Friday, March 30, 2018

Quality Initiative Recognition Program Updates from Quality Summit


2017 Quality Initiative Recognition Program Achievers,

The below outlines a few updates in follow-up to Quality Summit we'd like to share with you:  
  • Photos from the Quality Initiative Recognition Program luncheon at Quality Summit can be viewed here.
  • For those facilities or communities who are Quality Initiative Recognition Achievers and were unable to attend the Quality Summit, we will be mailing the awards to your facilities/communities next week. 
  • It is time to shift focus on the Quality Initiative 2018-2021. If you are a skilled nursing center, begin here. If you are an Assisted Living Community, begin here.
Congratulations once again on your accomplishment! 

If you have any further questions, please contact qualityinitiative@ahca.org.


Wednesday, March 28, 2018

NCAL Publishes Policy Briefs on HCBS Settings Rule: Spotlight on Co-location


To support states and providers implementing the Home and Community Based Services (HCBS) Settings Rule, NCAL has partnered with Health Management Associates to create four policy briefs that address areas that have been particularly challenging to ensure that assisted living (AL) continues as an appropriate home and community based setting. These briefs provide background on each issue, aggregate the available guidance from the Centers for Medicare and Medicaid Services (CMS), and provide examples of CMS-approved strategies to comply with the rule from those states with approved transition plans.

This week NCAL is spotlighting its brief on Co-location: Community Integration Options and Resident Choice Are Key in Assessment of Co-Located Assisted Living Communities and Inpatient Facilities.

This brief addresses options for AL communities located in the same building as inpatient facilities, including nursing homes. Each state must identify those settings for heightened scrutiny review by CMS. Co-located settings may demonstrate compliance with the rule by:
  1. differentiating the purpose, design, and programmatic features of the setting; 
  2. demonstrating the degree of physical, programmatic, and financial disconnect between the AL community and inpatient facility; and 
  3. demonstrating how the resident’s experience complies with the rule, including through valid consumer experience surveys. 
AL communities must have a clearly defined approach to support community integration and resident choice. The brief provides concrete examples from CMS guidance and approved transition plans to support states and providers ensure that AL communities continue as an appropriate home and community based setting.

Since 2014, implementation of has been underway to meet the extended 2022 deadline. States continue to work with CMS to have their transition plans approved. States must also assess all HCBS settings for compliance with the rule, and then assemble evidentiary packages for CMS heightened scrutiny review for settings that meet certain criteria.

Webinar: Running For the AHCA/NCAL Board



Webinar - So You Think You Might Want to Run for the AHCA or NCAL Board: Everything You Want to Know But Are Afraid to Ask
April 18, 2018 at 3 p.m. EST


American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) members in good standing may submit an application for the 2018-19 elections for the AHCA Board of Governors and the NCAL Board of Directors. 

This webinar will explain the application, credentialing and campaign process. It is perfect for those interested in running this year or in future years.

Speakers:
Tom Coble, President and CEO, Elmbrook Management Company
Chris Mason, President and CEO, Senior Housing Managers, LLC
Katherine Preede, Senior Director, Membership, NCAL

Upcoming LTC Trend Tracker Webinars for Independent Owners

Bobbie Vailes
Webinar: LTC Trend Tracker℠ 101 for Independent Owners
June 21, 2018 at 2 p.m. EST

Welcome to LTC Trend Tracker℠! LTC Trend Tracker℠ is a ‘one-stop-shop’ to access helpful tools and reports that will assist AHCA/NCAL members with providing better quality care. Reports containing Quality Measure Data, personalized publications containing facility specific Five-Star Data, and checking your status on Quality Initiative goals only scratch the surface of the capabilities of LTC Trend Tracker℠. Join us as we dive into this tool!

This webinar will go over the basic functionalities of LTC Trend Tracker℠ including the following:
  • Top 5 Utilized Reports
  • Quality Improvement Tools
  • Quality Awards & LTC Trend Tracker℠.
Want to learn more? Check out our resource center located at www.ltctrendtracker.com for helpful how-to videos and help documents!

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

Speaker: Lonnita Belk, Manager of LTC Trend Tracker

*Independent Owner members are also encouraged to attend the below webinar to dive deeper into how to use LTC Trend Tracker:

How Independent Owners Can Utilize LTC Trend Tracker℠ Data
October 18th, 2:30 p.m. Eastern


Description: Learn the potential of LTC Trend Tracker℠ and how it can help Independent Owners harness the untapped power of the data you collect. This session will provide a brief overview of LTC Trend Tracker℠ for 10 or fewer skilled nursing facilities and assisted living communities to understand its quality improvement and organizational performance benefits. You will learn how to complete the following:
  • Use LTC Trend Tracker℠ to support implementation of quality programs
  • AHCA/NCAL Quality Initiative 3.0 & LTC Trend Tracker℠
  • Enhance external negotiations with entities such as hospitals, managed care organizations, and other networks.



Speaker: Lonnita Belk, Manager of LTC Trend Tracker

AHCA Quality Initiative Webinar for IO Members




Webinar: The AHCA Quality Initiative 2018-2021: What’s New & What it Means for You 
May 152018 at 2 p.m EST



The American Health Care Association (AHCA) has announced new three-year goals as part of its nationwide, multi-year initiative to further improve quality in long term and post-acute care centers. Since the launch of the Initiative in 2012, members have been challenged to meet measurable targets in key areas such as hospitalizations and antipsychotic usage. 

While significant improvements have been made, more must be done. The next phase of the effort continues to challenge providers to achieve quantitative results in four areas by March 2021. This webinar will provide an overview of progress to date, outline the new goal areas and review strategies and resources to help members achieve the Quality Initiative goals.

Learning Objectives:
1. Review progress to date on AHCA Quality Initiative.
2. Discuss the new goal areas and the rationale for each selection. 3. Review systematic quality improvement strategies and resources to support member success in meeting the identified goals.

Speaker: Lyn Bentley, MSW, Vice President, Quality & Regulatory Affairs of AHCA

AHCA Quality Initiative Webinar for NFP Members

Bobbie Vailes

Webinar: The AHCA Quality Initiative 2018-2021: What’s New & What it Means for You 
May 1, 2018 at 2 p.m. EST


The American Health Care Association (AHCA) has announced new three-year goals as part of its nationwide, multi-year initiative to further improve quality in long term and post-acute care centers. Since the launch of the Initiative in 2012, members have been challenged to meet measurable targets in key areas such as hospitalizations and antipsychotic usage. 

While significant improvements have been made, more must be done. The next phase of the effort continues to challenge providers to achieve quantitative results in four areas by March 2021. This webinar will provide an overview of progress to date, outline the new goal areas and review strategies and resources to help members achieve the Quality Initiative goals.

Learning Objectives:
1. Review progress to date on AHCA Quality Initiative.
2. Discuss the new goal areas and the rationale for each selection. 3. Review systematic quality improvement strategies and resources to support member success in meeting the identified goals.

Speaker: Kiran Sreenivas, MS CPHQ, Research Director of American Health Care Association/National Center for Assisted Living

NSNCW is Just Over One Month Away



National Skilled Care Nursing Week® is just over a month away! Be sure to place your order for our promotional items including: t-shirts, posters, buttons, door clings and balloons. Decorate your center and help promote this year’s theme, Celebrating Life’s Stories

AHCA encourages you to order early for best product selection and size availability. Order online now or call by phone, 800-321-0343.


Posters Sold in sets of 4.

President Trump Signs Spending Bill

Drew Thies


President Trump signed a $1.3 trillion spending bill Friday after threatening to veto the legislation, averting a government shutdown with just hours to spare.

Both chambers of Congress worked late into the night on Thursday to whip votes on the massive spending deal. The deal language of the 2,232-page piece of legislation was publicly available for less than a day before lawmakers voted.

Concerns lingered over the Senate’s ability to move the bill to the president’s desk before the Friday night deadline. Sen. Rand Paul (R-Ky.) said he opposed the legislation and used delay tactics earlier this year to force a short-term shutdown. In the end, the Kentucky Senator opposed the measure but allowed it to move off the Senate floor.

The Senate sent the bill to the President’s desk early Friday morning only for Trump to tweet hours later that he was considering vetoing the bipartisan agreement over immigration provisions. The president was upset by the lack of funding for a border wall and provisions dealing with the Deferred Action for Childhood Arrivals (DACA) program.

President Trump ultimately signed the legislation to keep the government open and funded through September, but said in a press conference after the signing that he would like to be allowed line-item veto authority and for the Senate to amend rules to weaken the filibuster.

No significant changes to Medicare or Medicaid policy were included in the legislation. The bill was largely seen as the last major piece of legislation that will need to pass Congress prior to the November midterm elections.

Tuesday, March 27, 2018

Updated Part B Therapy Claims Processing Instructions - Bipartisan Budget Act of 2018



As AHCA announced in an earlier article, the Centers for Medicare & Medicaid Services (CMS) had begun the process of reprocessing calendar year (CY) 2018 Medicare Part B claims, including those for outpatient physical therapy, occupational therapy, and speech-language pathology services, in order to implement provisions of the Bipartisan Budget Act of 2018. This reprocessing will positively impact affected skilled nursing facility (SNF) providers as it will reverse prior therapy cap related denials across the country, as well as increase Part B payment rates for SNFs in certain geographic locations.

This law, enacted February 9, contained a number of provisions that may have impacted SNF Part B therapy claims, including the Work Government Practice Cost Index (GPCI) Floor, and the permanent repeal of the outpatient therapy caps beginning on January 1, 2018. 

Due to the retroactive effective dates of these provisions, your Medicare Administrative Contractor (MAC) was provided additional instructions to automatically reprocess claims impacted by this legislation from April 1 to no later than six months after this date. For the limited number of SNF providers impacted, you will not need to request any reprocessing unless you believe that the MAC systems did not automatically reprocess your impacted claim(s).     

CMS also posted a more reader-friendly MLN Matters article that provides additional details about these changes impacting SNFs, including the following specifics:


  • The MACs will reprocess therapy claims with the KX modifier containing Dates of Service in Calendar Year 2018, which were denied prior to the implementation of the updated legislative effective dates issued on January 25, 2018. NOTE: For institutional claims, these claims will include revenue codes 042x, 043x, or 044x and modifiers GN, GO, or GP.
  • The MACs will reprocess therapy claims with the KX modifier which were denied due to an invalid date provided by CMS on February 12, 2018.
  • The MACs reprocess MPFS claims for localities and States impacted by the Work GPCI Floor fee increase for Dates of Service in CY 2018. 
  • MACs shall ensure all reprocessing actions have been initiated within 6 months of the issuance of CR10531.
  • The MACs will reprocess 2018 therapy claims and claims for localities and States impacted by the Work GPCI Floor fee increase for Dates of Service in CY 2018 which cannot be automatically reprocessed only if you bring such claims to the attention of your MAC.

AHCA recommends that provider billing staff review these documents.

Train Now to Help Avoid the #1 Cited F-Tag



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. 


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!

Cool Jobs with Top Employers




The AHCA/NCAL Long Term Care Career Center helps employers fill their key health care job vacancies. And the jobs those employers seek to fill are among the best in the profession. Consider these job titles for positions recently posted on the Long Term Care Career Center:
  • Senior Director of Organizational Effectiveness
  • Risk Manager/Compliance Officer
  • Senior Vice President, Operations
  • Director of Nursing
Rates for posting job vacancies are affordable and give prospective employers far greater exposure than local ads and job boards by connecting to a network of more than 300 national and state health care organizations and societies and more than 98,000 searchable resumes.   

The LTC Career Center features many of the best positions available in the long term care profession and is always free for job seekers. And, job seekers are using the site!  Job postings on the AHCA/NCAL Long Term Care Career Center’s network, currently average nearly 1,300 views a month. 

As a leading employment information resource, the AHCA/NCAL Long Term Care Career Center  has been fully integrated with Google’s new job search feature “Google for Jobs.”  Google’s feature helps employers deliver success for AHCA/NCAL members, job seekers and other related employers in the long term care industry

There are two great ways for skilled nursing center and assisted living employers to save on their job postings on the Long Term Care Career Center. First-time job posters can receive 25% off their first posting by entering promo code New25off when they check out.

Employers with multiple positions to fill can purchase three job postings at one time and receive a 20% discount on the three postings by entering promo code Bundle20 at check out. Employers who use the site are also able to post vacancies as they occur and search resumes on the network.

In addition to receiving unique national exposure on a large health care job board network, employers who utilize the site also receive superior exposure through rotating job listings on AHCA’s home page – the web site where long term care professionals go for news and information. In addition, employers who post vacancies through the center receive bonus rotating listings on the Long Term Care Career Center  home page. View this employer resource and see how easy it is to create an account on the AHCA/NCAL Long Term Care Career Center site.

Give the LTC Career Center a try and take advantage of great savings by using either the New25off promo code to save 25% on your first job posting or the Bundle20 promo code to save on a package of three job postings.    

The Online Tool Designed to Help RNs Excel at Gerontological Nursing


AHCA/NCAL Gero Nurse Prep does much more than just prepare RNs to take the American Nurses Credentialing Center (ANCC) board certification exam in gerontological nursing. 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. 

The statistics prove it. Gero Nurse Prep grads know more about gerontological nursing. 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 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. 

Save $100 off the regular registration fee now through April 30 by using promo code QUALITY18 (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. 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 and don’t forget to use promo code QUALITY18 (all caps) when registering to save $100. 

Inspector General Releases Outpatient Physical Therapy Claims Error Report

Dan Ciolek


On March 14, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) issued a report, “Many Medicare Claims for Outpatient Physical Therapy Services Did Not Comply With Medicare Requirements” that has been reported in various print and web publications.

The OIG reports that 61 percent of Medicare claims for outpatient physical therapy services that they reviewed did not comply with Medicare medical necessity, coding, or documentation requirements.

The OIG recommended that the Centers for Medicare & Medicaid Services (CMS): 
1) Recover overpayments, 
2) Establish better oversight of outpatient therapy claims, and 
3) Improve provider education.

CMS responded that they believed the OIG misinterpreted Medicare coverage policy, particularly related to the definition of skilled services as clarified subsequent to the January 2013 Jimmo settlement, and disagreed that the error rate was as high as reported. CMS also indicated that a significant portion of the errors were likely more related to coding errors. However, CMS agreed that improvements can be made in monitoring and provider education.     

AHCA notes that this report is specific to Medicare outpatient physical therapy (PT) services only, and more specifically, outpatient PT services of 300 claims performed in office-based private practices from July-December 2013. Outpatient PT services furnished in skilled nursing facilities (SNFs) WERE NOT part of this audit. 

For context, the official CMS CERT error rate report for 2017 indicates that the error rate for SNF outpatient services was 4.1 percent (p.45 - PT/OT/SLP combined) and PT private practice was 16.9 percent (p.53).

While the OIG report is not specific to SNF outpatient therapy services, the same coverage and coding requirements apply to all outpatient therapy providers. AHCA recommends that providers share this report and the CMS response with therapy and billing personnel so they are aware of the coverage, documentation, and coding policies where the OIG and CMS  are focusing their audit efforts.   

Get Heard at Congressional Briefing


Wondering what you can do to most effectively advocate for your centers, your residents, your staff, and the issues you care about?

Come to Washington, D.C., and raise your voice!


West Virginia members on Capitol Hill in 2017
AHCA/NCAL’s Congressional Briefing helps you be heard as you personally meet with your Members of Congress and their staff. Get an update on the latest happenings in long term and post-acute care, make an effective plan of action with your peers, and take your message directly to the Hill.

Congressional Briefing offers you a unique opportunity to take real action with the support of AHCA/NCAL and your professional peers. Speak face-to-face with your members of Congress, discuss the most pressing issues of the day, and ask for what you need to provide the very best care in your centers.

Congressional visits take place on the afternoon of June 5. Contact your state association to set up your Hill visits. Then let us know of your schedule of meetings. We will have materials ready for your visit and have an AHCA lobbyist attend with you if needed. If your state association is unable to help you, email us at congressionalbriefing@ahca.org, and we can assist you to set up meetings with your members of Congress.

See the complete agenda, get more information, and register at cb.ahcancal.org.

Registration for this event is exclusively for long term and post-acute care provider members of AHCA/NCAL and AHCA/NCAL Associate Business Members only. AHCA/NCAL reserves the right to grant final approval for all registrants to attend this conference. The conference registration fee is complimentary to AHCA/NCAL Members and AHCA/ NCAL Associate Business Members, and their spouses, and is accepted on a first-come basis.

ADVANCED REGISTRATION DEADLINE: MAY 7

For additional information, contact Matt Smyth, Senior Director of Grassroots and Member Advocacy: 202-898-2817, msmyth@ahca.org


Official Sponsor: MEDLINE

Supporting Sponsors: Navigator, Reliant Rehabilitation, Zimmet Healthcare Services Group

Monday, March 26, 2018

The Next Phase of the AHCA/NCAL Quality Initiative


On March 13, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) announced new goals as part of its nationwide, multi-year initiative to further improve quality in long term and post-acute care centers and communities. Building on the progress of the profession over the last six years, the Quality Initiative will challenge member providers to achieve measurable targets in key areas by March 2021.

The three-year goals for skilled nursing centers are aligned with top priorities for the Centers for Medicare & Medicaid Services (CMS) and federal mandates that link financial outcomes to quality performance. They are:

  • Safely reduce long-stay and short-stay hospitalizations by improving 10 percent—or maintain a rate of 10 percent or less;
  • Improve functional outcomes (self-care and mobility) by 15 percent;
  • Improve long-stay and short-stay satisfaction by 10 percent—or achieve a rate of 90 percent or greater; and
  • Safely reduce the off-label use of antipsychotics by 10 percent—or maintain a rate of 8 percent or less in long-stay residents, and maintain a rate of 1 percent or less in short-stay residents.


The three-year goals for assisted living communities are:

  • Reduce turnover among direct care staff¬ to a rate of 50 percent or less;
  • At least 90 percent of customers (residents and/or families) are satisfied with their experience;
  • Safely reduce hospital readmissions within 30 days of hospital discharges to a rate of 20 percent or less; and
  • Safely reduce the off¬-label use of antipsychotics to a rate of 15 percent or less.


Since the launch of the Quality Initiative in 2012, skilled nursing members have achieved reductions in the use of antipsychotics and in re-hospitalizations. Specifically, over half (57 percent) of skilled nursing member organizations safely reduced the off-label use of antipsychotic medications by 30 percent in the third quarter of 2017. For hospital readmissions, skilled nursing members have safely prevented more than 142,000 individuals from returning to the hospital — a 12 percent reduction since 2011.

The Quality Initiative is also inspiring the state-based, assisted living profession to collect and report national quality data without a government mandate. While overall progress is not yet viable to report, the number of assisted living communities self-reporting to AHCA/NCAL is growing.

To monitor progress among skilled nursing centers nationwide, AHCA will use CMS measures to track progress on antipsychotic usage, and measures endorsed by the independent rating organization National Quality Forum (NQF) to track progress on re-hospitalizations, functional outcomes and customer satisfaction. The assisted living goals will use measures developed by AHCA/NCAL.

To help achieve the goals, AHCA/NCAL encourages members to access free resources on ahcancalED at educate.ahcancal.org

Members are also encouraged to view and track their progress using AHCA/NCAL’s LTC Trend Tracker, a web-based, data collection and benchmarking tool. Not sure if your organization uses LTC Trend Tracker? Email help@ltctrendtracker.com and request the name of your account administrator.  

To learn more about the AHCA/NCAL Quality Initiative, visit qualityinitiative.ahcancal.org (SNFs) or qualityinitiative.ncal.org (ALs).

And be sure to join AHCA/NCAL for a deeper dive with two free webinars for skilled nursing and assisted living members, respectively:

  • Assisted Living: “The NCAL Quality Initiative 2018-2021” on Tuesday, April 10 from 3:30 p.m. to 4:30 p.m. Eastern. Register here.


  • Skilled Nursing: “The Quality Initiative 2018-2021: What’s New & What it Means for You” on Thursday, April 12 from 3 p.m. to 4 p.m. Eastern. Register here


The First Program Year of SNF VBP: What you Need to Know

research@ahca.org
  
Data collected for the first year of the SNF VBP program, which will impact payment starting on Oct. 1, 2018, has already been collected by CMS, but there are still several reasons to continue to focus on the program and your SNF RM rehospitalization rates.

  • Data used to calculate your SNF RM rates in CY 2017 have been collected, but not finalized. CMS posts Quarterly Confidential Feedback reports via the Quality Improvement Evaluation System (QIES) and the CASPER reporting application. Providers are encouraged to review these reports and alert CMS of any potential errors pertaining to their SNF RM rates by emailing SNFVBPinquiries@cms.hhs.gov. Correction requests must be submitted before March 31, 2018. 
  • In August of 2018, CMS will be posting Annual Confidential Feedback reports that contain SNF RM rates for CY 2017 and the corresponding performance scores. Providers have 30 days from the posting of their annual report on the QIES reporting application to alert CMS of any issues.
  • While the performance window for the first year of SNF VBP (CY 2017) has passed, the performance window for the second year of SNF VBP (FY 2018) has already begun. Now is the time to improve rehospitalization rates that will impact payment starting on Oct. 1, 2019!  
In April of 2018, AHCA will be releasing a new dynamic report via LTC Trend Tracker that will enable centers to forecast the fiscal impact of the SNF VBP program. This report can be used for the first year of the program as well as program years to come. The SNF RM measure is claims based and is lagged over six-months. The new Trend Tracker tool will give members an estimate of how they will fare in the program well before CMS sends official notifications. AHCA will provide more information to members in April. 

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

Thursday, March 22, 2018

Webinar: Providing Culturally Competent Care: Meeting the LTSS Needs of Dually Eligible Beneficiaries

April 12, 12:00 PM - 1:30 PM ET

Providing culturally competent care is a key aspect of delivering an improved customer experience. Register to participate on this webinar that will focus on how to identify LTSS preferences, values, and needs of members from diverse cultural backgrounds. It will address providing services with cultural sensitivity and training the LTSS workforce in strategies to achieve cultural competence. Speakers will share concrete strategies for effectively meeting beneficiaries’ LTSS needs, in both institutional and community-based settings, while respecting their diverse cultural preferences.

Long-term services and supports (LTSS) are a vital part of care for many dually eligible beneficiaries. Individuals from racial and ethnic minority groups often experience disparities in access, quality, and outcomes in LTSS; such as higher rates of re-hospitalization under home health care and lower quality of care in nursing homes. To help address these disparities, providers and plans need ways to meet the cultural and linguistic needs, values, and preferences of diverse individuals.

Wednesday, March 21, 2018

CMS Updates Medicare Policy Manuals Impacting SNFs



On March 16, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a Medicare Learning Network (MLN) Matters article that announced several technical changes to the Medicare Eligibility and Entitlement, Benefit Policy, and Claims Processing manuals that impact skilled nursing facility (SNF) services. 

CMS states the “…changes are intended only to correct various minor technical errors and omissions…to clarify the existing content and no policy, or systems changes are anticipated.”  

The implementation and effective date for these changes is posted as June 19, 2018.  

The American Health Care Association (AHCA) has reviewed these documents and has identified that some of the technical changes are related to recent regulatory revisions, and other changes containing substantive detail that could impact SNF clinical documentation and billing practices necessary to receive payment for SNF services. 

We strongly encourage providers to review and share theses updates with appropriate clinical and billing staff prior to the June 19 implementation date.

Click here for highlights from AHCA of several of the key changes in these Medicare policy manuals that are substantive.      

Tuesday, March 20, 2018

Webinar: The NCAL Quality Initiative 2018-2021

Join Us For A Webinar: The NCAL Quality Initiative 2018-2021 
April 10th, 3:30 p.m  ET

The National Center for Assisted Living (NCAL) has announced new three-year goals as part of its nationwide, multi-year initiative to further improve quality in assisted living communities. The webinar will provide an overview of the new goal targets and review strategies and resources to help members achieve the NCAL Quality Initiative goals.

The next phase continues this challenge while putting forth another, encouraging assisted living providers to track their progress with these goals through AHCA/NCAL’s data collection tool, LTC Trend Tracker. Since the initiative’s launch in 2012, NCAL members have been challenged to meet measurable targets to improve resident outcomes and organizational success. 

Learning Objectives: 
  • Discuss the new goals and targets for the NCAL Quality Initiative
  • Discuss AHCA/NCAL tools and resources to help members achieve the Quality Initiative Goals
  • Review systematic quality improvement strategies to support member success in meeting the Quality Initiative Goals
Speakers:
  • Howie Groff, President, Tealwood Senior Living 
  • Gerald Hamilton, Owner, R&G Healthcare Management
  • Lindsay Schwartz, Associate Vice President, Workforce and Quality Improvement, AHCA/NCAL

Make Your Community Vibrant with Music from Mood Media



Famous American author Pat Conroy said, "without music, life is a journey through a desert." Members can quench their residents’ musical thirst through the 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).

Use Gero Nurse Prep to Increase Gerontological Nursing Competency


AHCA/NCAL Gero Nurse Prep does much more than just prepare RNs to take the American Nurses Credentialing Center (ANCC) board certification exam in gerontological nursing. 
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.

The statistics prove it. Gero Nurse Prep grads know more about gerontological nursing. 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 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. 

Save $100 off the regular registration fee now through April 30 by using promo code QUALITY18 (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. 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 and don’t forget to use promo code QUALITY18 (all caps) when registering to save $100. 

Do You Know About the Emergency Preparedness Program Plan That Crosswalks to CMS’ Guidelines?



Nursing facilities (SNFs/NFs) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) must comply with sweeping regulations affecting their emergency preparedness planning. These requirements took effect November 15, 2017 and include:


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

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

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

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

  • An electronic flash drive – easily add your facility’s information to customize your plan.
  • Hard copy of the documents – provides hard copy worksheet-style documents of your plan. 
  • Binder with tabs prepared for insertion of customized plan – an invaluable resource that organizes your plan documents.  
  • A crosswalk between the new CMS regulations and the customizable EPP plan manual – this indispensable tool provides a clear-cut detailed comparison that shows how your facility’s EPP plan meets CMS requirements and demonstrates precise compliance to survey agencies and AHJs.  
  • Access to an information-packed 75-minute “how to” webinar conducted by Russell Phillips & Associates.
Be confident that you have an emergency preparedness plan that correlates to the new CMS guidelines. Order the customizable EPP plan today through the AHCA/NCAL Bookstore and save $100 off the regular $495 price.  

Updated OIG Work Plan



The Department of Health and Human Services Office of Inspector General (OIG) has recently added to its work plan, which it began updating monthly in 2017. 

Several new work items are relevant to long-term care providers, including:


  • State Medicaid Fraud Control Units (MFCU) FY 2017 Annual Report: This annual report will analyze the statistical information that was reported by the MFCUs for FY 2017, describing aggregate outcomes of MFCU criminal and civil cases. This report will also identify trends in MFCU case results and will report on significant developments for the MFCUs over the course of the year.
  • Potential Abuse and Neglect of Medicare Beneficiaries: The Elder Justice Act recognizes an older person's rights, including the right to be free of abuse, neglect, and exploitation. In addition, all 50 States have mandated reporter laws for the reporting of the potential abuse or neglect of elders and vulnerable persons. Prior OIG reviews have shown that there are problems with the quality of care and the reporting and investigation of potential abuse or neglect at group homes, nursing homes, and skilled nursing facilities. By analyzing the treating medical facilities' diagnoses, OIG seeks to determine the prevalence of the potential abuse or neglect of Medicare beneficiaries. It will also determine whether the potential abuse or neglect occurred at a medical facility or at another location, such as the Medicare beneficiary's home.
  • Status Update on States' Efforts on Medicaid-Provider Enrollment: Previous OIG work found that many States had yet to complete fingerprint-based criminal background checks and site visits. The Centers for Medicare and Medicaid Services (CMS) continues to extend the deadline for completion of fingerprint-based criminal background checks, indicating that states are still working on provider enrollment. For this Status Update, OIG will determine the extent to which states have completed fingerprint-based criminal background checks and site visits, and challenges to implementation.
  • State Compliance With Requirements for Reporting and Monitoring Critical Incidents: OIG has conducted prior research finding that some states did not always comply with federal and state requirements for reporting and monitoring critical incidents such as abuse and neglect. OIG will review additional state Medicaid agencies to determine whether the selected states are in compliance with the requirements for reporting and monitoring critical incidents. OIG reports that its work will focus on Medicaid beneficiaries residing in both community-based settings and nursing facilities.