Wednesday, April 25, 2018

Jan Thayer Pioneer Award Nominations Open!

Katherine Preede

Nominations are now open for NCAL’s 2018 Jan Thayer Pioneer Award. ​The award recognizes an individual who has moved the senior care profession forward, positively affecting the lives of those served and those who serve. Recipients must demonstrate dedication, leadership and considerable contributions to the senior care profession.

Nominations must be submitted online and include a 500-word or less essay, along with a copy of the candidate’s resume. Nominators must be members of AHCA/NCAL; however, candidates are not required to be members. All nominations must be received by June 8, 2018. The recipient is selected by the NCAL Executive Committee and will be honored at NCAL Day at the AHCA/NCAL Convention & Expo in San Diego this October.

The Jan Thayer Pioneer Award is posthumously named after the first Board Chair of NCAL Jan Thayer. A provider for more than 25 years, Thayer owned and operated Riverside Lodge in Grand Island, Nebraska. She also founded and headed up the Excel Development Group, which owned and managed retirement communities throughout the Midwest and employed hundreds.

This is the fourth year NCAL is honoring an individual in the assisted living profession. The award was bestowed to Bob Van Dyk of Van Dyk Healthcare last year.

Participate in the Nursing Home Salary & Benefits Study


Rosanne Zabka, HCS Director of Reports

Hospital & Healthcare Compensation Service (HCS) is conducting its annual Nursing Home Salary & Benefits Study, and they need your help. Long-term care providers are asked to complete the study's questionnaire by May 7th. The study is published by HCS and supported by AHCA and LeadingAge.

There is no cost to participate in the study. Participants may purchase the results at the reduced price of $175, versus the $350 nonparticipant rate. Publication is scheduled for July 2018.

Questionnaires can be downloaded at
:  https://www.hhcsinc.com/survey-questionnaires.html

You can notify HCS you intend to submit your data, or request an extension past May 7th by emailing
Rich Cioffe, rjcioffe@hhcsinc.com. 

The report covers management salaries, bonuses, nonmanagement wages, and fringe benefits. Last year’s report contained data from over 1,900 long-term care facilities nationwide.

Data for 98 positions will be reported according to bed- size, profit type, revenue size, CBSA, state, region, and nationally. Both for-profit and not-for-profit data will be separately covered. Information on 18 fringe benefits will be reported by to region. Percent increases planned for 2018 will be reported for management, nonmanagement, RNs, LPNs, and CNAs.

HCS publishes ten annual compensation studies. The Nursing Home Report is nationally known and recognized as the standard for reliable, comprehensive, and affordable compensation data for SNFs/long-term care facilities.

AHCA/NCAL Annual Reports Available Now

Beth Martino and Rachel Reeves

​AHCA/NCAL is committed to being a leader and strong voice for the nation’s long term and post-acute care centers. Learn how the association and its members moved the profession forward in 2017 by reading the annual reports. The AHCA annual report is available here. The NCAL report is available here

AHCA/NCAL Announces Convention Keynote: History-Making U.S. Astronaut & Retired U.S. Navy Captain

Jon-Patrick Ewing


Get ready for fun, sun, and a great line up of speakers at this year’s AHCA/NCAL 69th Annual Convention and Expo! Registration is now open and you can confirm your spot in San Diego, October 7-10.  

The opening general session keynote is Captain Scott Kelly, History-Making U.S. Astronaut & Retired U.S. Navy Captain. Kelly's epic Year in Space, now a New York Times best-selling book, solidified his status as one of the greatest pioneers in history. In his acclaimed speech appearances, he now brings audiences to the edge of their seats with transcendent insights that inspire and challenge them to dream big, test the status quo, and "choose to do the hard things." With awe-inspiring stories from space and personal reflections on leadership, teamwork and testing limits, Scott inspires others to believe that they can reach any goal, no matter how ambitious or audacious.

Early bird registration ends July 20th so don’t wait and register today!




Tuesday, April 24, 2018

Train Now to Help Avoid the #1 Cited F Tag

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!

Gero Nurse Prep Spring Sale Ends April 30: Register Your RNs Today!

Dave Kyllo


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 and that knowledge increases credibility. 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.
 

Mood Media Has the Right Tunes to Set the Right Tone

Dave Kyllo

Billy Joel said that “No matter what culture we’re from, everybody loves music.” Members can create an upbeat atmosphere 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).

NPR Article on the Observation Stays Issue

Dana Halvorson


On April 20, 2018, NPR published an article written by Alison Kodjak entitled, “How Medicare's Conflicting Hospitalization Rules Cost Me Thousands Of Dollars”, on the observation stays matter.  The article focuses in on the author’s mother that was impacted by the issue, and how the use of observation status has increased significantly over the past decade.  

AHCA/NCAL continues to focus on the observation stays issue.  Increasingly, patients have no idea what their status is in a hospital, or the importance of it, which can lead to thousands of dollars in out-of-pocket medical expenses should they need skilled nursing center care following their hospital stay.  In addition to placing a financial burden on seniors and their families, this anomaly in Medicare rules can cause unnecessary spend-down, accelerating the time frame in which seniors will have to turn to programs such as Medicaid to pay for their care.  For more information about the observation stays issue, please visit the AHCA/NCAL website.

Wednesday, April 18, 2018

Register for the April 23 SNF VBP Predictor Tool Webinar


Join the LTC Trend Tracker team as we unveil the new SNF Value Based Purchasing (SNF VBP) Predictor Tool!  


Register here for the upcoming webinar on ahcancalED on Monday, April 23 from 1:00-2:00 p.m. Eastern.

During the webinar, AHCA Senior Vice President of Quality and Regulatory Affairs, Dr. David Gifford, will provide background information on the SNF VBP Program and a demo of the Tool. Coupled with peer testimony, this webinar will demonstrate the value of using the SNF VBP Tool even before the SNF VBP Program begins in October 2018.

The SNF VBP Predictor Tool provides valuable insights about your center's performance for the Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM), and enables you to plan for future Medicare Part A disbursement based on this performance to quickly establish benchmarks and set targets to guide performance improvement. 

As a reminder, current LTC Trend Tracker users can now access the Tool by logging to their account here. Non-users can sign up for an LTC Trend Tracker account here

If you have questions about the tool, you can access the SNF VBP Predictor Tool one-pager here and help document here.

For any assistance with LTC Trend Tracker, email help@ltctrendtracker.com.

We look forward to your participation in the webinar!

CMS Clarifies SNF Consolidated Billing Instructions Related to Ambulance Transportation

Dan Ciolek

On April 13, the Centers for Medicare and Medicaid Services (CMS) posted a Medicare Learning Network (MLN) Matters article and an associated program manual transmittal instructions to Medicare Administrative Contractors (MACs) that provide clarification on coverage of an ambulance transport for a SNF resident in situations where consolidated billing does and does not apply. 

The revised manual sections are attachments to the transmittal. Make sure your billing staff are aware of these clarifications.   

Specifically, CMS is revising Chapter 10 of the Medicare Benefit Policy Manual, and Chapter 15 of the Medicare Claims Processing Manual to clarify that a medically necessary ambulance transport from an SNF to the nearest supplier of medically necessary services not available at the SNF where the beneficiary is a resident (including the return trip) may be covered under Part B. 

This applies to beneficiaries who are in a SNF stay not covered by Part A, but who has Part B benefits. The revised instructions address potential SNF consolidated billing situations including:

  • The ambulance trip is to or from a hospital based or non-hospital based ESRD facility. 
  • The ambulance trip is for a SNF-to-SNF transport. Specifically, a transport between two SNFs (that is, a beneficiary’s same-day transfer from one SNF to another).


Register For Congressional Briefing to See HHS Secretary Speak


Have You Heard the News?
AHCA/NCAL is excited to announce that Alex M. Azar II, Secretary of Health and Human Services, will be among the speakers at Congressional Briefing. Azar has spent his career working in both the public and private sectors, as an attorney and in senior leadership roles focused on advancing health care reform, research, and innovation. He has worked on issues such as emergency preparedness as well as helping oversee the roll-out of the Medicare Part D prescription drug program. He is scheduled to appear on Tuesday morning, June 5

Don’t miss it!

Spring is a very busy time in Washington, D.C. We highly recommend that you register and make your accommodation plans as soon as possible. The Hyatt Regency Washington has already sold out. We have just added the Washington Court Hotel at 525 New Jersey Avenue, NW in Washington, D.C. Enjoy a special discounted rate of $329 single/double plus 14.8% occupancy tax when you reference American Health Care Association. Book now and save. The hotel deadline is May 3, 2018.

WHY ATTEND? 

Congressional Briefing offers you a unique opportunity to 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. 

Contact your state association to set up your Hill visits for the afternoon of June 5. Please 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 to get more information about everything that’s happening.

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 IS MAY 7
For additional information, contact Matt Smyth, Senior Director of Grassroots and Member Advocacy: 202-898-2817, msmyth@ahca.org

 Learn more about our sponsors:

Official Sponsor
Medline

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

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.  

RNs with Strong Gerontological Nursing Skills Help Reduce Rehospitalizations


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. 

There are less than two weeks left on the highly popular spring sale on AHCA/NCAL Gero Nurse Prep. Save $100 off the regular registration fee now through April 30 by using promo code QUALITY18 (all caps). 

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. 

Research conducted by AHCA/NCAL in 2016 found that the rehospitalization rates in nursing facilities with at least one RN certified in gerontological nursing by the ANCC consistently have run at least two percentage points lower than the national average since 2011. AHCA/NCAL believes that assisted living settings may experience similar results by increasing their RNs’ gerontological expertise. 

AHCA/NCAL Gero Nurse Prep is affordable and provides value at the $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. 

The Number of Open LTC Jobs Doubles in April



There are 32,485 open jobs posted by direct employers in the nursing care facility (including SNFs), assisted living, and continuing care retirement community (CCRC) sectors this month according to the latest CEB TalentNeuron statistics. That is more than double the number of open jobs posted by long term care employers in March.   

The CEB TalentNeuron statistics also show an estimated 2,101,000 potential candidates in the nation’s workforce whose skills likely match the qualifications being sought by long term care employers. Figures show that 2,381 direct employers are competing for candidates this month – an increase of more than 600 over March. The average number of days a job was posted increased by three days in April to 39 days.   

Finding qualified employees is one of the greatest challenges facing long term care providers and April’s statistics prove that the challenge is only growing in the strong economy. The AHCA/NCAL Long Term Care Career Center is designed to help members be competitive in attracting qualified candidates to fill their health care job vacancies. The LTC Career Center works because it attracts top health care candidates and employers. It is also fully integrated with Google’s job search feature “Google for Jobs” creating greater exposure for job postings.

Rates for posting job vacancies are affordable and give prospective employers far greater exposure than local ads and job boards by connecting to a network of more than 300 national and state health care organizations and societies. Employers are also able to post vacancies as they occur and search resumes on the network. 

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

Employers who utilize the site also receive outstanding exposure through rotating job listings on AHCA’s home page – the web site where long term care professionals go for news and information. In addition, employers who post vacancies through the center receive bonus rotating listings on the Long Term Care Career Center  home page. 

Of course, the LTC Career Center is always free for job seekers and the LTC Career Center  features many of the best positions the long term care profession has to offer. Job seekers are using the site with nearly 100,000 searchable resumes on the National Healthcare Career Network this month. Job postings on the AHCA/NCAL Long Term Care Career Center network are averaging nearly 1,300 views in April. 

Join the growing list of high profile employers who use AHCA/NCAL’s premier member resource to find top talent. Check out the LTC Career Center today and remember to use one of the two promo codes to save on your job postings.     

HCBS Settings Rule: Spotlight on Memory Care


Lilly Hummel

NCAL Publishes Policy Briefs on HCBS Settings Rule

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 Memory Care: An Effective Person-Centered Planning Process Is Key for Memory Care Units. CMS guidance emphasizes the crucial importance of a person-centered planning process for individuals with dementia. This includes the meaningful choice of setting (including one with controlled egress), ensuring that any modifications to the protections of the rule are based on a person-centered process and respond to a specific individual need, and how best practices in dementia care can assist with compliance with the rule and improve overall care. The brief also summarizes a variety of best practices in dementia care, including publications from the Center for Excellence in Assisted Living, the Alzheimer’s Association, CCAL, and the Administration for Community Living.

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.

NCAL Awards Program: 2018 Nominations are Underway!

Jean-Bernard Latortue

Know of an outstanding assisted living nurse or administrator? Last year, did your community create the best National Assisted Living Week® programming based on the "Family is Forever" theme? Or maybe there is an unlicensed caregiver or someone in the dietary, housekeeping, or maintenance departments who goes above and beyond the call of duty? If you answered yes, then check out NCAL’s 2018 Awards Program. This program gives awards in four categories:

  • Administrator of the Year
  • Nurse of the Year
  • Noble Caregiver in Assisted Living
  • National Assisted Living Week Programming

You must have all components of your application before you can submit a nomination online. To nominate, the following items are required:

  • Administrator and Nurse of the Year nominations - Must have essays and resumes
  • Noble Caregiver in Assisted Living nominations - Must have essays
  • National Assisted Living Week Programming nominations - Must have essay, calendar, and pictures.

Recipients (and one guest) receive a FREE trip to AHCA/NCAL’s 69th Annual Convention & Expo in San Diego, CA, October 7-10, 2018. Each will be honored in front of their peers during NCAL Day and the Closing General Session of the Convention.

For more information and to submit a nomination, please visit www.ncal.org/awards. Completed nominations must be submitted no later than Friday, June 8, 2018.

Help recognize those that demonstrate outstanding service!

Webinar: AALNA/NCAL Caring Together Webinar on Infection Control



April 24, 3:00 PM - 4:00 PM EST
Please join the American Assisted Living Nurses Association (AALNA) and National Center for Assisted Living (NCAL) for the first webinar in our 2018 Caring Together series. Our presenter, Dr. Abimbola Ogundimu, Dr.PH., RN, CIC is a certified Infection Preventionist with the Centers for Disease Control and Prevention (CDC). The webinar, Strategies for Preventing and Managing Multidrug-Resistant Organisms (MDROs) and C. difficile in Long-Term Care is for assisted living nurses but everyone interested in infection control is welcome to join. An overview of MDROs and C. difficile will be covered including the emergence and spread of both in health care settings. Dr. Ogundimu will outline actions that caregivers should take to minimize the spread of MDROs and C. difficile. The Webinar will be held on Tuesday, April 24th at 3:00pm – 4:00pm Eastern. Registration for the webinar can be found here.

Tuesday, April 17, 2018

CMS Revised Guidance: Penalty Period Start Date for 1915(c) Waiver Participants

Lilly Hummel


The Centers for Medicare and Medicaid Services (CMS) released new guidance this week to correct an unintended consequence of prior guidance for determining the penalty start date of an asset transfer for Medicaid applicants seeking eligibility for home and community-based services (HCBS) delivered under a 1915(c) waiver.

According to the revised guidance, the penalty period start date for these applicants is no later than the point at which the applicant would otherwise be receiving HCBS waiver coverage based on the approved application for such care, but for the penalty. 

Specifically, the penalty period start date would be no later than the date the state confirms that it has: 

(1) Determined that the applicant meets the financial and non-financial requirements for Medicaid eligibility and the level-of-care criteria for the 1915(c) waiver; 
(2) Developed a person-centered service plan; and 
(3) Identified an available waiver slot.

The earlier guidance (SMDL #06-018) created a catch-22 for those applying to receive HCBS services under a 1915(c) waiver and who were subject to an asset transfer penalty period.Under that guidance, the penalty period did not begin to run until the individual began receiving HCBS waiver services, but the individual could not begin to receive waiver services until the penalty period has run. The result was an infinite penalty period. 

CMS stated that the new guidance will ensure CMS is interpreting the provision consistent with statutory intent.

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. 

OIG announced plans to conduct work on Medicaid nursing home supplemental payments and to issue a report in FY2019. CMS has approved a nursing home supplemental payment program in some states that pays the difference between Medicare and Medicaid rates for nursing home services. 

OIG plans to review the nursing home supplemental payment program's flow of funding and determine how the funds are being used.

Secretary Azar to Speak at Congressional Briefing



Secretary of Health and Human Services (HHS) Alex Azar will address attendees at the 2018 AHCA/NCAL Congressional Briefing. The Secretary will speak to post-acute and long term care providers the morning of Tuesday, June 5, before the group goes to Capitol Hill to meet with lawmakers.

Secretary Azar was confirmed by the Senate on January 24 and was sworn in by Vice President Pence on January 29. He was formerly Deputy Secretary of HHS under George W. Bush from 2005 to 2007 and General Counsel of the agency prior to that. Before being confirmed as Secretary, Mr. Azar was President of the U.S. division of Eli Lilly and Company, a major pharmaceutical drug company.

Held on June 4 and 5 in Washington, D.C., Congressional Briefing offers attendees the chance to network with their peers, receive legislative briefings from professionals in the sector, as well as hear from other top voices in Washington.


The Advanced Registration Deadline is May 7 and prospective attendees are encouraged to register as soon as possible. Overflow space has been recently added, as this Congressional Briefing is on-pace to be the largest to-date.


During his confirmation hearings, Senate Finance Chairman Orrin Hatch told Mr. Azar, “You’re one of the best public servants that I’ve seen in the whole time. I’ve been here.” 

Mr. Hatch has served in the Senate for 41 years.

Mr. Azar graduated from Yale Law School and was a law clerk for Justice Antonin Scalia of the Supreme Court.


Thursday, April 12, 2018

Check Out the New LTC Trend Tracker SNF VBP Predictor Tool


AHCA/NCAL has launched the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Predictor Tool, available exclusively to skilled nursing center members through LTC Trend Tracker, to help organizations determine the financial impact of the Centers for Medicare & Medicaid Services' (CMS) SNF VBP Program on their facility. 

Data collected for the first year of the SNF VBP program will impact reimbursement for skilled nursing care centers beginning October 1, 2018.

About the Tool

The SNF VBP Predictor Tool provides valuable insights about your center's performance for the Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM), and enables you to plan for future Medicare Part A disbursement based on this performance to quickly establish benchmarks and set targets to guide performance improvement. 

By using the SNF VBP Predictor Tool, skilled nursing center members can create additional projections using their own internal revenue and readmissions data, such as SNFRM rates provided in CMS feedback reports. Using the tool's slider features, members can see the impact of readmissions on their Medicare reimbursement. 

If you have questions about the tool, you can access the SNF VBP Predictor Tool one-pager here and help document here. For additional FAQs and resources on the SNF VBP program, visit AHCA's SNF VBP website here.

Upcoming Webinar

Members are also encouraged to register for an upcoming webinar here about the SNF VBP Predictor Tool on Monday, April 23 from 1:00-2:00 p.m. Eastern. During the webinar, AHCA Senior Vice President of Quality and Regulatory Affairs, Dr. David Gifford, will provide background information on the SNF VBP Program and a demo of the Tool. Coupled with peer testimony, this webinar will demonstrate the value of using the SNF VBP Tool even before the SNF VBP Program begins.

Access the Tool Now

Current LTC Trend Tracker users can access the Tool by logging to their account here. AHCA member non-users can sign up for an LTC Trend Tracker account here

For any assistance with LTC Trend Tracker, email help@ltctrendtracker.com.

Wednesday, April 11, 2018

HCBS Settings Rule: Spotlight on Resolving Differences between Licensure and the Rule’s Requirements

NCAL Publishes Policy Briefs on HCBS Settings Rule 



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 Licensure: Resolving Differences Between State Assisted Living Licensure Requirements and HCBS Settings Rule. This brief provides information for AL communities in states whose state requirements may not match or comply with the Settings rule. Differences may include regulations regarding: staffing, which may require or encourage co-mingling and cross training of AL and nursing facility staff; discharge, which require discharge of an individual who has reached a higher level of care; and regulations that require controlled egress or other limitations for people with dementia. To date, CMS has approved transition plans that do not change state regulatory language that is counter to the rule, but the states’ plans promise future changes or clarification in provider manuals and other official communications.

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.

Concerned About Germs?

AHCA/NCAL’s On-Line Infection Prevention and Control Program Works for Assisted Living Settings Too


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 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.

Overflow Hotel Added for Congressional Briefing

Drew Thies


The Washington Court Hotel was added to the AHCA/NCAL Congressional Briefing due to increased registration. The official event location, the Hyatt Recency, is sold out. Last year’s Congressional Briefing was the largest ever and the event is expected to continue to grow.

The Advanced Registration Deadline is May 7 and prospective attendees are encouraged to register as soon as possible. The Washington Court Hotel is one block away from the Hyatt Regency and space continues to fill up quickly.

Held on June 4 and 5 in Washington, D.C., Congressional Briefing offers attendees the chance to network with their peers, receive legislative briefings from professionals in the sector, hear from some of the top voices in Washington, and meet with their legislators to advocate on behalf of the patients they serve. 

Pulitzer Prize-winning journalist Carl Berstein, known for his work on the Watergate scandal, is slated to give a speech.

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, first-serve basis. 

For questions, please contact meetings@ahca.org, or call (202) 842-4444.

Calling All Graduates – The Long Term Care Career Center is a Great Place for Jobs!



Graduation season is just around the corner. The AHCA/NCAL Long Term Care Career Center, is a great resource for nursing students and high school and college seniors 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 job seekers and has some of the top long term care jobs in the country. Serious job seekers use this site. Job postings on the AHCA/NCAL Long Term Care Career Center, average more than 1,200 views a month. That big number means the LTC Career Center  has the jobs people want and qualified candidates searching for positions. 

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

Gero Nurse Prep is the Fast, Effective and Affordable Way to Bolster Gerontological Nursing Expertise


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 and that knowledge increases credibility.    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. 

Make the Most Common F Tag Citation Less Common



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 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/ipcoDiscounted 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!