Friday, May 24, 2019

House Panel Tackles Surprise Billing; Advocates Pushing for Observation Stays Inclusion

Dana Halvorson

On May 21, the House Ways and Means Subcommittee held a hearing on surprise medical billing and how to eliminate enormous charges for unsuspecting consumers.  A number of members of a coalition supporting changes to how observation stays are classified are urging the Subcommittee to include the issue in any comprehensive effort to curtail bills that cause sticker shock.  In a written statement from the National Observation Stays Coalition, which includes the American Health Care Association/National Center for Assisted Living as a member, that will be sent to the Subcommittee -- the group said it formed to address a surprise medical billing issue that affects Medicare patients in hospitals who are called observation status patients, or outpatients.  Although these individuals receive medically necessary care that is no different from the care provided to formally admitted inpatients, their classification as observation or outpatient is significant, “because the Medicare statute covers a post-hospital stay in a skilled nursing facility only if the patient was hospitalized for three consecutive days as an inpatient,” the coalition said.  The group is also noting to the Subcommittee, which is chaired by Rep. Lloyd Doggett (D-Texas), that eliminating surprise medical bills and the observation stays classification go hand in hand. 

You can read the full Provider article on this hearing here.  More on the observation stays issue can be found on the AHCA/NCAL webpage.  

Wednesday, May 22, 2019

NADRC Webinar: Caregiving for People with Non-Alzheimer’s Dementia


Tuesday, June 4, 2019, 2:00-3:00 PM ET

Register for the event

In recent years, research on Alzheimer’s disease has increased significantly, but there has been less focus on other types of dementias. Because less is known about non-Alzheimer’s dementias, under- and misdiagnosis is common, treatment protocols are lacking and it is not clear how best to support people with these dementias and their caregivers. 

This web seminar hosted by the National Alzheimer's and Dementia Resource Center (NADRC), will provide an overview of the three most common causes of dementia after Alzheimer’s disease, which include Lewy body dementia, frontotemporal degeneration and vascular dementia. Presenters will draw upon available information to describe caregiving for people living with these dementias. Special attention will be given to how caregiving for people with Lewy body dementia and frontotemporal degeneration may be different from Alzheimer’s disease. Case studies of caregiving for people with Lewy body dementia and frontotemporal degeneration will be highlighted.

Presenters:
  • Sharon S. Denny, M.A., is senior director of Programs at the Association for Frontotemporal Degeneration where she leads strategic development of support and education for people with frontotemporal degeneration, their families and healthcare professionals.
  • Angela Taylor is the senior director of Research and Advocacy for the Lewy Body Dementia Association, where she leads research, advocacy and educational activities of the organization.
  • Sari Shuman is a senior research public health analyst at RTI International, and serves as the co-director of the National Alzheimer’s and Dementia Resource Center.
Registration is required to receive the webinar information. Visit the webinar webpage to learn more, including CE credit information.

CMS Issues MDS 3.0 RAI Manual Updates that include Significant PDPM- Related Changes

Dan Ciolek

On May 20 the Centers for Medicare and Medicaid Services (CMS) issued an early release of several files associates with the MDS 3.0 RAI Manual v1.17 that contains many updates including information related to the Patient Driven Payment Model (PDPM), both which are effective on October 1, 2019.  CMS indicates that “this early release is being provided in response to stakeholder feedback.” CMA also encourages providers to check back to the MDS-RAI webpage prior to October 1, 2019 for a final posting which may contain additional updates.  Specific files on the CMS site that are applicable to the PDPM implementation include:
  • MDS 3.0 RAI Manual v1.16 October 1, 2018 – Which is a single PDF file of the entire RAI manual for use as an electronic version with bookmarks that you can click on to take you to each section of the manual.
  • MDS 3.0 RAI Manual v1.16 and Change Tables October 2018 – Which is a traditional set of zip files of the RAI manual and the change tables that crosswalk the changes made to this year’s manual. Note: This is the same material as the first item above, except there are separate files for each chapter or subchapter.
  • MDS 3.0 RAI Manual v1.16 Replacement Manual Pages and Change Tables October 2018 – Which includes replacement pages for this year’s manual changes for those who want to update their existing paper-based manual with just the pages that have changed. It also includes the change tables that crosswalk the changes made to this year’s manual.
  • MDS Forms (Item Sets) v1.16.1 October 2018 – Which included two folders separate the v1.16.1 MDS forms (MDS item sets) into those used in long term care facilities (SNFs and NFs) and those used in swing bed facilities.
  • MDS RAI Manual Appendix B – Which includes updated contact lists for the state and regional RAI/MDS contacts. 
Specific Chapters in the new MDS-RAI manual updates related to PDPM to pay particular attention to are Chapter 2- which addresses the new PDPM-related MDS assessments and assessment schedule, and Chapter 6 – which addresses the new PDPM resident classification process for the PDPM payment model.  Other changes related to the new PDPM MDS Items, such as the new diagnosis items in Section I, surgery type in section J, as well as the new PDPM HIPPS codes in Section Z should also be looked at closely. 

AHCA has also included a link to the CMS MDS-RAI files webpage on the AHCA PDPM Academy and AHCA PDPM Resource Center web pages.   

Tuesday, May 21, 2019

Save the Date: Applications for 2020 AHCA/NCAL National Quality Award Available Aug. 1

qualityaward@ahca.org

The 2020 AHCA/NCAL National Quality Award Program cycle is just around the corner – application packets will be available August 1, 2019.

Based on the Baldrige Performance Excellence Framework, the AHCA/NCAL National Quality Award recognizes long term and post-acute care member centers and communities for quality care.

Participating in the Quality Award Program has many benefits:
  • The program provides a proven framework that organizations can use to make improvements in any clinical, quality or other operational issues (i.e. staff engagement, customer satisfaction, hospital readmissions).
  • It helps prepare organizations to meet regulatory requirements and navigate a changing market.
  • It serves as a team building activity to engage staff across all levels of the organization.
  • Organizations gain national recognition. 
  • It serves as a marketing resource for consumers, referral sources and other key stakeholders.
  • Participants receive customized feedback with their top strengths and improvement areas.
If you’re interested in other ways to get involved, consider becoming an Examiner for the 2020 program cycle. Examiners play a significant role in reviewing Quality Award applications and impacting quality improvement in organizations across the country.

It’s never too early to start preparing! For additional information, visit the Quality Award website at ahcancal.org/qualityaward or email qualityaward@ahca.org.

Study Highlights Need for Differing Prevention Strategies for Hip, Non-Hip Lower-Extremity Fractures

Rosa Baier

Prior studies have examined the incidence, risk factors, and outcomes of hip fractures among nursing center residents, but little is known about non-hip lower-extremity fractures. A national study involving researchers from Hebrew SeniorLife and Brown University looked at lower extremity fractures among long-stay nursing center residents, and found differences that suggest prevention strategies should differ for hip and non-hip fractures. 

The research team used national data to identify all long-stay nursing center residents aged 65 years or older who were enrolled in Medicare during a specific time period (2008 and 2009), and then looked at lower-extremity fractures for two years (as late as 2011). Compared with hip fracture residents, residents with non-hip fractures were more likely to be immobile, dependent in all activities of daily living, transferred mechanically, and to have diabetes.

These findings show that non-hip lower-extremity fractures often occur in severely functionally impaired residents, suggesting a different mechanism of injury than hip fractures. This highlights the need for distinct prevention strategies for hip and non-hip lower-extremity fractures.

Learn about research from AHCA’s research center at Brown: brown.edu/go/innovation.

Convention & Expo Preliminary Program is Available

Jon-Patrick Ewing

The AHCA/NCAL Preliminary Program is now available. You can download a copy or review it online. Watch your mailboxes this week for a copy. Get an overview of the exciting education sessions, guest speakers, networking events, and Expo Hall.

Don’t wait to register! Save $100 on all Premium/Full Meeting Registration packages when you do Early Bird Registration. Other Early Bird savings may apply depending on your registration type.

You can save an additional $100 on registration when you stay at a hotel in the AHCA/NCAL room block.

That's a minimum savings of $200 if you register by July 26th.

Learn more about all of your registration options and reserve your spot today.

You Must Be ICD-10 Ready To Be PDPM Ready

Dave Kyllo

The October 1 PDPM implementation date is rapidly approaching and training key staff now to be ICD-10 proficient is critical. The American Health Care Association (AHCA) and the American Health Information Management Association (AHIMA) are offering ICD-10 on-line training. Because staff needs differ based 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 changes based on the new 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.
To learn more or register for either on-line training, please visit the websites below.   
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. 
  

Cleary Energy Can Show You How Much You’re Donating to Utility Companies in Unnecessary Over Payments

Dave Kyllo

Most long term care facilities (about 75%) are being overcharged for one or more of their utilities and these overpayments are wasted dollars out the door. 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. A midwestern assisted living facility reported last month that it 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 to complete an audit comes directly from the utilities or suppliers. 

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

Cleary Energy has been finding huge savings for AHCA/NCAL members, so now is the time to 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. 

Take Advantage of the Pre-Sale Registration for AHCA’s Virtual PDPM Training

Dave Kyllo

The new Patient Driven Payment Model (PDPM) for skilled nursing facilities begins October 1, 2019. The PDPM system will rely on more than 180 MDS item fields and completely transforms the existing system Medicare Part A payment system for skilled nursing facilities. Staff roles and facility processes must be substantially modified to operate effectively under PDPM.

AHCA’s Virtual PDPM Training prepares AHCA members for PDPM and will mirror the in-person trainings that have been held for AHCA members in almost every state in recent months. The virtual training allows AHCA members who missed their state training to learn about the critical steps necessary on the pathway to success under PDPM. It is also a perfect opportunity for those members who have indicated interest in attending the training again to solidify what they learned during their day-long training.

Pre-registration for the online training program is now available to AHCA provider members only. The cost for the training is $350. NAB CE credit has been requested.

While the virtual training won’t go live until mid-June, AHCA members who pre-register now will have access to all materials on AHCA’s PDPM Academy within 48 hours of their purchase. The PDPM Academy is where updates, tools, webinars and other supporting materials are housed. AHCA members who pre-register for the Virtual PDPM Training will also be able to join in free monthly PDPM webinars hosted by AHCA. 

Pre-sale registration for AHCA’s Virtual PDPM Training is available here or by going to https://educate.ahcancal.org/p/virtualPDPM. Pre-sale registrants will be notified when AHCA’s Virtual PDPM Training goes live.

Wednesday, May 15, 2019

Centers Celebrate National Skilled Nursing Care Week

Cristina Crawford

The American Health Care Association (AHCA) kicked off the annual National Skilled Nursing Care Week (NSNCW), taking place this week through May 18.

Established by AHCA in 1967, NSNCW, formerly known as National Nursing Home Week, recognizes the essential role of skilled nursing care centers in caring for America’s frail, elderly, and disabled.

“National Skilled Nursing Care Week is a time to shine a spotlight on the important role nursing care providers have in improving the lives of those they care for every day,” said AHCA/NCAL President and CEO Mark Parkinson. “We hope community members take the opportunity to participate in the celebrations and experience this commitment first-hand.”

Centers across the country will celebrate their residents and staff this week, with the theme “Live Soulfully,” by showcasing how they achieve happy minds and healthy souls. Whether it’s planting, cooking, reading or listening to music, staff at our nation’s centers pay it forward by dedicating themselves to quality care and improving quality of life for residents.

Centers are encouraged to participate by hosting activities that display how they “Live Soulfully” and share their stories and experiences on social media using the hashtag #NSNCW. 

For more information, visit www.ahcancal.org/NSNCW.

DOJ Guidance on Evaluation of Corporate Compliance Programs

 
The Department of Justice (DOJ) has updated its guidance for Evaluation of Corporate Compliance Programs. This guidance is aimed at assisting prosecutors in making decisions as to whether and to what extent a compliance program was effective at the time of the offense. The 2019 Guidance Document is organized around three central questions:
  1. Is the corporation’s compliance program well designed?
  2. Is the compliance program being applied earnestly and in good faith? In other words, is the compliance program being implemented effectively?
  3. Does the corporation’s compliance program work in practice?
Earlier guidance from 2017 focused more on the design of a compliance program, while this updated guidance indicates that prosecutors will also be focused on a deeper dive into whether the program is effective.

The American Health Care Association (AHCA) has resources for nursing center member to support creating or updating a Compliance and Ethics Program per 42 CFR § 483.85 in the Requirements of Participation (RoP) Phase 3. The new resources that are now available here. It’s important to be aware of this guidance from DOJ, as well as other guidance from the Office of Inspector General, because they offer best practices for compliance programs and the Centers for Medicare and Medicaid Services may incorporate these principles into their survey process.

New Optimism for Observation Stays Bill

Dana Halvorson

On May 14, 2019, McKnight’s released an article entitled, New optimism for hearing on ‘observation status’ bill.  The article focuses around Congressman Joe Courtney’s (D-CT) recent comments on the observation stays issue at the Center for Medicare Advocacy’s annual summit in Washington, D.C. The article includes reference to the Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753).  Introduced by Congressmen Courtney and Glenn 'GT' Thompson (R-PA) and Senators Sherrod Brown (D-OH), Susan Collins (R-ME), Sheldon Whitehouse (D-RI) and Shelley Moore Capito (R-WV), the legislation ensures that time spent under “observation status” in a hospital counts toward satisfying the three-day inpatient hospital requirement for coverage of skilled nursing care services under Medicare.  AHCA/NCAL strongly supports this bill along with several other national organizations.  For more information about the observation stays issue, please visit the AHCA/NCAL website.         

Updated Conscience Rights in Health Care

Lilly Hummel

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) finalized regulations updating conscience requirements affecting recipients of federal funds, including Medicaid and Medicare dollars. Specific to long term and post acute care providers, this rule affects conscience protections related: to assisted suicide and related counseling; performance of advanced directives; specified programs such as hearing screening, occupational illness testing, vaccination, and mental health treatment; and religious nonmedical health care providers and their patients from certain requirements under Medicare and Medicaid that may burden their exercise of their religious beliefs regarding medical treatment. Providers are encouraged to consult with legal counsel to determine the applicability of the rule to their organization and any new policies or actions required. The rule will go into effect in approximately 60 days.

AHCA Convention Offers Not for Profit Education Program

Jon-Patrick Ewing

AHCA/NCAL Convention & Expo education sessions have been designed to give you exactly what you need to reach your goals and answer your pressing questions. Tuesday, October 15, offers special programming to Not for Profit providers.

Keynote Speaker Commander Kirk Lippold, USN (Ret.) will talk about Leadership and Accountability When It Matters.

Commander Lippold will show how the principle of integrity can create an environment for leadership, describing the harrowing experience in which he and his crew responded to a devastating suicide terrorist attack on their ship. Their own sense of personal accountability and leadership proved to be a guiding principle in the crucible of combat. Lippold will also share why his “Five Pillars of Leadership” are must-have business tenets for any team.

Additional programming follows:

Workforce Challenges Discussion for LTC Providers: A panel of experts will lead a moderated discussion to examine workforce policies and issues impacting the LTC world.

CMS Update for LTC Providers: CMS expert Evan Shulman, Acting Director, Division of Nursing Homes Centers for Medicare and Medicaid Services, will review survey and certification issues, delve into SNF/NF Interpretive Guidance, and talk about CMS' work on various initiatives.

The Not for Profit Reception caps off the day from 6:00 to 7:00 pm and is an excellent opportunity to network and catch up with other providers from around the country. It is just one of many special events taking place over the four-day convention in October.

Registering online is easy! Early Bird Discount registration ends July 26.

Higher-Rated Nursing Centers Better Able to Adopt Advance Care Planning Video Education

Rosa Baier

Nursing centers’ Medicare 5 star ratings are associated with their ability to integrate a novel advance care planning video education program into routine care, according to a Brown University study involving 119 facilities across the US.

Advance care planning helps to ensure that residents receive end-of-life care aligned with their goals. While research already shows that video interventions can improve advance care planning, understanding how nursing centers adopt such programs is an important next step to promoting widespread adoption. In the Brown study, nursing center staff adopted an advance-care planning video intervention as a new standard of care, while researchers examined process measures. This included how often staff offered residents a chance to view the videos.

Overall, staff offered to show the video to 69% of short-stay and 56% of long-stay residents. After taking into account different facility characteristics, the researchers found that centers with better 5-star ratings had higher “offer” rates than centers with 1 star rating. These findings suggest that nursing centers with lower star ratings may need support to successfully adopt this intervention.

Learn about research from AHCA’s research center at Brown: brown.edu/go/innovation.

Put Some Swing in Your Spring with Music from Mood Media

Dave Kyllo

Whether its Frank Sinatra’s “It Might as Well be Spring” or the Beach Boys’ “Spring Vacation,”  members can help residents celebrate the spring season through the music offered by Mood Media at AHCA/NCAL “Member Only” discounted rates.

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

Use Mood Media’s music to:
  • Improve the dining experience and set the mood in dining areas as residents gather for meals;
  • Provide a variety of background music in common areas;
  • Create a positive environment for activities; and
  • Provide musical entertainment for social gatherings and happy hours.
AHCA/NCAL members receive exclusive discounted rates on Mood services and equipment with three-year agreements.  The core music package starts at $29.99 per month or about $1 per day with a three-year agreement.

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

The Number of Open LTC Jobs Nationwide Holds Steady in May

Dave Kyllo

There are 49,295 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 Gartner TalentNeuron statistics.  That figure is virtually identical to the number of open jobs in April.     
    
The Gartner TalentNeuron statistics also show an estimated 2,661,000 potential candidates in the nation’s workforce whose skills likely match the qualifications being sought by long term care employers. Figures show that 3,148 direct employers are competing for candidates this month – a decrease of 136 employers over last month.  The average number of days a job was posted was 30 days in May.
      
Finding qualified employees is one of the greatest challenges facing long term care providers and the latest statistics prove that the challenge is only growing in the strong economy with a low unemployment rate.  Lead them to your job vacancy through the AHCA/NCAL Long Term Care Career Center

Now through May 31, open positions can be posted on the AHCA/NCAL Long Term Care Career Center for $250 per 30-day posting when employers use promo code GRAD100.  That’s $100 off the regular low AHCA/NCAL rate of $350.    

The LTC Career Center is designed to help AHCA/NCAL members be competitive in attracting qualified candidates to fill their health care positions.  Job postings receive far greater exposure than local ads and job boards because the LTC Career Center connects to a national network of nearly 300 national and state health care organizations and societies where serious candidates look for health care jobs. Employers are also able to post vacancies as they occur and search resumes on the network.

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 more than 61,000 searchable resumes on the National Healthcare Career Network this month. 

Make the smart, low-cost employee recruitment choice.  Check out the LTC Career Center today and don’t forget to use promo code GRAD100 to save $100 on your job postings.  Employers may use the code an unlimited number of times between now and May 31 on any number of postings.

AHCA Offers Hybrid Nurse Assistant Training to Address Workforce Challenges

Danielle Levitan

http://www.cnaonline.com/

The nurse assistant shortage is impacting long term care all over the country, and to help address this workforce problem, AHCA has a new CNA training program available. CNAonline.com combines online coursework with in-person clinical and skills training. It uses the renowned How To Be a Nurse Assistant curriculum in full e-book and audio book formats. Other features of the hybrid program include:
  • Practice tests, study guides, and quizzes to ensure student success
  • Competency-based skills checklists, videos, and visual aids
  • Professional instructors for online and in-person clinical training
Students can begin training any time, and the online portion is accessible 24 hours a day.

This flexibility and convenience is key to training quality nurse assistants who will make a real difference in the care you can provide in your centers.

For more information, please visit CNAonline.com or call 502-221-7765.

Changes to the Medicare Claims and Medicare Prescription Drug Coverage Determination Appeals Procedures

Nisha Hammel

On May 7, the Centers for Medicare & Medicaid Services (CMS) published the final rule titled Changes to the Medicare Claims and Medicare Prescription Drug Coverage Determination Appeals Procedures that provides Medicare beneficiaries, providers and suppliers clarifications on changes to the appeals process for adverse determinations under Medicare Part A and Part B and the prescription drug coverage under Part D.  CMS’ stated intent is to “…help streamline the appeals process and reduce administrative burden on providers, suppliers, beneficiaries and appeals adjudicators”.  AHCA/NCAL submitted comments on this very technical rule and CMS finalized most of the proposals supported by AHCA/NCAL including the removal of requirements that appellants sign appeal requests, change of timeframe for vacating dismissals from 6 months to 180 days and removal of redundant appeals processes.  The rule will go into effect July 8, 2019.

New SNF PEPPER Webinar Available

Lilly Hummel

The RELI Group, which is a contractor for the Centers for Medicare and Medicaid Services, has released a transcript, slides, and recording of a recent webinar on the new 2018 fourth quarter skilled nursing facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) data. That most recent SNF PEPPER report was released April 5, 2019 and includes data from 2016 fourth quarter through 2018 fourth quarter.

The SNF PEPPER is a free Microsoft Excel file summarizing provider-specific Medicare data statistics for targeted areas often associated with Medicare improper payments. The SNF target areas include: Therapy RUGs with High ADL; Nontherapy RUGs with High ADL; Change of Therapy Assessment; Ultra High Therapy RUGs; 20 day and 90+ day episodes of care. During the webinar, the presenter noted that new target areas have not been finalized for once the Patient Driven Payment Model goes into effect, but gave insight on what current target areas could be kept or phased out.

To obtain more information go to the PEPPER Website. The website includes a lot of training materials to support providers using the data.

Monday, May 13, 2019

What's Your Story?


Grab your ticket for the 13th Annual NCAL Day in Orlando, Florida. NCAL Day will be held on Sunday, October 13 from 7:30 AM – 4:00 PM EST, for a full day of learning.

NCAL Day will help you see your assisted living community with fresh eyes, so you can identify its strengths and unique qualities to better tell its story.                        

Opening Keynote Brett Culp is an award-winning documentary filmmaker and founder of the not for profit, The Rising Heroes Project. His films explore the power of heroic stories and the individuals who inspire us to believe in a better tomorrow. He encourages audiences to find the superhero within and to forge their own path to everyday leadership.






Mitch Hagins with the Studer Group will give the closing keynote. Using its Evidence-Based Leadership TM Studer Group partners with organizations to build a sustainable culture that promotes accountability, fosters innovation, and consistently delivers a great patient experience and the best quality outcomes over time. 








Spend the day with other senior living professionals focusing on the issues and concerns that are most important to you:

  • Workforce recruitment and retention
  • Leadership development
  • Preparing for the next generation of residents
  • Collecting and using date effectively
  • Collaborating with third parties
  • Improving transparency with customers


NCAL Day includes five different learning sessions and the opportunity to earn CEUs for administrators as well as CEs for nurses.

Find out more about NCAL Day and start making your plans!

NCAL Day is a separate ticketed event. Make sure to select it when you register for convention.

LEARN MORE ABOUT CONVENTION

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 April 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.

Tuesday, May 7, 2019

Registration Open – Upcoming Population Health Management Webinar

Jill Sumner

A Population Health Management webinar has been scheduled for Friday, May 17 and will be led by Jill Sumner. Population Health Management is becoming a common term to describe the evolution of Accountable Care Organizations (ACOs) and Bundled Payments. Learn to how to identify the models operating in your market and how this knowledge can help position your organization for success.

AHCA/NCAL members may register by clicking on the below link.

Friday, May 17: Population Health Management 

This webinar will also allow participants to learn about the different population health models and their relevance to long term care providers.

Registration for this webinar is for AHCA/NCAL members only.

Kool & the Gang Performs at the AHCA/NCAL Convention

Jon Patrick Ewing

This year’s 70th AHCA/NCAL Convention & Expo promises to be extra-ordinary, out-of-this-world event. Registration is now open with early bird discounts through July 26.

When registering for the Convention & Expo, don’t forget to purchase tickets to the Gala Dinner & Show*. This night of celebration, caps off the four-day convention with a unique opportunity to relax with colleagues, spend more time networking, and have fun enjoying good food and a great show. This year’s entertainment is the legendary Kool & the Gang. With iconic songs like Celebration, Cherish, Jungle Boogie, Summer Madness, and Open Sesame, the band has earned two Grammy Awards, seven American Music Awards, 25 top ten R&B hits, nine top ten pop hits, and 31 gold and platinum albums.

The Gala is a popular event , so purchase your tickets early. See you in Orlando!

*The Gala is a separate ticketed event.

Opportunity to Participate in Research Project

As you plan for this coming fall’s influenza season, there is an opportunity to participate in a research project with the AHCA sponsored research center at Brown University working with Insight Therapeutics, LLC. The research project will compare two FDA-approved vaccines and their effectiveness in preventing respiratory-related hospital admissions in nursing home residents.  Consent is not necessary since this study was approved as minimal risk and compares two CDC-recommended and FDA-approved vaccines.

If you participate, you will receive a supply of influenza vaccine at no cost for use with your residents and staff for the 2019-2020 fall’s flu season. Each participating facility will also receive a small honorarium for monthly data reports on vaccination rates throughout the flu season.

We encourage you to contact Insight Therapeutics, LLC, at NHFlustudy@inther.com or 757-625-6040. 

For additional information on the participation requirements go to  https://join.nhflustudy.com/.

Online Registration Deadline Extended



Danielle Levitan

If you have not yet registered for this year's Congressional Briefing, it is not too late. The online registration deadline has been extended to May 13th.

Plan to attend!

June 3-4
Hyatt Regency Washington on Capitol Hill

Congressional Briefing provides two invaluable days of
  • Networking with your colleagues
  • In-person meetings with your Members of Congress
  • Updates on what's happening in Washington
  • Excellent speakers and guests
You can also earn CEs.

See the complete agenda and register today.

Official Sponsor: Medline
Supporting Sponsors: Navigator, Reliant Rehabilitation, Zimmet Healthcare Services Group

PDPM Success is Grounded in ICD-10 Coding Know-How

Dave Kyllo

The October 1 PDPM implementation date is rapidly approaching and training key staff now to be ICD-10 proficient is critical. The American Health Care Association (AHCA) and the American Health Information Management Association (AHIMA) are offering ICD-10 on-line training. Because staff needs differ based 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 changes based on the new 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.

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

• AHCA/AHIMA ICD-10 Training for PDPM – Coderahcancal.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. 

Pre-Sale Registration is Now Open for AHCA’s Virtual PDPM Training

Dave Kyllo

The new Patient Driven Payment Model (PDPM) for skilled nursing facilities begins October 1, 2019. The PDPM system will rely on more than 180 MDS item fields and completely transforms the existing system Medicare Part A payment system for skilled nursing facilities. Staff roles and facility processes must be substantially modified to operate effectively under PDPM.

AHCA’s Virtual PDPM Training prepares AHCA members for PDPM and will mirror the in-person trainings that have been held for AHCA members in almost every state in recent months. The virtual training allows AHCA members who missed their state training to learn about the critical steps necessary on the pathway to success under PDPM. It is also a perfect opportunity for those members who have indicated interest in attending the training again to solidify what the learned during their day-long training.

Pre-registration for the online training program is now available to AHCA provider members only. The cost for the training – whether first time or repeated – is $350. NAB CE credit has been requested.

While the virtual training won’t go live for several weeks, AHCA members who pre-register now will have access to all materials on AHCA’s PDPM Academy within 48 hours of their purchase. The PDPM Academy is where updates, tools, webinars and other supporting materials are housed. AHCA members who pre-register for the Virtual PDPM Training will also be able to join in free monthly PDPM webinars hosted by AHCA. 

Pre-sale registration for AHCA’s Virtual PDPM Training is available here or by going to https://educate.ahcancal.org/p/virtualPDPM. Pre-sale registrants will be notified when AHCA’s Virtual PDPM Training goes live.

The Compass MEC Health Plan Delivers the Benefits Employees Want with No Deductibles, Low Copays and Unlimited Free 24/7 access to TELADOC®

Dave Kyllo

AHCA/NCAL Insurance Solutions offers a minimum essential coverage (MEC) health plan to members. The plan was developed by Compass Total Benefit Solutions and offers two affordable options for providing many of the health insurance benefits that are important to long term care employees. This short video explains the MEC plan for AHCA/NCAL members in less than two minutes and highlights the features that make the MEC plan so popular with LTC employers and employees.   

Both Compass plans feature affordable premiums and co-pays for valued and commonly used services, including prescriptions, physician visits and free unlimited 24/7 access to TELADOC®.  Benefits are instantaneous with no deductibles. The difference in the two plans is based on the level of hospital indemnity benefits. Here’s the exclusive AHCA/NCAL “Member Only” rate schedule:

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


The plan is designed to help AHCA/NCAL members recruit and retain frontline staff who cannot afford major medical health plan premiums or high deductibles. Employers determine their level of contribution for plan expenses for coverage for employees, their spouses, their children or family coverage. 

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

Read this Q&A document for more information about Compass plans for AHCA/NCAL members. Versions of the Compass Plan are available in all 50 states. Hospital indemnity benefits vary based on state approvals, which is why some states have different hospital indemnity benefit levels.

For more information, please contact Nick Cianci at 202-898-2841 or Dave Kyllo at 202-898-6312, visit www.ahcabenefits.org or www.ncalbenefits.org or email ahcainsurancesolutions@ahca.org.

Collaboration Between Hospitals and Nursing Centers Can Improve Outcomes

Rosa Baier

A Brown University team led by Dr. Vincent Mor examined the nature and degree of hospitals’ efforts to collaborate with skilled nursing centers and associated patient outcomes. They found that collaboration  is associated with positive outcomes for people transitioning from hospitals to nursing centers.

The study involved interviewing staff in 16 hospitals and 25 nursing centers in eight markets across the US, as well as examining Medicare claims data for nearly 300,000 patients discharged from those same 16 hospitals in a seven-year period (2008-2015). The team used the interview data to classify hospitals’ collaboration efforts with nursing centers into “high” versus “low” collaboration groups and to understand collaboration activities. These included establishing partnerships, transition management initiatives, and conducting hospital staff visits at nursing centers. Compared to low-collaboration hospitals, high-collaboration facilities were more likely to discharge patients to nursing centers (vs. other post-acute care settings, home, or home with home health); discharged a higher share of patients to high-quality nursing centers; and reduced nursing center readmissions from sooner and more.

Although the Brown researchers recognize that collaboration been hospitals and nursing centers requires significant investment in administrative and clinical time, they conclude that such relationships can improve patients’ transitions and outcomes.

Learn about research from AHCA’s research center at Brown: brown.edu/go/innovation.

Wednesday, May 1, 2019

U.S. Senate Hearing and Implementation of Veterans Care Agreements

Dana Halvorson

Yesterday, at a hearing of the U.S. Senate Military Construction and Veterans Affairs Appropriations Committee, Senator John Hoeven (R-ND) urged the U.S. Department of Veterans Affairs (VA) Secretary Robert Wilkie to ensure his long-term care (LTC) legislation is properly implemented, allowing veterans to access more of these services closer to home. Key provisions of the senator’s legislation, the Veterans Access to Long Term Care and Health Services Act, were signed into law last year as part of the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act.  The senator’s legislation allows the VA to enter into Veterans Care Agreements with qualified LTC providers, including nursing care centers.  The VA is expected to roll out proposed regulations relating to Veterans Care Agreements before the June 2019 implementation date, and Senator Hoeven is working to ensure the VA’s new LTC regulations remove duplicative layers of review and match the standards under the Centers for Medicare and Medicaid Services (CMS).  Aligning with CMS rules would provide relief from onerous and often times costly federal contracting requirements and enable more LTC providers to accept veteran patients.

The American Health Care Association (AHCA) worked with Senator Hoeven and other key Congressional champions on the Hill to get Veterans Care Agreements signed into law last year.  At yesterday’s hearing, Hoeven received commitment from the VA to hold a webinar in the near future for AHCA’s members and other LTC providers educating them and answering questions on these new agreements and the Community Care Network (CCN).  If you have any questions relating to this matter, please contact AHCA’s Senior Director of Not for Profit & Constituent Services, Dana Halvorson, at dhalvorson@ahca.org.        

High-Dose Flu Vaccine is Cost Effective for Nursing Center Residents

Rosa Baier

Nursing center leaders seeking to reduce hospital transfers may want to consider the type of influenza vaccine they offer their residents, according to research from Brown University. Flu is one of the leading causes of avoidable hospitalizations.

A team led by Vincent Mor and Stefan Gravenstein randomized more than 800 nursing centers across the country to use one of two FDA-approved flu vaccines, high dose or standard dose. A 2017 paper from this research study showed that fewer residents were hospitalized at nursing centers using the high-dose vaccine. Now findings published in February go one step further, to examine the cost benefit of using this more expensive vaccine.

Despite the fact that high-dose vaccine costs nearly $20 more per dose than low-dose vaccine ($31.82 vs. $12.04), the Brown team found a net benefit of $526 per resident offered the high-dose flu vaccine. Medicare benefits most directly, because the savings result from lower healthcare expenditures in this group. But these findings will be important and actionable for nursing centers seeking strategies to improve care delivery and to avoid payment penalties associated with hospital transfers.

Learn about research from AHCA’s research center at Brown: brown.edu/go/innovation.

Convention Offers More Than 70 Education Sessions

Danielle Levitan
 
The AHCA/NCAL Convention & Expo, taking place this October 13-16 in Orlando, FL, offers essential education sessions on all the key topics you need to know to stay compliant and provide quality care.
 
Get ready for PDPM. Find out what you need to know about the new Rules of Participation. Hear some fresh ideas and strategies for quality improvement.
 
You’ll earn CEs and get answers to some of your most pressing questions. Other key topics include:
  • ICD-10 Training
  • Risk Management
  • Workforce Solutions
  • Post-Acute Care
  • Dementia Care
  • Innovation and Technology
Browse all the education sessions and preview the speakers. AHCA/NCAL has designed convention to prepare you for all the challenges and hurdles coming your way.
 

Find Out the What’s Happening on the Hill at Congressional Briefing

Danielle Levitan


Join AHCA/NCAL President & CEO Mark Parkinson and hundreds of your colleagues to learn all the latest news in Washington.

June 3-4
Hyatt Regency Washington on Capitol Hill

Senator Tim Scott (R-SC) will be one of the guest speakers at Congressional Briefing. Senator Scott has a unique perspective to share—he grew up watching his single mother work 16-hour days as a nurse assistant to keep him and his brother afloat. Today he serves on multiple committees including the Senate Finance Committee, the Senate Special Committee on Aging, and the Senate Committee on Health, Education, Labor and Pensions. He is a leader on education and job training, and he has a great passion for creating jobs and solving workforce challenges.

To see who else is speaking at Congressional Briefing and review the complete agenda, visit cb.ahcancal.org.

Official Sponsor:
Medline


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

Reach the Class of 2019 for Less through the LTC Career Center

Dave Kyllo

Rates for posting job vacancies are reduced in time for spring graduation season. Now through May 31, open positions can be posted on the AHCA/NCAL Long Term Care Career Center for $250 per 30-day posting when employers use promo code GRAD100. That’s $100 off the regular low AHCA/NCAL rate of $350.
    
The LTC Career Center gives unprecedented targeted national exposure because it connects with the Health Care Career Network by providing visibility on the network’s nearly 300 national and state health care organizations and societies.  Serious health care candidates and new grads look for jobs on this national network built for health care employers to reach health care professionals.
 
The $250 sale price for a 30-day posting gives even more value because employers who utilize the AHCA/NCAL Long Term Care 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 GRAD100 to save $100 on your job postings.  Employers may use the code an unlimited number of times between now and May 31 on any number of postings.           

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.

Be RoP Phase III Ready: Use AHCA’s Online IPCO Training to Prepare Your Infection Preventionists & Boost Your Infection Prevention and Control Programs

Dave Kyllo

Phase III Requirements of Participation (RoP) take effect November 28, 2019 and mandate that every nursing facility have a designated and specially trained Infection Preventionist who is running a comprehensive infection prevention and control program.  AHCA’s Infection Preventionist Specialized Training (IPCO) program is specifically designed to prepare individuals to effectively implement and manage an Infection Prevention & Control program in nursing facilities.

AHCA/NCAL recommends that each nursing facility train at least two Infection Preventionists through AHCA’s Infection Preventionist Specialized Training (IPCO) program. It is important to have at least two people trained in the event that if one specially trained individual leaves, the facility will not be found to be out of compliance with the requirement to have at least one designated Infection Preventionist who is specially trained and that meets the other requirements set forth by the CMS Requirements of Participation for this mandatory role.

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.  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 nursing center’s Infection Prevention & Control program.  

Another reason for nursing facility staff to take the course now is to reduce the risk of receiving 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 infection prevention and control mandates began, more than one-third of surveys conducted across the nation have included a F880 Infection Prevention & Control citation.  The primary change coming this November under Phase III RoP is the designation of a specially trained Infection Preventionist who must work at least part-time at the facility.  Facilities will continue to be surveyed on all the new infection prevention and control requirements and the antibiotic stewardship requirements.

While CDC/CMS released a free infection prevention training course in March that members can access, AHCA’s training provides more in-depth learning.  AHCA’s course is the only specialized training for the long term and post-acute care setting that provides in-depth learning about the leadership and culture change elements necessary to create a comprehensive and sustainable infection prevention and control program that covers all operational components of a nursing facility.  

The AHCA training program gets rave reviews with nearly 97 percent of health care professionals who have completed the course recommending IPCO to their colleagues. The registration fee is $450 for AHCA/NCAL members and $650 for non-members.  There are no refunds and no transfers. 

Payment and registration are made online at ahcancalED.  The IPCO course can be accessed here or at: https://educate.ahcancal.org/p/ipco.   Discounted group purchase rates are available for groups of 25 or more.  Those interested in making a group purchase should email AHCA at educate@ahca.org.  

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. 

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

Dave Kyllo

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

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

Issue Briefs for Contracting with Health Plans

Lilly Hummel

The Centers for Medicare and Medicaid Services (CMS) offers Resources for Integrated Care that supports providers integrating benefits for people receiving both Medicare and Medicaid. This website has a variety of useful free resources for long term care providers.
Specifically, in response to the growth of both Medicare Advantage and Medicaid managed care long term services and supports (LTSS), the agency has several briefs to support provider interactions with health plans:

Northern California Wildfires and Lessons Learned: Medical Health Response and Shelters

Dana Halvorson and Erin Prendergast

The U.S. National Library of Medicine’s Disaster Information Management Research Center recently posted a recording about lessons learned from the northern California wildfires of 2017, the medical health response, and the need for shelters.  Panelists discuss their experiences in responding to the fires, which affected five counties, and the community and personal impact of the fires.  The 6,000 structures destroyed included homes, businesses, and hospitals.  The recording can be found here.  AHCA/NCAL also has an emergency preparedness website that you might find of interest.   

Monday, April 29, 2019

RIC Webinar: Promising Practices for Meeting the Needs of Dually Eligible Older Adults with Substance Use Disorders

Thursday, May 16, 2019, 1:30-3:00 PM ET

Register for the event

By 2020, the number of older adults with substance use disorders (SUDs) is expected to reach 5.7 million. This group faces unique challenges in receiving appropriate care: formal diagnosis criteria are less relevant for older adults than the general population; older adults are less likely to be screened for a SUD; and individuals dually eligible for Medicare and Medicaid have about twice the rate of co-occurring SUD and chronic pain compared to Medicare-only beneficiaries, making them a particularly vulnerable group.

This interactive webinar hosted by Resources for Integrated Care (RIC), will discuss common SUDs, identify promising practices for screening, treatment, and care coordination, and demonstrate practical strategies for meeting the needs of older adults with SUDs. Speakers, including a consumer with lived experience, will share lessons learned and strategies to provide effective care for dually eligible older adults with SUDs.

Featured Speakers:

  • Louis Trevisan, MD, Associate Professor of Psychiatry, Yale University
  • Nicole MacFarland, PhD, Executive Director, Senior Hope
  • Elizabeth Baumann, LSW, Case Manager, Council of Aging of Southwestern Ohio
  • Sherri, CASAC, Consumer

Registration is required to receive the webinar information. Visit the webinar information webpage to view CE credit information, sign up, and learn more.



Questions? Contact Resources for Integrated Care

Wednesday, April 24, 2019

AHCA/NCAL and AALNA Caring Together Webinar: Pain Management in the Elderly


Please join AHCA/NCAL and the American Assisted Living Nurses Association (AALNA) for our quarterly Caring Together webinar on Monday, April 29th at 3:00pm Eastern on pain management. Our presenter, Kevin W. O’Neil, MD, FACP, CMD, Chief Medical Officer for Affinity Living Group will discuss sources of pain in the elderly and review methods for assessing pain in the elderly. Participants will learn to recognize common pain behaviors in cognitively impaired older adults. Dr. O’Neil will address nonpharmacologic and pharmacologic management of persistent pain. Potential adverse effects associated with drugs (e.g., acetaminophen, NSAIDs, opioids) will be discussed. Please register here prior to the webinar.

New Five-Star Ratings Live on Nursing Home Compare

research@ahca.org

Today, the Centers for Medicare & Medicaid Services (CMS) published new Five-Star rankings on its Nursing Home Compare (NHC) website that reflect several significant updates to all three components of the system - survey, staffing and quality. A summary of the changes can be found here (member login required).

On April 8, AHCA hosted a webinar that walked through these new changes. Members can access the recorded webinar and other resources here.

AHCA has several tools to help members continue to improve. AHCA/NCAL's LTC Trend Tracker here is a one-stop-shop that allows members to gain timely information and valuable insight about their own performance as well as the entire profession's, including reports that capture Five-Star and Quality Measure (QM) rates.

For questions on the new Five-Star ratings, please email research@ahca.org.

CMS Issues FY2020 SNF Proposed Payment Rule

Natalie Visnick

On April 19, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) for FY (Fiscal Year) 2020. The proposed rule includes a net market basket increase of 2.5 percent, which CMS estimates would increase Medicare SNF payments by approximately $887 million in FY 2020. Additionally, CMS expanded the definition of “group” therapy. Specifically, CMS notes, “we are proposing to define group therapy in the SNF Part A setting as a qualified rehabilitation therapist or therapy assistant treating two to six patients at the same time who are performing the same or similar activities.”

CMS also issued the proposed rule with no material changes in the Patient-Driven Payment Model (PDPM) payment policy section. In addition to advancing PDPM itself, the FY 2020 proposed rule, as expected, continues to advance the integration of payment policy and quality-related provisions with PDPM and quality reporting, producing new implications from the proposed rule for SNFs.

AHCA provided a full summary of all the payment updates (member login required).

Register Today for ICD-10 Coding Online Training Built for SNF PDPM Success

Dave Kyllo

The October 1 PDPM implementation date is rapidly approaching and training key staff now to be ICD-10 proficient is critical. The American Health Care Association (AHCA) and the American Health Information Management Association (AHIMA) are offering ICD-10 on-line training. Because staff needs differ based 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 changes based on the new 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.
 
To learn more or register for either on-line training, please visit the websites below.    
 
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.