Tuesday, February 19, 2019

AHCA/NCAL Quality Summit: Disruption to Create Change

Jon-Patrick Ewing

Join quality practitioners from around the country at the 2019 AHCA/NCAL Quality Summit. Opening keynote speaker Chris Field, author of Disrupting for Good: Using Passion and Persistence to Create Lasting Change, shares a memorable and motivational message featuring inspirational stories from his book on how passion + persistence = lasting change. From running for mayor as a teenager to breaking multiple Guinness World Records to helping save over a hundred children from slavery, Chris has been disrupting most of his life. Seamlessly weaving his own story with those of other ordinary people who became extraordinary disruptors, Chris offers a clear call to action: anybody, anywhere, can choose to disrupt for good. Chris will end by walking you through his personal Disruption MAP so that you leave both prepared and inspired to disrupt for good in your own job, non-profit, school, neighborhood, and family.

Don’t miss the opportunity to stay at the host hotel and save with AHCA/NCAL discounted rates. The hotel reservation deadline for the Quality Summit is today! You may register for the Quality Summit through March 5. You must be registered for the event before hotel reservations can be made.

Upcoming Independent Owner Leadership Conference Will Help You Compete, Succeed, and Evolve in Ever-Changing Market

Danielle Levitan
 
 
The deadline is less than two weeks away!
 
2019 promises continuous challenges and changes, including the new Payment Driven Payment Model (PDPM).  Don’t go it alone.

Get ideas and insight from experts in the field, get your questions asked and answered, and get inspired at this year’s IO Leadership Conference.

March 20-22, 2019
Marriott Tampa Waterside

Key sessions include:
  • PDPM – learn what you need to know to be ready for the October 1 deadline
  • Workforce Stability – find out how to create successful retention and recruitment programs 
  • Long Term Care Provider Owned Health Plans – discover why a growing number of providers across the country have engaged in population health management initiatives and learn what it can do for you

Earn up to 12.75 CEs. Network with your colleagues. Take in the sun and the warmth of beautiful Tampa, FL.

Learn more, see the complete agenda, and register at IO.ahcancal.org. Receive special savings for first-time attendees and multiple attendees from the same facility.

Advance registration deadline is March 5.
Sponsors as of February 19, 2019:
Cantata Health, CapitalOne, Compass Total Benefit Solutions, Drive DeVilbiss, Ecolab, Evans Senior Investments, Guardian Pharmacy Services, HealthCap, Kronos, MatrixCare, Navigator, Pharmscript, PointClickCare, Prelude, Prime Care Technologies, Reliant Rehabilitation

 

Train Your Infection Preventionist Now to Meet the CMS November 2019 Requirement

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’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 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.   

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.  

While CMS has announced plans to offer a free infection prevention training course some time in Spring 2019, no specific date has been announced yet.  AHCA/NCAL recommends investing in staff training now rather than waiting to train staff on the requirements that already are in effect.  Facilities will continue to be surveyed on all the new infection prevention and control requirements and the antibiotic stewardship requirements. 

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. 

Timely Risk Management Advice from HealthCap®

Dave Kyllo

The winter edition of HealthCap’s quarterly Risk Watch newsletter is chock-full of sound advice for mitigating risks in nursing facility and assisted living settings.  The winter issue explores  facility audit practices, the link between CMS-5 Star ratings and risk, and the impact of ANCC Board certification on gerontological nursing outcomes.

HealthCap is endorsed by AHCA/NCAL and is the premier program solely dedicated to providing liability insurance to senior care communities.  One of the reasons HealthCap gets such great results is its focus on quality care as the foundation of good risk management practices.  HealthCap clients have the fewest liability claims in the industry and HealthCap settles claims for approximately one-half the industry average. 
HealthCap is owned and governed by the senior care providers insured by HealthCap.  AHCA/NCAL members get a bonus advantage by always receiving a 10% discount on their HealthCap premiums.
HealthCap clients also receive:
  • Risk management services that make a financial difference
  • An annual on-site risk consult
  • Unlimited telephone support
  • Accredited in-service education

For more information about HealthCap, email Stephanie Hale at stephanie.hale@chelsearhone.com or call (877) 855-4227. 

Friday, February 15, 2019

Congressman Horsford to Speak at AHCA/NCAL’s ID/DD Hill Fly-in Event Next Month!

Dana Halvorson


AHCA/NCAL’s Intellectual and Developmental Disabilities (ID/DD) Residential Services Providers will be in Washington, D.C., for AHCA/NCAL’s annual Hill Fly-In event on Wednesday, March 6, 2019. Participants will hear from Congressional speakers and others, including Congressman Steven Horsford of Nevada.  The event runs from 8 am – 10:15 am ET.  After the morning event is over, the ID/DD providers will head to Capitol Hill to discuss critical issues, including Medicaid.  If you have any questions relating to this event or would like to attend (it is free to attend, and breakfast and lunch are provided), please don’t hesitate to contact AHCA’s Senior Director of Not for Profit & Constituent Services, Dana Halvorson.   

Wednesday, February 13, 2019

We Want Your Feedback About LTC Trend Tracker

help@LTCTrendTracker.com

AHCA/NCAL is focused on our mission to improve lives by delivering solutions for quality care, and LTC Trend Tracker is one of those solutions.

If you aren't using LTC Trend Tracker, we would like to know why so we can help you utilize this great member benefit. If you are a using LTC Trend Tracker, we want to hear more about your experience.

Please take this short, online survey by Monday, February 18. It should take less than 10 minutes to complete.


To learn more about this exclusive member benefit, please visit www.LTCTrendTracker.com

Complete the Survey: State of Seniors Housing 2019

Lilly Hummel

NCAL is teaming up, once again, with the American Seniors Housing Association (ASHA), National Investment Center for Seniors Housing & Care (NIC), LeadingAge, and Argentum to issue The State of Seniors Housing, a report on the financial performance data for seniors housing communities. We need your participation in order to provide a representative picture of the industry.

Please download the 2019 State of Seniors Housing Survey (Excel format) and submit completed surveys to colleen.blumenthal@healthtrust.com by close of business Monday, March 18, 2019. Questions about the survey should be directed to Colleen Blumenthal of HealthTrust, LLC at (941) 363-7502 or at her email address noted above.

For owners or managers of multiple properties, please submit data for as many of your properties as is practical. The report will adjust overall results so large portfolios are neither over-represented nor under-represented.

The quality of our industry’s data relates directly to the size and composition of this sample. For the last few years, the State of Seniors Housing has collected data from 1,500 to 2,200 properties annually. If you contributed data for a given property last year, it is particularly important that we obtain information about that property this year also, so that “same-store” industry trends in revenues, costs, and census can be analyzed.

Properties Eligible for Inclusion in Survey
Properties eligible for inclusion in the State of Seniors Housing sample include the following: 
  • For-profit or not-for-profit communities
  • Communities where the majority of units provide Independent Living, including Active Adult 
  • Communities where the majority of units provide Assisted Living services 
  • Communities where the majority of units provide Memory Care 
  • Life Plan Communities/Continuing care retirement communities 
Please do not complete surveys for properties where rates are subsidized, such as Sec. 202 elderly housing.

Benefits of Participating
All organizations that complete surveys will receive a complimentary copy of The State of Seniors Housing 2019, which compiles the survey results for comparisons to your own operations.

Confidentiality
As always, the State of Seniors Housing data will be handled with complete confidentiality and the results presented only in the aggregate.

Thank you, in advance, for your participation in this important annual research study. The 2018 State of Seniors Housing publications can be purchased through the AHCA/NCAL Bookstore.

Take Action! Raise Awareness about Careers in the Field of Aging

Careers in Aging Week
March 3-9, 2019
#careersinaging19
People are living longer, and populations are aging worldwide. The demand for professionals with expertise in long term care is growing rapidly. The U.S. will need between 5.7 million and 6.5 million nurses, nurse aides, home health, and personal care workers to care for the 27 million Americans who will require long term care by 2050. Careers in Aging Week (CIAW), created by the Gerontological Society of America (GSA), is dedicated to bringing greater awareness and visibility to the wide-ranging career opportunities in long term care. During the first full week of March, CIAW is observed annually by businesses, clinics, coalitions, organizations, universities, colleges, and other parties across the world.
HOW CAN YOU GET INVOLVED?
  • Participate on social media. Share how you’re celebrating and showcasing careers in aging on social media using the hashtag #CareersInAging19.
    • Share your selfie! Snap a photo of your office, your facility, your clinic, your business, or your classroom. Describe your career in aging using #CareersInAging19.
    • During CIAW, AHCA/NCAL will share resources, graphics, and more on social media. Spread the word by retweeting us on Twitter or sharing our posts on Facebook.
  • Watch “The Information and Tools You Need to Promote Careers in Aging” video. This video, created in partnership with AHCA/NCAL, Argentum, LeadingAge, and GSA, shares a variety of ideas on how to participate. Watch it here.
  • Attend our kick-off webinar. On March 4, hear from caregivers across the country share their story and answer questions about why they work in long term care. Learn about the different roles, opportunities, and benefits that come with a career in aging. Registration coming soon!
  • Celebrate your staff. Host a party to celebrate/thank your staff members, and invite families of staff, residents and their family members. Recognize your staff for accomplishments, like tenure or outstanding customer service.
  • Open your doors to the community. Host a facility tour for local students, parents and teachers to showcase the day to day operations as a long term care professional.
  • Visit your local schools and talk about careers in aging. Informing the next generation about the opportunities in this profession is critical to meet future workforce needs.
  • Participate in job or educational fairs. The overall goal of these events should be to spark the interest of students and give them a sense of what a career in long term care is all about.
  • Plan a community celebration. Community events can be organized by local businesses, Chambers of Commerce, economic development groups and more. Talk to your community partners about how to best organize a celebration.
RESOURCES:
Visit www.careersinaging.com for more resources and information on how to get involved.

CMS MLN Article – Implementation of the SNF PDPM On October 1, 2019

Dan Ciolek

The Centers for Medicare and Medicaid Services (CMS) recently issued a MLN Matters Article titled “Implementation of the Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM)”.  The article summarizes specific instructions CMS has issued to its Medicare Administrative Contractors (MACs) via Change Request CR 11152 to effectuate changes to the SNF Prospective Payment System (PPS) that are required for the PDPM. These changes were finalized in the FY 2019 SNF PPS Final Rule (83 FR 39162). SNFs billing on Type of Bill (TOB) 21X and hospital swing bed providers billing on TOB 18X, (subject to SNF PPS) will be subject to these requirements. The Effective and Implementation Date are both listed as October 1, 2019.  Make sure your billing staff is aware of these changes.

BACKGROUND
Currently under the SNF PPS, revenue code 0022 indicates that the claim is being paid under the SNF PPS. This revenue code can appear on a claim as often as necessary to indicate different Health Insurance Prospective Payment System (HIPPS) Rate Code(s) and assessment periods. The HCPCS/Rates field must contain a 5-digit “HIPPS Code”. Currently, the first three positions of the code contain the Resource Utilization Group (RUG) group, and the last two positions of the code contain a 2-digit assessment indicator (AI) code.

PDPM Changes
Under the PDPM, the HIPPS code is structured differently. There are five case-mix adjusted rate components under the revised model:
  • The first position represents the Physical and Occupational Therapy case-mix group.
  • The second position represents the Speech-Language Pathology case-mix group.
  • The third character represents the nursing case-mix group.
  • The fourth character represents the Non-Therapy Ancillary case-mix group.
  • The fifth character represents the AI code.

This also affects the number of potentially valid HIPPS codes under PDPM, as compared to RUG-IV.

PPS Assessment Schedule
The PPS assessment schedule under PDPM is also significantly different from that used under the current case-mix classification system, the RUG Version IV (RUG-IV) model. The only required assessments under PDPM that would produce a HIPPS code would be the 5-day PPS assessment, which follows the same schedule as under the current SNF PPS, and an Interim Payment Assessment (IPA), which may be completed at any point during a PPS stay.

Per Diem Adjustment
Additionally, under PDPM, SNF PPS payments will be reduced according to a prescribed schedule, referred to as the variable per diem adjustment. Under the current SNF PPS, all days within any given RUG during a covered stay are paid at the same per diem rate. Under PDPM, however, the per diem rate for a given day of the SNF PPS stay may be different from the prior day, depending on an adjustment factor that may be applied against the SNF PPS rate connected with the HIPPS code. Moreover, the variable per diem schedule applies only to the Physical Therapy (PT), Occupational Therapy (OT), and Non-Therapy Ancillary (NTA) components of the per diem rate, with different schedules for the PT/OT components than for the NTA component. More details on this may be found in Table 30 of the FY 2019 SNF PPS Final Rule (83 FR 39228). A similar adjustment exists under the Inpatient Psychiatric Facility (IPF) PPS.

Interrupted Stay Policy
PDPM also includes an interrupted stay policy, similar to that which exists in the Inpatient Rehabilitation Facility (IRF) PPS and the Inpatient PPS (IPPS). Specifically, if a patient in a covered Part A SNF stay is discharged from the SNF but returns to the same SNF no more than three consecutive calendar days after having been discharged, then this would be considered a continuation of the same SNF stay. In such cases, no new patient assessments are required and the variable per diem adjustment is not reset. If the patient returns to the same SNF after the 3-day window, or returns to a different SNF, then this would be considered a new PPS stay. The interrupted stay would be recorded on the claim in the same manner as is done for the IRF PPS and IPPS.

AIDS/HIV Patients
As under the current SNF PPS, patients with a “B20” code on the SNF claim, meaning the patient has AIDS/HIV, receive an adjustment factor for their PPS rate. Under PDPM, the adjustment factor is different from that used under the current SNF PPS. Rather than a 128 percent adjustment for the entire PPS per diem rate, the adjustment under PDPM is an increase of 18 percent in the nursing component of the per diem rate and a reclassification under the NTA component to a higher rate category.

Transition to PDPM
With regard to transition between the current SNF PPS and PDPM, CMS anticipates that days paid under RUG-IV would stop on September 30, 2019, and days would be paid under PDPM beginning October 1, 2019. All other adjustment factors, such as adjustments for geographic variation in wage costs, remain the same under PDPM as under the current SNF PPS.

AHCA offers PDPM preparation resources for all members at the AHCA PDPM Resource Center, and for PDPM Academy Workshop registrants at the AHCA PDPM Academy web page. 

Agenda: Skilled Nursing Facilities/Long-Term Care Open Door Forum

Dan Ciolek

The proposed agenda for the next Skilled Nursing Facilities/Long-Term Care Open Door Forum scheduled for Thursday, February 14, 2019 from 2pm-3pmET is as follows below. If you wish to participate, dial 1-800-837-1935. Conference ID: 3693669. Please see the full participation announcement in the Downloads section. Thank you for your continued interest in the CMS Open Door Forums.
Announcements & Updates:

Tuesday, February 12, 2019

Quality Summit Housing Deadline Extended to February 20

Jon-Patrick Ewing

Don’t miss the opportunity to stay at the host hotel and save with AHCA/NCAL discounted rates. The hotel reservation deadline for the Quality Summit has been extended to February 20. You may register for the Quality Summit through March 5. You must be registered for the event before hotel reservations can be made.

What does disruption and innovation in the context of long term care mean? Join your peers, experts and others at the Quality Summit to generate strategies to begin, extend or sustain your quality program and improve clinical outcomes.

Sessions include:
  • Connecting Restorative Nursing with PDPM
  • Practical Strategies for Recruitment and Retention
  • PDPM: Your Roadmap to Person Centered Care
  • Join Roundtables on workforce pressures, innovation, resident satisfaction
  • and many more.

Summit faculty includes national subject matter experts who understand the professional development needs of practitioners along the long term care continuum. The Summit has education sessions ideal for skilled nursing, post-acute care and assisted living providers.

Don’t get left behind. Register now to join quality-focused providers from around the country for a Summit packed with content and tools for success.

The 2019 National Emerging Leadership Summit

Urvi Patel

Come engage with fellow emerging leaders in an unrivaled opportunity to strategize, advocate, connect, and innovate the future of the health and aging services profession. The National Emerging Leadership Summit in Washington, D.C. aims to increase, improve, and support the health and aging services profession to attract talent and future leaders by giving a voice to the next generation of leaders. More information, and an application, is available at:
http://www.nelssummit.org

Put an End to Utility Company Overcharges with Cleary Energy

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. That’s a significant savings! 

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

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. 

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. 

Deliver the “Food of Love” with Music from Mood Media

Dave Kyllo

William Shakespeare said “if music be the food of love, play on…”  Members can deliver the magic of music in their communities 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).

Understanding How SNF Value Based Purchasing Works is Key to VBP Success

Dave Kyllo

AHCA has an education program designed to help skilled nursing facilities succeed under the CMS value based purchasing payment program (SNF VBP) that took effect on October 1, 2018.  The course (Understanding SNF VBP in Detail) contains six modules that provide an in-depth description of each feature of the CMS SNF VBP program along with helpful tools, documents, and primary source references to the program. 

This training program is intended for nursing home administrators, directors of nursing and any other staff including corporate staff who are responsible for payment models and rehospitalization reduction efforts.   No specific license is required take the course and no contact hours or CEUs are awarded for completing the curriculum.
The training program is specifically designed to help long term care professionals:
  • Understand how CMS calculates the measures, risk adjustment, the facility score and payment adjustment.
  • Use and access the CMS SNF VBP feedback reports and the SNF Performance Score Report.
  • Apply the incentive payment multiplier.
  • Use the SNF VBP prediction calculator to estimate the financial impact different SNFRM rates have on your Part A revenue.
  • Adopt best practices to help either avoid a payment penalty or receive an increase in your Medicare Part A payments.
Possessing a detailed understanding of SNF VBP is critical to operational success.  SNF payment adjustments began on Oct. 1, 2018 for all SNF Medicare Part A claims ranging from a 2 percent cut to potentially a 1.5 percent increase based on rehospitalization rates in prior years. CMS will recalculate the payment adjustment annually every fiscal year (FY) hereafter for the next ten years.

The registration fee for AHCA’s SNF VBP online course is $25 for AHCA/NCAL members and $65 for nonmembers.

The individual who wants to take the SNF VBP course must login to ahcancalED and register for the course under their individual login.  To access ahcancalED, 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. 

Payment is made in ahcancalED upon registration via credit card or check. If paying by check, an order is not complete until the check is received and approved by AHCA staff. You will not have access to the training until approval.  Registrations for SNF VBP cannot be done by another person or under another person’s ahcancalED login.

Know how to succeed under SNF VBP.  Follow this link to register today for Understanding SNF VBP in Detail or go to https://educate.ahcancal.org/p/snfvbp

Updates to the OMHA Case Processing Manual

Lilly Hummel

The Office of Medicare Hearings and Appeals (OMHA) has published a revised chapter of the OMHA Case Processing Manual (OCPM). The revised chapter is Chapter 9: Request and Correspondence Intake, Docketing, and Assignment. The changes went into effect February 1, 2019. The manual standardizes the day-to-day procedures for carrying out adjudicative functions, in accordance with applicable statutes, regulations, and OMHA directives, and gives OMHA staff direction for processing appeals at the OMHA level of adjudication. As part of an ongoing effort to make the manual more user friendly and reflect recent regulatory changes, OMHA is in the process of drafting new OCPM chapters and revising existing chapters under a new format.

Register Today for the 2019 Independent Owner Leadership Conference

Danielle Levitan

Hotel Deadline Is Next Week
 
 
Now is the time to register and save! We have extended the hotel deadline to February 20, and the early registration deadline is March 5. Be sure to register so you don’t miss out on all the essential education, networking, and learning opportunities offered at this year’s Independent Owner (IO) Leadership Conference.

You can earn up to 12.75 CEs.

Topics include:
  • Patient-Driven Payment Model (PDPM)
  • Workforce Stability
  • Risk Sharing and Risk Bearing
  • Grassroots Advocacy

In addition, the Owner-to-Owner Town Hall discussion will tackle emerging trends as well as litigation, records requests, and risk management.

You can also enjoy time with your IO peers in a more casual atmosphere when you take part in one of the social networking events taking place. Choose from a golf outing, paddle board or kayaking tour, or a unique Mixology class.

Get all the details and see the complete agenda at IO.AHCANCAL.org.

Sponsors as of February 11, 2019:
Cantata Health, CapitalOne, Compass Total Benefit Solutions, Drive DeVilbiss, Ecolab, Evans Senior Investments, Guardian Pharmacy Services, HealthCap, Kronos, MatrixCare, Navigator, Pharmscript, PointClickCare, Prelude, Prime Care Technologies, Reliant Rehabilitation

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 January 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.

2018 AHCA/NCAL Annual Report Now Available

Abigail Barreto

AHCA/NCAL is dedicated to improving lives by delivering solutions for quality care. Each year, the Association establishes goals to help achieve this mission, and 2018 was very successful. We continued to grow as an association, remained a powerful policy and political voice in Washington, addressed important issues such as workforce, and advanced quality care.



This year’s annual report also features a short video that highlights the work done in 2018 and our success. We appreciate our members and everything they do to continue delivering the highest quality care for millions of patients and residents.




Wednesday, February 6, 2019

Warn Your Residents About this Social Security Scam

The Federal Trade Commission is getting reports about people pretending to be from the Social Security Administration (SSA) who are trying to get individuals' Social Security number and even their money.

The Administration for Community Living (ACL) shared the following scenarios in a recent e-newsletter:
In one version of the scam, the caller says your Social Security number has been linked to a crime (often, he says it happened in Texas) involving drugs or sending money out of the country illegally. He then says your Social Security number is blocked – but he might ask you for a fee to reactivate it, or to get a new number. He will ask you to confirm your Social Security number.
In other variations, he says that somebody used your Social Security number to apply for credit cards, and you could lose your benefits. He also might warn you that your bank account is about to be seized, that you need to withdraw your money, and that he’ll tell you how to keep it safe. 
All of these are scams. Here’s what you and your residents need to know:

  • The SSA will never call and ask for your Social Security number. It will not ask you to pay anything. It won’t call to threaten your benefits.
  • Your caller ID might show the SSA’s real phone number (1-800-772-1213), but that’s not the real SSA calling. Computers make it easy to show any number on caller ID. You cannot trust what you see there.
  • Never give your Social Security number to anyone who contacts you in this way. Do not confirm the last 4 digits. Do not give a bank account or credit card number – ever – to anybody who contacts you by phone asking for it.
  • Remember that anyone who tells you to wire money, pay with a gift card, or send cash is always a scammer no matter who they say they are.
ACL also recommends that if you or a resident is worried about a call from someone who claims to be from the Social Security Administration, get off the phone. Then call the real SSA at 1-800-772-1213.

If you have spotted a scam, then tell the FTC at ftc.gov/complaint.

To learn more, you can go to Fake Calls about your SSN.

We Need You for Our New Social Media Initiative

Drew Thies

AHCA/NCAL is beginning a new social media advocacy initiative this year and is encouraging all members to get involved.

The effort focuses on improving the overall image of the post-acute and long term care profession by sharing positive stories and pushing back on pieces that attempt to tie all providers to isolated negative events.

AHCA/NCAL will be sending interested members tips for getting more involved on social media, best practices for posting content, sample posts, and a roundup of positive stories about the profession on a regular basis. Individuals who want to get involved should email socialmedia@ahca.org to get on the mailing list. AHCA/NCAL is encouraging all members to get involved.

The campaign also will include a rapid response to stories that are unfairly negative about the profession or do not accurately portray the reality of post-acute and long term care.

AHCA/NCAL hopes to build on these successes as the year continues. With thousands of buildings nationwide who touch the lives of millions of people, there is the chance to seriously affect the way the profession is viewed and treated by lawmakers and the media.

CMS Issues New PDPM Related MDS Draft Data Specifications Effective October 1, 2019

Dan Ciolek

On February 5, the Centers for Medicare and Medicaid Services (CMS) posted on their MDS 3.0 Technical Information Webpage a new draft version (V3.00.0) of the MDS 3.0 Data Specifications.  This version is scheduled to become effective October 1, 2019. 

These specifications are used for software developers and vendors to update SNF PPS grouper, MDS, electronic health record, and billing systems to align with annual updates to the MDS-RAI (yet to be issued) and SNF PPS billing requirements. 

Note that there are many significant changes, to align with the transition to the new Skilled Nursing Facility Prospective Payment System (SNF PPS) from the Resource Utilization Groups, Version 4 (RUG-IV) to the Patient Driven Payment Model (PDPM).  These changes include the removal of eight RUG-IV assessment item sets (NS, NSD, NO, NOD, SS, SSD, SO, SOD), the addition of two new PDPM assessment item sets (IPA – Interim Payment Assessment and OSA – Optional State Assessment), and item additions in Sections A, GG, I, J, O and Z. See this link for the draft MDS 3.0 Item Sets v1.17 for October 1, 2019) that were issued on January 3.  The MDS draft data specifications also accommodate the utilization of the PDPM grouper (not issued yet) , which also begins on October 1, 2019.

In addition, a new version (V1.04.0) of the MDS 3.0 CAT Specifications was posted. This version is also scheduled to become effective October 1, 2019. The specification for CAT 12 (Nutritional Status) has been updated in accordance with the changes in V3.00.0 of the MDS 3.0 Data Specifications.

Tuesday, February 5, 2019

Quality Summit Housing Deadline Ends Next Friday

Jon-Patrick Ewing

Don’t miss the opportunity to stay at the host hotel and save with AHCA/NCAL discounted rates. The hotel reservation deadline for the Quality Summit is February 15. You may register for the Quality Summit through March 5. You must be registered for the event before hotel reservations can be made.

The 2019 AHCA/NCAL Quality Summit is an event that harnesses the energy and passion of assisted living, post-acute, and skilled nursing quality practitioners and turns them into the foundation for a must-attend three days. This year the goal of the Quality Summit programming is to highlight the power and limitless possibilities that come from the pursuit of excellence and to shine a spotlight on the results that come from disruption and innovation, as well as practical approaches to care and operational challenges. The Summit programming is designed for quality practitioners at all levels. From sessions showcasing the innovative practices of providers across the county, to short, targeted LED talks designed to challenge your thinking, to peer-to-peer idea exchanges, new solutions from sponsor partners, and informative keynote speakers; you will leave with information and ideas that you can implement as soon as you return to your centers and communities.

Program topics include:
  • We Are a Gold AL. Here is How We Got Here
  • Best Practices to Avoid Your Resident Being “Lost in Transition”
  • PDPM as a Vehicle to Advance Person-Centered Care
  • No One Told Me That the Skills I Learned Playing Clue, Chutes and Ladders and Candy Land, Would Be Needed to Be A Leader of Healthcare
  • Competent Geriatric RNs – The New Driver of Financial Performance
  • Transforming an Organization One Neighborhood at a Time
  • The Value of Occupational Therapy: Implementing AOTA Quality Improvement Resources
  • Practical Strategies for Recruitment & Retention 
  • And much, much more!

Escape the dregs of winter for the warm Tampa, FL sunshine. REGISTER NOW and attend sessions, connect with sponsors, and network and share your successes and challenges with like-minded colleagues from across the country. We know you will return home with solutions that will show results in your organization!

CMS Emergency Preparedness Update

Erin Prendergast and Dana Halvorson

The Centers for Medicare and Medicaid Services (CMS) recently sent a memo to state survey agency directors regarding an update to Appendix Z of the State Operations Manual (SOM) to add emerging infectious diseases to the definition of all-hazards approach.  In the memo, CMS also responds to questions about alternate source power and emergency standby systems under the Emergency Preparedness Final Rule.  Since the release of the Interpretive Guidelines for Emergency Preparedness in 2017, stakeholders and providers have asked for additional clarifications related to portable/mobile generators.  CMS has added guidance under Tag E0015- Alternate Source Power as well as clarifications under Tag E0042- Emergency Standby Power Systems. Facilities should use the most appropriate energy source or electrical system based on their review of their individual facility's all-hazards risks assessment and as required by existing regulations or state requirements.  Regardless of the alternate sources of energy a facility chooses to utilize, it must be in accordance with local and state laws, manufacturer requirements, as well as applicable Life Safety Code (LSC) requirements.

The revisions, as the provisions under emergency preparedness themselves, do not take away existing requirements under LSC, physical environment or any other Requirements/Conditions of Participation that a provider type is subject to.  If you have any questions relating to this, please contact AHCA’s Erin Prendergast for SNF focuses and AHCA’s Dana Halvorson for ICF/IID related questions.

Webinar Lets You Step into Residents’ Shoes for Better Behavior

Joanne Kaldy

Imagine this scenario. A certified nurse assistant (CNA) gives Mrs. Jones a cup of coffee. Mrs. Jones takes one sip, then throws the coffee at the CNA. While this behavior is upsetting, it may not be as mysterious or as difficult to address as one may think.

Barbara Speedling, quality of life specialist and presenter at an upcoming AHCA/NCAL webinar on “Toward Better Behavior: Yours, Mine, and Everyone Else’s,” suggests looking at it from Mrs. Jones’ perspective. “If you bring your own coffee to work because you don’t like the facility’s coffee, maybe Mrs. Jones doesn’t either, and this could explain her behavior,” she says. In this case, the solution might be to find a way to get her coffee or other beverages she will enjoy.

In her program, Speedling will provide a framework for developing an assessment process that results in a deeper understanding of what motivates someone to do what they do. “With greater understanding comes a more focused, personalized plan to accommodate the complicated needs of every individual,” she says. “I help people go away from the webinar thinking more about putting themselves in the place of the people they care for.”

To understand someone’s behavior, Speedling says, “You have to distinguish whether behaviors qualify as symptom, reaction, or personality.” For instance, if some behavior is part of someone’s personality—such as he or she is judgmental or sarcastic—that isn’t likely to change, and it would be a waste of time to try to change the person. Instead, she suggests, learn ways not to trigger negative behaviors that are related to the person’s personality.

It’s important to imagine what life in a skilled nursing center would be like for you, says Speedling. “Consider never being alone, never being able to do exactly what you want, when you want. No one can be fine all the time. No one can be expected never to be angry or get upset,” she says. “We have to realize that and address behavior accordingly.”

The webinar is set for 2:00 PM EST on February 20. Go to https://educate.ahcancal.org/p/190220 to register.

Avoid the #1 Survey Citation Now & Be Ready for the Phase III Infection Prevention Requirements This November

Dave Kyllo

The most frequently cited F-Tag in standard nursing facility health inspection surveys under the new survey process is F880 – Infection Prevention & Control.  Since November 2017 when the new survey process began, more than one-third of surveys conducted across the nation have included a F880 Infection Prevention & Control citation. 

AHCA’s Infection Preventionist Specialized Training (IPCO) program is specifically designed to prepare individuals to effectively implement and manage an Infection Prevention & Control program in skilled nursing centers. It addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control which are fundamental to effectively leading and administering a center’s Infection Prevention & Control program. 

AHCA’s course is an online, self-study program with 23 hours of training that meets the educational requirements outlined by CMS. It includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term/post-acute care.  The AHCA program gets rave reviews with nearly 97 percent of health care professionals who have completed the course recommending IPCO to their colleagues.

The course addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control that are fundamental to effectively leading and administering successful infection prevention and control programs and antibiotic stewardship programs.   Upon successful completion of this program, participants will receive certificates including 23 ANCC contact hours. 

The training course registration fee is $450 for AHCA/NCAL members and $650 for non-members.  There are no refunds and no transfers.  Payment and registration must be made online in ahcancalED. The IPCO course can be accessed here or at: https://educate.ahcancal.org/p/ipco. Discounted group purchase rates are available for groups of 25 or more.  Those interested in making a group purchase should email AHCA at educate@ahca.org.  

While CMS has announced plans to offer a free infection prevention training course some time in Spring 2019, AHCA/NCAL recommends investing in staff training now rather than waiting to train staff on the requirements that already are in effect.  Despite the CMS training announcement, facilities will continue to be surveyed on all the new infection prevention and control requirements and the antibiotic stewardship requirements – the same requirements leading to the most commonly cited F-Tag since November 2017 under Phase I and Phase II of the CMS Requirements of Participation and the implementation of the new survey process.

Phase III requirements take effect November 2019 and mandate that every nursing facility have a designated and specially trained Infection Preventionist.  AHCA’s IPCO training prepares individuals to take on the Infection Preventionist role and now is the time to train those individuals!

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. 

Take Advantage of Your “AHCA/NCAL Member Only” Discounts on FedEx Express® Services through PartnerShip®

Dave Kyllo

AHCA/NCAL members can lower their costs on FedEx Express services.  Through the AHCA/NCAL Shipping Program, managed by PartnerShip, members receive exclusive discounts with FedEx, including up to 29%* off select FedEx Express services. There are no fees or minimum shipping requirements, simply great savings and great efficiency.

Participation in this exclusive program helps AHCA/NCAL members ship smarter with more convenience.  To participate in the AHCA/NCAL Shipping Program and receive these discounts of up to 29%*, simply enroll now or email sales@PartnerShip.com to start saving today. Enrollment is free. 

Whether sending important documents on tight deadlines or shipping small packages, FedEx Express gets shipments where they need to go, when they need to get there. Your AHCA/NCAL membership gets you the most out of shipping options, and PartnerShip can help lead the way. Here are a few things to know in order to take full advantage of FedEx Express services.

Order free shipping supplies - Cut your shipping costs by ordering supplies for your FedEx Express shipments for free through fedex.com. You can order envelopes, boxes, tubes, shipping label pouches—everything you need to make sure your shipment is packaged properly.

Take advantage of FedEx One Rate® options - Select FedEx Express services are available with FedEx One Rate. These flat rate options can be very cost-effective for envelopes up to 10 lbs. and boxes or packs up to 50 lbs. FedEx makes it easy to compare pricing and determine whether FedEx One Rate is right for you. Simply enter your shipment information to find out your rate. It’s fast, easy, and convenient.

Solutions to ship on your terms - When you need to ship urgent small packages on a tight schedule, FedEx gives you greater control and flexibility. Each location offers different levels of service for what you need to take care of business. Easily search online by zip code to find the service type and location that works best for you. Whether you need a simple self-serve pick up and drop off, or a one-stop shop for printing and packaging assistance, FedEx has you covered.

Enroll and start saving - It’s easy to start saving with your AHCA/NCAL “member only” discounts. If you already have a FedEx account, PartnerShip will ensure you’re receiving the best possible pricing and link your discounts to your existing account. All you need to do is enroll.  The savings can be substantial with discounts up to 29%*. Start saving today!  

*Includes a bonus 5% online processing discount. Full details available at PartnerShip.com/85AHCA/FedExdiscounts.

Take Advantage of Your Exclusive AHCA Member Benefits

Dave Kyllo

One of the many benefits of AHCA membership is the AHCA/NCAL Member Savings Program where AHCA members obtain exclusive discounts on distinguished products and services.  Members can save on liability insurance, utility audits, electronic job board postings, outstanding on-line education, FedEx® shipping and more.  Visit www.AHCAsavings.org to learn more.

AHCA members can also save on their employee health benefit plans through AHCA/NCAL Insurance Solutions.  A minimum essential coverage plan (MEC) is now available for a low $162 monthly premium per employee and offers employees the benefits they actually use with no deductibles and low co-pays.  Employers can choose to pay from 0-100% of the premiums.   For more information on the MEC plan and ACA-compliant major medical plans, go to www.AHCAbenefits.org.   

Participate in the Behavioral Health Salary & Benefits Study

Rosanne Zabka

Hospital & Healthcare Compensation Service (HCS) is conducting its 3rd annual Behavioral Health Salary & Benefits Study, and they need your help. Behavioral Health providers are asked to complete the study's questionnaire by March 11th.
 
There is no cost to participate in the study. Participants may purchase the results at the reduced price of $175, versus the $350 nonparticipant rate. Publication is scheduled for May 2019.
Questionnaires can be downloaded at: https://www.hhcsinc.com/survey-questionnaires.html 

You can notify HCS you intend to submit your data, or request an extension past the March 11th deadline by emailing Rosanne Zabka, rzabka@hhcsinc.com.

The report covers mental health, AoD, and developmental disability jobs.  The results will include hourly and bonus data for 50+ jobs, caseload size, productivity, turnover, and 12 fringe benefits.  Job data will include the 10th, 25th, 50th, 75th, and 90th percentiles, average, number of employees, and number of facilities reported by job.  Planned increases for 2020 will be reported for management, hourly, program managers, direct support professionals, case managers, clinicians, and RNs. 

All data results are compliant with anti-trust regulations for survey data reporting.  HCS surveys are recognized as an acceptable survey source by the GAO.  All data received remains confidential.

HCS publishes ten annual healthcare compensation studies. Nationally known, their reports are recognized as the standard for reliable, comprehensive, and affordable compensation data.

Independent Owner Leadership Conference Takes Place Next Month

Danielle Levitan


The hotel deadline is Friday, February 15. Secure your hotel room now and take advantage of the room rate savings.

Why attend this year’s conference?
  • Network with your IO peers from around the country
  • Learn about and discuss critical topics like:
    • Patient-Driven Payment Model (PDPM)
    • Workforce Stability
    • Risk Sharing and Risk Bearing
    • Grassroots Advocacy
  • Earn up to 12.75 CEs
  • Enjoy the sunshine and beautiful setting

It’s three full days of inspiration and priceless answers to your most pressing questions.

Get all the details and see the complete agenda, social events, speakers, and more at IO.AHCANCAL.org.

Registration Deadline: March 5

Sponsors as of February 1, 2019:
CapitalOne, Compass Total Benefit Solutions, Drive DeVilbiss, Ecolab, Evans Senior Investments, Guardian Pharmacy Services, Kronos, MatrixCare, Navigator, Pharmscript, PointClickCare, Prime Care Technologies, Reliant Rehabilitation

Nursing Home Compare Quarterly Refresh with SNF QRP Data Now Available

The January 2019 Nursing Home Compare Refresh, including quality measure results based on SNF QRP data submitted to CMS, is now available.

The updated SNF quality measure results are based on data submitted to CMS between:
 
1. Quarter 2 – 2017 to Quarter 1 – 2018 data
  • Application of Percent of Residents Experiencing One or More Falls with Major Injury (Long Stay) (#0674)
  • Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (Short Stay) (NQF #0678)
  • Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function (#2631)
2. Quarter 4 – 2016 to Quarter 3 – 2017 data
  • Medicare Spending Per Beneficiary – Post-Acute Care (PAC) Skilled Nursing Facility Measure
  • Discharge to Community- Post Acute Care (PAC) Skilled Nursing Facility (SNF) Quality Reporting Program (QRP)
As a reminder, CMS announced in October 2018 that it will not publish a 6th previously posted quality measure, Potentially Preventable 30-Day Post-Discharge Readmissions, at this time. Additional time will allow for more testing to determine if modifications to the measure and method of displaying it are needed. This additional testing will ensure that the future publicly reported measure is thoroughly evaluated so Compare users have an accurate picture of provider quality. While this additional testing is conducted, CMS will not post reportable data for this measure, including each SNF’s performance, as well as the national rate.
 
Please visit the NH Compare website to view the updated quality data.

For more information, visit the CMS SNF Quality Public Reporting webpage.