Tuesday, December 18, 2018

Mark Parkinson Named a 2018 Top Lobbyist

Abby Barreto

AHCA/NCAL President & CEO Mark Parkinson has been named a Top Lobbyist by The Hill for the sixth consecutive year. According to the publication, the 2018 list includes “the most distinguished and accomplished professionals from the influence world who are on the front lines of the nation’s most consequential political and policy battles.”

Under Mark’s leadership, the Association continues to improve the lives of millions of long term and post-acute care residents by delivering solutions for quality care. This year’s success included the permanent repeal of Medicare Part B outpatient therapy caps and authorization of VA Provider Agreements for long term and post-acute care providers – among many others.

The Hill publishes the Top Lobbyist list annually. See the full list here.

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

Lilly Hummel

The US Department of Health and Human Services, Office of Inspector General (OIG) has released its updated List of Excluded Individuals and Entities (LEIE) database file, which reflects all OIG exclusions and reinstatement actions up to, and including, those taken in November 2018. This new file replaces the updated LEIE database file available for download last month. Individuals and entities that have been reinstated to the federal health care programs are not included in this file.

The updated files are posted on OIG’s website at http://www.oig.hhs.gov/exclusions/exclusions_list.asp, and healthcare providers have an “affirmative duty” to check to ensure that excluded individuals are not working in their facilities or face significant fines.

Instructional videos explaining how to use the online database and the downloadable files are available at http://oig.hhs.gov/exclusions/download.asp.

As a best practice, long term care providers should check the LEIE on a regular basis.

Wednesday, December 12, 2018

Knowledge is a Powerful Weapon in the War on Germs

Dave Kyllo

AHCA/NCAL has a comprehensive program to help nursing facilities meet the infection prevention and antibiotic stewardship requirements being enforced by CMS. While originally designed for nursing facilities, the program is an equally effective training tool for assisted living settings.

The Infection Preventionist Specialized Training (IPCO) course provides education for any healthcare professionals who want to lead infection prevention efforts and prepares individuals to play an active role in the antibiotic stewardship efforts. Antibiotic stewardship is an overarching goal and priority among all health care professionals and is receiving a lot of attention from physicians and state and national health care regulators.       

The methods for preventing and controlling infections and managing antibiotic use are universal, so what works in the nursing facility setting will work in the assisted living setting. AHCA/ NCAL’s course is an online, self-study program with 23 hours of training. It includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term/post-acute care.

The 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. Strong and effective infection prevention programs and antibiotic stewardship efforts can set an assisted living center apart from the competition, especially when working with social workers and discharge planners who help seniors with their post-acute decisions

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/NCAL at educate@ahca.org

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

New LTC Trend Tracker 101 Course

Lonnita Myles

Interested in learning about LTC Trend Tracker? Visit ahcancalED to access the new LTC Trend Tracker 101 course to learn all about how skilled nursing facilities can utilize this tool for quality improvement, peer comparisons, and supporting metric data for Quality Award applications. Click here to access this free resource! Are you an assisted living community interested in learning more about LTC Trend Tracker? Click here to access a free course in ahcancalED that walks through all of the features available to you in this tool.

Have questions about LTC Trend Tracker? Feel free to contact our team at help@ltctrendtracker.com.

Government Shutdown Prospects Loom After Democrats Meet with President

Drew Thies

President Donald Trump clashed with Democratic Leaders Nancy Pelosi and Chuck Schumer in a rare, televised Oval Office meeting.

The meeting was set to address a government funding bill, which Trump has indicated should include $5 billion for a border wall. Government funding runs after Dec. 21.

In perhaps the most definitive terms he has used, President Trump said he would “be proud” to shut the government down if it meant getting concessions on border security.

House Republicans are considering passing a stopgap spending bill that includes the $5 billion Trump requested, but such a bill would need Democratic votes in the Senate for it to pass. On the prospect of the Senate failing to pass a spending bill, Senate Majority Leader Mitch McConnell said, “I hope that's not where we end up."

Pelosi said that if the government does shut down, the House, when it returns under Democratic leadership in January, will pass a bill that funds the government and border security at current levels.

Tuesday, December 11, 2018

Knowledge is Key to Avoiding the #1 Cited F Tag in Nursing Facility Inspections

Dave Kyllo

The most frequently cited F-Tag in standard nursing facility health inspection surveys under the new survey process is F880 – Infection Prevention & Control.  Since November 2017 when the new survey process began, more than one-third of surveys conducted across the nation have included a F880 Infection Prevention & Control citation. 

AHCA’s Infection Preventionist Specialized Training (IPCO) program is specifically designed to prepare individuals to effectively implement and manage an Infection Prevention & Control program in skilled nursing centers. It addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control which are fundamental to effectively leading and administering a center’s Infection Prevention & Control program. 

AHCA’s 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.  The AHCA program gets rave reviews with 96 percent of health care professionals who have completed the course recommending IPCO to their colleagues. 

The 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.  

While CMS has announced plans to offer a free infection prevention training course some time in Spring 2019, AHCA/NCAL recommends investing in staff training now rather than waiting to train staff on the requirements that already are in effect.  Despite the CMS training announcement, facilities will continue to be surveyed on all the new infection prevention and control requirements and the antibiotic stewardship requirements – the same requirements leading to the most commonly cited F-Tag since November 2017 under Phase I and Phase II of the CMS Requirements of Participation and the implementation of the new survey process.

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

Prepare your center and staff now for a successful survey and avoid the F880 tag. Register for IPCO!

Check Out the Employee Health Plan That Delivers Highly Valued Benefits and 24/7 Unlimited TELADOC® Services for Just $161 a Month

Dave Kyllo

AHCA/NCAL Insurance Solutions offers a minimum essential coverage health plan to members.  The new plan was developed by Compass Total Benefit Solutions and offers two affordable options for providing many of the health insurance benefits that are important to long term care employees.  The plan is designed to help AHCA/NCAL members recruit and retain frontline staff who cannot afford major medical health plan premiums or high deductibles.
 
The new plans feature affordable premiums and co-pays for valued and commonly used services, including prescriptions, physician visits and free unlimited 24/7 access to TELADOC®.  Benefits are instantaneous with no deductibles.  The Compass 1 plan costs about $1 per hour for a full-time employee or $161 per month.  The Compass 2 plan costs $182 per month.  The Compass 2 plan costs a little more because it includes higher indemnity payments for hospitalizations. Here’s the rate schedule:

  Monthly Premiums
Compass 1
Compass 2
EE
$161.29
$181.75
EE & Spouse
$264.70
$306.39
EE & Children
$244.19
$279.94
Family
$356.70
$417.20

Employers determine their level of contribution for plan expenses for coverage for employees, their spouses, their children or family coverage.  Employers can pay all the costs, share the costs with employees, or have employees pay for coverage completely as a voluntary option.  Or LTC employers can increase their employer contribution over time based on an employee’s length of service.  Both plans are flexible. In addition, employers have options such as covering all the costs for employee coverage but having the employee pay the premiums for their spouse and/or children. 

While this new AHCA/NCAL Insurance Solutions plan satisfies all 71 benefits required under the Affordable Care Act, it is not a fully compliant ACA plan.  It is considered a minimum essential coverage (MEC) plan and should be offered alongside a traditional ACA compliant plan to avoid any ACA employer penalties. 

There is no additional underwriting for the Compass plan and no mandatory wait periods for new employees to join the Compass MEC plans.  Any wait periods are determined by the employer.  There is a minimum of five employees that must be enrolled to offer the plan to employees.

The ability to offer a health insurance plan at little to no cost to employees allows AHCA/NCAL members to market their facilities as superior employers in comparison to competing employers.   This plan is much less expensive to an employer compared to a traditional employee health benefit plan and costs less than the expense of an employee who turns over.

Read this Q&A document for more information about Compass plans for AHCA/NCAL members. Versions of the Compass Plan are available in all 50 states. Changes to the Hospital Indemnity benefit vary based on state approvals. To see what's available in your state, please
contact Nick Cianci at 202-898-2841 or Dave Kyllo at 202-898-6312 or email ahcainsurancesolutions@ahca.org.

AHCA/NCAL Supports the BOLD Infrastructure for Alzheimer’s Act

Dana Halvorson

AHCA/NCAL has added its name to the list of national organizations that support the bipartisan Building Our Largest Dementia Infrastructure for Alzheimer’s Act, or BOLD Infrastructure for Alzheimer’s Act (S. 2076/H.R. 4256), which would apply a public health approach to Alzheimer’s disease.  Headed by the Centers of Disease and Prevention (CDC), it would create a modern infrastructure for the prevention, treatment, and care of Alzheimer’s and related dementias.  More than five million Americans are living with Alzheimer’s, and the United States spends more than $277 billion per year, including $186 billion in costs to Medicare and Medicaid.  Without further action, the number of Americans with Alzheimer’s is expected to triple to as many as 14 million by 2050, costing the nation more than $1.1 trillion per year.

Senators Susan Collins (R-ME), Catherine Cortez Masto (D-NV), Shelley Moore Capito (R-WV) and Tim Kaine (D-VA) introduced S.  2076, and it is co-sponsored by 56 Senators.  Reps. Brett Guthrie (R-KY), Paul Tonko (D-NY), Maxine Waters (D-CA), and Christopher Smith (R-NJ) introduced a companion bill in the House of Representatives, and it is co-sponsored by 251 members.  It is also supported by 181 organizations and individuals. The bill was approved by the Senate Health, Education, Labor and Pensions (HELP) Committee on November 29, 2018, and it now goes to the full Senate for consideration. 

2019 Independent Owner Leadership Conference Provides Unique Opportunities for Learning and Networking

This year’s conference is an essential gathering that will tackle key challenges that Independent Owners (IOs) face. Emphasis will be on new strategies and best practices for staying competitive and adapting in the evolving marketplace. At the forefront is helping you understand the Patient-Driven Payment Model (PDPM).

March 20-22
Marriott Tampa Waterside
Tampa, FL
 
 
In addition to the PDPM, other education topics include:
  • The Ever-Changing World of Assisted Living
  • Creating a Strong and Stable Workforce
  • Risk-Sharing
  • Grassroots Advocacy

LED Talks, curated by Provider magazine, will kick off the conference. These short, targeted sessions designed to lead, engage, and discover will showcase five different speakers specifically chosen for their fresh ideas and exciting perspectives.

The popular Owner-to-Owner Town Hall discussion will focus on emerging trends as well as litigation, records requests, and risk management.

The IO Leadership Conference offers you the chance to earn up to 12.75 CEs.

You can see a detailed agenda with descriptions of all the education sessions at IO.AHCANCAL.org.

The keynote speakers will also offer interesting and inspiring lessons not to be missed. Opening Keynote David DeLong, MIT AgeLab Research Fellow, is the author of Lost Knowledge: Confronting the Threat of an Aging Workforce and an expert on workforce management. His talk will help IOs to understand the importance of closing skills gaps, learn solutions for evaluating talent-related risks, identify talent problems that kill profits, and accelerate knowledge transfer in the multigenerational workplace.




The Closing Keynote is Green Beret Commander Captain Mark Nutsch who led the first 12-man Special Forces A-team on horseback as they infiltrated the mountains of Northern Afghanistan immediately following the September 11th attacks. His story of unyielding dedication to one’s country demonstrates the importance of loyalty and dependability in achieving success.







Before you close out the year, make plans to attend the 2019 IO Leadership Conference. You’ll enjoy three days of face time with your IO peers from across the country while getting your crucial questions answered.
Sponsors as of December 10, 2018:
Drive DeVilbiss Healthcare, Ecolab, Evan Senior Investments, Guardian Pharmacy Services, Kronos, MatrixCare

Long Term Care and the Law Conference February 27-March 1, 2019

Lilly Hummel

Register to attend the Long Term Care and the Law program February 27-March 1, 2019 in Phoenix, AZ. This informative program brings together some of the leading in-house and external counsel to discuss legal, compliance, and operational issues that long term care providers face. This year’s conference features many sessions useful for nursing centers and assisted living providers, such as Medicaid managed care contracting, sexual harassment, accounts receivable, HIPAA, and the Fair Housing Act—just to name a few. Provider members of AHCA/NCAL receive a discounted rate of $695 registration fee.

The morning of February 27 before the conference begins, the National Center for Assisted Living will host a FREE round table open to all assisted living in-house counsel. This is a unique opportunity for in-house counsel peers to discuss their concerns and how to manage emerging issues. Email Lilly Hummel at LHummel@ncal.org to attend. The American Health Lawyers Association (AHLA) offers CLE, CPE, NHA, and CCB credits for the conference. Don’t miss this excellent educational opportunity.

The Impact of Quality Incontinent Products on Incontinence Associated Dermatitis and Operational Costs in Skilled Nursing Facilities- Clinical Research Study

Join Michele Mongillo, RN, BSN, MSN RAC-CT, Global Clinical Leader at First Quality for a timely education session. 

January 15, 2019 at 2pm

Michele will discuss the measurements and outcomes of a third party clinical research study conducted at three skilled nursing facilities, and the impact of quality products and education on IAD rate, laundry costs and wound care. The presentation will include specific interventions that can be utilized to improve key clinical and operational outcomes in a facility’s incontinence management program. IAD is a precursor to pressure ulcer development and it is essential for nursing staff to implement steps to prevent IAD by utilizing incontinent products appropriately with essential education.

Check Out the New AHCA/NCAL Workforce Resource Center!

Lindsay Schwartz

The new AHCA/NCAL Workforce Resource Center is a one stop shop for workforce resources. Discover resources to improve your organization’s overall workforce efforts to ensure staff stability. The center includes resources to recruit and retain staff, leadership, recognize staff, comply, train staff, and data. Make sure to check out the updated toolkit to reduce turnover and the Guiding Principles of Leadership. LTC Professionals can find links for training and developing new skills including IPCO, Gero Nurse Prep, and CNA Training.

The 2019 AHCA/NCAL National Quality Award Application Deadline

Erin Prendergast

Did you know that Quality Award recipients perform consistently better than the rest of the nation in key areas of quality care? Get started with your application today for the 2019 AHCA/NCAL National Quality Award Program. The deadline to apply is quickly approaching!

All applications and payments for all three award levels must be submitted through the Quality Award Portal by January 31st at 8 p.m. EST.

All applications must be submitted by a Primary Center Contact or a Center Contact, which are the only two roles that have access to start, write and submit an application. Additionally, only center level staff can be assigned as Primary Center Contacts or Center Contacts. If these contacts have not been set up for your center, please have them log into the Quality Award Portal and request access to be connected. This must be completed prior to the deadline.

The Quality Award Program will also be hosting a first-ever Bronze Early Submission Day on January 14!  Join the Quality Award staff for a step-by-step, how-to on submitting your Bronze Quality Award application and payment, including a live Q&A. Bronze applicants who submit their application on or before January 14 will be entered into a raffle for a waived application fee. Click here to register today.

More information about the AHCA/NCAL National Quality Award Program and resources, such as the criteria series, to help streamline your application process are available at ahcancal.org/qualityaward.

We hope you will take the next step to continue your quality journey this coming year by submitting an application. If you have any questions, please feel free to contact the AHCA/NCAL Quality Award team at qualityaward@ahca.org

Learn from the AL Gold Recipients – In More Ways Than One

qualityaward@ahca.org

In 2018, AHCA/NCAL recognized four organizations with a Gold – Excellence in Quality Award, the highest of three distinct levels possible through the AHCA/NCAL National Quality Award Program. Two of those organizations, Maine Veterans Home–Machias and Sunrise of Gurnee, are the first free-standing assisted living communities to ever attain Gold in the history of the program.

They demonstrate that if an independent, rural non-profit and a more urban community belonging to one of the nation’s largest companies can achieve the Gold, any assisted living community can. Take their advice on why to set out on the Quality Award journey and how to navigate it successfully—in more ways than one.

The executive directors from both Maine Veterans Home–Machias and Sunrise of Gurnee recently shared their insights for an AHCA/NCAL webinar, “Perception vs. Reality: The Quality Award Program for Assisted Living Providers.” The webinar also breaks down the commonly cited barriers preventing assisted living communities from participating in the program and talks about the many free resources available to help assisted living providers succeed. Access the webinar on ahcancalED anytime, on-demand.

Also check out their spotlight profiles, tribute videos, and blog posts for a synopsis of their journeys.

Maine Veterans Home—Machias
Sunrise of Gurnee

Ready to take the plunge? Quality Award applications at all levels (Bronze, Silver and Gold) are due January 31, 2019 by 8:00 PM Eastern. Find resources, applications and how to apply on our website.

The Membership Advantage in the AHCA Quality Initiative

Kiran Sreenivas

The AHCA Quality Initiative is able to use publicly reported measures to compare the success of members to non-members. As opposed to self-reported measures, publicly reported measures reduce the possibility of bias when gauging results and allow us to measure progress on a larger population than we could otherwise.

With that said, 62 percent of skilled nursing centers in the nation are AHCA members. Looking at the comparison of members and non-members that meet the AHCA Quality Initiative goals for hospitalization and off-label antipsychotics, a higher proportion of members meet the goals compared to non-members. (See Figures below)

Currently, the AHCA Quality Initiative uses public measures from Nursing Home Compare and AHCA’s Research Department for the hospitalization and antipsychotic goals, and AHCA is working on releasing nationwide public measures for functional outcomes in the near future.

AHCA is committed to helping members improve lives by delivering solutions for quality care. Expect this to continue in 2019 through additional ahcancalED courses, enhancements to LTC Trend Tracker, and dynamic meetings, like the upcoming Quality Summit on March 18-20, 2019 in Tampa, FL.




































Source: Nursing Home Compare and LTC Trend Tracker

Wednesday, December 5, 2018

CMS Posts Annual Update to Part B Therapy Modifier and Targeted Review Dollar Thresholds

Dan Ciolek

CMS recently posted a MLN Matters article describing the annual per-beneficiary incurred expense amounts now known as the KX modifier thresholds, and related Medicare Part B therapy policy updates for CY 2019. These amounts were previously associated with the financial limitation amounts that were more commonly referred to as “therapy caps” before the application of the therapy limits/caps was repealed when the Bipartisan Budget Act of 2018 (BBA of 2018) was signed into law. Another provision of the BBA of 2018 lowered the threshold of the targeted medical review process as listed below.

For CY 2019:
  • The KX modifier threshold amount for physical therapy (PT) and speech-language pathology (SLP) services combined is $2,040. For occupational therapy (OT) services, the CY 2019 threshold amount is $2,040. 
  • The Targeted Medical Review (MR) threshold amount is $3,000 for PT and SLP services combined and $3,000 for OT services.

Make sure that your billing staffs are aware of these updates

Congress Proposes Plan to Fund Government for Two More Weeks

Drew Thies

House leaders released a bill Monday morning that will extend government funding through December 21st, giving lawmakers just days before the Christmas holiday to reach a long-term deal.

Senate Majority Leader Mitch McConnell said the Senate will take up the extension if the House passes it. House Democrats initially wanted a one week deal but accepted the two week proposal.

A key sticking point in negotiations on a broader deal is President Trump’s desire for $5 billion in funding for a wall on the southern border. Senate Democratic leadership offered some concession on wall funding, but not the full amount the President wants.

The short-term deal also comes after the death of President George H. W. Bush, which stalled negotiations this week while the President lies in state at the Capitol.

Democratic House Leader Nancy Pelosi and Senate Minority Leader Chuck Schumer were scheduled to meet with the President privately on Tuesday, but the death of President Bush delayed the meeting until December 11. Negotiations are said to be on hold until Trump meets with Democratic leadership.

Advance Your Long Term Care Career with ACHCA Administrator Credentialing

Dave Kyllo

Administrators are key leaders on long term care teams and are entrusted with the responsibility of caring for residents and patients.  They touch the lives of residents and families, and most importantly, ensure that their staff provides the highest level of quality care to a vulnerable population.

AHCA/NCAL partners with the American College of Health Care Administrators (ACHCA) for its administrator certification programs.  The goals of the partnership are to increase awareness of advanced certification and professional growth opportunities and to encourage independent professional certification for nursing facility and assisted living administrators/directors. 

ACHCA has established eligibility criteria prior to taking the exam, including two years of licensure (other options exist for assisted living administrators in states without administrator licensure) and continuing education requirements.  Both must be established before an individual is authorized to sit for the credentialing exam. While ACHCA membership has many benefits for administrators/directors, ACHCA membership is not a requirement for ACHCA certification.

The application fee for either the nursing facility or assisted living certification exam is $150.   AHCA/NCAL members should use AHCA/NCAL members should use code AHCANCAL when they complete their initial ACHCA applications. The single credential fee (the fee paid after an individual passes the exam) is only $300 for AHCA/NCAL members, a $50 discount off the regular non-ACHCA member price when AHCA/NCAL members use promo code AHCANCAL at checkout. 

Credentialing through ACHCA lasts five years.  Recertification involves obtaining 150 hours of continuing education in five areas during the five-year certification period and paying a recertification fee.

ACHCA certification can provide State licensure reciprocity with certain states.  Licensing rules and requirements vary by state. Check with your state licensing board for your state’s reciprocity requirements. A list of state licensure boards and contact information is maintained on the NAB website at www.nabweb.org.

For more information about ACHCA certification, go to www.achca.org/certification or call 800-561-3148. 

It’s Winter Graduation Season and the Long Term Care Career Center is a Great Place for Jobs!

Dave Kyllo

Winter graduation season is here.  The AHCA/NCAL Long Term Care Career Center, is a great resource for nursing students and high school and college graduates who are interested in careers in long term care or health care. Our Center contains a Career Learning Center that includes professional resources for creating powerful resumes and acing job interviews. 

The LTC Career Center is always free for all job seekers and has some of the top long term care jobs in the country.  Serious job seekers and top health care employers rely on this site to connect. 

Creating an account and posting a resume is quick, free and easy!  Give the graduates you know a graduation gift that will be remembered – their first job leads.  Tell them about www.LTCCareerCenter.com and the free Career Learning Center job seeker resources today and help them launch their health care careers.      

Learn How to Avoid the SNF VBP Payment Penalties with AHCA’s Online Training

Dave Kyllo

AHCA has a new education program designed to help skilled nursing facilities succeed under the CMS value based purchasing payment program (SNF VBP) that took effect on October 1, 2018.  The course (Understanding SNF VBP in Detail) contains six modules that provide an in-depth description of each feature of the CMS SNF VBP program along with helpful tools, documents, and primary source references to the program. 

This training program is intended for nursing home administrators, directors of nursing and any other staff including corporate staff who are responsible for payment models and rehospitalization reduction efforts.   No specific license is required take the course and no contact hours or CEUs are awarded for completing the curriculum.
The training program is specifically designed to help long term care professionals:
  • Understand how CMS calculates the measures, risk adjustment, the facility score and payment adjustment.
  • Use and access the CMS SNF VBP feedback reports and the SNF Performance Score Report.
  • Apply the incentive payment multiplier.
  • Use the SNF VBP prediction calculator to estimate the financial impact different SNFRM rates have on your Part A revenue.
  • Adopt best practices to help either avoid a payment penalty or receive an increase in your Medicare Part A payments.
Possessing a detailed understanding of SNF VBP is critical to operational success.  Starting October 1, 2018, all SNFs will receive a payment adjustment to their SNF Medicare Part A claims ranging from a 2 percent cut to potentially a 1.5 percent increase based on rehospitalization rates in prior years. CMS will recalculate the payment adjustment annually every fiscal year (FY) thereafter for the next ten years.

The registration fee for AHCA’s SNF VBP online course is $25 for AHCA/NCAL members and $65 for nonmembers.

The individual who wants to take the SNF VBP course must login to ahcancalED and register for the course under their individual login.  To access ahcancalED, members will need to login with their AHCA/NCAL usernames and passwords.  For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail educate@ahca.org with your name and facility contact information. 

Payment is made in ahcancalED upon registration via credit card or check. If paying by check, an order is not complete until the check is received and approved by AHCA staff. You will not have access to the training until approval.  Registrations for SNF VBP cannot be done by another person or under another person’s ahcancalED login.
Know how to succeed under SNF VBP.  Follow this link to register today for Understanding SNF VBP in Detail or go to https://educate.ahcancal.org/p/snfvbp

Bronze Early Submission Day January 14

Save the date for the first-ever Bronze Early Submission Day on January 14!  Join the Quality Award staff for a step-by-step, how-to on submitting your Bronze Quality Award application and payment, including live Q & A. Applicants who submit their application on January 14 will be entered into a raffle for a waived application fee.

Click here to register today.

If you have any questions, please feel free to contact the AHCA/NCAL Quality Award team at qualityaward@ahca.org

Independent Owner Leadership Conference Offers Critical Education Sessions

It’s time to register for the 2019 Independent Owner Leadership Conference. 

Taking place in sunny Tampa, FL March 20-22, the conference has tremendous networking and educational opportunities you can’t get anywhere else.

“Learning different views on how others are handling the challenges we deal with is true value.”
— J. Mark Traylor, President, Traylor-Porter Healthcare

The popular Owner-to-Owner Town Hall discussion will focus on emerging trends as well as litigation, records requests, and risk management.

You can earn up to 12.75 CEs.

Learn fresh ideas and perspectives when you attend education sessions such as:
  • Patient-Driven Payment Model (PDPM)
  • Navigate the Ever-Changing World of Assisted Living
  • The Building Blocks to Creating a Strong and Stable Workforce
  • Risk-Sharing: A Path to IO Success
  • Grassroots Advocacy for Independent Owners

Get more details on all the education sessions, social events, speakers, and more at IO.ahcancal.org.

Register today.

Sponsors as of December 3, 2018:
Drive DeVilbiss Healthcare, Ecolab, Evan Senior Investments, Guardian Pharmacy Services, Kronos, MatrixCare

Disrupt to Lead. Innovate to Succeed.

2019 Quality Summit Takes Exciting Approach to Inspire Fresh Ideas


What does it take to disrupt the status quo? How can you best move forward with new ideas in patient-centered care and operational excellence?

Find out at this year’s Quality Summit.

March 18-20, 2019
Marriott Tampa Waterside
Tampa, FL
 
It’s packed with sessions and speakers who will challenge you to think in new ways.  Sessions focus on:
  • Providing stronger patient-centered care
  • Using quality improvement methodology to begin or advance change
  • Disruption and innovation to tackle workforce challenges
  • How PDPM will create innovation in patient care

Keynote Speaker Chris Field
Inspirational speaker and author of Disrupting for Good: Using Passion and Persistence to Create Lasting Change, Chris Field will weave his own story with those of other ordinary people who became extraordinary disruptors. His clear call to action is sure to motivate you — anybody, anywhere, can choose to disrupt for good. Field will also walk attendees through his personal Disruption MAP so that everyone leaves prepared and inspired to disrupt for good.

Join us for three-days of value-packed education, networking, and fun!

Get more information and register at QS.AHCANCAL.ORG.

The Independent Owner Leadership Conference immediately follows the Quality Summit. Save $50 when you register for both.

Host sponsors: MatrixCare, Medline
Contributing Sponsors: Kronos, nrc Health

Updates to the OMHA Case Processing Manual

Lilly Hummel

The Office of Medicare Hearings and Appeals (OMHA) has published two revised chapters of the OMHA Case Processing Manual (OCPM). The revised chapters are Chapter 17: Dismissals and Chapter 18: Requests for Information and Remands. The changes went into effect November 30, 2018. The manual standardizes the day-to-day procedures for carrying out adjudicative functions, in accordance with applicable statutes, regulations, and OMHA directives, and gives OMHA staff direction for processing appeals at the OMHA level of adjudication. As part of an ongoing effort to make the manual more user friendly and reflect recent regulatory changes, OMHA is in the process of drafting new OCPM chapters and revising existing chapters under a new format.

Thursday, November 29, 2018

CMS launches Civil Money Penalty Reinvestment Program

Urvi Patel

The Centers for Medicare & Medicaid Services (CMS) launched the Civil Money Penalty Reinvestment Program (CMPRP) as a three year effort to help providers reduce adverse events, improve staffing quality, and improve dementia care. Under this program, CMS provides a variety of resources to providers on the aforementioned topics, and last week announced the availability of the first of three toolkits – Nursing Home Staff Competency Assessment. This toolkit contains competency assessments for Certified Nursing Assistants (CNA)/Certified Medication Technicians (CMT), Licensed Practical/Vocational Nurses (LVN/LPN) and Registered Nurses (RN), and assistant directors of nursing (ADON), directors of nursing (DON) and administrators. Each competency assessment incorporates in questions on behavioral, technical and resident based competencies.

The second toolkit, Nursing Home Employee Satisfaction Survey, and third toolkit, Guide to Improving Nursing Home Employee Satisfaction will be available on the CMPRP website by next summer.

Questions on CMPRP can be directed to CMP-info@cms.hhs.gov.

Wednesday, November 28, 2018

AHCA/NCAL and AALNA Caring Together Quarterly Webinar

Lindsay Schwartz

Please join AHCA/NCAL and AALNA for the last Caring Together webinar of 2018, Assisted Living Nurse Competencies – What are they, how are they used”. Have you ever had difficulty explaining what exactly assisted living nurses do? This webinar will describe the assisted living nurses’ scope of practice and identify the competencies that make up their practice. Information will be shared about the structure and process used to develop the competencies, practical aspects of how to use them to support personal growth and application of the competencies to help with nurse recruitment and retention. Review of competencies and opportunities to provide feedback on this work also will be presented. The webinar will be held on Tuesday, December 11th from 3:00pm – 4:00pm Eastern. Attendees must register prior to the webinar.

Resources to Meet ROP Compliance and Ethics Program Requirement

Lilly Hummel

Nursing center providers are encouraged to start creating or updating their Compliance and Ethics Program that is required for Phase 3 of the Requirements of Participation (ROP). AHCA has published a members-only toolkit to help meet the requirement. It's free for provider members after logging in to ahcancalED. An effective Compliance and Ethics Program takes time to implement because of the need to create policies and procedures, ensure proper staffing and training, and have monitoring and auditing systems in place.

AHCA also updated the AHCA compliance webpage to summarize key resources nursing centers can access to help create or update their program. Members will be notified when there are interpretive guidelines or other new information to support the creation of an effective Compliance and Ethics Program.

AHCA/NCAL Announces Quality Summit Keynote: Register Today!

Jon-Patrick Ewing

The AHCA/NCAL Quality Summit is scheduled for March 18-20 in Tampa, Florida. This year’s keynote speaker is Chris Field. Field is the author of Disrupting for Good: Using Passion and Persistence to Create Lasting Change. Check out Field’s unique story online and get inspired for what’s to come at this year’s Quality Summit. The Quality Summit is an excellent networking forum. This is the perfect time to share your successes and your challenges with like-minded colleagues from across the country. Three days of timely education sessions will give you the knowledge to excel in your quality journey. Plus, earn valuable CEs to start the year.

Don’t miss these important dates. The registration deadline is March 5, 2019.  To take advantage of our discounted housing block you must make your hotel reservation before the February 25th deadline. You must be registered for the summit before a housing reservation can be made. You may do both when registering online.

Become a Quality Award Examiner: Applications Due Tomorrow

Meghan Karstetter

Time is running out to apply to serve as a Quality Award Examiner for the 2019 program by completing the Examiner Application form, available on our brand-new Quality Award Portal. The portal can be accessed via our website.

Serving as an Examiner is an incredible opportunity for professionals currently applying for a Quality Award and interested in continuous quality improvement. Examiners review Quality Award applications and are offered the following benefits:
  • Education in Baldrige criteria from content experts
  • Positively impacting long term care performance nationally
  • Earning Continuing Education Units (CEUs)
  • Networking in the long-term care profession 
  • Opportunities for professional development
  • Discounted attendance to the AHCA/NCAL Convention or Quality Summit

Sunrise Senior Living National Director of Performance Excellence, Alana Wolfe, explained why she continues to serve as a Quality Award Examiner:

“Serving as an Examiner in the AHCA/NCAL Quality Award Program has been of immeasurable benefit to me, both personally and professionally. Not only have I been able to develop a more marketable skillset, but it has created a knowledge base, a peer network, and a best practice resource that has been of great value to me as an individual and to what I am able to contribute to my own organization. I encourage everyone to consider becoming an Examiner for the AHCA/NCAL Quality Award Program!”

The deadline to apply is this Thursday, November 29, 2018. For more information on the Examiner role, and timeline, visit the 2019 National Quality Award Examiner website: https://www.ahcancal.org/quality_improvement/quality_award/Pages/Examiners.aspx.

Please do not hesitate to reach out to us at qualityaward@ahca.org with questions.

Members of Congress Elect Leadership

Drew Thies

Both Chambers of Congress are holding leadership elections that will determine who decides the priorities for the next two years of legislative activity.

Senate leadership is already largely set, as both Senate Majority Leader Mitch McConnell (R-Ky.) and Senate Minority Leader Charles E. Schumer (D-N.Y.) won the votes earlier this month to keep their posts next year.

Leadership elections for the new Democratic majority in the House will happen later this week. The Democratic party will vote to nominate a speaker candidate for the January 3 floor vote and to elect its other leaders for the 116th Congress.

The races for the top three posts are uncontested, making it likely that Nancy Pelosi (D-Ca.) will be nominated for speaker, Steny Hoyer (D-Md.) will be elected majority leader, and James Clyburn (D-S.C.) will be elected majority whip.

House Republicans picked Rep. Kevin McCarthy (R-Calif.) as their leader. He will take over as head of the party following Speaker Paul Ryan’s (R-Wis.) when Republicans become the minority next year. McCarthy fended off a conservative challenge from Rep. Jim Jordan (R-Ohio).

Filling out the rest of Republican House leadership is Steve Scalise (R-La.), who will return as party whip and Liz Cheney (R-Wyo.) will serve in the number three spot, House Republican conference chair. Coincidentally, Cheney’s father, former-Vice President Dick Cheney, served in the same role from 1987 to 1989 when he was a member of the House.

Planning and Response for Active Shooter Incidents

Dana Halvorson and Erin Prendergast

According to a November 27, 2018, McKnight's article entitled, "Feds encourage healthcare facilities to brush up on active shooter training following deadly incident," the Office of the Assistant Secretary for Preparedness and Response is encouraging all providers to review its planning and response guide for active shooter incidents and other resources issued by the agency.  This comes post the deadly shooting at the Mercy Hospital and Medical Center in Chicago last week.  The full McKnight's article can be found here.  More emergency preparedness resources can also be found on AHCA’s website.     

Tuesday, November 27, 2018

Special November Discount on CARES Online Dementia Training Programs Ends November 30

Dave Kyllo

Only two days remain on a November sale where AHCA/NCAL members can purchase any version of CARES Dementia Basics & Dementia-Related Behavior online training program and receive 15% off with promo code AHCA15. 

Healthcare Interactive® CARES online training is recommended by AHCA/NCAL to help reduce the off-label use of antipsychotics.  The training specifically teaches staff members about the important topics of:
  • Person-centered care
  • Facts about dementia
  • Description of dementia-related behavior
More importantly, it teaches staff members what they are supposed to do when caring for someone with a behavioral issue. 

CARES training is different because it includes direct video “before and after” training on an easy-to-use, easy-to-apply approach to dementia care called the CARES® Approach®. The CARES Approach can be used in any situation, with any person with dementia, at any stage of the disease.  The training topics include:
  • What is the CARES Approach?
  • Using the CARES® Approach with Dementia-Related Behavior
  • Breaking down the CARES® Approach for Dementia-Related Behavior
  • Key Responses to Dementia-Related Behavior
All modules include extensive video interviews and vignettes of experts in dementia care, actual dementia caregivers and family members, and, most importantly, real footage of people living with dementia (not actors). Staff members will learn person-centered techniques to address issues, which often leads to behavior such as biting, kicking, punching, screaming, public urination and sexual behaviors.

CARES programs are easy to use, can be used from any computer, tablet, or mobile device and can be started and stopped as often as users wish. To experience the CARES online training difference, test drive the first module at no cost

Take advantage of this sale on CARES Dementia Basics & Dementia-Related Behavior online training programs.  Don’t forget to use promo code AHCA15 to receive 15% off your order.    Feel free to call HealthCare Interactive at (952) 928-7722 with any questions.  

Lower The Odds of Getting the #1 Cited F Tag with AHCA/NCAL’s Highly Rated Infection Prevention and Control Training

Dave Kyllo

The most frequently cited F-Tag in standard nursing facility health inspection surveys under the new survey process is F880 – Infection Prevention & Control.  Since November 2017 when the new survey process began, more than one-third of surveys conducted across the nation have included a F880 Infection Prevention & Control citation. 

AHCA’s Infection Preventionist Specialized Training (IPCO) program is specially designed to prepare individuals to effectively implement and manage an Infection Prevention & Control program in skilled nursing centers. It addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control which are fundamental to effectively leading and administering a center’s Infection Prevention & Control program. 

AHCA’s 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.  The AHCA program gets rave reviews with 96 percent of health care professionals who have completed the course recommending IPCO to their colleagues. 

The 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.  

While CMS has announced plans to offer a free infection prevention training course some time in Spring 2019, AHCA/NCAL recommends investing in staff training now rather than waiting at least another year to train staff on the requirements that already are in effect.  Despite the recent CMS training announcement, facilities will continue to be surveyed on all the new infection prevention and control requirements and the antibiotic stewardship requirements – the same requirements leading to the most commonly cited F-Tag since November 2017 under Phase I and Phase II of the CMS Requirements of Participation and the implementation of the new survey process.

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

Avoid the F880 tag.   Prepare your center and staff now for success in infection prevention and control under the new survey process: Register for IPCO!

Loss Protection from Cyber Criminals is Key to Avoiding Devastating Financial Consequences

Dave Kyllo

Headlines about data breaches and cyber extortion are commonplace.  Those same cyber threats are real for long term care communities of all sizes.  Protecting your long term care community against these threats is essential. 

Before purchasing cyber liability insurance, it’s important to understand critical cyber risks facing businesses today and what risks long term care providers should insure against.  Below are examples of key components of a comprehensive cyber liability insurance policy: 
  • Security & Privacy Liability – A cyber thief hacks your facility’s computer system and steals the personal data of past and current residents/patients.  Your facility gets sued for $1 million on behalf of several resident families for the negligent unauthorized release of personal information.   
  • Breach Event Costs – The cost of notifying all the victims of the data breach and their families can be staggering as can the public relations expense of explaining what went wrong.
  • Regulatory Fines and Proceeding Coverage – Regulators will likely be interested in the cause of your data breach and whether your response followed state and federal laws.   Coverage includes paying for your legal counsel, hearing expenses and any fines where insurable under the law. 
  • Multimedia Liability – This includes protection should your facility’s logo be similar to another company’s logo or should your website contain content that is copyrighted or trade-marked by others. 
  • Network Asset Protection – Hackers may destroy software and the information/data stored in your computers.  This coverage pays for the expenses to replace or restore software and data.
  • Business Interruption Income Loss – Facility revenue may be impacted through a tainted reputation following a data breach.  Insuring against this risk pays for the reduction in profit and extra costs such as renting a replacement computer system.
  • Cyber Extortion – Possibly one of the most talked about cyber security risks is “ransomware” – a computer virus that freezes your computer system until the demanded ransom is paid.  The insurance pays for expert advice on how to retrieve your system, negotiate with the hackers and pay any ransom if necessary.
HealthCap is the AHCA/NCAL endorsed carrier for liability insurance and cyber liability coverage.  The company’s sole focus is serving the needs of long term care providers, including assisted living.  HealthCap® carrier partners offer cyber liability insurance and it is not necessary for a long term care provider to have General or Professional liability insurance through HealthCap to purchase cyber liability insurance through HealthCap’s carrier partners.

For more information about HealthCap’s comprehensive suite of data security and privacy insurance solutions and to find a local agent, contact Stephanie Hale at Stephanie.Hale@chelsearhone.com
 

Sale Ends Friday on the Tool That Better Prepares RNs for PDPM Challenges

Dave Kyllo

The new CMS patient driven payment model (PDPM) takes effect October 1, 2019 for skilled nursing facilities and will dramatically change how Medicare Part A payments are determined.  That change moves away from the current system that focuses heavily on therapy minutes to a system that will focus on a wide range of clinical characteristics.  This transformation in payment methodology will make having competent, proactive RNs and other clinical staff even more vital to a SNF’s financial success. 

How do you bring your RNs up to this level of competency?  AHCA/NCAL Gero Nurse Prep can help.  This on-line education program does much more than just prepare RNs to take the American Nurses Credentialing Center (ANCC) board certification exam in gerontological nursing. It increases RNs’ knowledge of gerontological nursing practice.  Gero Nurse Prep students see a dramatic 24 percent average increase between their pre- and post-course test scores.  That’s a remarkable improvement considering that many Gero Nurse Prep students are RNs who have several years of long term care experience. 

Taking the AHCA/NCAL Gero Nurse Prep course does not obligate a RN to sit for the ANCC Board certification exam.  Registered nurses who are interested in increasing their knowledge of gerontological nursing practice can simply complete the AHCA/NCAL Gero Nurse Prep course, receive 30 nursing contact hours, and increase their skills and knowledge of geriatric nursing.  While there are requirements for RNs taking the ANCC exam, any RN who wants to strengthen his/her geriatric nursing skill set may take the Gero Nurse Prep course.  

For those RNs who want ANCC Board certification, AHCA/NCAL Gero Nurse Prep also thoroughly prepares interested RNs to take the 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. 

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. 

The sale on Gero Nurse Prep ends Friday.  Save $100 off the regular registration fee now through November 30 by using promo code REALRN18 (all caps).  AHCA/NCAL Gero Nurse Prep provides tremendous value at this AHCA/NCAL member $590 sale price.   That’s less than $20 per contact hour for outstanding nursing education that makes a measurable difference on so many fronts.  Nurses have up to one year to complete the course.  For RNs interested in pursuing Board certification through ANCC, there is an additional and separate cost of $395. 

Watch this video to learn more about AHCA/NCAL Gero Nurse Prep and take advantage of the sale by Friday. 

Independent Owner Leadership Conference Features Exciting Keynote Speakers

Find Inspiration and Earn CEs
 
Plan to attend this year’s IO Leadership Conference in Tampa, FL. It's a one-of-a-kind gathering that will leave you full of fresh perspectives and insights to help you make an immediate and long-lasting impact back home at your centers.

You'll also have numerous opportunities to network, share ideas, and learn. Education sessions focus on your critical needs and questions.

Earn up to 12.75 CEs.


Opening Keynote
David DeLong, MIT AgeLab Research Fellow, is the author of Lost Knowledge: Confronting the Threat of an Aging Workforce and an expert on workforce management. His talk will help you understand the importance of closing skills gaps, learn solutions for evaluating talent-related risks, identify talent problems that kill profits, and accelerate knowledge transfer in the multigenerational workplace.





Closing Keynote
Green Beret Commander Captain Mark Nutsch led the first 12-man Special Forces A-team on horseback as they infiltrated the mountains of Northern Afghanistan immediately following the September 11th attacks. His team’s courageous and relentless spirit served as a catalyst in overthrowing the Taliban Regime. His story of unyielding dedication to one’s country demonstrates the importance of loyalty and dependability in achieving success.

 
 
Get all the details and register today!
 

Wednesday, November 21, 2018

Business Acumen Webinar 11/28: Improve Quality, Improve Relationships

Lindsay Schwartz

Join the HCBS Business Acumen Center, Wednesday, November 28, 12:30 – 1:30 PM Eastern as Debra Scheidt, Executive Director of United Disabilities Services (UDS) describes how they incorporated the use of clinical tools and language to improve outcomes for their clients and relationships with payers and providers of health services.

Learning objectives:
  • Understand how a specific quality management program can improve outcomes for individuals; 
  • Understand how to incorporate clinical tools, resources and language in your community-based organization; and 
  • Understand how to use this program and tools in your relationships with payers of health care services. 
This one hour webinar is available as part of the Business Acumen for Disabilities Grant provided by the Administration for Community Living to the National Association of States United for Aging and Disabilities in collaboration with national partners. The HCBS Business Acumen Center is dedicated to providing resources to sustain disability organizations.

*** 

Learn more about the HCBS Business Acumen Center. This effort is led by NASUAD in partnership with national organizations and funded through a grant from the Administration for Community Living.

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.

Tuesday, November 20, 2018

Calling for Presentations

Teresa Eyet

The AHCA/NCAL 70th Convention & Expo is set for Oct. 13-16, 2019, in Orlando, Fla. AHCA/NCAL is already seeking presentation proposals for that program. Now is your chance to share ideas that reflect your success stories and professional insights, as well as information and programs that enhance the long term and post-acute care service delivery. Program organizers are particularly interested in proposals that reflect and help support providers in achieving AHCA/NCAL Quality Initiative goals. Visit
www.ahcancal.org/quality_improvement/qualityinitiative/Pages/default.aspx for Quality Initiative goals.

Submit your proposal here by the Nov. 30 deadline.

Guidance on Fires from Past, Help for Future

Back in 2008, a post on AHCA/NCAL’s Disaster Planning blog talked about California wildfires, and the article could have been written this month. The column said, “The threat of a wildfire is a reality for facilities. Smoke can cause very low air quality, which is dangerous for elderly individuals.” The piece went on to offer some suggestions to keep residents and staff alike safe during such a disaster:
  • Avoid outdoor activities, especially for those with respiratory problems.
  • Keep windows and doors closed as much as possible, and use the recycle or recirculate mode on your facility air conditioner.
  • Avoid the use of non-HEPA paper face mask filters, which are not capable of filtering extra-fine particles.
  • If you must evacuate, ensure that your residents drink lots of water and breathe through a warm, wet washcloth if needed.
Members can access the Disaster Planning blog at https://www.ahcancal.org/facility_operations/disaster_planning/blog.

For those who want to help those in the long term care community affected by the recent California fires, fundraising campaigns have been established to help victims. The California Association of Health Facilities has posted links to these at www.cahf.org/Resources/Help-the-Long-Term-Care-Fire-Victims.

Monday, November 19, 2018

Consider This Affordable Insurance Solution for Frontline Staff

Dave Kyllo

AHCA/NCAL Insurance Solutions now offers a minimum essential coverage health plan to members.  The new plan was developed by Compass Total Benefit Solutions and offers two new affordable options for providing many of the health insurance benefits that are important to long term care employees.  The plan was built to help AHCA/NCAL members recruit and retain frontline staff who cannot afford major medical health plans. 

The new plans feature affordable premiums and co-pays for valued and commonly used services, including prescriptions, physician visits and free unlimited 24/7 access to TELADOC.  The Compass 1 plan costs about $1 per hour for a full-time employee or $161 per month.  The Compass 2 plan costs $182 per month.  The Compass 2 plan costs a little more because it includes higher indemnity payments for hospitalizations. Here’s the rate schedule:

  Monthly Premiums
Compass 1
Compass 2
EE
$161.29
$181.75
EE & Spouse
$264.70
$306.39
EE & Children
$244.19
$279.94
Family
$356.70
$417.20

The plan was designed with long term care staff members in mind to help those employees who cannot afford Affordable Care Act (ACA) compliant plan premiums or the high deductibles associated with many ACA plans.  Even though traditional ACA compliant plans are classified as “affordable,” they are not an option that many long term care employees can afford.  

Employers decide the level of contribution for plan expenses for coverage for employees, their spouses, their children or family coverage.  Employers can pay all the costs, share the costs with employees, or have employees pay for coverage completely as a voluntary option.  Or LTC employers can increase their employer contribution over time based on an employee’s length of service.  Both plans are flexible. In addition, employers have options such as covering all the costs for employee coverage but having the employee pay the premiums for their spouse and/or children. 

While this new AHCA/NCAL Insurance Solutions plan satisfies all 71 benefits required under the Affordable Care Act, it is not a fully compliant ACA plan.  It is considered a minimum essential coverage (MEC) plan and should be offered alongside a traditional ACA compliant plan to avoid any ACA employer penalties. 

There is no additional underwriting for the Compass plan and no mandatory wait periods for new employees to join the Compass MEC plans.  Any wait periods are determined by the employer.  There is a minimum of five employees that must be enrolled to offer the plan to employees.

The ability to offer a health insurance plan at little to no cost to employees allows AHCA/NCAL members to market their facilities as superior employers in comparison to competing employers.   This plan is much less expensive to an employer compared to a traditional employee health benefit plan and costs less than the expense of an employee who turns over.

Read this Q&A document for more information about Compass plans for AHCA/NCAL members. Versions of the Compass Plan are available in all 50 states. Changes to the Hospital Indemnity benefit vary based on state approvals. To see what's available in your state, please
contact Nick Cianci at 202-898-2841 or Dave Kyllo at 202-898-6312 or email ahcainsurancesolutions@ahca.org.