Wednesday, August 15, 2018

Can a Comedy Class Improve Your Dementia Care?

Rachel Reeves

"Yes and..." Two essential words in improv. Two life-changing words for a resident living with dementia.

NCAL Day at the AHCA/NCAL Convention & Expo offers an interactive workshop, “IMPROV and Dementia: Learning to Say 'Yes and' When Interacting with Residents with Dementia​.” Join us Sunday, October 7 at the San Diego Convention Center for this fun, eye-opening experience.

Improvisation, or improv, is a form of live theater in which the plot, characters, and dialogue of a game, scene, or story are made up in the moment. The lessons from improv can be applied to dementia care, as staff should get into the residents’ world rather than try to force the residents into theirs.

This train-the-trainer program will give you vital tools to teach caregivers how to use improv theater skills in their interactions with residents with dementia. Learn how to use “yes and” as a positive way to respond to residents and how to be in the moment with them.


Presenter: Laura Nolan
Specialist for Wisconsin CBRF Training Registry, University of Wisconsin - Green Bay

Laura has 23 years of experience in long term care, including as an assisted living provider and developing assisted living curriculum. She is an active member of the Purple Angel Dementia Friendly Communities for Green Bay, Wisconsin, which trains businesses on how to be dementia-friendly. 

Give your residents with dementia one of the greatest gifts - a sense of purpose and acceptance.

Improv is the language staff can use to accomplish this.

Learn more about what NCAL Day at Convention has to offer.

NCAL Day is a separate ticketed event and must be purchased in addition to any convention registration package. 

The AL Cost Calculator is Here


Today NCAL revealed a new member benefit for assisted living providers, the AL Cost Calculator. Powered by Prime Care Technologies, the AL Cost Calculator is web-based, enhanced resident assessment tool that allows assisted living providers to assess how costs are allocated across residents.

“With resident acuity on the rise and workforce availability shrinking, assisted living providers face increasing pressures to efficiently and effectively meet consumer demands,” said Chris Mason, CEO of Senior Housing Managers and NCAL Immediate Past Chair. “The AL Cost Calculator will allow assisted living providers to better understand the full needs of their residents, so they can put the right staff with the right skills in the right place at the right time.”

The AL Cost Calculator allows an assisted living community to assess costs by completing an assessment with 25 possible health and service categories for each resident. Users then enter in wages for licensed and unlicensed staff, and then the AL Cost Calculator computes the average monthly costs for each resident and the overall monthly costs for the community. Other anticipated monthly costs, such as taxes and benefits, may also be factored in to total costs.

Other features include:
  • Multi-facility companies can compare costs per community over time
  • Attractive, customizable graphs of cost data across the organization
  • Download, print or export graphs and data in multiple formats
  • Easily update resident assessments or care costs at any time 
Why use the AL Cost Calculator? 
  • ​Assisted living communities may already fill out resident assessment forms, but the AL Cost Calculator puts dollars behind that information.
  • Better understand where your resources are going across your organization, over time.
  • Drill down costs per resident, or compare costs organization-wide, per community.
  • Compare between licensed and unlicensed staff as well as the type of care task.
  • With acuity rising in assisted living, better monitor the evolving needs of your residents.
  • If you’re a Medicaid provider, help educate state Medicaid programs about assisted living costs.
  • Best of all, it’s an exclusive benefit as part of NCAL membership, meaning there’s no additional cost.

“This data is imperative in today’s value-based marketplace,” said NCAL Executive Director Scott Tittle. “As managed care companies, accountable care organizations, and other health care providers look to partner with high-quality, low-cost providers, assisted living communities could use the AL Cost Calculator to help demonstrate their value. NCAL is pleased to offer yet another data solution to help assisted living providers stay ahead of the curve.”

Learn more, register for the tool, or see how-to videos on our website: www.ALCostCalculator.org.

Concerned About Germs? Check Out AHCA/NCAL’s Infection Prevention and Control Program

Dave Kyllo

The methods for preventing and controlling infections are universal and apply regardless of setting. In other words, what works in the nursing facility setting will work in the assisted living setting.

AHCA/NCAL developed a new comprehensive program to help nursing facility members meet the new infection prevention and antibiotic stewardship requirements now being enforced by CMS. While originally designed for nursing facilities, the Infection Preventionist Specialized Training (IPCO) course provides education for all 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 state and national health care regulators.

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.

Are You Ready for the New Not-for-Profit Financial Statements Reporting and Revenue Recognition Standards?

Lonnita Myles


Date: 9/20/2018 2:00pm ET


*Please note this is only “hosted” on the ahcancalED platform, and not a live presentation. Members will be redirected to the registration page after locating the product on ahcancalED through this link.*

Description:
This session will discuss the following:
  • Not-for-Profit financial statement standards being updated for the first time in 20 years that will enhance the reporting of expenses both by function and natural classification for all Not-for-Profits and new disclosures on liquidity and more!
  • Exchange transactions for Not-for-Profits and Healthcare may be subject to the new revenue recognition standard through the review of the contracts.
  • New revenue recognition will significantly affect the practices of most companies and many organizations and is intended to increase financial comparability across industries.


Consider ACHCA Administrator Credentialing as Part of Your Professional Growth Plan

Dave Kyllo

Administrators are key players in the long term care team and are entrusted with the responsibility of caring for our loved ones. 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 1-800-561-3148.

Congratulations to the California Association of Health Facilities!

Dana Halvorson


The California Association of Health Facilities has earned a 2018 ASAE Power of A Gold Award for its Nursing Home Leader Academy of Excellence, a professional development program to produce immediate improvements in the care and dignity of residents in a skilled nursing setting.  ASAE honored the program which offers high-level leadership training, meaningful improvement action projects and shared success through lessons learned to advance each professional’s skills.  According to ASAE, ASAE’s Power of A (association) Awards, the industry’s highest honor, recognize the association community’s valuable contributions on the local, national and global levels.  The Power of A Awards reward the outstanding accomplishments of associations and industry professionals who work tirelessly to strengthen lives, the workforce, our systems and structures, the economy and the world.

Improve Your Odds of Avoiding 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 97 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.
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!

Stop Overpaying on Your Facility’s Utility Bills with Cleary Energy

Dave Kyllo

AHCA/NCAL is pleased to announce a new preferred provider partnership program called Cleary Energy. The program is designed to save AHCA/NCAL members significant money on their utility bills without adding new expenses to their budgets.

Most long term care facilities (about 75%) are being overcharged for one or more of their utilities. Clear y Energy has recouped on average 4% to 8% savings on utilities for long term care facility customers. That’s a significant savings!

Cleary Energy performs utility bill audits by examining utility, supplier and government charges on utility bills to obtain refunds and/or credits and rate reductions. Specifically, Cleary Energy audits a facility’s electric, natural gas, propane, heating oil, diesel fuel, water, sewer and telecommunications bills.

Cleary Energy guarantees savings or its auditing services are free. Cleary Energy’s fees are based on facility savings on their utility bills.

AHCA/NCAL member facilities enter into an audit agreement with Cleary Energy, which is a shared savings agreement that lasts for a period of three years. If no refund, savings or credits are received, the AHCA/NCAL member facility owes nothing to Cleary Energy for conducting the audit and AHCA/NCAL members will have the peace of mind of knowing that their facilities are not being overcharged for their utilities.

The process for engaging Cleary Energy to conduct a utility audit is easy. Most of the information Cleary Energy needs to complete an audit comes directly from the utilities or suppliers.

Cleary Energy’s long term care experience sets the company apart. The founder of Cleary Energy has 40 years of long term care experience and has spent the last seven years specializing in finding energy cost savings for skilled nursing, assisted living and senior living centers. That in-depth knowledge of long term care operations enables Cleary Energy to find the greatest costs savings on utility expenses for AHCA/NCAL members because Cleary Energy knows where to look for savings.

Take advantage of this unique no-risk opportunity to save on utility costs. Contact Cleary Energy today in one of the three ways listed below.

www.ClearyEnergy.com

Email: AHCA-NCAL@ClearyEnergy.com

Phone: (203) 416-6568

Tuesday, August 14, 2018

AHCA Disappointed with Proposed Tax Rule

Drew Thies


The American Health Care Association (AHCA) expressed disappointment last week concerning an Internal Revenue Service (IRS) proposed rule relating to the tax status of skilled nursing providers.

The proposed rule stipulates that skilled nursing facilities (SNFs) cannot take advantage of some of the tax deductions in the 2017 tax law because of their status as "specified service trade or businesses.”

The Trump administration’s signature tax law allows passthrough entities like limited liability corporations, partnerships, S corporations, and sole proprietors to deduct 20% of their "qualified business income” but only if they are not a specified service business.

AHCA CEO and President Mark Parkinson said “[t]he rule is inconsistent with Congressional intent” and that [t]he intent of the law was to provide tax cuts to job creators and those willing to put capital into the economy.”

AHCA will “submit comments and will forcefully advocate our position” and “go to the Hill and seek legislative relief” if necessary, Parkinson continued.

The rule is part of the regular notice of proposed rulemaking (NPRM) process, is not final, and will become law after stakeholders weigh-in and the IRS codifies it. Comments are due by October 1st.

Monday, August 13, 2018

2018 Gold Quality Award Recipients Announced

Last week, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) announced that two skilled nursing care centers and two assisted living communities have earned the 2018 Gold – Excellence in Quality Award. The award is the final of three distinct levels possible through the AHCA/NCAL National Quality Award Program, which recognizes organizations nationally that serve as models of excellence in providing high-quality care.

The 2018 Gold – Excellence in Quality Award recipients are:
• Comer Health and Rehabilitation; Comer, Georgia
• Holly Heights Nursing Center; Denver, Colorado
• Maine Veterans Home - Machias; Machias, Maine
• Sunrise of Gurnee; Gurnee, Illinois

Maine Veterans Home – Machias and Sunrise of Gurnee are the first free-standing assisted living communities to ever attain the Gold – Excellence in Quality Award in the history of the program.

Based on the core values and criteria of the nationally recognized Baldrige Performance Excellence Program, the AHCA/NCAL National Quality Award Program challenges member providers to achieve performance excellence through three progressive levels—Bronze, Silver, and Gold. The Gold – Excellence in Quality Award is the most prestigious of the program. At this level, recipients have invested multiple years in mastering and applying the rigorous quality improvement standards of the Baldrige Criteria to achieve superior results in leadership, strategic planning, customer and workforce focus, and operations and knowledge management.

Since the inception of the National Quality Award Program in 1996, only 34 long term and post-acute care providers—excluding this year’s recipients—have achieved this level of quality recognition.

AHCA/NCAL announced the recipients of the Bronze – Commitment to Quality on May 31 and Silver – Achievement in Quality on June 28. A full list of recipients is available on the AHCA/NCAL Quality Award website here.

The program is sponsored by the following AHCA/NCAL Associate Business Members: First Quality, NRC Health, and Team TSI Corporation. The awards will be presented to recipients during AHCA/NCAL’s 69th Annual Convention & Expo in San Diego, California, October 7-10, 2018.

Wednesday, August 8, 2018

Special Session on New Payment Model at Convention

Jon-Patrick Ewing


The Patient-Driven Payment Model (PDPM) is now final with implementation scheduled for October 2019. Register for the AHCA/NCAL Convention and receive the answers to your implementation questions during a four-hour intensive session: Replacing RUGs - CMS' New SNF Payment System & How to Get Ready.

The intensive will be held on Sunday, October 7 and repeated on Wednesday, October 10. AHCA's educational approach to PDPM will be to offer a holistic picture of how PDPM impacts SNFs and will incorporate PDPM interactions with:
  • Requirements of Participation
  • Survey and Licensure
  • SNF Rehospitalization Measure Value-Based Purchasing
  • IMPACT Act Quality Reporting Program
  • Other payers' (Medicare Advantage and Medicaid) and their probable responses to PDPM
In addition to in-depth training on the PDPM final rule, a members-only tool kit will be introduced that will contain the core competencies framework and a readiness review tool that will help you track your operational readiness for PDPM. The intensive will also cover data gathered from 12 companies testing impacts of PDPM and provide hospital and discharge pattern data that could be helpful in member markets. Finally, a panel discussion of AHCA members will discuss opportunities and potential pitfalls for SNFs as they consider operational changes necessary to be successful under PDPM.
Attendance at the PDPM Intensive: Due to proprietary information, attendance at the PDPM intensive sessions (Sunday at 1:00 pm and Wednesday at 10:30 am) is limited to SNF providers only. No other attendee types will be permitted inside the session rooms. If attending the Sunday intensive, you must pick up your convention badge at registration prior to attending the session.

Advance registration continues through September 21, after this date on-site rates apply.



Medicare Advantage Plans Allowed to Negotiate Drug Prices

Drew Thies


Under a new policy announced by the Trump administration, insurers which offer Medicare Advantage plans will be able to directly negotiate with drugmakers in an effort to reduce prices.

The Centers for Medicare and Medicaid Services (CMS) said Medicare Advantage plans will be allowed to require that patients first try certain lower-cost drugs before moving to a more expensive alternative if the first treatment is not effective.

Until now, insurers were not able to negotiate prices under Medicare Part B and Part D, which are administered in a hospital or doctor’s office. In 2017, Medicare Advantage plans spent $11.9 billion on Medicare Part B drugs.

Secretary of Health and Human Services Alex Azar said, "By allowing Medicare Advantage plans to negotiate for physician-administered drugs like private-sector insurers already do, we can drive down prices for some of the most expensive drugs seniors use."

According to CMS Administrator Seema Verma plans will be required to pass on to patients more than half of the savings generated from the negotiations. Patients can receive benefits in the form of gift cards and other rewards programs.

Smarter RNs Are Key to Fewer Rehospitalizations. Fewer Rehospitalizations Are Key to Future SNF Reimbursements.

Dave Kyllo


It increases experienced RNs’ knowledge of gerontological nursing practice. Gero Nurse Prep students see a dramatic 24 percent average increase on their pre- and post-test scores.

Those specially trained RNs can net tangible results. 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.  
Lower rehospitalization rates will be key to success under the CMS Value-Based Purchasing (VBP) program. CMS is tracking skilled nursing rehospitalization rates on for the SNF VBP program. Under the VBP program, claims for services furnished on or after Oct. 1, 2018, will be subject to a 2 percent withhold. Providers will have the opportunity to get some or all of this money back depending on how well they do in managing hospital readmissions and meeting or exceeding performance standards.
 The key metric for the program is known as the SNF 30-Day All-Cause Readmission Measure (SNFRM). SNFRM estimates a risk-standardized rate of all-cause, unplanned hospital readmissions of Medicare SNF beneficiaries within 30 days of discharge from their prior acute hospitalization.

AHCA/NCAL Gero Nurse Prep 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. That means having an ANCC Board certified RN can easily give providers an edge in the marketplace.

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.

AHCA/NCAL Gero Nurse Prep is affordable and provides value at the $690 AHCA/NCAL member price.  That’s $23 per contact hour for outstanding nursing education that makes a measurable difference in an RN’s knowledge of gerontological nursing. 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.  Check out AHCA/NCAL Gero Nurse Prep today.

Delivering What Everybody Loves Through Mood Media

Dave Kyllo

Billy Joel said that “No matter what culture we’re from, everybody loves music.” Members can keep music alive in their communities through music offered by Mood Media at AHCA/NCAL “Member Only” discounted rates.

Mood Media offers great musical variety for events or casual common area listening via the internet or streaming, and offers customized commercial free music options that allow facilities to tailor musical selections to meet changing resident preferences. Mood customers enjoy freedom from music licensing worries on Mood Media’s huge collection of music selections played on Mood Media‘s portable devices.

Use Mood Media’s music to:

· Improve the dining experience and set the mood in dining areas as residents gather for meals;

· Provide a variety of background music in common areas;

· Create a positive environment for activities; and

· Provide musical entertainment for social gatherings and happy hours.

AHCA/NCAL members receive exclusive discounted rates on Mood services and equipment with three-year agreements. The core music package starts at $29.99 per month or about $1 per day with a three-year agreement.

For more information about Mood Media’s services, call 800-345-5000 or go to http://partner.moodmedia.com/ahcancal/ (password: moodpartner).

Check Out the Affordable Health Benefit Plan Built to Help AHCA/NCAL Members Recruit and Retain Frontline Staff


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 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 far 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.

Tuesday, August 7, 2018

Quality Award Criteria Video Series Now Available!

Now that the 2019 National Quality Award Applications have been released, be sure to watch the Criteria series for each award level—Bronze, Silver and Gold—available on ahcancalED!

As a reminder, these series are updated to reflect changes in the Criteria each year, so even if you have viewed the series previously, you will want to view it again this year.

The Bronze Series
  • The Bronze Series is a sequential set of videos that was developed to help applicants understand and meet the demands of each question of the Bronze criteria. Each video is less than 10 minutes! 
The Silver Series
  • The Silver Series is a 5-part video series that covers the Criteria questions asked in the Silver Award application; the Organizational Profile, the basic and select overall item requirements within the seven Baldrige categories. 
The Gold Series
  • The Gold Series is a 5-part video series covering the Criteria questions asked in the Gold Award. The Criteria for this Award comes directly from the 2017-2018 Baldrige Excellence Framework in its entirety. You should purchase a copy of the Framework here before beginning the series.
Tips and Tricks:
  • All three Criteria series can serve as a team building experience for your staff. We suggest that you form an application team that views the videos together and then complete the responses to the Criteria as a team effort. This will result in a better application, a greater understanding of the foundational elements of quality in your center, and enhanced excitement as your center engages in the program.
  • The Criteria questions are interdependent, and responses often build on what has previously been written in other responses.

Want to learn more about the Criteria?
  • State Affiliates often offer classroom-style Criteria workshops for the Bronze and Silver level. Consider reaching out to your state affiliate for more information.
  • Attend this year’s Convention and participate in the Quality Award Sessions and Criteria Intensives offered throughout the event. 
If you have questions on how to sign into ahcancalEd, please reach out to educate@ahca.org for your credentials. If you have questions regarding the Quality Awards, please reach out to qualityaward@ahca.org

Thursday, August 2, 2018

2019 Quality Award Applications Available NOW! Get Started Today!

The National Quality Award Program is pleased to announce that the 2019 application packets are now available online. In addition, the 2019 program calendar and submission checklist have been posted to each award level page. 
This is an opportunity to show residents, family members and the community-at-large your organization's commitment to continuous quality improvement, and to establish recognition on a national level. Get ready to begin your journey today!
Please visit the Bronze, Silver or Gold application pages to download application materials specific to your respective award level to learn how your center should begin preparing. New for 2019, is our Gold criteria series , which is already available on ahcancalED. The Bronze and Silver criteria series will be available next week on ahcancalED
The Quality Award Program is also proud to introduce the Quality Award Portal, a new online application and payment portal. You may visit this portal starting now to get an early start on your application and submit your Intent-to-Apply. 
As a reminder, all applicants should read the application packet in full before submitting an intent-to-apply payment. 
**Important Dates to Remember**
November 8, 2018 - Intent to Apply Deadline
January 31, 2019 - Application Deadline
All deadlines are at 8 pm EST

If you have any questions, please email qualityaward@ahca.org. We look forward to seeing your application in 2019!

Sincerely,
Quality Award Team Staff

P.S. If you are interested in serving as a Quality Award Examiner, the application is also available! Visit our Examiner webpage to learn more and apply today. 

Wednesday, August 1, 2018

JFNA Webinar: Trauma, Hoarding, and Home Safety: Person-Centered, Trauma-Informed Interventions for Older Adults

Thursday, August 9, 2018, 1:00 PM - 2:15 PM EDT

Webinar attendees will learn about the relationship between trauma and hoarding, as well as the unique issues that older adults who have experienced trauma face in terms of home safety and hoarding. It will address how to determine the difference between a cluttered home and a hoarding situation, and what case managers should do when they encounter an older adult living in unsafe condition. The webinar will address ways to ensure that the homes of older adults who have experienced trauma are safe in a person-centered, trauma-informed way. It will highlight inexpensive changes that can be made in terms of products available and teachable techniques. Finally, it will cover what to tell occupational therapists, contractors, and mental health service providers who specialize in hoarding about older adults who have experienced trauma, so they are prepared to work with your clients.

Registration is required by August 7 to attend this event. All registrants will receive the webinar information via email on August 8.

Presenters

Leah Bergen is the Project Manager at The Jewish Federations of North America’s Center for Advancing Holocaust Survivor Care.
With a thesis focused on Post Traumatic Stress Disorder and a doctoral degree in Psychology from University College London, Dr. Chia-Ying Chou has worked with over 100 individuals with Hoarding Disorder. She is currently developing a Compassion Focused Therapy treatment protocol, tailored for individuals suffering from Hoarding Disorder. Dr. Chou's clinical and research interests fall in the intersection between trauma and hoarding.
Amy Neuman is Program Manager of Holocaust Survivor Services in Aviv Older Adult Services at JF&CS Atlanta.
Andrew Sever, MS, OTR/L, ECHM, CAPS, CEAC is a licensed occupational therapist who has specialized in healthcare for seniors.

Learn more about the Center for Advancing Holocaust Survivor Care

CMS Quarterly Update of SNF Consolidated Billing Codes Fixes Errors Impacting 2016-2018 SNF PPS

Dan Ciolek

SNF billers are advised to review a recent Centers for Medicare and Medicaid Services (CMS) MLN Matters article MM10852 titled “Quarterly Update to 2018 Annual of HCPCS Codes Used for Skilled Nursing Facility (SNF) Consolidated Billing Used for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Enforcement.”   This article describes updates to the lists of Healthcare Common Procedure Coding System (HCPCS) codes that are subject to the Consolidated Billing (CB) provision of the SNF Prospective Payment System (PPS). Changes these changes allow Medicare Administrative Contractors (MACs) to make appropriate payments in accordance with policy for SNF CB in the “Medicare Claims Processing Manual”, Chapter 6, Section 20.6. 

Included in the updated code list are the following codes that should not have been subject to consolidated billing rules beginning as far back as January 1, 2016:

  • Codes that should have been added effective January 1, 2016 - 77770, 77771, 77772
  • Codes that should have been added effective January 1, 2017 - G0491, G0500, J9034, J9301, Q0083, Q0084, Q0085, 36598, 77385, 77386, 77770, 77771, 77772, 79005, 79101, 79445, 96446, 99151, 99152, 99155, 99156, and 99157
  • Codes that should have been added effective January 1, 2018 - 00731, 00732, 00811, 00812, 00813, and 77772

In these cases, the SNF has the right to request a refund from providers and suppliers they may have paid separately due to this CMS error. The Part B provider or supplier would then be able to submit a request for payment from their MAC.

SNF billing staff should review this article for full details of this opportunity to retrieve potentially lost revenue back to 2016, and to identify two new biologic injection codes that are exempt from SNF CB effective July 1, 2018.

CMS issues Final SNF Payment Rule

Drew Thies


The Centers for Medicare & Medicaid Services (CMS)  finalized the Fiscal Year (FY) 2019 Medicare payment rule for the Skilled Nursing Facility (SNF) Prospective Payment System (PPS). The rule establishes a market basket increase of 2.4 percent, a figure statutorily mandated by Congress, and will start October 1, 2018.

CMS anticipates aggregate payments to SNFs will increase by $820 million from payments in in the previous Fiscal Year. This is $30 million less than in the proposed payment rule issued previously this year. AHCA has begun work to identify errors and opened dialogue with CMS. 

Additionally, CMS finalized a payment system called the Patient-Driven Payment Model (PDPM) to replace the current PPS. The PDPM is an updated version of a proposed change to the payment system announced in 2017. The implementation date for the final system is October 1, 2019 and will be done in a budget neutral manner.

PDPM is composed of five case-mix-adjusted payment components: Physical Therapy (PT), Occupational Therapy (OT), Speech Language Pathology (SLP), Nursing, and Non-Therapy Ancillaries Services (NTAS). Reimbursement would be based on the sum of the five component rates. The model also limits the use of group and concurrent therapy to 25% of all therapy given.

Mark Parkinson, President and CEO at the American Health Care Association (AHCA), said in a statement that while the 2.4% increase is necessary for struggling providers, the therapy limits were reason for concern.

“The therapy language in the rule criticizes skilled nursing providers for providing therapy when CMS has promulgated rules over the last 20 years that encourage therapy,” the statement said. “[T]his rule micromanages patient care and therapy minutes at a time when providers are already overburdened by unnecessary regulation.”

Both the final rule and a fact sheet are available online. The FY19 SNF PPS wage index will be posted in the coming weeks.


AHCA is offering  PDPM-intensive sessions at our AHCA/NCAL Convention & Expo in San Diego take place on Sunday, October 7 and Wednesday, October 10th, more information can be found here.

Build Your Knowledge of Cyber Liability Risks in Long Term Care

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 offered through the company.

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

A New Affordable Health Benefit Plan That Truly “Wows” Frontline Staff

Dave Kyllo


AHCA/NCAL Insurance Solutions offer a new 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.

An executive director from an Oklahoma member facility recently shared the impact the new plan had on one of her staff in an email. “I had a CNA who literally was in tears because she did not qualify for Insure Oklahoma and couldn’t afford Community Care,” she wrote. “It was such a blessing to offer this young couple [the CNA & her husband] coverage that most places can’t/don’t. She was so thankful and so am I.”  

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 far 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 1 & 2 MEC plans are available in all 50 states. Changes to the Hospital Indemnity benefit vary based on state approvals. For more information about this innovative new employee health benefit, please contact Nick Cianci at 202-898-2841 or Dave Kyllo at 202-898-6312 or email ahcainsurancesolutions@ahca.org.