Friday, December 20, 2019

Save the Date for Careers in Aging Week

Careers in Aging Week (CIAW) is a national, annual observance created by the Gerontological Society of America (GSA) to raise awareness about the diverse careers available in the field of aging. CIAW will take place on April 19-25, 2020.

CIAW is observed annually by businesses, clinics, coalitions, organizations, universities, colleges, and other parties across the nation. Check out our efforts from last year’s CIAW that include webinars, workforce interviews, and more at www.careersinaging.com. Visit AHCA/NCAL’s Workforce Resource Center for more information on our workforce efforts, and stay tuned for more information on CIAW 2020 coming soon!

Achievers of 2020 AHCA/NCAL Quality Initiative Recognition Program Announced

Kiran Sreenivas

At AHCA/NCAL’s Quality Summit in Grapevine, Texas on March 10, 2020, 9,898 skilled nursing and assisted living member facilities will be recognized for their quality performance over the past two years.

The 2018-2021 AHCA/NCAL Quality Initiative set goals in four key performance areas. Those areas for skilled nursing are hospitalizations, off-label use of antipsychotics, customer satisfaction, and functional outcomes. For assisted living, the areas are hospitalizations, off-label use of antipsychotics, customer satisfaction, and staff stability.


Thirty-nine percent of skilled nursing members achieved 3 or 4 national quality goals. Recognition is tiered from 1 to 4 based on the number of goals achieved. 

You can find your local achievers on the Recognition Program’s webpage.

Highest Performance on Improved Functional Outcomes and Reduced Antipsychotics 

In order to measure improvement, the Initiative uses publicly reported data, such as those found on Nursing Home Compare. All assisted living and all customer satisfaction data is dependent on facilities uploading their metrics to LTC Trend Tracker, AHCA/NCAL’s online data tracking tool, which largely explains the lower achievement percentages on those measures. 

The two skilled nursing focus areas with the most achievers were functional outcomes at 66 percent and antipsychotics at 79 percent. These achievements are possible through hard work, creativity, and strategic operations, such as PruittHealth’s use of consultant pharmacists to lower antipsychotic rates and rewarding high performing nurse aides with a trip to Disney to learn additional skills.  

AHCA/NCAL created the Quality Initiative Recognition Program to honor member facilities for their individual work in achieving national quality goals. The Initiative continues to challenge member providers to meet these measurable targets by March 2021. 

Submit Your AHCA/NCAL National Quality Award Application

qualityaward@ahca.org

The deadline to apply for the 2020 AHCA/NCAL National Quality Award Program is quickly approaching. Providers must submit their application and payment by 8 pm ET on January 23, 2020. Late submissions will not be accepted.

An application can be submitted regardless of whether or not you submitted an Intent to Apply payment, so don't delay and start your application today.  To get started, find all of the information you need in our application packets and additional resources available on the applicant webpages: BronzeSilver, and Gold.

Then submit your application and payment through the Quality Award Portal! We encourage members to log in to the Portal before the deadline to avoid any delays in setting up your user account.

Why should you apply?
  • The program provides a proven framework that organizations can use to make improvements in clinical, quality or other operational outcome areas;
  • Quality Award recipients perform better than the national average on key quality metrics;
  • The program criteria prepare providers for regulatory demands such as CMS’ Quality Assurance/Performance Improvement (QAPI) requirements and the Medicare and Medicaid Requirements of Participation (RoP);
  • The award journey increases staff morale and engagement; and
  • It provides national validation of your quality and services – the perfect information to share with your consumers, stakeholders and referral partners.

Questions? Contact qualityaward@ahca.org.

Updated Five-Star Quality Measure Predictor Tool Released on LTC Trend Tracker

Kiran Sreenivas

Starting December 19, LTC Trend Tracker users have access to a tool that shows what is determining their Five-Star Quality Measure ratings and how they can improve.

The tool reflects three major changes the Centers for Medicare & Medicaid Services (CMS) introduced to the Five-Star rating in April and October 2019. The first was the addition of short- and long-stay quality component star ratings. The second was a change in individual measure weighting. Measures deemed by CMS in need of greater national improvement are weighted up to 150 points, while other measures have a max of 100 points. The third major change was in the measures used. Some measures were removed (e.g. pain and restraints), while others were added (e.g. long-stay ED visits) or substituted (e.g. short-stay pressure ulcers with quality reporting program’s pressure ulcer measure).

The tool is dynamic and allows users to model how a change in one or more quality measures would impact their Five-Star Quality ratings. Users can also save these values.

The below image shows the sub-component short- and long-stay star ratings alongside the overall quality rating.

In the below image, you see the individual short-stay measures used in Five-Star. The shaded bars show how many points you have received for each measure and how close you are to gaining or losing additional points based on your current rate on Nursing Home Compare. 


LTC Trend Tracker is a free member benefit. Make sure you registered today to take advantage of this and other tools. 

Phase 3 Interpretive Guidance – Delayed

Pam Truscott

Phase 3 of the Requirements of Participation (RoP) went into effect on November 28, 2019. However, as the Centers for Medicare & Medicaid Services (CMS) announced in a memo (QSO-20-03-NH) released on November 22, 2019, CMS will not be releasing the interpretive guidance (IG) for Phase 3 until the second quarter of 2020.  Centers are expected to comply with all requirements. However, CMS stated that surveyors will have limited ability to survey for compliance with the Phase 3 requirements until the IGs are released.

Phase 3 regulations include the implementation of the following key areas:
  • Infection Preventionist
  • Compliance and Ethics Program  
  • Quality Assurance and Performance Improvement (QAPI) Program
  • Trauma-informed Care
  • Beside Call System
  • Comprehensive Training Program
Although the IGs are an important tool to help you implement these requirements, there are many steps centers can take now using tools and resources AHCA has developed to navigate Phase 3.  We encourage you to visit the ahcancalED platform located at https://educate.ahcancal.org/. Examples of resources include: Phase 3 overview materials, behavioral health and trauma informed care, infection preventionist role & competencies including the Infection Prevention and Control Officer (IPCO) training, Compliance and ethics program, as well as a plethora of general resources to support the implementation and compliance of Phase 3.


Wednesday, December 18, 2019

Key Considerations for the 2020 FedEx and UPS Rate Increases


Rates are going to increase in 2020 with carriers FedEx and UPS. Here are the top takeaways AHCA/NCAL members need to know to keep costs low:
  • FedEx and UPS small package rates are increasing an average of 4.9% - effective January 6, 2020 and December 29, 2019 respectively.
  • Your actual costs will vary. Depending on the service you use and your package characteristics, you could see increases above or below the average. 
  • Many common surcharges are also increasing. On top of the base rates, you need to be aware of the charges that apply to your shipments and how they’ll affect your total costs.
PartnerShip®, the endorsed shipping provider for AHCA/NCAL, has sorted through the rate charts and put together a complete guide for AHCA/NCAL members. Download the free white paper for key details about the new rates and how they may impact your business.

AHCA/NCAL members have exclusive access to discounts on select FedEx® services to help offset these increases. Enroll today to start saving.

Networking and More at the 2020 Independent Owner Leadership Conference



The Independent Owner (IO) Leadership Conference offers a unique setting for networking and sharing ideas and solutions.  It takes place immediately following the Quality Summit.

March 11-13, 2020
Gaylord Texan Resort & Convention Center
Grapevine, TX


This year’s theme is Solutions to Differentiate Your Business. 

Join other owners, operators, or administrators of roughly 10 or fewer facilities to discuss the challenges you face. You’ll learn some new strategies and best practices for workforce issues, PDPM, business growth, and more.

See the agenda and get details on all the education sessions. You can earn up to 13.75 CEs.

In addition to informal networking opportunities, highlights include:
  • Owner-to-Owner Town Hall facilitated by Mark Parkinson, President & CEO of AHCA/NCAL
  • LED Talks curated by Provider magazine
  • Networking Dinner
  • Lunch and Learn
  • Marketplace Meet Ups with sponsors
  • Choice of networking activities
Register and make your hotel reservations early. Hotel reservations must be made by Friday, February 7, 2020 in order to take advantage of the special AHCA/NCAL group rates.

Sponsors as of December 16, 2019:
Evans Senior Investments, Grace Financial Services, Guardian Pharmacy Services, srx

Sign Up to be Notified about the Launch of AHCA’s 2020 PDPM Academy

Dave Kyllo

Now that the Patient Driven Payment Model (PDPM) system is in effect for skilled nursing facilities, AHCA’s existing PDPM Academy resources will be archived at the end of December and no longer updated.

AHCA then will launch its new 2020 PDPM Academy that will provide new tools and resources to help AHCA members navigate challenges, incorporate changes and successfully operate under PDPM.  Resources available through 2020 PDPM Academy will include:

  • Virtual in-depth training modules on PDPM best practices (including role-specific modules);  
  • Monthly webinars; 
  • Additional tools and resources; and,
  • AHCA’s analyses of CMS’s technical changes and updates to PDPM.  

To receive an email notification when enrollment for 2020 PDPM Academy opens, follow this link and enter your name, company name and email address.  Signing up for the early notification is fast and easy. 

AHCA members who have questions now about PDPM can send an email to pdpm@ahca.org or  call 202-842-4444 and ask to speak to a PDPM Resource Navigator. 

Watch this Webinar to Learn What “Now Hiring All Shifts” Says to Prospective Employees

Dave Kyllo

AHCA/NCAL now offers an instructional webinar titled “Pioneering Solutions to the Workforce Crisis.”  This 45-minute webinar developed in collaboration with PHI delivers practical action steps and strategies assisted living and nursing facilities of all shapes and sizes can take to improve their employee and retention efforts. The webinar also covers ways to improve the hiring process and explains supportive supervision and coaching methods that positively impact employee retention. 
The webinar’s learning objectives include:

  1. Explain the key factors contributing to the workforce shortage
  2. Identify at least 3 strategies to improve employee recruitment
  3. Identify at least 3 strategies to improve employee retention
  4. Explain the impact of supportive supervision on retention

This webinar is part one to a more extensive on-line training for middle managers that will be released in the coming months.  While no CEUs are offered for this webinar, participants can receive a certificate of completion.  The cost of the course is $25 for AHCA/NCAL members and $60 for non-members. 

The instructor is Sue Misiorski who served as Vice President of Workforce Innovations for PHI and currently serves as the New England Regional Director of Operations for SageLife.  Starting as a CNA, she later held positions as a DON and VP of Nursing in multi-site skilled nursing homes in New England and has supported the construction of several assisted living and nursing facilities. 

Follow this link to read more about this educational webinar and to register for the course:  https://educate.ahcancal.org/products/pioneering-solutions-to-the-workforce-crisis#tab-product_tab_overview. 

To access ahcancalED and the Pioneering Solutions webinar, 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.

ACHCA Discontinues CNHA & CALA Exams and Revises Criteria for its Fellow Program

The American College of Health Care Administrators (ACHCA) released the following announcement this week about the discontinuation of the ACHCA certification exams (Note: not mandated state licensure exams) for nursing home and assisted living administrators:

“Recently the ACHCA Board of Directors on the recommendation of the Professional Advancement Committee determined that the CNHA and CALA exams shall be discontinued.  ACHCA will no longer offer the Certified Nursing Home Administrator (CNHA) and the Certified Assisted Living Administrator (CALA) exams.

Individuals who have previously earned these credentials will be able to keep them and renew them. Those who have earned the CNHA and CALA credential, whether singly or as a component of multiple credentials, may maintain their status by renewing it every five years as they do now, with the only change being that these credentials can no longer be renewed by taking the exams. The Executive Portfolio or Executive Level Course may be utilized for renewing credentials.

Several factors contributed to the discontinuation of the certification exams. A critical decline in interest in these credentials, trends in post-acute health care delivery, negligible candidates for test taking (only one person has taken and passed the CNHA exam in 2019), and a lack of methodology to demonstrate the value of these credentials contributed to the decision. Our current practice analysis, the blueprint upon which the exams are based, is extremely outdated.  Added to these factors is the hard reality that the maintenance of the credentials places a significant financial burden on the entire certification program. The financial estimate to do a new practice analysis and reinvigorate the program is far in excess of our organization’s ability to manage.

Changes reflecting the discontinuation of the CNHA and CALA credentials will appear on the ACHCA website and in the Certification Candidate Handbook.”

ACHCA’s Fellow program continues to operate as before but with changes to the criteria for earning points toward the Fellow (FAHCA) designation.  The designation of Fellow represents the highest level of ACHCA membership.  Obtaining and maintaining the FACHCA distinction demonstrates the administrator’s commitment to professionalism and dedication to leadership and service excellence.  FACHCA is also considered a mark of distinction that sets the administrator apart from his/her peers. 

Two noteworthy changes to the Fellow criteria are the ability to earn points for receiving a AHCA/NCAL Bronze, Silver or Gold National Quality Award, and points can be earned for earning NAB’s Health Services Executive™ (HSE) credential. 

For questions or more information regarding the exam announcement or ACHCA’s Fellow program, please feel free to contact ACHCA President/CEO Bill McGinley at bill@achca.org.

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

Lilly Hummel

The US Department of Health and Human Services, Office of Inspector General (OIG) has released its updated List of Excluded Individuals and Entities (LEIE) database file, which reflects all OIG exclusions and reinstatement actions up to, and including, those taken in November 2019. This new file replaces the updated LEIE database file available for download last month. Individuals and entities that have been reinstated to the federal health care programs are not included in this file.

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

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

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

Long Term Care and the Law Conference March 2-4, 2020

Che'z-Marie Franklin 

Register to attend the Long Term Care and the Law program March 2-4, 2020 in San Antonio, TX. This informative program brings together some of the leading in-house and external counsel to discuss legal, compliance, and operational issues that long term care providers face. This year’s conference features many sessions useful for nursing centers and assisted living providers, such as Medicaid managed care contracting, sexual harassment, accounts receivable, HIPAA, and the Fair Housing Act—just to name a few. State affiliates and attorneys in-house with provider members of AHCA/NCAL receive the AHLA member rate of $895. Non-attorney provider staff have a rate of $750.

The morning of March 2 before the conference begins, the National Center for Assisted Living will host a FREE round table open to all assisted living in-house counsel. This is a unique opportunity for in-house counsel peers to discuss their concerns and how to manage emerging issues. Email Che’z-Marie Franklin at CFranklin@ncal.org to attend. The American Health Lawyers Association (AHLA) offers CLE, CPE, NHA, and CCB credits for the conference. Don’t miss this excellent educational opportunity.

Tuesday, December 17, 2019

Mark Parkinson Named a 2019 Top Lobbyist

AHCA/NCAL President & CEO Mark Parkinson has been named a Top Lobbyist by The Hill for the seventh consecutive year. According to the publication, the 2019 list includes those that are "at the top of their game — and the ones the nation’s biggest companies, labor unions and associations turn to when they want their voices heard in the nation’s capital."

Under Mark’s leadership, the Association continues to improve the lives of millions of long term and post-acute care residents by delivering solutions for quality care.

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

Wednesday, December 11, 2019

2020 Quality Summit Features Vital PDPM Sessions

Jon-Patrick Ewing

Come network with your colleagues and receive valuable education at the 2020 AHCA/NCAL Quality Summit, March 9-11, 2020, in Texas. At this year’s Summit, national subject matter experts will lead sessions on person-centered care, emergency preparedness, leadership, infection prevention, and more. Attendees can generate strategies to improve clinical, quality, regulatory and workforce outcomes.

Additionally, the 2020 Quality Summit features PDPM sessions highlighting AHCA’s approach to breaking down the barriers between payment policy and quality.  And, in keeping with CMS’ vision, the session will offer concrete approaches to linking quality to payment in compliance with CMS Policy.

Check one thing off your holiday to do list and register for the Quality Summit!

For more information and to register visit QS.ahcancal.org. The housing deadline is February 7.

Tuesday, December 10, 2019

How’s your Quality Award application coming?

qualityaward@ahca.org

The deadline to apply for the 2020 AHCA/NCAL National Quality Award Program is quickly approaching. Providers must submit their application and payment by 8 pm ET on January 23, 2020. Late submissions will not be accepted.

An application can be submitted regardless of whether or not you submitted an Intent to Apply payment, so don't delay and start your application today.  To get started, find all of the information you need in our application packets and additional resources available on the applicant webpages: Bronze, Silver, and Gold.

Then submit your application and payment through the Quality Award Portal! We encourage members to log in to the Portal before the deadline to avoid any delays in setting up your user account.

Why should you apply?

  • The program provides a proven framework that organizations can use to make improvements in clinical, quality or other operational outcome areas;
  • Quality Award recipients perform better than the national average on key quality metrics;
  • The program criteria prepare providers for regulatory demands such as CMS’ Quality Assurance/Performance Improvement (QAPI) requirements and the Medicare and Medicaid Requirements of Participation (RoP);
  • The award journey increases staff morale and engagement; and
  • It provides national validation of your quality and services – the perfect information to share with your consumers, stakeholders and referral partners.

Questions? Contact qualityaward@ahca.org.

Looking for a New Year Resolution That Pays: Have Cleary Energy Audit Your Utility Bills in 2020

Dave Kyllo

Three out of four long term care facilities are being overcharged for one or more of their utilities. Providers don’t receive better service or any other benefit for over paying utility companies. The good news is that putting an end to the overpayments is easy.

Cleary Energy is a AHCA/NCAL preferred provider and has recouped on average 4% to 8% savings on utilities for long term care facility customers. Here are some real life examples of how long term care providers saved:

  • A nursing facility recovered $25,000 in retroactive charges from an electric and gas utility account and the facility will save an additional $7,500 per year going forward.     
  • A nursing facility was overpaying the tariff on their gas account and is now saving $10,000 annually going forward.
  • A Midwest assisted living facility received $5,800 from utility overpayments that Cleary Energy recently found.      

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. 

The program is designed to save AHCA/NCAL members significant money on their utility bills without adding new expenses to their budgets.  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 for an audit comes directly from the utilities or suppliers. 

Cleary Energy’s long term care experience sets the company apart with over 40 years of long term care operational experience.  That in-depth knowledge 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

AHCA Has the Training New Staff Need to Understand ICD-10 Coding

Dave Kyllo

While staff will come and go, the need to understand ICD-10 coding remains constant for skilled nursing facility (SNF) professionals. The American Health Care Association (AHCA) and the American Health Information Management Association (AHIMA) offer ICD-10 on-line training. Because staff needs differ based on their coding responsibilities, two specific trainings have been developed – one training for coders and a shorter less intense course for non-coders. 

AHCA/AHIMA ICD-10 Training for PDPM – Coder is an in-depth course designed for SNF billing staff, MDS staff, Nursing and Therapy staff, and Admissions and Discharge staff.  The course contains seven modules and comes with 16 CNEs for nurses and 16 AHIMA CEs upon successful completion.  The cost is $499 for AHCA members and $599 for non-members.

AHCA/AHIMA ICD-10 Training for PDPM – Non-Coder is a four-hour course developed for individuals who need to lead a successful PDPM transition and is intended for Administrators, DONs, and other management staff.  The course for non-coders comes with 4 CNEs for nurses, 4 AHHIMA CEs or 4.5 NAB approved CEs upon successful completion.  The cost is $199 for AHCA members and $249 for non-members.

With thousands of codes and nuances specific to the SNF Patient Driven Payment Model (PDPM), accurate ICD-10 coding is essential. PDPM relies on accurate patient assessments and diagnosis on the MDS and ICD-10 coding to determine payment for each patient. Inaccurate coding can negatively impact a facility’s bottom line and resident care, so it is imperative for new SNF staff to quickly build their ICD-10 coding knowledge.

To learn more or register for either on-line training, please visit the websites below.   

AHCA/AHIMA ICD-10 Training for PDPM – Coder:        ahcancal.org/icd10pdpmcoder
AHCA/AHIMA ICD-10 Training for PDPM – Non-Coder: ahcancal.org/icd10pdpmnoncoder

Members will need to login with their AHCA/NCAL usernames and passwords.  For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail educate@ahca.org with your name and facility contact information. 

CMS Skilled Nursing Facilities/Long Term Care Open Door Forum

The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for: 

Date:  Thursday, December 12, 2019
Start Time:  2:00 PM – 3:00 PM Eastern Time (ET);

Please dial-in at least 15 minutes before call start time.

Conference Leaders: Todd Smith & Jill Darling
**This Agenda is Subject to Change**

  1. Opening Remarks
    • Chair – Todd Smith (Center for Medicare)
    • Moderator – Jill Darling (Office of Communications)
  2. Announcements & Updates
    • *PDPM Update
    • *Fiscal Year 2020 SNF VBP Facility-Level Dataset and SNF VBP Aggregate Performance
  3. Open Q&A

Mailbox: SNF_LTCODF-L@cms.hhs.gov

This Open Door Forum is open to everyone, but if you are a member of the Press, you may listen in but please refrain from asking questions during the Q & A portion of the call. If you have inquiries, please contact CMS at Press@cms.hhs.gov.

Open Door Participation Instructions:
This call will be Conference Call Only.

To participate by phone:
Dial: 1-888-455-1397 & Conference Passcode: 4676500
Persons participating by phone do not need to RSVP. TTY Communications Relay Services are available for the Hearing Impaired.  For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

Instant Replay: 1-800-509-8621; Conference Passcode: No Passcode Needed
Instant Replay is an audio recording of this call that can be accessed by dialing 1-800-509-8621. Instant Replay begins 1 hour after the call has ended. The recording expires December 15, 2019, 11:59 PM ET

For ODF schedule updates and E-Mailing List registration, visit http://www.cms.gov/OpenDoorForums/.

Were you unable to attend the recent Skilled Nursing Facilities (SNF)/Long Term Care (LTC) ODF call? We encourage you to visit our CMS Podcasts and Transcript webpage where you can listen and view the most recent Skilled Nursing Facilities (SNF)/Long Term Care (LTC) ODF call. Please allow up to three weeks to get both the audio and transcript posted to: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts.html.

CMS provides free auxiliary aids and services including information in accessible formats. Click here for more information. This will point partners to our CMS.gov version of the “Accessibility & Nondiscrimination notice” page.

Wednesday, December 4, 2019

Coalition Letters to Congress on the Medical Expense Deduction

Dana Ritchie

AHCA/NCAL recently signed onto AARP driven House and Senate letters to members of Congress around the medical expense deduction. Specially, the letters urge support for the Medical Expense Savings Act (S. 110/H.R. 2073), which is bipartisan legislation that would make permanent the 7.5 percent threshold for the medical expense deduction. The letters also ask to support an extension of the 7.5 percent threshold in an end-of-year legislative package. Without action, 4.4 million Americans with high medical costs will face an unexpected tax increase when they file their returns in the coming months. For more than 75 years, Americans with high health care costs have been able to deduct medical expenses from their taxes. For the millions of Americans who annually take this deduction, it provides important tax relief which helps offset the costs of acute and chronic medical conditions. This includes costs associated with long-term care, assisted living, and nursing homes.

The Sources for Generating Electricity Are Changing

Special Feature Article from APPI Energy

Renewable energy is projected to provide half of the world’s electricity within the next 30 years. Renewable energy currently accounts for 28% of the global electricity and power capacity is expected to increase by 49% in the next 5 years.   In 2018, 96% of renewable energy was produced by three main areas; hydropower, wind, and solar. Projections are already being made that by 2024 a third of the Earth’s electricity will be provided by renewable energy which will be neck and neck with the world’s current generating leader, coal.

Leading the renewable energy growth trio is solar generation with expectations of growing 60% by 2024. Declining technology costs, regional load growth, and renewable policies all lead to an increase in the solar generation market. Second to solar, wind power should also show substantial growth in the next few years. Onshore wind is expected to make up a quarter of the renewable energy growth and off shore wind project costs are expected to decline 45-50% in the next five years. Growth in the hydropower market is not as vast since the main production method for hydropower is through an existing dam or construction of a man-made dam for generation pushing it third in growth expectation.

AHCA/NCAL partners with APPI Energy, a trusted name in energy consulting for 23 years, as our preferred provider of energy procurement and efficiency services.  APPI Energy can provide AHCA/NCAL members with the steps to utilizing renewable energy through its Energy Solutions Division.  For more information about an energy efficiency project, please visit APPI’s website at www.appienergy.com or call 800-520-6685.

New Training Offers Practical Strategies to Boost Employee Recruitment and Retention

Dave Kyllo

AHCA/NCAL offers a new instructional webinar titled “Pioneering Solutions to the Workforce Crisis.”  This 45-minute webinar developed in collaboration with PHI delivers practical action steps and strategies assisted living and nursing facilities of all shapes and sizes can take to improve their employee and retention efforts. The webinar also covers ways to improve the hiring process and explains supportive supervision and coaching methods that positively impact employee retention. 

The webinar’s learning objectives include:

  1. Explain the key factors contributing to the workforce shortage
  2. Identify at least 3 strategies to improve employee recruitment
  3. Identify at least 3 strategies to improve employee retention
  4. Explain the impact of supportive supervision on retention

The instructor is Sue Misiorski who served as Vice President of Workforce Innovations for PHI and currently serves as the New England Regional Director of Operations for SageLife.  Starting as a CNA, she later held positions as a DON and VP of Nursing in multi-site skilled nursing homes in New England and has supported the construction of several assisted living and nursing facilities.
 
This webinar is part one to a more extensive on-line training for middle managers that will be released in the coming months.  While no CEUs are offered for this webinar, participants can receive a certificate of completion.  The cost of the course is $25 for AHCA/NCAL members and $60 for non-members. 

Follow this link to read more about this educational webinar and to register for the course:  https://educate.ahcancal.org/products/pioneering-solutions-to-the-workforce-crisis#tab-product_tab_overview.

To access ahcancalED and the Pioneering Solutions webinar, 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.

Coming Soon…AHCA’s 2020 PDPM Academy

Dave Kyllo

Now that the Patient Driven Payment Model (PDPM) system is in effect for skilled nursing facilities, AHCA’s existing PDPM Academy resources will be archived at the end of December and no longer updated.

AHCA then will launch its new 2020 PDPM Academy that will provide new tools and resources to help AHCA members navigate challenges, incorporate changes and successfully operate under PDPM.  Resources available through 2020 PDPM Academy will include:

  • Virtual in-depth training modules on PDPM best practices (including role-specific modules); 
  • Monthly webinars;
  • Additional tools and resources; and,
  • AHCA’s analyses of CMS’s technical changes and updates to PDPM. 

To receive an email notification when enrollment for 2020 PDPM Academy opens, follow this link and enter your name, company name and email address.  Signing up for the early notification is fast and easy.

AHCA members who have questions now about PDPM can send an email to pdpm@ahca.org or  call 202-842-4444 and ask to speak to a PDPM Resource Navigator.

Tuesday, December 3, 2019

CDC Releases FAQs about Enhanced Barrier Precautions and Multidrug-Resistant Organisms

Pamela Truscott

The Centers for Disease Control and Prevention (CDC) have received numerous questions following the July 2019 release of the enhanced barrier precautions. In response, the CDC has released a frequently asked questions website in reference to the enhanced barrier precautions (EBPs) and multidrug resistant organisms (MDROs).  The frequently asked questions (FAQs) include discussion about the definition and scope of the EBPs, application and duration of EBPs, and implementation of EBPs.  The FAQs can be found on the following website: https://www.cdc.gov/hai/containment/faqs.html

Plan to Attend the 2020 Independent Owner Leadership Conference

If you’re an owner, operator, or administrator of roughly 10 or fewer facilities, the Independent Owner (IO) Leadership Conference is an outstanding opportunity for you to discuss the issues that are critical to your business.

March 11-13, 2020
Gaylord Texan Resort & Convention Center
Grapevine, TX


This year, the focus is on Solutions to Differentiate Your Business. You can earn up to 13.75 CEUs.

Education sessions are specifically designed to help you thrive and succeed by distinguishing your organization amidst larger competitors.

  • Patient-Driven Payment Model (PDPM): Hear solutions for overcoming the top areas where providers struggle to implement PDPM.
  • Innovative Building Design: IOs will share how they implemented innovative design elements into their buildings.
  • Workforce Issues: Get new ideas and specific strategies and tools for addressing challenges in hiring, retention, and turnover.
  • New Assisted Living Opportunities for Quality and Payment in a Value-Based World: As private pay residents decline and Medicaid reimbursements stagnate, providers of assisted living are in a unique position to offer high quality care at a cost savings to consumers and health plans. Learn why and how providers and health plans can partner to create new funding opportunities for assisted living and which partnership models can best differentiate your business and position IOs for success.
  • Should Independently Owned Facilities Grow, and If So, How?: IOs who have grown their business share success stories and lessons learned. Learn if this is the right path for your business.
  • Translating Current Dining Trends to Senior Living for Success: Key aspects of the importance of food, nutrition, the dining experience, and regulatory requirements will be included. A culinary demonstration will also show you how to incorporate these lessons into successful facility operations.

Other highlights of the conference include:

  • Pre-conference session of LED Talks curated by Provider magazine
  • Owner-to-Owner Town Hall
  • Washington Update

Don’t miss this chance to learn, network, and strategize. Get all the details and register to attend.

Sponsors as of December 1, 2019:
Evans Senior Investments, Grace Financial Services, Guardian Pharmacy Services

Tuesday, November 26, 2019

CMS Speaker confirmed for 2020 AHCA/NCAL Quality Summit

Jon-Patrick Ewing

The Opening Keynote Speaker for the 2020 AHCA/NCAL Quality Summit has been confirmed. David Wright currently serves as the Director of the Quality, Safety & Oversight Group within the U.S. Centers for Medicare and Medicaid Services (CMS).  Under Wright’s leadership, the Quality, Safety & Oversight Group provides oversight of national accrediting organizations, certifies providers and suppliers for Medicare reimbursement, and shares important quality of care information to the public through various CMS websites, including Quality Certification Oversight Reports, the Integrated Surveyor Training Website, and Nursing Home Compare.  Wright sees this Group’s work as a primary driver for improving health care quality in the United States, which can only be accomplished through meaningful collaboration with all who are impacted by its programs.

Don’t miss Wright’s session and more than a dozen additional education sessions at the 2020 AHCA/NCAL Quality Summit, March 9-11, 2020 in Texas. Attendees can earn up to 11.5 CEs and will benefit from valuable networking opportunities with other professionals dedicated to quality in assisted living, long term, and post-acute care.

Reserve your spot before the holidays and register today. The housing deadline for this event is February 7, 2020.

Thank you to our event sponsors (as of 11/26/2019):

Host Sponsors: Medline and MatrixCare

Contributing Sponsors: Healthcare Academy, Kronos, Select Rehabilitation, RCare, Team TSI

New Training Offers Practical Strategies to Boost Employee Recruitment and Retention

Dave Kyllo

AHCA/NCAL offers a new instructional webinar titled “Pioneering Solutions to the Workforce Crisis.”  This 45-minute webinar developed in collaboration with PHI delivers practical action steps and strategies assisted living and nursing facilities of all shapes and sizes can take to improve their employee and retention efforts. The webinar also covers ways to improve the hiring process and explains supportive supervision and coaching methods that positively impact employee retention. 

The webinar’s learning objectives include:

  1. Explain the key factors contributing to the workforce shortage
  2. Identify at least 3 strategies to improve employee recruitment
  3. Identify at least 3 strategies to improve employee retention
  4. Explain the impact of supportive supervision on retention

The instructor is Sue Misiorski who served as Vice President of Workforce Innovations for PHI and currently serves as the New England Regional Director of Operations for SageLife.  Starting as a CNA, she later held positions as a DON and VP of Nursing in multi-site skilled nursing homes in New England and has supported the construction of several assisted living and nursing facilities. 

This webinar is part one to a more extensive on-line training for middle managers that will be released in the coming months.  While no CEUs are offered for this webinar, participants can receive a certificate of completion.  The cost of the course is $25 for AHCA/NCAL members and $60 for non-members. 

Follow this link to read more about this educational webinar and to register for the course:  https://educate.ahcancal.org/products/pioneering-solutions-to-the-workforce-crisis#tab-product_tab_overview

To access ahcancalED and the Pioneering Solutions webinar, 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.

CMS Posts 2020 Annual Update to the Medicare Part B Therapy Code List

Dan Ciolek

Recently, the Centers for Medicare and Medicaid Services (CMS) posted a MLN Matters article containing updates to the list of codes that sometimes or always describe therapy services under Medicare Part B. The additions, changes, and deletions to the therapy code list reflect those made in the Calendar Year (CY) 2020 Current Procedural Terminology (CPT) and Level II HCPCS.  These changes , effective for dates of service starting January 1, 2020, impact Medicare Part B claim coding for physical therapy, occupational therapy, and speech-language pathology services include:

  • Two new biofeedback training CPT codes 90912 and 90913 were added
  • Two new cognitive function CPT codes 97129 and 97130 were added
  • The following four manual muscle testing codes were removed: 95831, 95832, 95833, and 95834    
  • The following 42 HCPCS Level II G-codes related to the discontinued functional reporting requirement are deleted for dates of service after December 31, 2019: HCPCS codes G8978 through G8999; G9158 through G9176; and G9186

The official instruction, CR 11501, issued to your MAC regarding this change can be found here.  Make sure your billing staff are aware of these updates.

Monday, November 25, 2019

NCAL/AALNA Caring Together Webinar - Dementia Care: Managing Wandering and the Risk of Elopement

Lindsay Schwartz

Please join the National Center for Assisted Living (NCAL) and the American Assisted Living Nurses Association (AALNA) for the quarterly webinar on Tuesday, December 3rd from 3pm – 4pm Eastern Time. Juliet Holt Klinger, Senior Director Dementia Care with Brookdale Senior Living will review symptoms of dementia that could contribute to wandering. The presentation will include definitions and discussion of types of wandering and elopement. The presenter will share processes that can help manage wandering and reduce elopement risk. This will include a special focus on person-centered approaches and environmental adaptations that reduce the risk of wandering and elopements. Attendees must register prior to the webinar.

Wednesday, November 20, 2019

Deadline TOMORROW: Quality Award Intent to Apply

Last chance to save on your Quality Award application! Intent to Apply (ITA) for the 2020 AHCA/NCAL National Quality Award cycle closes tomorrow at 8:00 pm ET

Submit your ITA payment by logging in to the Quality Award Portal. Late payments will not be accepted. 

While not mandatory, applicants who submit an ITA payment will save money on their overall application, and no paperwork is needed! Before submitting, please review the application packets in full, which are available at ahcancal.org/qualityaward.

You can access help documents for the Quality Award Portal here, or if you need additional assistance please email qualityaward@ahca.org.

We hope you will commit to continuing your Quality Award journey by submitting an ITA payment!

The LTC Career Center Sale Ends November 30

Dave Kyllo

Ten days remain for employers to get national exposure for their open positions that can be posted on the AHCA/NCAL Long Term Care Career Center for $250 per 30-day posting when employers use promo code LTCHERO. That’s $100 off the regular low AHCA/NCAL rate of $350. Rates for posting job vacancies are also reduced for 60- and 90-day postings through November 30. 

The LTC Career Center gives affordable targeted national exposure because it connects with the Health Care Career Network by providing visibility to members of nearly 300 national and state health care organizations and societies participating in the national network. Serious health care candidates look for jobs on this national network built specifically to help health care employers reach health care professionals. This short video shows how easy it is to create an account and post a job vacancy.

The $250 sale price for a 30-day posting gives even more value because employers who utilize the LTC Career Center receive free bonus 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 that post vacancies through the AHCA/NCAL LTC Career Center get extra value through free 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. Graduates and experienced health care professionals utilize the Health Care Career Network to find the best health care openings.

Make the smart, low-cost employee recruitment choice. Check out the LTC Career Center today and don’t forget to use promo code LTCHERO to save $100 on your job postings. Employers may use the code an unlimited number of times between now and November 30. 

Visit the LTC Career Center Employer Page or call Robin at 866-964-2765 x2736 for more information about posting job vacancies on the LTC Career Center and other discounted job listing packages. 

10 Days Left for the Fall Gero Nurse Prep Sale! Save Now and Take up to One Year to Complete the Course

Dave Kyllo

Research conducted by AHCA/NCAL earlier this year shows that SNFs that employ at least one American Nurses Credentialing Center (ANCC) Board certified RN also, on average, performed higher on SNF VBP performance.

The ANCC offers certification in gerontological nursing – the gold standard in demonstrating clinical excellence in geriatric patient care. 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. 

To help RNs prepare for the certification exam, AHCA/NCAL offers an online course called Gero Nurse Prep. RNs who complete the course earn 30 nursing contact hours and experience a 96% pass rate on the ANCC certification exam on the first try. Gero Nurse Prep students see a whopping 24 percent average increase between their pre- and post-test scores.

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

The average 2017 SNF VBP performance score across the nation was 34.4. For SNFs with at least one RN who has been ANCC Board certified in gerontological nursing, the average SNF VBP performance score was 44.2. The net result is that these SNFs get higher Medicare Part A reimbursements. 

The AHCA/NCAL 2019 research also found that SNFs with at least one ANCC Board certified RN also experienced:

  • Fewer survey deficiencies
  • Fewer IJ citations
  • Lower rehospitalization rates
  • Lower rates of off-label use of antipsychotics
  • Higher CMS 5-Star ratings

To learn more about Gero Nurse Prep and ANCC Board certification, watch this video. For an even deeper dive into competent geriatric nursing, listen to this free AHCA/NCAL webinar “Competent Geriatric RNs – The New Driver of Financial Performance.” 

2020 is Just Around the Corner and so is the Launch of AHCA’s 2020 PDPM Academy

Dave Kyllo

Now that the Patient Driven Payment Model (PDPM) system is in effect for skilled nursing facilities, AHCA is preparing for 2020. AHCA soon will launch its new 2020 PDPM Academy and the existing PDPM Academy resources will be archived and no longer updated at the end of 2019.   

2020 PDPM Academy will provide tools and resources to help AHCA members navigate challenges, incorporate changes and successfully operate under PDPM. Resources available through PDPM 2020 Academy will include:

  • Virtual in-depth training modules on PDPM best practices (including role-specific modules);  
  • Monthly webinars; 
  • Additional tools and resources; and,
  • AHCA’s analyses of CMS’s technical changes and updates to PDPM.  

To receive an email notification when enrollment for 2020 PDPM Academy opens, follow this link and enter your name, company name and email address. Signing up for the early notification is fast and easy. 

AHCA members who have questions now about PDPM can send an email to pdpm@ahca.org or call 202-842-4444 and ask to speak to a PDPM Resource Navigator. 

Senate Aging Committee Releases Report on Falls Prevention and Holds Hearing on Strategies to Protect Seniors from Injury

Dana Ritchie

Last month, the U.S. Senate Aging Committee held a hearing titled, “Falls Prevention: National, State, and Local Level Solutions to Better Support Seniors.” At the hearing, the Committee unveiled a report that provides evidence-based recommendations on ways to reduce the risk of falling. More specifically, the Aging Committee’s report made recommendations in four key areas that can be found here in the Committee’s press statement. The press statement includes that “Falls are the leading cause of both fatal and nonfatal injuries among older adults that incur $50 billion annually in total medical costs. That number is expected to double to $100 billion by 2030, and the majority of these costs are borne by Medicare and Medicaid.” You can also read the full testimony of the witnesses and watch a recording of the hearing here.

Monday, November 18, 2019

Independent Owners: Need Solutions to Differentiate Your Business?

Danielle Levitan


The Independent Owner (IO) Leadership Conference offers a special opportunity for owners, operators, and administrators of roughly 10 or fewer facilities to discuss pressing topics, share ideas, and learn new strategies that will help your business stand out and succeed.

March 11-13
Gaylord Texan Resort & Convention Center
Grapevine, Texas


Why attend?

  • Priceless networking in formal and informal settings
  • Exciting speakers that will inspire you
  • Exclusive education sessions that will give you an edge

Education sessions are specifically designed to help you thrive by using the strengths unique to an independently owned facility and distinguishing your organization amidst larger competitors.

  • Patient-Driven Payment Model (PDPM
  • Innovative Building Design
  • Workforce Issues
  • Value-Based Care
  • Growth at IO Facilities
  • Successful Current Dining Trends
You could earn up to 13.75 CEs.

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

Current sponsors: Grace Financial Services

Population Health Management Summit- Hotel Deadline: November 20

Danielle Levitan


Reserve your room before the end of the day on Wednesday, November 20 to get the AHCA/NCAL special room rate.


Get all your population health management questions asked and answered.
  • Discuss the ways in which PHM models are improving quality and outcomes while reducing costs
  • Learn new strategies to expand and improve your leadership capabilities in PHM
  • Network with peers and nontraditional partners
  • Gain a deeper understanding of CMS' view of provider-led PHM efforts

CE accreditation has been requested.

Register and reserve your hotel today.

Host Sponsors: MatrixCare, Medline
Contributing Sponsors: CLA, Centene Corporation, Compass Total Benefit Solutions

CMS Posts 2020 Annual Update to the Medicare Part B Therapy Code List

Dan Ciolek

Recently, the Centers for Medicare and Medicaid Services (CMS) posted a MLN Matters article containing updates to the list of codes that sometimes or always describe therapy services under Medicare Part B. The additions, changes, and deletions to the therapy code list reflect those made in the Calendar Year (CY) 2020 Current Procedural Terminology (CPT) and Level II HCPCS.  These changes , effective for dates of service starting January 1, 2020, impact Medicare Part B claim coding for physical therapy, occupational therapy, and speech-language pathology services include:

  • Two new biofeedback training CPT codes 90912 and 90913 were added
  • Two new cognitive function CPT codes 97129 and 97130 were added
  • The following four manual muscle testing codes were removed: 95831, 95832, 95833, and 95834    
  • The following 42 HCPCS Level II G-codes related to the discontinued functional reporting requirement are deleted for dates of service after December 31, 2019: HCPCS codes G8978 through G8999; G9158 through G9176; and G9186

The official instruction, CR 11501, issued to your MAC regarding this change can be found here

Make sure your billing staff are aware of these updates.

AARP Report on Caregiving Released during National Family Caregivers Month

Dana Ritchie

On November 14, AARP released Valuing the Invaluable 2019 Update: Charting a Path Forward, finding that 41 million family caregivers provided 34 billion hours of care worth $470 billion in 2017. The report includes state data on the number of family caregivers, hours of care they provide, and the value of this unpaid care. It also, among other things, highlights key trends in family caregiving and provides a series of family caregiving related policy recommendations. You can access the full report, an infographic, and more at www.aarp.org/valuing.

Wednesday, November 13, 2019

Time’s Running Out to Get Recognized for Your Quality Efforts

qualityinitiative@ncal.org



Let’s celebrate the hard work you have done to measurably improve the lives of your residents.

The 2020 AHCA/NCAL Quality Initiative Recognition Program honors member centers and communities that have achieved one or more of the AHCA/NCAL Quality Initiative goals. The deadline to submit your Quality Initiative data in LTC Trend Tracker is November 21, 2019.

Nursing centers must submit customer satisfaction data, and all other data is automatically uploaded. Assisted living members must submit data for all of the NCAL goals: staff stability, customer satisfaction, hospital readmissions and off-label use of antipsychotics.

Identified achievers will be notified in December, and the recognition will take place at the AHCA/NCAL Quality Summit in March 2020.

If you need assistance with LTC Trend Tracker, please visit the Resource Center or email help@ltctrendtracker.com

For more information on the Quality Initiative Recognition Program, please visit the respective websites for skilled nursing centers and assisted living communities.

Participate in Research on Care and Resident Safety in AL

Lindsay Schwartz

Investigators from the University of Rochester, in partnership with the Center for Excellence in Assisted Living (CEAL) and 9 national organizations representing providers, advocates, and other stakeholders in assisted living (AL) are conducting a national survey focusing on care and resident safety. We ask for your participation in this important survey, which includes over 4,000 AL communities randomly chosen from across the country. If your AL community receives this survey, we strongly encourage the administrators and staff to complete them and mail back to investigators in postage-paid envelopes provided with the survey. All surveys are totally confidential. Findings from this survey, which will be shared in aggregate (no individual data will be shared) with all participating ALs, may help to improve the quality of the work environment for staff as well as care safety for all residents.

Tuesday, November 12, 2019

2020 AHCA/NCAL Quality Summit: Registration Open

Jon-Patrick Ewing

No matter what your focus or interest, we’ve got you covered! Join AHCA/NCAL for the 2020 Quality Summit, March 9-11 at the Gaylord Texan Resort & Convention Center in Grapevine, Texas (centrally located near Dallas/Ft. Worth).

With a program inspired by AHCA/NCAL’s Quality Cabinet and members, the 2020 Quality Summit has a sharper focus on key issues facing long term care, including a full track of education sessions on the Patient Driven Payment Model (PDPM). Come network with your colleagues and receive valuable education while you earn up to 11.5 CEs. At this year’s Summit, national subject matter experts will lead sessions on person-centered care, emergency preparedness, leadership, infection prevention, and more. Attendees will take away strategies to improve clinical, quality, regulatory, and workforce outcomes.

The Summit provides programming for all levels of staff in long term and post-acute care: administrators, DONs/clinical staff, quality managers and directors, assisted living providers and independent owners.

Registration Deadline: February 24, 2020

For more information and to register, visit: QS.AHCANCAL.ORG


Cybersecurity, Ransomware & Planning Resources

Steven Chies 

Last month, there was a data breach reported in the media that detailed a ransomware demand from a hospital system in Alabama that includes a post-acute care facility.  The hospital shut down new admissions and transferred patients due to the inability to access electronic health records.  Unfortunately, this is not a single occurrence – data breaches have been occurring at an increasing rate in the past few years. As the use of electronic health records has become a necessary tool for facility operators to function, the loss of access could create serious operational issues for long term and post-acute providers.

We want to make you aware of this threat and encourage you to access tools and resources to help prevent it from happening.

What can you do?

Facilities should prepare a cybersecurity plan to address these potentially damaging occurrences.  The Homeland Security’s Cybersecurity and Infrastructure Security Agency website here has considerable information on protection, reporting, and other topics to assist your planning. 

The agency and other experts in cybersecurity have recommended several basic actions for all health care providers to consider as part of their risk assessment and management responsibility.  They are:

  1. Evaluate the current infrastructure the organization has for electronic health care records and technology.  Create a plan to mitigate any identified risk. 
  2. Have a detailed backup procedure for data and diligently execute the backup systems, preferably off-sight.
  3. Train and prepare staff on the risks of cybersecurity, including attempts to human engineer individual staff with phishing and other email schemes.
  4. Establish immediate processes with personnel in the event of a ransomware attack and/or contract with a third-party vendor.
  5. Consider the purchase of cyber insurance that could assist in a breach.
  6. Report all breaches or attempts to law enforcement (i.e. FBI and Homeland Security)

Additional resources

Here are some additional resources that may help in the cybersecurity planning process:


Questions?

If there are any questions or concerns regarding this information, please contact research@ahca.org.

Have Questions About Managed Care?

Get them answered at the Population Health Management (PHM) Summit for Long Term and Post-Acute Care Leaders.

December 9-10, 2019
InterContinental Washington, DC – The Wharf

Hotel Deadline: November 20



Managed care continues to grow, and you need to know what you can do to grow with it. Make the commitment to secure quality care for your residents and your organization by actively participating in managed care. The PHM Summit can help you do that.

Excellent education sessions and networking opportunities will help you steer towards a more successful and profitable future in managed care.  All attendees will participate in facilitated sessions to develop nontraditional partnerships between organizations such as:

  • LTC providers and health plans 
  • Legal consultants and provider-owned integrated care networks 
  • Senior housing with services and health plans
Other notable sessions will look at which PHM models are improving quality and outcomes while reducing costs. You’ll gain a deeper understanding of PHM, and learn new strategies to expand and improve your leadership capabilities. Review the full agenda for more details.

CE accreditation has been requested.

The hotel deadline is next week so don’t wait. Register and reserve your room before November 20th to get the AHCA special room rate.

Host Sponsors: MatrixCare, Medline
Contributing Sponsors: CLA, Centene Corporation, Compass Total Benefit Solutions

HICN Claims Reject

There are 50 days until the end of the Medicare Beneficiary Identifier (MBI) transition period. Use the MBI on Medicare claims and other transactions now. Starting January 1, regardless of the date of service:

  • CMS will reject claims submitted with Health Insurance Claim Numbers (HICNs) with a few exceptions 
  • CMS will reject all eligibility transactions submitted with HICNs

See the MLN Matters Article to learn how to get and use MBIs.

Monday, November 11, 2019

CMS Update to SNF Billing Specific to Veterans Administration (Demo 31) Claims Under PDPM

Dan Ciolek

The Centers for Medicare and Medicaid Services (CMS) recently published MLN Matters Article MM11513 that impacts SNFs that furnish services ordinarily covered by Medicare but are furnished to veterans eligible for both Veterans Administration (VA) and Medicare benefits and also having Medicare supplemental insurance.  Specifically, as per transmittal CR 11513, MACs will terminate use of code AAA00 as of October 1, 2019 and will update the edit with a workaround that ensures that the default ZZZZZ Health Insurance Prospective Payment System (HIPPS) code is present on VA Demo 31 claims and is properly processed.  The workaround will expire on April 6, 2020.   

Background
Current law permits the VA to collect appropriate Medicare coinsurance and deductible amounts from supplemental insurers for claims for supplies and services ordinarily covered by Medicare but furnished:

  • At VA facilities; and 
  • For veterans eligible to receive both VA health and Medicare benefits and also having Medicare supplemental insurance. 

To facilitate this process, the Centers for Medicare & Medicaid Services (CMS) entered into an interagency agreement with the VA whereby CMS will help the VA work with the designated CMS MAC to adjudicate claims for these services to produce remittance advices equivalent to those ordinarily produced for Medicare claims. Medicare does not pay these claims, but the remittance advices show how much Medicare would have paid had the claims been payable by Medicare along with the applicable deductibles and coinsurance. In adjudicating a claim and generating these remittance advice notices, the CMS MAC must verify that the services provided are covered benefits, certify admission where appropriate, conduct prepayment utilization screening, and authorize payment. CMS has a single A/B MAC (A) and (B) to process these claims. The remittance advices, sent by the VA to the supplemental insurers, will help the insurers determine payment amounts they owe to the VA.  With the SNF PPS transition from RUG-IV to PDPM, provider VA Demo 31 claim default HIPPS coding must also change from AAA00 to ZZZZZ, effective October 1, 2019.  Details regarding the VA Claims Adjudication Services Project are located in Chapter 37 of the Medicare Claims Processing Manual.

It Pays to Have Cleary Energy Audit Your Utility Bills…and Keeps Paying

Dave Kyllo

Three out of four long term care facilities are being overcharged for one or more of their utilities. Providers don’t receive better service or any other benefit for over paying utility companies. The good news is that putting an end to the overpayments is easy.

Cleary Energy is a AHCA/NCAL preferred provider and has recouped on average 4% to 8% savings on utilities for long term care facility customers. Here are some real life examples of how long term care providers saved:

  • A nursing facility recovered $25,000 in retroactive charges from an electric and gas utility account and the facility will save an additional $7,500 per year going forward.     
  • A nursing facility was overpaying the tariff on their gas account and is now saving $10,000 annually going forward.
  • A Midwest assisted living facility received $5,800 from utility overpayments that Cleary Energy recently found.      

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. 

The program is designed to save AHCA/NCAL members significant money on their utility bills without adding new expenses to their budgets.  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 for an audit comes directly from the utilities or suppliers. 

Cleary Energy’s long term care experience sets the company apart with over 40 years of long term care operational experience.  That in-depth knowledge 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. 

SNFs with Board Certified RNs Have Significantly Higher VBP Scores

Dave Kyllo

Research conducted by AHCA/NCAL earlier this year shows that SNFs that employ at least one American Nurses Credentialing Center (ANCC) Board certified RN also, on average, performed higher on SNF VBP performance. The average 2017 SNF VBP performance score across the nation was 34.4.  For SNFs with at least one RN who has been ANCC Board certified in gerontological nursing, the average SNF VBP performance score was 44.2.  The net result is that these SNFs get higher Medicare Part A reimbursements. 
The AHCA/NCAL 2019 research also found that SNFs with at least one ANCC Board certified RN also experienced:

  • Fewer survey deficiencies
  • Fewer IJ citations
  • Lower rehospitalization rates
  • Lower rates of off-label use of antipsychotics
  • Higher CMS 5-Star ratings

The ANCC offers certification in gerontological nursing – the gold standard in demonstrating clinical excellence in geriatric patient care.  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. 

To help RNs prepare for the certification exam, AHCA/NCAL offers an online course called Gero Nurse Prep.  RNs who complete the course earn 30 nursing contact hours and experience a 96% pass rate on the ANCC certification exam on the first try.  Gero Nurse Prep students see a whopping 24 percent average increase between their pre- and post-test scores.

Gero Nurse Prep is flexible.  RNs study online at their own pace and have one year from the time they enroll to complete their Gero Nurse Prep coursework. 

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

To learn more about Gero Nurse Prep and ANCC Board certification, watch this video. For an even deeper dive into competent geriatric nursing, listen to this free AHCA/NCAL webinar “Competent Geriatric RNs – The New Driver of Financial Performance.”