest reporting quarter). The start and end dates, data correction deadline date, date correction period as of report run date, and the quality measure data results associated to the reporting quarters are all correct. The issue is simply the way in which the reporting quarters are displayed in the table. This will be corrected in early December.

The remaining issue, affecting the calculation of the Application of Percent of LTCH Patients with Admission and Discharge Functional Assessment and a Care Plan that Addresses Function (NQF#2631), is still being corrected and tested by CMS. SNFs will be notified once this issue has been resolved in early December. At that time, the data for this measure will be recalculated and the updated results will be available on the Review and Correct Report.

View previous updates on 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 1 (800) 339-9313.

SNF QRP Confidential Feedback Reports Available – Claims Based Measures


The Skilled Nursing Facility Quality Reporting Program (SNF QRP) Confidential Feedback Reports containing the claims-based Improving Medicare Post-Acute Care Transformation (IMPACT) Act measures are now available via the CASPER Reporting System.

For more information on these reports, please refer to the September 28, 2017 presentation and audio and transcript on the SNF QRP Training website.

Please note that these reports only contain information for the following claims-based quality measures:
  • Total Estimated Medicare Spending Per Beneficiary Measure
  • Discharge to Community-Post Acute Care– SNF QRP
  • Potentially Preventable 30-Day Post Discharge Readmission Measure
The full Confidential Feedback Reports or Quality Measure reports containing all SNF QRP quality measures (claims and assessment-based) will be released later this year and further training will be forthcoming.

If you have questions about the information contained in your report, please contact the SNF QRP Help Desk at SNFQualityQuestions@cms.hhs.gov

Friday, October 13, 2017

Get Trained Now! New Antibiotic Stewardship Requirements Take Effect November 28


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

Even though nursing facilities are not required to have a designated “Infection Preventionist” until November 2019, there are three compelling reasons why it is critical to register for this training now:
  • As of November 28, 2016 nursing facilities are being held accountable to more expansive infection prevention and control federal regulations. 
  • Beginning November 28, 2017, the federal requirements for nursing facilities expand further and require that every nursing facility develop and implement an antibiotic stewardship program. This is a new requirement that should be conducted with oversight from specially trained healthcare professionals. 
  • Surveyors nationwide are being trained now 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 that meets the educational requirements outlined by CMS. It includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term/post-acute care.  

AHCA’s course addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control that are fundamental to effectively leading and administering successful infection prevention and control programs and antibiotic stewardship programs. Upon successful completion of this program, participants will receive certificates including 23 ANCC contact hours.

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

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

To access ahcancalED and the IPCO course, members will need to login with their AHCA/NCAL usernames and passwords.  

For assistance obtaining AHCA/NCAL usernames and passwords, please email update@ahca.org with your name and facility contact information. 

The Number of Open LTC Jobs Jumps in October


There are 20,090 open jobs posted by direct employers this month in the nursing care facility - including skilled nursing facilities (SNFs), assisted living (AL), 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 rebounded this month after a significant dip in September.      

The CEB TalentNeuron statistics also show an estimated 2,101,000 potential candidates in the nation’s workforce whose skills likely match the qualifications being sought by long term care employers. Figures show that 1,875 direct employers are competing for candidates this month – nearly the same number as last month. The average number of days a job was posted this month increased by one day to 37 days.   

Finding qualified employees is one of the greatest challenges facing long term care providers. The AHCA/NCAL Long Term Care Career Center is designed to help members be competitive in attracting qualified candidates to fill their health care job vacancies.The LTC Career Center is also fully integrated with Google’s new job search feature, “Google for Jobs”, creating even greater exposure for job postings.

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

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

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 1,400 views in October. 

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.     

Help Your RNs Help You Succeed! Take Advantage of the Gero Nurse Prep Sale

AHCA/NCAL Gero Nurse Prep is on sale now through November 30 and each RN registrant can save $100 off his/her Gero Nurse Prep by entering promo code VBPRN17 (all caps) at checkout. That means RNs who are interested can become board certified for less than $1,000 ($590 sale price for AHCA/NCAL Gero Nurse Prep and a separate $395 to take the American Nurses Credentialing Center (ANCC) exam.
Hospitals are keeping a close watch on their Medicare beneficiaries to ensure that they are not readmitted within 30 days of discharge, including those hospitalized Medicare beneficiaries who live in skilled nursing and assisted living settings. Well trained RNs can play a critical role in reducing re-hospitalizations. 
Hospitals face having Medicare reimbursements withheld if their re-hospitalization rates are too high. In October 2018, skilled nursing facilities (SNFs) also will face financial consequences if their re-hospitalization rates are too high. Managing rehospitalization rates has become a key part of a successful long term care business strategy in caring for the elderly in an increasingly competitive marketplace.
  
Research conducted by AHCA/NCAL in 2016 found that the rehospitalization rates in nursing facilities with at least one RN certified in gerontological nursing by the ANCC consistently have run at least two percentage points lower than the national average since 2011. AHCA/NCAL believes that assisted living settings may experience similar results by increasing their RNs’ gerontological expertise. 

ANCC is the world’s largest and most prestigious nurse credentialing organization and a subsidiary of the American Nurses Association. Less than one percent of America’s RNs are ANCC board certified in gerontological nursing. 

To help increase the number of board certified RNs, AHCA/NCAL’s Gero Nurse Prep program is designed to help RNs prepare for and pass the ANCC gerontological certification exam. RNs who complete the AHCA/NCAL Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam and receive 30 CEUs. They also increase their knowledge of gerontological nursing by 20 percent on pre- and post-test scores.

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

Emergency Preparedness Requirements - Part IV Webinar in AHCA Series


AHCA, along with guest speakers, has been hosting an ongoing webinar series event this year on the new emergency preparedness final rule impacting skilled nursing facilities (SNFs), nursing facilities (NFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IID).This final rule is not applicable to assisted living (AL) providers. 

The rule was released on Friday, September 16, 2016, and can be found here. Providers will need to be in compliance by November 15, 2017.

The webinar series has thus far included, among other things, special guest speakers, an overview of the key new requirements, a list of tools to assess whether you are prepared for the rule, and recommended steps to take in order to prepare.

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

You can register here for the webinar. Further details on the webinar will be sent out towards the end of October.    

Wednesday, October 11, 2017

Regulatory Reform Effort Continues in House and Senate

Drew Thies

Two letters asking for regulatory relief for skilled nursing providers are circulating in the House of Representatives and Senate. The letters signed by lawmakers asks the Centers for Medicare and Medicaid Services (CMS) to revise and delay costly requirements for nursing centers.

The House letter, which closes today, is led by Congressman Jim Renacci of Ohio and has more than one hundred cosigners. The bipartisan group includes Members of Congress on the influential Ways and Means, and Energy and Commerce Committees, as well as some full state delegations.

The Senate letter is led by Senator John Hoeven of North Dakota and has the support of nine other Senators. The deadline to sign onto the effort is October 18th.

Both letters request that CMS revise the “requirements of participation” for nursing centers. Made final in October 2016 and implemented the following November, the rule has considerable provisions that begin in November 2017 and represent a large burden to providers.

CMS estimates the unfunded mandate will cost an average provider in excess of $50,000 annually to implement. The House and Senate letters request CMS delay some of the more costly provisions to allow providers to better cope with the burden.

AHCA will continue to urge Senators to sign onto the letter. A booth will be set up at the annual convention to allow members to contact their Senators regarding the effort.

Tuesday, October 10, 2017

Discover Exclusive AHCA/NCAL Member Savings Opportunities in the AHCA/NCAL Convention Expo Hall!

Dave Kyllo

AHCA/NCAL members receive special “member only” discounts from select partners in AHCA/NCAL’s Preferred Provider Program.  Learn more about their exclusive savings programs by visiting these booths in the AHCA/NCAL Convention Expo Hall next Monday and Tuesday in Las Vegas.

Booth #1127 CARES®:  CARES® is the only online dementia training recommended by CMS! 

CARES® delivers affordable, high quality online person centered dementia care training programs for staff at all levels.  The essentiALZ® certification program provides a way for individuals to be recognized by the Alzheimer’s Association for learning quality dementia care practices. 

Booth #628  AHCA/NCAL Gero Nurse Prep:  Conquer Value Based Purchasing with Smarter RNs!
Gero Nurse Prep prepares RNs for the ANCC Board Certification exam in gerontological nursing and increases geriatric nurse competency by 20% on pre- and post-test scores.  Visit with Dr. Heidi Keeler to learn how Gero Nurse Prep can help strengthen your clinical performance.

Booth #513  HealthCap:  HealthCap is the premier AHCA/NCAL endorsed insurance program providing liability insurance to the senior care sector!  
HealthCap clients have both lower claims frequency and lower claims serverity than other major liability insurance carriers.– two powerful  reasons why AHCA/NCAL members rave about HealthCap.  Another plus – AHCA/NCAL members receive a 10% discount on their HealthCap premiums.
 
Booth #624  AHCA/NCAL Insurance Solutions:  AHCA/NCAL Insurance Solutions saves AHCA/NCAL members money on their employee health benefit plans!
Tap the expertise of brokers who know long term care.  Stop by and ask the Insurance Solutions team to conduct a free, no obligation review of your current plan to see if there are more affordable options that can save you money too. 

Headshot Lounge (Across from Booth #300):  AHCA/NCAL Long Term Care Career Center:  Your Source for Talented LTC Professionals and Great Career Opportunities!
The AHCA/NCAL Long Term Care Career Center offers increased exposure for job listings through our affordable network of millions of members of more than 330 prestigious health care associations and is fully integrated with “Google for Jobs.” 

Booth # 1008 Mood Media:  Mood Media delivers creative and affordable music solutions starting at just $29.99 per month for AHCA/NCAL members!

Mood’s dependable and proven line of solutions provides comfortable and relaxing environments in assisted living communities and nursing facilities.  All Mood Media music solutions are fully licensed for all Mood usage applications.  

The Word is Spreading in Las Vegas About AHCA’s Infection Preventionist Specialized Training Program

Dave Kyllo

AHCA/NCAL convention attendees can learn more about ACHA’s new Infection Preventionist Specialized Training (IPCO) course by visiting Booth #206-A next Monday and Tuesday in the AHCA/NCAL convention Expo Hall. The IPCO course is designed 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. 

Individuals who successfully complete the IPCO course will be trained to effectively implement and manage an Infection Prevention and Control Program (including antibiotic stewardship programs) at their nursing facilities. The new antibiotic stewardship requirements take effect next month. 

The course is an online, self-study program with 23 hours of training and meets the training requirement expectations laid out by CMS.  IPCO includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term/post-acute care. 

AHCA’s training program also 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

Be ready for your next survey.  Stop by Booth 206-A next week to learn more about this exciting training program. Feel free to contact educate@ahca.org with any questions.

Time is Running Out! Submit Your Intent to Apply Now

qualityaward@ahca.org

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

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

Members who submit an Intent to Apply save money on their overall application fee and receive weekly tips and other resources that support submitting a successful Quality Award application.

Reminders: 

  • All applicants should read the appropriate application packet in full before submitting an Intent to Apply payment. Application packets for all award levels can be found on the Quality Award website.
  • If your center last received a Bronze or Silver Quality Award in 2015 and has not submitted an application meeting minimum requirements since then, this is your last year to submit an application at the next level. If you do not submit an application this year, you will be considered a past recipient and have to resubmit at the Bronze level if your center chooses to participate again in the program. For more information, please review the recertification policy here.   

If you would like to review your center’s award history or have any questions, please visit the Quality Award program website here or email qualityaward@ahca.org.

Monday, October 9, 2017

AHCA Quality Initiative: The Latest Data

Kiran Sreenivas

People have different needs as they age. The long-term and post-acute care continuum is quite expansive, and as such not all nursing homes are the same. Some nursing homes specialize in dementia care for Alzheimer’s, others on post-acute rehabilitation from joint replacements and everything in between. All provider types are represented in AHCA/NCAL’s membership, and all have a stake in the AHCA/NCAL Quality Initiative with its various measures. 

As a specific example, consider Edgemoor DPSNF, one of this year’s AHCA/NCAL Gold Quality Award recipients. They are a county-run “safety net” facility with a mission to take those individuals who cannot be served by other skilled nursing facilities in the area and who would otherwise be a burden on the community. Even with their unique circumstances, there are Quality Initiative goals, like long-stay hospitalizations, that are applicable to them. 

At the macro-level, the latest data as of September 2017 shows AHCA/NCAL members are improving in quality, regardless of their specialty or unique circumstances. There is just as much progress on measures pertinent to members that focus on long-term care, such as antipsychotics, with 55 percent of members achieving the goal, as those measures relevant to short-stay post-acute care, such as functional improvement, with 53 percent of members achieving the goal. 

The graph below shows the specific breakdown across the long-stay and short-stay goals in the Initiative. For the latest progress data on all other goals, click here.

The Quality Initiative Recognition Program relaunched last month is fitting given the tremendous progress seen. Learn more about the recognition program here.


Get Recognized for Meeting Quality Initiative Goals: Submit Your Data by Oct. 13!

By qualityinitiative@ahca.org

Last month, AHCA/NCAL relaunched the Quality Initiative Recognition Program to honor skilled nursing and assisted living members for their individual work in achieving the goals of the AHCA/NCAL Quality Initiative. To be considered for recognition, eligible member organizations must submit the appropriate data through LTC Trend Tracker by October 13, 2017. Requirements for goals and data submission are outlined below.

Eligibility 

For skilled nursing care centers, members must achieve four or more of the AHCA Quality Initiative goals to be eligible for recognition. The goals are:
  1. Decrease turnover rates among nursing staff by 15% from 2015 or achieve/maintain at or less than 40%
  2. Adopt Core-Q customer satisfaction questionnaire and measure and upload data to LTC Trend Tracker
  3. Reduce the number of unintended health care outcomes
  4. Safely reduce the number of hospital readmissions within 30 days during a skilled nursing center stay by 30% from December 2011 or achieve and maintain a low rate of 10%
  5. Improve discharge back to the community by 10% from December 2014 or achieve and maintain a high rate of at least 70%
  6. Improve functional outcomes by 10% from December 2015 or maintain an average rate of improvement of 75%
  7. Safely reduce the off-label use of antipsychotics in long-stay nursing center residents by a total of 30% from December 2011
  8. Safely reduce hospitalizations among long-stay residents by 15% from December 2014 or achieve/maintain a low rate of 10% or less
For assisted living communities, members must achieve two or more of the four NCAL Quality Initiative goals. The goals are:
  1. Increase staff stability by maintaining nursing and direct care staff turnover below 40%
  2. Increase customer satisfaction to 90%
  3. Safely reduce hospital readmissions by 15% or achieve a low readmission rate of 5% or less
  4. Safely reduce the off-label use of antipsychotics by 15% or achieve a low off-label usage rate of 5% or less
What to Do Next

By October 13, 2017, nursing centers must submit staffing and customer satisfaction data in LTC Trend Tracker. All other data is automatically uploaded by LTC Trend Tracker.

For assisted living communities, members must submit data for all NCAL goals in LTC Trend Tracker by October 13, 2017.

Customer satisfaction vendors can upload data to LTC Trend Tracker on behalf of members. A list of vendors able to upload can be found here.

AHCA/NCAL also encourage members to:
Notification & Assistance

Later this year, achievers will be notified by the AHCA/NCAL Quality Initiative Recognition Program team using the latest available data. All achievers will be recognized at the AHCA/NCAL Quality Summit in New Orleans, March 12-14, 2018.

For those who need assistance with LTC Trend Tracker, email help@ltctrendtracker.com and be sure to add the email address to your “Safe Sender” list.

If you have questions about the program, email the team at qualityinitiative@ahca.org.

New Emergency Preparedness Resources

Erin Prendergast

Webinar: Health and Social Services Recovery Lessons Learned from the 2016 Louisiana Flooding. ASPR’s Technical Resources, Assistance Center, and Information Exchange (TRACIE), in collaboration with the ASPR Division of Recovery, is hosting a webinar on Wednesday, October 18, 2017 from 2:00-3:00 PM ET. Join this Health and Social Services Recovery Lessons Learned from the 2016 Louisiana Flooding Webinar to learn more about how to navigate different federal recovery programs, what challenges should be anticipated during recovery efforts, and what tips are available from other communities to help determine vulnerabilities and areas of focus for maximizing the recovery timeline. Louisiana health and human services representatives will discuss their lessons learned and how their experiences may help their counterparts and other leaders supporting disaster recovery in communities recovering from recent disasters. Click HERE for additional information. REGISTER HERE for this free webinar.

Additionally, the Wisconsin Department of Health Services has created toolkits to assist providers affected by the emergency preparedness new rule. This toolkits gives facilities that fall under the new rule an overview of the requirements for their provider type, as well as some sample templates in a workbook that can be used in their planning efforts. Make sure to check out the CMS Preparedness Rule Tool Kit by the Wisconsin Department of Health.


CMS Releases Update to Skilled Nursing Facility Utilization and Payment Data

Dan Ciolek

On October 3, the Centers for Medicare and Medicaid Services (CMS) posted the calendar year (CY) 2015 Skilled Nursing Facility Public Use File (SNF PUF). The SNF PUF presents summarized information on Medicare Part A SNF prospective payment system (SNF PPS) services provided to Medicare beneficiaries. It contains information on utilization, payment (Medicare payment and Medicare standardized payment), submitted charges, and beneficiary demographic and chronic condition indicators organized by CMS Certification Number (6-digit provider identification number), Resource Utilization Group (RUG), and state of service.

The new 2015 PUF (similar to prior CY 2013 and CY 2014 SNF PUFs) has information for 15,030 skilled nursing facilities, over 2.5 million stays, and over $27 billion in Medicare payments for 2015. As in the previous version, demographic and chronic condition information is included in this release.  CMS protects beneficiaries’ personal information in all public data releases and these files do not contain information from SNFS with fewer than 11 Part A stays, or in data fields with fewer than 11 beneficiaries.



Wednesday, October 4, 2017

NCAL Report: States Make Continuous Changes to Assisted Living Regulations


Lilly Hummel

Assisted living regulations, statutes, and policies in 17 states were updated between June 2016 and June 2017, according to the National Center for Assisted Living’s (NCAL) 2017 edition of “Assisted Living State Regulatory Review.” The association released the latest edition of its annual review today. The report also found that four states—California, Oregon, Rhode Island, and Virginia—each passed new laws within the past year to enhance penalties and oversight.

“Once again, states are demonstrating their effectiveness in regulating assisted living communities,” said NCAL Executive Director Scott Tittle. “These targeted changes indicate a robust oversight system is in place, as providers continue to meet the local demands of residents and families. We all have the same goal in mind—ensuring the utmost care for our residents.”

NCAL’s Assisted Living State Regulatory Review summarizes key selected state requirements for assisted living licensure or certification. It includes information on 20 categories, including which state agency licenses assisted living as well as recent legislative and regulatory activity. Additional categories cover requirements for resident agreements, admission and discharge policies, scope of care, life safety, among others.

This year’s review found that the most common changes among the 17 states that reported updates to assisted living requirements were in the areas of civil monetary penalties and oversight requirements. Other changes were made to training requirements, administrator licensing, background checks, and medication administration.

“We anticipate that more than half of states will be proposing, formally reviewing, or considering changes that would affect assisted living communities in the coming year. Some may make significant changes, while others may make small updates,” said Lilly Hummel, NCAL’s senior policy director and the report’s author. “States are also in the process of reviewing their regulations to comply with federal requirements for assisted living communities and other home and community-based settings that are Medicaid providers.”

The full report along with each states’ summary is available online at www.ncal.org.

New Anti-Bullying Resource from NCAL

Rachel Reeves

October is National Bullying Prevention Awareness Month, and the NCAL Customer Relations Committee has developed a new resource for assisted living providers in recognition. “Bullying Among Seniors (and Not the High School Kind)” is a prevention and surveillance resource aimed towards helping providers better understand bullying behaviors among certain residents in their communities.

The resource provides an overview of bullying, including typical traits of residents who bully as well as potential victims of bullying. It then provides ideas on how to create a positive environment for residents in order to deter bullying. Lastly, the resource offers a potential process for addressing bullying when it occurs.

NCAL cautions that “Bullying Among Seniors” is not intended as legal advice and should not be used as or relied upon as legal advice. The Customer Relations Committee felt it was a critical issue that providers be more aware of and prepared for.

“While assisted living communities offer a great opportunity for seniors and individuals with disabilities to socialize with others facing similar needs, we cannot assume that everyone will get along, or that victimization won’t occur,” said Committee Chair Jeanne Jaeckels. “But that does not mean we simply accept it either.”

“Bullying Among Seniors” can be found on the NCAL website, with other resources focused on customer relations.

NCAL members are encouraged to share any anti-bullying resource or sample policies on AHCA/NCAL’s learning management system ahcancalED. Please email educate@ahca.org, and AHCA/NCAL staff will provide members with the information needed regarding the process.

AHCA Mounts Congressional Campaign Against Unfunded Mandate

Drew Thies

AHCA is urging Members of Congress to sign a letter asking the Centers for Medicare and Medicaid Services (CMS) to revise a recent unfunded mandate. The mandate, which creates various new regulations for skilled nursing facilities (SNFs), was finalized in October 2016 and large parts of it roll out in November of this year.

Two letters are circulating both chambers of Congress, one in the House led by Representative Jim Renacci of Ohio, and one in the Senate led by Senator John Hoeven of North Dakota. Both letters urge CMS to revise and delay various parts of the rule to allow providers to more easily comply with the complex and expensive regulation.

The rule is the first complete overhaul of regulations for nursing centers since 1991. By CMS’s own estimate, will cost providers between $60,000 and $50,000 annually to implement.

Quality of care has been steadily improving in nursing centers in recent years. While many of the provisions in the rule mean well, it ultimately represents a doubling-down on heavy-handed regulation that shifts resources away from the bedside and toward paper compliance.

AHCA urges all of its members who have a relationship with their Member of Congress to ask them to sign on to the letter. An online issue brief explains the regulation in more depth and outlines the estimated per-state costs. Members seeking guidance on how to comply with the rule can find resources on AHCA’s website.

Tuesday, October 3, 2017

Check Out This Valuable Tool: Interactive Map Matches State Dementia Training Mandates with CARES® Courses

Dave Kyllo

Health Care Interactive has an interactive U.S. map that shows which CARES dementia training courses fulfill existing state dementia training requirements for various care settings.  In states without specific training requirements for certain settings, HCI make recommendations on which training modules would be helpful for staff.

CARES contains six training courses that can be ordered individually or as a group.  Bulk on-site licenses are also available.  In addition, up to five essentiALZ® certifications from the Alzheimer’s Association can be earned by completing the training modules.

AHCA/NCAL recommends the CARES training program to help safely reduce the off-label use of antipsychotics and the CARES program is also supported by CMS.  All AHCA/NCAL members receive a 10% discount on the CARES programs by using the promo code AHCA10 when ordering. 

For more information, go to www.hcinteractive.com.

Gero Nurse Prep is on Sale: Tap the Expertise of Board Certified RNs to Improve Success

Dave Kyllo

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

Hospitals are keeping a close watch on their Medicare beneficiaries to ensure that they are not readmitted within 30 days of discharge, including those hospitalized Medicare beneficiaries who live in skilled nursing and assisted living settings. 

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

ANCC is the world’s largest and most prestigious nurse credentialing organization and a subsidiary of the American Nurses Association.  Less than one percent of America’s RNs are ANCC board certified in gerontological nursing. 

To help increase the number of board certified RNs, AHCA/NCAL’s Gero Nurse Prep program is designed to help RNs prepare for and pass the ANCC gerontological certification exam.  RNs who complete the AHCA/NCAL Gero Nurse Prep program have a passing rate of 96 percent on the ANCC exam and receive 30 CEUs.  They also increase their knowledge of gerontological nursing by 20 percent on pre- and post-test scores.

Watch this video to learn more about AHCA/NCAL Gero Nurse Prep or click on the course preview to get a quick view of this engaging on-line curriculum designed to help RNs pass the ANCC exam. 
Strengthen your position in the marketplace by demonstrating your ability to reduce re-hospitalizations.  Take advantage of the sale on Gero Nurse Prep and remember to enter promo code VBPRN17 at check out. 

Customizable Emergency Preparedness Program Tool Helps Providers Prove Compliance with New CMS Requirements

Dave Kyllo

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

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

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

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

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

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


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

Statement on the Events in Las Vegas

Jennifer Shimer

We know that our membership community shares our deepest concerns and sympathy with those who were injured or lost their lives in the Las Vegas shootings. Our hearts go out to the families of the victims as they grieve this horrific loss of life.

Our Annual Convention & Expo will go on as planned on October 15-18. We are in contact with the hotels and event sites and will be working with them to implement any additional needs during our event.  A safe Convention & Expo is our number one priority.  We look forward to seeing our long term and post-acute care community in Las Vegas. 

For questions please email meetings@ahca.org

Did you complete the AHCA survey yet?

Jennifer Shimer

As part of our 2017 strategic planning effort, we are asking our state affiliates, skilled and post-acute care provider members to complete a short survey to help AHCA understand your expectations and our performance in key areas. The questionnaire will close on Tuesday, October 10th, so please be sure to complete the survey as soon as possible. 

You should have received an email invitation with a link to participate on September 26th from McKinley Advisors - be sure to check your "junk" folder. If you did not receive your custom link, please email Candace Vanderpoel, Research Manager at McKinley Advisors, by emailing cvanderpoel@mckinley-advisors.com.

Two New OIG Reports Related to Nursing Homes

Lilly Hummel 

The Department of Health and Human Services Office of Inspector General (OIG) released a new data brief, finding that while states conducted nearly all the required onsite investigations for the most serious nursing home complaints within the required timeframes, a few states did not. The priority level that the State assigns to each nursing home complaint determines the State’s required action and timeframe for addressing the complaint. OIG found that each year, half of all nursing home complaints required prompt onsite investigation. Among the most serious complaints, the most common allegations related to quality of care or treatment. OIG stated that the brief offers CMS some insights into the specific states that have room to improve in prioritizing and responding to nursing home complaints. There were no recommendations, though the OIG did state that it will continue to monitor the oversight of nursing homes and will initiate additional reviews as necessary.

OIG has also released a new report finding that enhancements are needed in the tracking and collection of Medicare overpayments identified by zone program integrity contractors (ZPICs) and program safeguard contractors (PSCs). This study updates ongoing work reviewing the collection of ZPIC- and PSC-referred overpayments and identifies ongoing challenges that contractors face in tracking and collecting overpayments. Based on its study of collections in fiscal year 2014, OIG had several recommendations, including that the Centers for Medicare and Medicaid Services (CMS) identify and implement strategies to increase the identification of overpayments, as well as Medicare administrative contractors (MACs) collection of referred overpayments. To increase collections, OIG recommended that CMS should implement the surety bond requirement for home health providers and consider surety bonds for other providers based on their level of risk. CMS did not agree with this recommendation, and stated that it is evaluating how to effectively implement the surety bond requirement while avoiding undue provider burden.

November is National Family Caregivers Month

Dana Halvorson

November is National Family Caregivers Month, and Caregiver Action Network sets the theme for it each year.  The 2017 theme is “Caregiving Around the Clock”.  More background on National Family Caregivers Month can be found here.  AARP notes that about 40 million family caregivers provide about $470 billion annually in unpaid care to their loved ones.  According to the Caregiving in the U.S. 2015 study from the National Alliance for Caregiving and AARP, about 3.7 million family caregivers provide care to a child under age 18 because of a medical, behavioral, or other condition or disability, and 6.5 million family caregivers assist both adults and children.






CMS Updates on SNF VBP

On July 31, the Centers for Medicare & Medicaid Services (CMS) issued a final rule [CMS-1679-F] outlining fiscal year (FY) 2018 Medicare payment rates and quality programs for skilled nursing facilities (SNFs). In that rule, CMS finalized some key components of the SNF Value Based Purchasing (VBP) program, which impacts reimbursements starting next year.

As a reminder, starting on October 1, 2018 for FY 2019, CMS will adjust Medicare payments to providers based on how well they manage hospital readmissions based on performance in this calendar year (CY) 2017 compared to CY 2015. Some SNFs will see some sort of payment reduction, which can be as high as two percent for all of their Part A Medicare payments for an entire fiscal year. There is a potential for some SNFs who achieve low rehospitalization rates to see an increase in reimbursements, but how many and by how much will not be determined until the performance period of calendar year 2017 concludes.

AHCA’s summary of newly finalized SNF VBP program components can be found on our website here.

For more information on the SNF VBP program and to access tools and resources on ahcancalED and other sites, please visit AHCA's VBP website here.

Please contact David Gifford or Thomas Martin with any questions. 

Monday, October 2, 2017

RoP Phase 2 Preparation: AHCA Convention Intensive

Lyn Bentley

On November 28, 2017, Phase 2 of the Requirements of Participation (RoP) will be implemented.There are also new F-Tags associated with all requirements, new interpretive guidance, and a new survey process.

In preparation for November 28, join AHCA staff and your peers for the Convention Intensive, "Preparing for Requirements of Participation Phase 2 and the New Survey Processfrom 1 p.m. - 4 p.m. Pacific on Sunday, October 15 in the Mandalay Bay Ballroom D.  


You'll hear from AHCA subject matter experts about:

  1. What you can expect; 
  2. What you are doing now that has prepared you for November 28, 2017; 
  3. How AHCA plans to provide you with information, tools, and materials to help you understand and implement changes; 
  4. Utilizing a framework to navigate your way through these changes; and 
  5. Any late-breaking news from DC and CMS related to these changes.
Pre-registration is not required to attend this session, but we encourage you to arrive early so that you are able to secure a seat. More information on the Convention Intensive can be found here.

Additional resources for RoP Phase 2 can be found on the Centers for Medicare & Medicaid Services (CMS) website here and on AHCA's website here.

Music Licensing and Mood Media

Lilly Hummel

Some AHCA/NCAL members have been contacted by one or more of the three entities which hold copyrights for music, BMI, SESAC, or ASCAP. These contacts, by letter or telephone call, assert the member is violating US Copyright laws by playing music in a “public space.” They are requesting the provider apply and pay for license to play music in their communities (both assisted living and nursing centers).

Under the 1976 Copyright Act, the holder of the copyright or its assigns (BMI, SESAC or ASCAP) has the exclusive right to reproduce the work and, in the case of a sound recording, to perform the copyrighted work publicly. Perform has a broad definition and includes singing, playing music, broadcasting, playing a CD or DVD, or turning on a radio or TV.  Publicly means to perform any place where a substantial number of persons outside a normal circle of family and social acquaintances hear the music or it is open to the public.

Examples of situations where playing music may be a public performance include live performances, DJ’s, Karaoke, music in common areas, large screen or multiple TV’s, background music, resident social gathering/holiday events, aerobic/dance/fitness classes.

There are two exceptions which may apply to AHCA/NCAL members:
Areas less than 2,000 total square feet (excluding residential areas) may be excluded from having to obtain a license.
Live performances for residents in a not-for-profit community that does not create any direct or indirect commercial activity (marketing) do not need a license.  A local choir singing Christmas carols would be an example.

A determination of whether you need a license from BMI, SESAC and or ASCAP will depend on the specific circumstances in your community.  We recommend consulting an attorney before deciding to apply for a license. You can get more information by going to the web site of each of the licensing entities: www.bmi.com; www.sesac.com; www.ascap.com

In response, AHCA/NCAL has launched a new preferred product program with Mood Media.  Mood offers several music packages at exclusive AHCA/NCAL member pricing starting at $29.99 per month with a three-year agreement.  Members also have access to exclusive pricing on purchasing or leasing different musical equipment and on Mood’s scent services.

Members can use Mood’s fully licensed music services 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.

While Mood’s services do not cover music licensing for recorded music, televised music and for live musical performances, Mood does offer an alternative source of music to members that is fully licensed. For more information about Mood Media’s services, call 800-345-5000 or go to http://partner.moodmedia.com/ahcancal/ (password: moodpartner).

Secure Your Umbrella License with the Motion Picture Licensing Corporation

Lilly Hummel


AHCA/NCAL and all other leading industry associations have secured member savings on the Umbrella License®, the annual public performance license offered by Motion Picture Licensing Corporation (MPLC). The Umbrella License is the most comprehensive copyright license available for senior living and health care communities and provides annual copyright coverage for over 1,000 motion picture studios and producers. The license includes public performance rights for both major Hollywood studios and independent producers. Once licensed, an unlimited number of movies may be shown. Movies can be secured from any legal source whether rented, purchased, or borrowed via DVD, stream, or download.

If your community currently shows movies or would like to start, please be sure to secure a license to avoid copyright infringement penalties.

As AHCA/NCAL advised last year, the 2016 Agreement establishes guidelines for the licensing of motion picture exhibitions in all senior living and health care communities regardless of the level of care provided or the license status of the community. The Agreement states that:


  • All communities, regardless of their type or license status, must obtain licensure for exhibitions of Videos transmitted over a closed circuit television system or in-house channel.
  • All communities, regardless of their type or license status, must obtain licensure for exhibitions of Videos in common areas such as a theater, lounge, or community room. This includes:
    • Affordable housing facilities and units.
    • Assisted living, nursing and rehabilitation facilities and units.
    • Independent living facilities and units.
    • Adult day services centers.
  • Assisted living, nursing and rehabilitation units receive a reduced rate on the license. Minimum fees are waived for campuses that are strictly nursing, assisted living, or rehabilitation. 
  • Affordable housing units receive a reduced rate on the license. 
  • Members of AHCA/NCAL receive a 10% discount on standard Umbrella License fees.


Please contact MPLC directly at (800) 462-8855 or online at seniorliving.mplc.org for assistance with pricing or to ask any questions about the Umbrella License. 

If your senior living community operates assisted living, nursing or rehabilitation units, and held an Umbrella License prior to October 2016, if you have not done so already AHCA/NCAL strongly encourages you to provide MPLC with updated unit counts for the aforementioned units prior to your renewal date. Longstanding licensees are eligible for reduced pricing for any assisted living, nursing, or rehabilitation units/rooms added during this renewal year only. Thereafter, the license requirement remains, but units will be priced at a higher fee.

Please feel free to contact AHCA/NCAL at (202) 842-4444 with any questions about motion picture licensing requirements within our industry.