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. 


The Checks are Coming in for AHCA/NCAL Members Who Use Cleary Energy to Audit their Utility Bills

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 week 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. 

Gero Nurse Prep Spring Sale Ends April 30: Register Now and Strengthen Your RN Team!

Dave Kyllo

New research conducted by AHCA/NCAL shows that SNFs that employ at least one American Nurses Credentialing Center (ANCC) Board certified RN also, on average, performed higher on SNF VBP performance. The average 2017 SNF VBP performance score across the nation was 34.4.  For SNFs with at least one RN who has been ANCC Board certified in gerontological nursing, the average SNF VBP performance score was 44.2.  The net result is that these SNFs get higher Medicare Part A reimbursements. 
The AHCA/NCAL 2019 research also found that SNFs with at least one ANCC Board certified RN also experienced:
  • Fewer survey deficiencies
  • Fewer IJ citations
  • Lower rehospitalization rates
  • Lower rates of off-label use of antipsychotics
  • Higher CMS 5-Star ratings
The ANCC offers certification in gerontological nursing – the gold standard in demonstrating clinical excellence in geriatric patient care.  ANCC is the world’s largest and most prestigious nurse credentialing organization and a subsidiary of the American Nurses Association.  Less than one percent of America’s RNs are board certified in gerontological nursing. 

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

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

Gero Nurse Prep is on sale through April 30!  Save $100 off the regular registration fee by using promo code VBP2019 (all caps).  AHCA/NCAL Gero Nurse Prep provides tremendous value at this AHCA/NCAL member $590 sale price.   That’s less than $20 per contact hour for outstanding nursing education that makes a measurable difference on so many fronts.  For RNs interested in pursuing Board certification through ANCC, there is an additional and separate cost of $395.

To learn more about Gero Nurse Prep and ANCC Board certification, watch this video. For an even deeper dive into competent geriatric nursing, listen to this free AHCA/NCAL webinar “Improving Clinical Outcomes through Competent Gerontological Nurses.” 
 
If your RNs are not yet ANCC Board certified, take this important step on your quality journey and check out AHCA/NCAL Gero Nurse Prep today.        

Tuesday, April 23, 2019

Congressional Briefing Stacked with Unique Events and Guests: Register Today

Danielle Levitan

Don't miss all of the exciting and valuable events taking place at this year's Congressional Briefing June 3-4 in the heart of the nation's capital. See the complete agenda and make your plans today. AHCA/NCAL has requested 8.5 CEs. for nursing home administrators, assisted living administrators, and nurses. Individuals seeking approval for all other professional licensures must file independently and should contact Teresa Eyet, teyet@ahca.org, Senior Director, Education and Development for the materials needed.

Please be aware that our online registration portal is temporarily unavailable while we make some improvements to our service. You can register for the Congressional Briefing by downloading and completing the registration form, then email it to meetings@ahca.org or fax to 202-898-6302.

Keynote Speaker: John Roberts, Chief White House Correspondant, Fox News
This year's Joe Warner Patient Advocacy Award winners are Nanci Wilson, Industry/Government Liaison and Partner at Plum Healthcare Group, LLC and Leonard Russ, Principal Partner of Bayberry Health Care. The awards will be given out on the afternoon of June 3rd, following the Congressional Briefing and keynote address. A reception follows.

Nanci Wilson, Industry/Government Liaison and Partner at Plum Healthcare Group, LLC

Leonard Russ, Principal Partner of Bayberry Health Care

HCS Extended Deadlines for CCRC and Nursing Home Salary & Benefits Studies

HCS has extended the deadlines for both the CCRC and Nursing Home Salary & Benefits studies. 

  • The CCRC study deadline has been extended to Friday, May 3rd.  
  • The Nursing Home study deadline has been extended until Monday, May 20th. 

Those that need additional time should contact Rich Cioffe, RJCioffe@hhcsinc.com, or (201) 405-0075, ext. 10. 

Questionnaires are available on the HCS website: https://www.hhcsinc.com/survey-questionnaires.html.  Facilities with multiple locations in varying counties or states should use the Multi-Site questionnaire; facilities with one location should download the Single-Site survey. 

Reminder -- Participants receive a reduced rate off the Report price.  The CCRC Salary & Benefits Report will be published in late June; the Nursing Home Report will be published in late July.

Thriving in the Shark Waters of Healthcare…How Non-Profits Meet the Challenge

Dana Halvorson

AHCA Not for Profit Council (NFP) member and Program Director for Long-Term Care Administration at St. Joseph's College, Steve Chies, recently did an ahcancalED recording entitled, “Thriving in the Shark Waters of Healthcare….How Non-Profits Meet the Challenge.”  You can view the recording here.  The main learning objectives include:

  • Understand the key business model elements for skilled nursing facility operations.
  • Lists tactics for non-profit providers in meeting the challenges in skilled nursing facility
  • operations.
  • Create models for sustainability in skilled nursing operations.

If you have any questions, please do not hesitate to contact Steve Chies at sedwardchies@gmail.com

Mary K. Ousley Champion of Quality Award Nominations Are Open!

Erin Prendergast

AHCA is now accepting nominations for the 2019 Mary K. Ousley Champion of Quality Award. This award recognizes an individual who has made significant national contributions in advancing quality performance in long term and/or post-acute care in skilled nursing or assisted living settings.

Nominations must be submitted online here by Friday, June 7 at 11:59 p.m. ET. The recipient will be announced the week of July 24 and will be presented with the award on stage at the 70th AHCA/NCAL Convention & Expo, October 13-16 in Orlando, Florida. This year’s recipient will receive a complementary registration to Convention, round-trip airfare, and a one-night hotel stay. For more information about the Champion of Quality Award and past recipients, please visit the award web page here

Nominate today, and honor a long term or post-acute care colleague who is dedicated to improving the lives of others and their surrounding communities.  

Wednesday, April 17, 2019

New Resources Available: RoP Phase 3 Compliance and Ethics Program

educate@ahca.org

The American Health Care Association (AHCA) is pleased to announce new nursing center member resources 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, include:
  • AHCA toolkit
  • Sample checklist for compliance and ethics training
  • Sample tool for monitoring and auditing risk assessment
  • 10 webinars
Although the interpretive guidelines have not yet been published, the RoP Compliance and Ethics Program stems from the Office of Inspector General's (OIG) long-standing guidance for the seven elements of a compliance program. AHCA's resources rely on best practices for an effective compliance program, calling out provisions specific to the RoP. These resources also provide practical explanation and tips for how to create or update your compliance program. Starting November 28, 2019, the Centers for Medicare & Medicaid Services (CMS) and state survey agencies will be authorized to issue survey deficiencies under F-Tag F895 to centers that do not have an effective compliance program.  Although this requirement does not go into effect until November, members should not wait to update and refine their compliance and ethics programs. We hope these resources will help you along the way.
 
For any questions on this topic, please email educate@ahca.org

Out of this World Convention Keynote Speakers

Jon Patrick-Ewing

Registration is now open for the AHCA/NCAL 70th Convention & Expo in Orlando, Florida, October 13-16.

Convention features two exciting keynote speakers that are not to be missed.

The Opening Keynote is Doris Kearns Goodwin, world-renowned presidential historian and Pulitzer Prize-winning author.  During her address, Goodwin will reflect on more than 150 years of U.S. history and put into context the current fast-paced, unpredictable, and, at times, impulsive administration. By sharing her deep understanding of the ambition, resolution, and resilience of some of our nation’s most revered presidents, she will explain how past setbacks and triumphs shed light on the cultural, economic, and political transformations that define today’s turbulent times. Goodwin brings to life some of our most successful presidents, providing insight on today’s leaders and demonstrating that however fractured our modern political culture has become, our democracy is also resilient and has survived, and even thrived, through more troubling times in the past.

Brad Montgomery, this year’s Closing Keynote, is a well-known motivational speaker who uses humor, interactivity, sound, music, and visuals to ignite audiences so that they can use happiness as a tool to improve their lives and their jobs. He has spoken all over the world and was recently inducted into the CPAE Speakers Hall of Fame. He turns typical meetings into transformational events using the power of happiness.

To learn more about all Convention & Expo keynote speakers, education sessions, events, and sponsors, visit our official convention website.

The early bird deadline is July 26. All attendees must be registered for the event before hotel reservations can be made. You may do both when registering online.

CMS Issues Significant Revisions to Appeals of Claims Decisions Chapter 29 of the Medicare Claims Processing Manual

Dan Ciolek

On April 12, the Centers for Medicare and Medicaid Services (CMS) MLN Matters Article MM11042 announced the publication of Change Request CR 11042, Transmittal R4278CP, which includes significant updates to Chapter 29 of the Medicare Claims Processing Manual associated with the process of appealing claims decisions.  The effective and implementation dates for these changes is June 13, 2019.  Provider billers and audit/compliance staff are encouraged to review these changes.

SUMMARY OF CHANGES: 
This Change Request (CR) updates Pub. 100-04, Chapter 29 with several policy updates, including electronic signatures, limiting scope of redetermination review in certain instances, application of good cause for late filing involving beneficiary accessibility, as well as application of good cause where there is a declared disaster.  As more Medicare Administrative Contractors (MACs) are brought on board to the Medicare Appeals System (MAS), instruction is being added related to MAS processing functions.  In addition, the requirement for both signatures on an appointment of representative instrument and the Assignment of Appeal Rights form to be made within 30 days of each other is being removed.  There are also minor grammar or formatting corrections made throughout the chapter.  Changes in the appeals regulations at 405 subpart I are incorporated, which include tolling an adjudication timeframe when trying to cure a defective appointment form, as well as changes relative to the third level of appeals handled by the Office of Medicare Hearings and Appeals (OMHA).

Take Advantage of Your Exclusive AHCA/NCAL Member Benefits

Dave Kyllo

One of the many benefits of AHCA/NCAL membership is the AHCA/NCAL Member Savings Program where AHCA/NCAL 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  or www.NCALsavings.org to learn more.

AHCA/NCAL 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, watch this short video or go to www.AHCAbenefits.org.   

Tuesday, April 16, 2019

34.4 – The Average SNF VBP Performance Score Nationwide: 44.2 – the Average Score in Facilities with ANCC Board Certified RNs

Dave Kyllo

New research conducted by AHCA/NCAL shows that SNFs that employ at least one American Nurses Credentialing Center (ANCC) Board certified RN also, on average, performed higher on SNF VBP performance. The net result is that these SNFs get higher Medicare Part A reimbursements. 

The average 2017 SNF VBP performance score across the nation was 34.4.  For SNFs with at least one RN who has been ANCC Board certified in gerontological nursing, the average SNF VBP performance score was 44.2.  The SNF VBP performance score is used to determine how much of the automatic 2% Medicare Part A withhold is returned to a SNF. 

The ANCC offers certification in gerontological nursing – the gold standard in demonstrating clinical excellence in geriatric patient care.  ANCC is the world’s largest and most prestigious nurse credentialing organization and a subsidiary of the American Nurses Association.  Less than one percent of America’s RNs are board certified in gerontological nursing. 

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

Gero Nurse Prep is on sale!  Save $100 off the regular registration fee now through April 30 by using promo code VBP2019 (all caps).  AHCA/NCAL Gero Nurse Prep provides tremendous value at this AHCA/NCAL member $590 sale price.   That’s less than $20 per contact hour for outstanding nursing education that makes a measurable difference on so many fronts.  For RNs interested in pursuing Board certification through ANCC, there is an additional and separate cost of $395. 

To learn more about Gero Nurse Prep and ANCC Board certification, watch this video. For an even deeper dive into competent geriatric nursing, listen to this free AHCA/NCAL webinar “Improving Clinical Outcomes through Competent Gerontological Nurses.”   

If your RNs are not yet ANCC Board certified, take this important step on your quality journey and check out AHCA/NCAL Gero Nurse Prep today.    

The Number of Open LTC Jobs Nationwide Tops 49,000 in April

Dave Kyllo

There are 49,317 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 represents an increase of more than 1,300 open jobs compared to March figures.     
  
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 3,284 direct employers are competing for candidates this month – an increase of 226 employers over last month.  The average number of days a job was posted was 31 days in April.      

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 nearly 63,000 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.    

Register for the 2019 Congressional Briefing

Angela Sargent

Registration for the 2019 AHCA/NCAL Congressional Briefing is in full swing! Last year’s Congressional Briefing was the largest ever, and the event is expected to continue to grow.

This year’s Congressional Briefing is held on June 3rd and 4th in Washington, D.C. The event allows attendees the chance to hear from some of the top voices in Washington, receive legislative briefing from professionals in the sector, network with their peers, and meet with their legislators to advocate on behalf of the patients that they serve. 

The Advanced Registration Deadline is May 6 and prospective attendees are encouraged to register as soon as possible. The Hyatt Regency Washington on Capitol Hill, where the Congressional Briefing is being held, is almost sold out, so please be sure to make a reservation at the hotel promptly.

The conference registration fee is complimentary to AHCA/NCAL Members and AHCA/ NCAL Associate Business Members, and their spouses, and is accepted on a first-come basis. For questions, please contact meetings@ahca.org, or call (202) 842-4444.

GAO Releases Report on the Veterans Community Care Program

Dana Halvorson

On April 10, 2019, the U.S. Government Accountability Office (GAO) released a report on the Veterans Community Care Program. The Department of Veterans Affairs (VA) plans to replace the Veterans Choice Program in June 2019 with the Veterans Community Care Program.  The Veterans Choice Program allowed eligible veterans to obtain health care services from providers not directly employed by VA (community providers).  According to the GAO, they testified in the report on challenges and lessons learned from the Veterans Choice Program that could help VA successfully implement its new program.  These challenges include:
  • Complex referral and appointment scheduling processes
  • Incomplete and unreliable data on the timeliness of veterans' access to care
  • A lack of timely payments to community providers
GAO has made 12 recommendations to VA to improve its management and oversight of the Choice Program and the Veterans Community Care Program (VCCP).  VA generally agreed with all but one of GAO's recommendations.  GAO continues to believe that all of the recommendations are warranted.  As of April 2019, these recommendations have not been implemented.  The highlights of the GAO report can be found here.

CMS Expands the Successful Formal Telephone Discussion Demonstration to Part A Providers Starting July 2019

Dan Ciolek

Recently, the Centers for Medicare and Medicaid Services (CMS) announced the expansion of the Telephone and Reopening Process Demonstration to the Part A East qualified independent contractor (QIC) jurisdiction. Effective on or after May 1, 2019, the Part A East QIC will offer telephone discussions and/or reopenings to providers within Medicare administrative contractor (MAC) Jurisdictions H, J, K, L, M, and N for all Part A claim types, except reconsiderations for service termination and hospital discharge reviews and claims or providers that are already involved in another CMS initiative (i.e., Settlement Conference Facilitation). If selected and offered a telephone discussion, provider participation remains voluntary under the expanded Demonstration. Current Demonstration activities conducted within DME MAC Jurisdictions will continue.

More information including a description of the demonstration and links to fact sheets are available here.

CMS Posts Final MDS 3.0 Item Sets (Version 1.17.1) Effective October 1, 2019

Dan Ciolek

On April 5, 2019, the Centers for Medicare & Medicaid Services (CMS) posted on their MDS 3.0 Technical Information web page the final version of the MDS 3.0 Item Sets (Version 1.17.1) which will be effective October 1, 2019.  These changes will correspond with and support the implementation of the Patient Driven Payment Model (PDPM) that is replacing the Resource Utilization Groups, version four (RUG-IV) model for determining the skilled nursing facility prospective payment system (SNF PPS) per-diem case-mix payment rates for Medicare Part A stays.
 
In addition, CMS posted a 10 page errata document to correct 21 issues identified in the earlier DRAFT data submission specifications item sets. Specific MDS item changes described are: 
  • One new item (X0570A) was added to account for the new optional state assessment (OSA). 
  • Four existing items were added to additional item sets to support the SNF quality reporting program (QRP) quality measures (QMs).  Specifically, I0100, I0400, and I1500 were added to the NQ, NP, and SP item sets while O0100J1 will be added to the SP item set.  
  • Additionally, item X0600F (correction: entry/discharge reporting) is being added to the new SNF PPS interim payment assessment (IPA) item set to support the MDS correction policy. 
Nine new edits were added, and eight existing edits were revised.  Most of these address how the MDS software would handle the new or revised MDS items listed above or the new MDS assessment types being introduced on October 1, 2019, addressing topics including:
  • How OSA correction assessments are processed
  • How the PDPM grouper will handle Item I8000 duplicate ICD-10-CM codes for the non-therapy ancillary (NTA) case-mix determination
  • How MDS Section GG items impacting PDPM components will be handled for stays of 2 or fewer days versus those with 3 or more days
  • How IPA assessment MDS items related to nutritional approach needs including parenteral/IV feeding that impact the PDPM nursing component case mix determination (K0510A1 and K0510B1), and K0510Z1 are handled when the assessment reference date (ARD) is six or fewer days from the entry date, or when the ARD is seven or more days from the entry date 
  • How the WARNING edits will be generated for SPF PPS Discharge assessments in order to report when the number of concurrent and group therapy minutes combined surpass the 25% per-stay compliance threshold – which is independently determined for each of the physical therapy, occupational therapy, and speech-language pathology disciplines   
None of the changes summarized above represent changes in the underlying PDPM policy for determining resident classification.  Further detail of these new and revised MDS items will be available when CMS issues the MDS Resident Assessment Instrument (MDS-RAI) manual, which CMS has indicated will likely occur as early as May 2019. 

Updated Medicare Fraud And Abuse Prevention Materials

Lilly Hummel

The Centers for Medicare & Medicaid Services (CMS) has materials to support providers’ efforts to prevent, detect, and report suspected Medicare fraud and abuse. CMS has a poster that providers can print or incorporate into their Compliance and Ethics Program flyers that are posted in the buildings. This February, the agency updated its booklet summarizing many relevant fraud and abuse laws that are applicable to all federal health care programs, including both Medicare and Medicaid. Nursing centers are encouraged to review this material for the Phase 3 Requirements of Participation Compliance and Ethics Program.

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 March 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.

Wednesday, April 10, 2019

Registration for the 70th AHCA/NCAL Convention & Expo Is Now Open

Jon-Patrick Ewing

This year’s jam-packed, four-day event honors you —the superheroes, warriors, and champions of quality care!

Prepare to take on your toughest challenge in a single bound…

From PDPM to changes in Five-Star to the new Rules of Participation, you’ll get concrete solutions and strategies that will make you feel like you have super powers:
  • Extraordinary education sessions for SNF, AL, and post-acute care providers and staff. Earn CEs, network, and learn from your peers.
  • Super speakers, like Opening Keynote Speaker Doris Kearns Goodwin, World-renowned Presidential Historian and Pulitzer Prize-winning Author.
  • An out-of-this-world Expo Hall with hundreds of business partners providing demonstrations of the latest industry products and services.
Fill your toolbox with fresh ideas, inspiration, and action plans. Bring your staff and your family. There’s something for everyone.

Visit AHCAConvention.org for details and hotel information.

REGISTER TODAY!
 

Join AHCA/NCAL on Capitol Hill to Raise Your Voice and Advocate for Quality Care

Danielle Levitan


When you attend and participate in Congressional Briefing, you have the invaluable opportunity to meet and discuss key issues with your Members of Congress and their staff. Don’t miss the chance to discuss your concerns face to face.

Contact your state affiliate to set up your meetings today.

First time attending Congressional Briefing?
The special First Timers Session takes place the afternoon of June 3rd and provides answers to all of your questions. You’ll be reminded about why your participation is so important, discuss and develop your Asks and Talking Points, and go over the details of your meeting and what to expect. AHCA/NCAL staff will get you ready and charged up, and review important do’s and don’ts. You will even get a packet of essential information to help you feel completely prepared.

Reserve Your Spot

New speakers are being added every day! See the complete agenda and get all the details at cb.ahcancal.org.

Host Sponsor:
Medline


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

2019-2020 NCAL Elections and Solicitation for Candidates



Katherine Preede

The 2019-2020 election cycle has officially opened for NCAL members in good standing interested in running for the NCAL Board of Directors.
  • The NCAL elections are for three officer positions (Chair, Vice Chair, Secretary/Treasurer) and seven At-Large Representative positions. NCAL members interested in running for an NCAL Board position may obtain the necessary candidacy materials online.
  • Applicants must complete and electronically submit the NCAL candidacy materials by close of business on May 20, 2019.
  • Candidates will submit completed materials by sending an e-mail to Katherine Preede.
The NCAL elections will take place during the second Council of States meeting at the AHCA/NCAL 70th Annual Convention & Expo, October 13-16 in Orlando, Florida. Once the application phase has ended, the AHCA/NCAL Credentialing Committee will hold an in-person meeting to conduct a certification process for each candidate. Once certification occurs, NCAL will announce the slate of candidates to the membership.

If you have further questions, contact Katherine Preede.

Tuesday, April 9, 2019

PBS NewsHour Story on Observation Stays Issue and Surprise Medical Bills

Dana Halvorson

On April 3, PBS NewsHour released a story by Philip Moeller titled, “How this Medicare loophole can lead to surprise medical bills.” The full article can be found here, and focuses on the observation stays issue. Thirty-three national organizations, including AHCA/NCAL, supports the Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753).  Introduced by Congressmen Joe Courtney (D-CT) 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.  For more information about the observation stays issue, please visit the AHCA/NCAL website.        

Update on Department of Labor Proposed Rules

Lilly Hummel

The Department of Labor has recently published three Notice of Proposed Rulemaking that may be of interest to nursing centers, assisted living communities, and ID/DD providers:
  1. Overtime Threshold, comments due May 21: proposes several changes related to overtime, including raising the overtime threshold for exempt employees. https://www.dol.gov/whd/overtime2019/
  2. Regular Rate Requirements, comments due May 28: proposes to define what forms of payment employers include and exclude in the “time and one-half” calculation when determining workers’ overtime rates. https://www.dol.gov/whd/overtime/regularrate2019.htm 
  3. Joint Employer Status, comment date not announced but likely early June: proposes to revise and clarify the responsibilities of employers and joint employers to employees in joint employer arrangements. https://www.dol.gov/whd/flsa/jointemployment2019/

CARES Online Dementia Training Programs Just Got Cheaper for AHCA/NCAL Members

Dave Kyllo

AHCA/NCAL members now receive 15% off the purchase of any Healthcare Interactive® CARES online training program when they use promo code AHCA15 at checkout.  CARES is the only online dementia training to be recognized by CMS.  In addition, CARES online training is recommended by AHCA/NCAL to help reduce the off-label use of antipsychotics. 

HealthCare Interactive’s CARES® Dementia Basics™ module is recognized by the Alzheimer’s Association® for successfully incorporating the evidence-based Dementia Care Practice Recommendations in the following topic areas: Alzheimer’s and dementia, person-centered care, assessment and care planning, activities of daily living, and behaviors and communication. Providers who train their staff with HealthCare Interactive’s CARES® Dementia Basics™ online training program are eligible to purchase Alzheimer’s Association essentiALZ® certification exams.

CARES training is different because it includes direct video “before and after” training on an easy-to-use, easy-to-apply approach to dementia care called the CARES® Approach®. The CARES Approach can be used in any situation, with any person with dementia, at any stage of the disease.  CARES has six training modules including:
CARES is also the only dementia care training to make extensive use of actual footage of real residents and real staff members (no actors) for truly authentic virtual training environment. Staff members will learn person-centered techniques to address issues, which often leads to behavior such as biting, kicking, punching, screaming, public urination and sexual behaviors.

CARES programs are easy to use, can be used from any computer, tablet, or mobile device and can be started and stopped as often as users wish. To experience the CARES online training difference, test drive the first module at no cost

Take advantage of the new lower prices for AHCA/NCAL members.  Don’t forget to use promo code AHCA15 to receive 15% off your order.  Feel free to call HealthCare Interactive at (952) 928-7722 with any questions about the training programs.  

Want Fewer Survey Deficiencies? Try ANCC Board Certification for Your RNs

Dave Kyllo

New research conducted by AHCA/NCAL shows that nursing facilities that employ at least one American Nurses Credentialing Center (ANCC) Board certified RN also performed better on average on their annual surveys.   

Looking at statistics for the last two survey cycles, the national average number of citations was 7.53 and 7.55 respectively, while nursing facilities with at least one ANCC Board certified RN averaged 5.90 and 5.71 citations respectively.  Nursing facilities with at least one ANCC Board certified RN also averaged fewer Immediate Jeopardy (IJ) citations in the last three survey cycles when compared to facilities nationwide. 

The ANCC offers certification in gerontological nursing – the gold standard in demonstrating clinical excellence in geriatric patient care.  ANCC is the world’s largest and most prestigious nurse credentialing organization and a subsidiary of the American Nurses Association.  Less than one percent of America’s RNs are board certified in gerontological nursing. 

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

Gero Nurse Prep is on sale!  Save $100 off the regular registration fee now through April 30 by using promo code VBP2019 (all caps).  AHCA/NCAL Gero Nurse Prep provides tremendous value at this AHCA/NCAL member $590 sale price.   That’s less than $20 per contact hour for outstanding nursing education that makes a measurable difference on so many fronts.  For RNs interested in pursuing Board certification through ANCC, there is an additional and separate cost of $395. 

To learn more about Gero Nurse Prep and ANCC Board certification, watch this video. For an even deeper dive into competent geriatric nursing, listen to this free AHCA/NCAL webinar “Improving Clinical Outcomes through Competent Gerontological Nurses.”   

If your RNs are not yet ANCC Board certified, take this important step on your quality improvement journey and check out AHCA/NCAL Gero Nurse Prep today.        

Be PDPM Ready: Register for ICD-10 Coding Online Training Today

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. 

National Skilled Nursing Care Week 2019 Toolkit Available

Cristina Crawford

National Skilled Nursing Care Week (NSNCW) is just around the corner, taking place from May 12 to 18!  This year, NSNCW will celebrate how residents and staff Live Soulfully, achieving happy minds and healthy souls. This coming May, be sure to participate! The 2019 NSNCW Toolkit is now available online here, which includes:
  • Sample Press Release Template
  • Sample Social Media Posts/Newsletter Content
  • Sample Proclamation
  • Sample Media Advisory
  • Sample Letter to the Editor
Promotional graphics and the Product and Planning Guide are also available for download at ahcancal.org/NSNCW.

We encourage centers to use social media to share their great ideas for NSNCW and to check out what others are planning for this special week. Use the hashtag #NSNCW and like us on the NSNCW Facebook page here.

We look forward to celebrating with you next month!

Wednesday, April 3, 2019

Jan Thayer Pioneer Award Nominations Open!

Katherine Preede

Nominations are now open for NCAL’s 2019 Jan Thayer Pioneer Award. ​The award recognizes an individual who has moved the senior care profession forward, positively affecting the lives of those served and those who serve. Recipients must demonstrate dedication, leadership and considerable contributions to the senior care profession.

Nominations must be submitted online and include a 500-word or less essay, along with a copy of the candidate’s resume. Nominators must be members of AHCA/NCAL; however, candidates are not required to be members. All nominations must be received by June 7, 2019. The recipient is selected by the NCAL Executive Committee and will be honored at NCAL Day at the AHCA/NCAL Convention & Expo in Orlando this October.

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

This is the fifth year NCAL is honoring an individual in the assisted living profession. The award was bestowed to Loretta Kaes last year.

AHCA Awards Program Nominations Are Open!

Dana Halvorson and Natalie Visnick

 
We are now accepting entries for the AHCA Awards Program. AHCA honors individuals who are committed to improving the quality of life for residents. Categories include:
  • ID/DD Hero of the Year
  • Not for Profit Trustee of the Year
  • Not for Profit Program of the Year
  • Volunteer of the Year
    • Young Adult (Ages 13-19)
    • Adult
    • Group
Nominations packets are available on AHCA's website now through June 7, 2019. We encourage AHCA members take the time to submit a nomination to recognize those making a difference in the long term care industry. Honorees will be recognized at AHCA/NCAL's 70th Annual Convention and & Expo in Orlando this October.

Tuesday, April 2, 2019

NCAL Awards Program: 2019 Nominations are Open!

NCALAwards@ncal.org
    
Know an outstanding assisted living nurse or executive director? Last year, did your community create the best National Assisted Living Week® programming based on the "Capture the Moment" theme? Or maybe there is an unlicensed caregiver or someone in the dietary, housekeeping, or maintenance departments who goes above and beyond the call of duty? If you answered yes, then check out NCAL’s 2019 Awards Program. This program gives awards in four categories:
  • Administrator of the Year
  • Nurse of the Year
  • Noble Caregiver in Assisted Living
  • National Assisted Living Week Programming
Before submitting your nomination, make sure you have all the necessary components. To nominate, the following items are required:
 
Administrator and Nurse of the Year nominations: 500-word essay and candidate’s resume
Noble Caregiver in Assisted Living nominations: 500-word essay
National Assisted Living Week Programming nominations: 500-word essay, activity calendar from the week, and pictures from the week.
 
 
 
Recipients (and one guest) receive a FREE trip to AHCA/NCAL’s 70th Convention & Expo in Orlando, FL, October 13-16, 2019. Each will be honored in front of their thousands of their peers during NCAL Day and the Closing General Session of the Convention.
 
For more information and to submit a nomination, please visit www.ncal.org/awards. Completed nominations must be submitted no later than Friday, June 7, 2019.
 
Help recognize those that demonstrate outstanding service!

Webinar: Intergenerational Connections Help Build Healthy and Prosperous Communities

Thursday, April 4, 2019, 2:00-3:00 PM ET
When older adults are actively involved and engaged in their community while participating in intergenerational programs, it benefits both older adults and the teens or children with whom they interact. 
In this webinar hosted by the Administration for Community Living (ACL), you will hear from public health and government officials, as well as aging and volunteer community leaders. They will provide an overview of the role intergenerational programs play in building healthy communities, discuss the federal programs and initiatives that focus on boosting older adult community engagement, highlight new research on the health benefits of volunteering, and share how intergenerational programs promote community engagement in boosting resilience. 
Featured Speakers:
  • Jerome M. Adams, 20th Surgeon General of the United States, Vice Admiral, U.S. Public Health Service Commissioned Corps
  • Lance Robertson, Assistant Secretary for Aging and Administrator, Administration for Community Living
  • Debbie Cox Roush, Director, Senior Corps, Corporation for National and Community Service
  • Kimberly Gallo, Director Aging and Adult Services and Pam Plimpton, Intergenerational Coordinator, Aging & Independence Services, County of San Diego, Health and Human Services Agency
  • Cheryl Christmas, Project Director, DC Senior Corps Foster Grandparent Program

For any questions please contact Vijeth Iyengar with ACL.

ANCC Board Certified RNs Make a Big Difference on Average SNF VBP Performance Scores

Dave Kyllo

New research conducted by AHCA/NCAL shows that SNFs that employ at least one American Nurses Credentialing Center (ANCC) Board certified RN also, on average, performed higher on SNF VBP performance. The net result is that these SNFs get higher Medicare Part A reimbursements.
 
The average 2017 SNF VBP performance score across the nation was 34.4. For SNFs with at least one RN who has been ANCC Board certified in gerontological nursing, the average SNF VBP performance score was 44.2. The SNF VBP performance score is used to determine how much of the automatic 2% Medicare Part A withhold is returned to a SNF. 

The ANCC offers certification in gerontological nursing – the gold standard in demonstrating clinical excellence in geriatric patient care. ANCC is the world’s largest and most prestigious nurse credentialing organization and a subsidiary of the American Nurses Association.  Less than one percent of America’s RNs are board certified in gerontological nursing. 

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

Gero Nurse Prep is on sale! Save $100 off the regular registration fee now through April 30 by using promo code VBP2019 (all caps). AHCA/NCAL Gero Nurse Prep provides tremendous value at this AHCA/NCAL member $590 sale price. That’s less than $20 per contact hour for outstanding nursing education that makes a measurable difference on so many fronts. For RNs interested in pursuing Board certification through ANCC, there is an additional and separate cost of $395. 

To learn more about Gero Nurse Prep and ANCC Board certification, watch this video. For an even deeper dive into competent geriatric nursing, listen to this free AHCA/NCAL webinar “Improving Clinical Outcomes through Competent Gerontological Nurses.”   

If your RNs are not yet ANCC Board certified, take this important step on your quality journey and check out AHCA/NCAL Gero Nurse Prep today.

Be Seen by the Class of 2019: LTC Career Center Launches Spring Sale

Dave Kyllo

Rates for posting job vacancies just got more affordable 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.   

Take 97 Seconds and See How the Compass MEC Health Plan Delivers the Benefits LTC Employees Want and Use

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.

Observation Status Lawsuit Update

Dana Halvorson

The Center for Medicare Advocacy released a March 28, 2019, press statement titled, “Court Denies All Government Motions in Class Action Seeking Appeal Right for Medicare Beneficiaries on ‘Observation Status.’” The statement included that “in a decision issued on March 27, 2019, a federal judge denied multiple attempts by the federal government to halt a lawsuit by Medicare patients seeking a right to appeal their placement on ‘outpatient observation status’ in hospitals.  Alexander v. Azar is a nationwide class action brought by individuals who were forced to pay up to $30,000 for post-hospital skilled nursing facility care because they had been classified as outpatients in observation status, rather than as inpatients.”

The statement goes on to include that, “Although care provided to patients on observation status is often indistinguishable from inpatient care, it does not count toward the three-day inpatient hospital stay requirement for Medicare coverage of nursing home care. This leaves beneficiaries with the burden of paying for – or forgoing – extremely costly nursing and rehabilitative care.  The opportunity to appeal is critical because of the severe ramifications that can result from the observation status categorization.”  McKnight’s also published an article around the court decision titled, “Lawsuit over observation status, SNF payment finally going to trial.” 

33 national organizations, including AHCA/NCAL, supports the Improving Access to Medicare Coverage Act of 2019 (H.R. 1682/S. 753).  Introduced by Congressmen Joe Courtney (D-CT) 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.  For more information about the observation stays issue, please visit the AHCA/NCAL website.         

PANEL DISCUSSION - So You Think You Might Want to Run for the AHCA or NCAL Board: Everything You Want to Know but Are Afraid to Ask

Monday, June 3, 2019 (in conjunction with the AHCA/NCAL Congressional Briefing)
2:30pm – 3:30pm Eastern Time
Hyatt Regency Washington on Capitol Hill
Washington, DC

Facilitator: Tom Coble, Immediate Past Chair, AHCA Board of Governors
Panelists: Chris Marson, NCAL Immediate Past Chair, Senior Housing Managers, LLC; Len Russ, Past Chair, Bayberry/CPR Associates (invited); Debbie Meade, AHCA Vice Chair, Health Management, LLC; Laurie Shepard, NCAL At-Large Board Member, New Fiends, Memory Care and Assisted Living (invited)

While this panel will happen following the May 20 application deadline, it will be an opportunity for those considering applying in the future for either the AHCA or NCAL Boards. This session will explain the application, credentialing and campaign process. The primary focus is a panel discussion with current and former Board members who will share their stories about why they decided to serve on the board, their journey there, and what lessons they learned along the way. There will be time for questions and answers. It is perfect for those interested in future service on either Board.

WEBINAR - So You Think You Might Want to Run for the AHCA or NCAL Board: Everything You Want to Know but Are Afraid to Ask

Friday, April 12, 2019
1:00pm – 2:00pm Eastern Time

AHCA and NCAL members in good standing may apply for the 2019-20 elections for the AHCA Board of Governors and the NCAL Board of Directors. This webinar will explain the application, credentialing and campaign process. It is perfect for those interested in running this year or in future years.

Click here to register.

Presenters: Tom Coble, President & CEO, Elmbrook Management Company, Chris Mason, President & CEO, Senior Housing Managers, LLC and Christy Herle, Senior Director Member Services, AHCA/NCAL

2019-2020 AHCA Elections and Solicitation for Candidates

Christy Herle

The 2019-2020 election cycle has officially opened for AHCA members in good standing interested in running for the AHCA Board of Governors. The AHCA elections are for three officer positions (Chair, Vice Chair, Secretary/Treasurer), one Independent Owner Representative, one Regional Multifacility Representative and two At-large Representatives. AHCA members interested in running for an AHCA Board position may obtain the necessary candidacy materials online. Applicants must complete and electronically submit the AHCA candidacy materials by close of business on May 20, 2019. Candidates will submit completed materials by sending an e-mail to Christy Herle.

The AHCA elections will take place during the second Council of States meeting at the AHCA/NCAL 70th Annual Convention & Expo, October 13 - 16 in Orlando, FL. Once the application phase has ended, the AHCA/NCAL Credentialing Committee will hold an in-person meeting to conduct a certification process for each candidate. Once certification occurs, AHCA will announce the slate of candidates to the membership. If you have further questions, contact Christy Herle.