Wednesday, July 31, 2019

CMS Issues FY 2020 SNF PPS Final Rule

Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued a final rule outlining the proposed Fiscal Year (FY) 2020 Medicare prospective payment system rate update and quality reporting requirements for skilled nursing facilities (SNFs). The FY20 final rule establishes a market basket increase of 2.4 percent, a figure statutorily mandated by Congress, and will start October 1, 2019.

The contents of this final rule become effective October 1, 2019. Please note there is NO delay in the scheduled implementation of the Patient-Driven Payment Model (PDPM), which replaces the Resource Utilization Group IV (RUG-IV).

Based on changes contained within this final rule, CMS indicates aggregate payments to SNFs will increase in FY20 by $851 million from payments in FY19. Of note, the final rule codifies the proposed definition of group therapy. The final rule issued today allows groups of between two and six patients starting October 1, 2019.

Furthermore, the final rule made no material changes to the new payment system, the Patient-Driven Payment Model (PDPM). Register for the virtual PDPM training and gain access to PDPM Academy resources, monthly webinars, and past webinar recordings. Be sure to take advantage of our ICD-10 trainings, as well, that are offered for both coders and non-coders.

Finally, make plans to join us at the 70th AHCA/NCAL Convention and Expo, October 13-16 in Orlando. We will offer several education sessions focused on the new payment system, such as PDPM and the Future of SNF Payment and Organizational Success under PDPM: Budgeting to Benchmarking. Convention is a great opportunity to network with your peers and learn best practices from each other.

Tuesday, July 30, 2019

July 2019 OIG Report and Outpatient Stays Issue

Dana Halvorson

The Office of the Inspector General’s (OIG’s) July 2019 report noted their top unimplemented recommendations which included that the Centers for Medicare and Medicaid Services (CMS) should analyze the potential impacts of counting time spent as an outpatient toward the 3-night requirement for SNF services so that beneficiaries receiving similar hospital care have similar access to these services.  AHCA/NCAL supports efforts and legislation that 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.  The observation stays issue is an outdated policy that continues to leave millions of Medicare beneficiaries surprised by thousands of dollars in medical bills and hanging with uncertainty regarding their access to the Medicare coverage they deserve.  For more information about the observation stays issue, please visit the AHCA/NCAL website.         

It Pays to Have Cleary Energy Audit Your Utility Bills

Dave Kyllo

Most long term care facilities (about 75%) are being overcharged for one or more of their utilities. Providers don’t receive better service or any other benefit for over paying utility companies. The good news is that putting an end to the overpayments is easy.

Cleary Energy is a AHCA/NCAL preferred provider and has recouped on average 4% to 8% savings on utilities for long term care facility customers. Here are some real life examples of how long term care providers saved:
  • A nursing facility recovered $25,000 in retroactive charges from an electric and gas utility account and the facility will save an additional $7,500 per year going forward.     
  • A nursing facility was overpaying the tariff on their gas account and is now saving $10,000 annually going forward.
  • A Midwest assisted living facility received $5,800 from utility overpayments that Cleary Energy recently found.     
Cleary Energy performs utility bill audits by examining utility, supplier and government charges on utility bills to obtain refunds and/or credits and rate reductions.  Specifically, Cleary Energy audits a facility’s electric, natural gas, propane, heating oil, diesel fuel, water, sewer and telecommunications bills.
 
The program is designed to save AHCA/NCAL members significant money on their utility bills without adding new expenses to their budgets.  Cleary Energy guarantees savings or its auditing services are free.  Cleary Energy’s fees are based on facility savings on their utility bills.
 
AHCA/NCAL member facilities enter into an audit agreement with Cleary Energy, which is a shared savings agreement that lasts for a period of three years.  If no refund, savings or credits are received, the AHCA/NCAL member facility owes nothing to Cleary Energy for conducting the audit and AHCA/NCAL members will have the peace of mind of knowing that their facilities are not being overcharged for their utilities.
   
The process for engaging Cleary Energy to conduct a utility audit is easy.  Most of the information Cleary Energy needs for an audit comes directly from the utilities or suppliers.

Cleary Energy’s long term care experience sets the company apart with over 40 years of long term care operational experience.  That in-depth knowledge enables Cleary Energy to find the greatest costs savings on utility expenses for AHCA/NCAL members because Cleary Energy knows where to look for savings.
 
Take advantage of this unique no-risk opportunity to save on utility costs. Contact Cleary Energy today in one of the three ways listed below. 

Time is Running Out to Prepare for PDPM! Take the Courses Built for PDPM Success

Dave Kyllo
 
A new payment system known as the Patient Driven Payment Model (PDPM) takes effect in two months that will transform the way skilled nursing facilities are reimbursed for Medicare Part A stays.  Some of the changes coming October 1, 2019 include: 
  • The PDPM system will rely on more than 180 MDS item fields and completely transforms the existing system Medicare Part A payment system for skilled nursing facilities. Staff roles and facility processes must be substantially modified to operate effectively under PDPM, including ICD-10 coding which will directly tie to reimbursement. 
  • Simply accepting the hospital’s ICD-10 code or using the ICD-10 code that seem most appropriate won’t work under PDPM.  Assuming the admitting physician has the correct diagnosis and code won’t work either. MDS Coordinators and billing staff must be masters at ICD-10 coding and how it maps to PDPM and play an active role in admission process.
  • As a condition of coverage, physicians must certify on admission and then recertify by day 14 and every 30 days thereafter that skilled care is needed.  Physicians and MDS Coordinators must be able to understand and effectively communicate about arriving at the reason for SNF care and defining the clinical basis for admission using appropriate ICD-10 codes that map to PDPM.
  • Primary diagnosis tied to accurate ICD-10 coding will matter more than ever under PDPM.  CMS will have a much clearer way to monitor whether SNF care is really needed.  Accurate ICD-10 coding will minimize the risk of payment delays and denials. 
  • SNFs that are not well versed in PDPM and ICD-10 coding are at a much higher risk of seeing their revenue negatively impacted and are at a substantial increased risk for potential audit and recovery. 
AHCA SNF members that did not attend an in-person PDPM Academy training hosted by an AHCA state affiliate earlier this year, should register now for AHCA’s Virtual PDPM Training. Included with the virtual training is access to all materials on AHCA’s PDPM Academy. The PDPM Academy is where updates, tools, webinars and other supporting materials are housed. AHCA SNF members who attend the Virtual PDPM Training will also be able to join in free monthly PDPM Academy webinars hosted by AHCA. 
 
This training is available to AHCA SNF provider members only. The cost for the training – whether first time or repeated - is $350. The training has been approved for 8 NAB CE credits. 
 
Virtual ICD-10 Coding training is also available through AHCA and is equally important to PDPM success and bulk purchases are available.  There are two online trainings offered, including: 
  • 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 – Coder: ahcancal.org/icd10pdpmcoder
  • 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. AHCA/AHIMA ICD-10 Training for PDPM – Non-Coder: ahcancal.org/icd10pdpmnoncoder
Members will need to login with their AHCA/NCAL usernames and passwords to register for any of these courses.  For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail educate@ahca.org with your name and facility contact information. 

Time is running out.  Prepare for PDPM today by registering for AHCA’s on-line courses built for PDPM success. 

Wednesday, July 24, 2019

It’s Summertime and the Living is Easy with Mood Media

Dave Kyllo

Whether you want to sing Sweet Home Alabama all summer long or the Summer Breeze makes you feel fine,  AHCA/NCAL members can create a festive summer atmosphere in their communities through music offered by Mood Media at AHCA/NCAL “Member Only” discounted rates.

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

Use Mood Media’s music to:
  • Improve the dining experience and set the mood in dining areas as residents gather for meals;
  • Provide a variety of background music in common areas;
  • Create a positive environment for activities; and 
  • Provide musical entertainment for social gatherings and happy hours.
AHCA/NCAL members receive exclusive discounted rates on Mood services and equipment with three-year agreements.  The core music package starts at $29.99 per month or about $1 per day with a three-year agreement.    
 
For more information about Mood Media’s services, call 800-345-5000 or go to   http://partner.moodmedia.com/ahcancal/ (password: moodpartner).

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

Dave Kyllo

AHCA/NCAL Insurance Solutions offers a minimum essential coverage (MEC) health plan to members.  The plan was developed by Compass Total Benefit Solutions and offers two affordable options for providing many of the health insurance benefits that are important to long term care employees.  This short video explains the MEC plan for AHCA/NCAL members in less than two minutes and highlights the features that make the MEC plan so popular with LTC employers and employees.
   
Both Compass plans feature affordable premiums and co-pays for valued and commonly used services, including prescriptions, physician visits and free unlimited 24/7 access to TELADOC®.  Benefits are instantaneous with no deductibles.  The difference in the two plans is based on the level of hospital indemnity benefits.  Here’s the exclusive AHCA/NCAL “Member Only” rate schedule:
  Monthly Premiums
Compass 1
Compass 2
EE
$161.29
$181.75
EE & Spouse
$264.70
$306.39
EE & Children
$244.19
$279.94
Family
$356.70
$417.20

The plan is designed to help AHCA/NCAL members recruit and retain frontline staff who cannot afford major medical health plan premiums or high deductibles.  Employers determine their level of contribution for plan expenses for coverage for employees, their spouses, their children or family coverage.
 
There is no additional underwriting for the Compass plan and no mandatory wait periods for new employees to join the Compass MEC plans.  Any wait periods are determined by the employer.  There is a minimum of five employees that must be enrolled to offer the plan to employees.
Read this Q&A document for more information about Compass plans for AHCA/NCAL members. Versions of the Compass Plan are available in all 50 states. Hospital indemnity benefits vary based on state approvals, which is why some states have different hospital indemnity benefit levels.

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

Act Now to Enjoy Early Bird Savings

Jon-Patrick Ewing

Save $100 on all AHCA/NCAL Convention & Expo Premium/Full Meeting Registration packages when you do Early Bird Registration. Other Early Bird savings may apply depending on your registration type.

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

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

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

Wednesday, July 17, 2019

CMS Releases Proposed Rule for Requirements of Participation and Final Arbitration Rule

Yesterday, the Centers for Medicare and Medicaid Services (CMS) issued the proposed rule that is intended to ease some of the pressures of the Requirements of Participation (RoPs) and delays implementation of Phase 3 by a year: Medicare and Medicaid Programs: Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency, and Transparency.

Many of the changes that AHCA advocated for are included in this proposed rule.

The proposed rule includes changes to the current long term care (LTC) requirements of participation and survey process designed to reduce excessively burdensome and overly prescriptive regulations while allowing centers to focusing on providing high-quality care. Some of the significant proposed changes include:
  • Reducing paperwork burden by only requiring facilities to send discharge notices to the State LTC Ombudsman for "facility-initiated involuntary transfers and discharges."
  • Revising the requirements for new staffing positions that were created by the final rule released in October 2016, including removing requirements for a compliance officer and compliance liaisons, removing specific duties required of the grievance official, and revising certain training requirements for the director or food and nutrition services.
  • Removing overly prescriptive details in the Quality Assurance and Performance Improvement (QAPI) requirements.
  • Updating portions of the enforcement regulations, including those related to the informal dispute resolution and independent informal dispute resolution processes.
As mentioned, CMS has delayed implementation of some Phase 3 requirements for one year. The total estimated cost savings over each of the first five years is approximately $644 million. AHCA's press statement on the proposed rule can be found here.

CMS also issued yesterday the final rule that reverses the Obama-era ban on the use of arbitration agreements. This rule makes it very clear that we have the ability to use pre-dispute agreements, while at the same time adding provisions intended to make sure that residents and/or their representatives understand the agreements into which they are entering. Additionally, the rule prevents a facility from making the signing of an agreement a precondition of admission. AHCA's press statement on the final rule can be found here.


2020 AHCA/NCAL Quality Award Applications and Criteria Series Available Aug. 1

Erin Prendergast

Become the best in quality and get ready for the 2020 AHCA/NCAL National Quality Award Program cycle! It’s just around the corner – applications and the criteria series will be available August 1, 2019.

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

Get ready for August 1 by visiting ahcancal.org/qualityaward!
 

AHCA/NCAL Early Bird Registration Ends Next Friday

Jon-Patrick Ewing

Don’t miss everything we have planned for you at the 70th AHCA/NCAL Convention & Expo! Early bird registration ends next Friday, July 26.

Join your fellow superheroes, warriors, and champions of quality care this fall in Orlando, FL. Together, we will take on the challenges facing long term and post-acute care providers. From the Patient Driven Payment Model (PDPM) to Requirements of Participation (ROP) and critical workforce issues, you’ll gain new tools and strategies that will help you tackle any hurdle in a single bound.

Don’t wait any longer, register before the early bird deadline and you can save $200.*

** Some restrictions apply see our official website.


https://www.youtube.com/watch?v=zUcrkdtV718&feature=youtu.be

The Number of Open LTC Jobs Nationwide Drops Again This Month

Dave Kyllo

There are 37, 292 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 a decrease of 1,711 open jobs compared to June figures and a decrease of nearly 12,000 open jobs since May.
        
The Gartner TalentNeuron statistics also show an estimated 2,101,000 potential candidates in the nation’s workforce whose skills likely match the qualifications being sought by long term care employers. Figures show that 2,153 direct employers are competing for candidates this month which is a decrease of more than 300 employers over June figures.  The average number of days a job was posted was 33 days in July – two days longer than in June.
          
Finding qualified employees is one of the greatest challenges facing long term care providers and labor statistics prove that the challenge continues in a strong economy with a low unemployment rate.  Lead them to your job vacancy through the AHCA/NCAL Long Term Care Career Center.
 
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.

Rates for posting job vacancies are affordable at $350 for a 30-day job posting.  Employers who utilize the site also receive complimentary additional exposure through rotating new job listings on AHCA’s home page – the web site where long term care professionals go for news and information.  In addition, employers who post vacancies through the center receive free bonus rotating listings on the Long Term Care Career Center  home page. 

Of course, the LTC Career Center is always free for job seekers and the LTC Career Center  features many of the best positions the long term care profession has to offer.  Job seekers are using the site with nearly 60,000 searchable resumes on the National Healthcare Career Network this month.  

Join the high profile employers that use AHCA/NCAL’s premier member resource to find top talent.  Check out the LTC Career Center 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.   

You Must be ICD-10 Coding Ready to be PDPM Ready

Dave Kyllo

The October 1 PDPM implementation date is less than three months away 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. 

Master PDPM with AHCA’s Virtual PDPM Training

Dave Kyllo

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

Did you miss the in-person PDPM training in your state or attend the training but feel like you could benefit from taking the course again?  AHCA’s Virtual PDPM Training prepares AHCA SNF members for PDPM and mirrors the in-person trainings that have been held for AHCA provider members in almost every state earlier this year. The virtual training allows AHCA SNF members to learn about the critical steps necessary on the pathway to success under PDPM.

Included with the virtual training is access to all materials on AHCA’s PDPM Academy. The PDPM Academy is where updates, tools, webinars and other supporting materials are housed. AHCA SNF members who attend the Virtual PDPM Training will also be able to join in free monthly PDPM Academy webinars hosted by AHCA. 

With less than three months left before PDPM implementation, AHCA’s Virtual PDPM Training can set your facility up for success. This training is available to AHCA SNF provider members only. The cost for the training – whether first time or repeated - is $350. The training has been approved for 8 NAB CE credits. 

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. 

Root Cause Analysis Advice from HealthCap®

Dave Kyllo

A recent edition of Angie’s Blog from HealthCap focuses on the effectiveness of the Fishbone Diagram as a tool in conducting root cause analyses. Angie’s Blog is a regular source of news and information about reducing risk from HealthCap Director of Risk Management Angie Szumlinksi.  She explains in her posting how fishbone diagrams are used to graphically display potential causes of a problem in the analysis phase of an event investigation.
To find more information like this, check out the Resource and Education Center on the HealthCap website. There you will find education (including ANCC-approved sessions), manuals, best practices and policies. 
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, contact Peter Feeney at Peter.Feeney@chelsearhone.com
 

Updates to the OMHA Case Processing Manual

The Office of Medicare Hearings and Appeals (OMHA) has published ten revised chapters of the OMHA Case Processing Manual (OCPM). The revised chapters, which were effective July 8, 2019, are:
  • Chapter 4; Parties 
  • Chapter 5; Representatives 
  • Chapter 6; CMS, CMS Contractor, and Plan Roles 
  • Chapter 7; Adjudication Time Frames, Case Prioritization, and Escalations 
  • Chapter 9; Request and Correspondence Intake, Docketing, and Assignment 
  • Chapter 11; Procedural Review and Determinations 
  • Chapter 14; Scheduling and Noticing for Prehearing Conferences and Hearings 
  • Chapter 17; Dismissals 
  • Chapter 18; Requests for Information and Remands
  • Chapter 20; Post-Adjudication Actions
This 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.

New and revised OCPM chapters can be accessed at https://www.hhs.gov/about/agencies/omha/the-appeals-process/case-processing-manual/index.html.

Chapters that were published before May 10, 2018, can be accessed at:
https://www.hhs.gov/about/agencies/omha/the-appeals-process/case-processing-manual/2017/index.html.

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 June 2019. This new file replaces the updated LEIE database file available for download last month. Individuals and entities that have been reinstated to the federal health care programs are not included in this file.

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

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

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

Tuesday, July 16, 2019

Webinar on Delivering Culturally Competent Direct Care

Thursday, July 25, 2019, 12:30 PM - 2:00 PM ET

Register for this event

Nearly half of individuals dually eligible for Medicare and Medicaid need Long-term Services and Supports (LTSS) for help with daily tasks such as dressing, bathing, and eating. Direct care workers provide most of this help. This event hosted by Resources for Integrated Care (RIC), will review strategies for providing services with cultural sensitivity and it will discuss training direct care workers to achieve cultural competence. Speakers will share strategies for meeting LTSS needs in a variety of settings and while respecting diverse preferences. A direct care worker, along with a beneficiary, will share experiences and recommendations on providing care.

Featured Speakers:
  • MariaElena Del Valle, Organizational Change Consultant, PHI
  • Andrew Adams, Chief of Staff, Homebridge
  • Direct care worker, Homebridge

Registration is required to receive the webinar information. Follow the registration link above to view CE credit information, sign up, and learn more. Questions? Contact Resources for Integrated Care

Wednesday, July 10, 2019

AHCA Has the Solution for Teaching New Staff about SNF Value Based Purchasing

Dave Kyllo

Need to teach a new employee about value based purchasing?  AHCA has an education program designed to help skilled nursing facility staff 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

CARES® Online Dementia Training Programs are AHCA/NCAL Recommended, CMS Recognized & Members Save 15% on all Purchases

Dave Kyllo

AHCA/NCAL members receive 15% off the purchase of any Healthcare Interactive® CARES online training program by using 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 unique because it includes direct video “before and after” training with 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 affordable.  When AHCA/NCAL members purchase CARES® Dementia Basics™ 25-user package using the AHCA15 promo code, the final cost is less than $21 per staff person for four hours of highly quality dementia care training.  Bundle the BASICS training with another training module and the cost is only $34 per staff member. 

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.

The training 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 CARES Dementia Basics 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.

Train Your Back-Up Infection Preventionist Now to Ensure Your Facility is ROP Phase III Ready

 Dave Kyllo

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

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

AHCA’s course is an online, self-study program with 23 hours of training that meets the educational requirements outlined by CMS. It includes online lectures, case studies and interactive components taught by subject matter experts who have real life experience working in long term/post-acute care.  It addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control which are fundamental to effectively leading and administering a nursing center’s Infection Prevention & Control program.  

Another reason for nursing facility staff to take the course now is to reduce the risk of receiving the most frequently cited F-Tag in standard nursing facility health inspection surveys under the new survey process is F880 – Infection Prevention & Control.  Since November 2017 when the new infection prevention and control mandates began, more than one-third of surveys conducted across the nation have included a F880 Infection Prevention & Control citation.  The primary change coming this November under Phase III ROP is the designation of a specially trained Infection Preventionist who must work at least part-time at the facility.  Facilities will continue to be surveyed on all the new infection prevention and control requirements and the antibiotic stewardship requirements. 

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

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

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

To access ahcancalED and the IPCO course, members will need to login with their AHCA/NCAL usernames and passwords.  For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail update@ahca.org with your name and facility contact information. 

Tuesday, July 9, 2019

#WhyICare: Judy Digioia, Charge Nurse

Rachel Reeves and Cristina Crawford

AHCA/NCAL’s #WhyICare workforce campaign broadcasts the stories of individuals who work in long term care, sharing what inspires them about their careers and how they got to where they are today.

This week, we’re pleased to introduce Judy Digioia, a charge nurse at Maine Veterans Home – Machias. From working in an antique shop to getting her education in nursing, Judy’s 15-year-long career in long term care developed from her desire to help others and her community. Click here to watch and share Judy’s inspiring story.



Follow us on Facebook and Twitter to hear more stories as we continue to release new #WhyICare videos in the coming weeks.  Click here to see more #WhyICare videos on YouTube.

Conscience Rule Postponed

Lilly Hummel

The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) has postponed the conscience requirements affecting recipients of federal funds, including Medicaid and Medicare dollars. A coalition of states, health care groups, and civil rights groups filed a lawsuit in California claiming the rule is unconstitutional. The rule was scheduled to go into effect later this month. Specific to long term and post acute care providers, this rule affects conscience protections related: to assisted suicide and related counseling; performance of advanced directives; specified programs such as hearing screening, occupational illness testing, vaccination, and mental health treatment; and religious nonmedical health care providers and their patients from certain requirements under Medicare and Medicaid that may burden their exercise of their religious beliefs regarding medical treatment.

AHCA/NCAL Convention Early Bird Registration Ends July 26

Jon-Patrick Ewing

You can save $200* when you register for the 70th AHCA/NCAL Convention & Expo before July 26th. Take advantage of the Early Bird discount, and get the maximum savings, but hurry — you only have about two weeks! Attendees can save $100 off the Premium/Full Registration Package when registering before the Early Bird deadline. In addition to this discount, you can also save another $100 when you stay within the AHCA/NCAL hotel room block.

If you haven’t registered for the AHCA/NCAL Convention & Expo, don’t wait any longer. There’s no easier way to save.

For a full schedule of AHCA/NCAL events, visit our official website.

PS -- Consider bringing your family. You can arrive early, or extend your trip and take advantage of discounted tickets for Orlando’s many theme parks.

See you in Orlando, October 13-16.

** Some restrictions apply, visit our website for complete information.



SNF QRP PDPM MDS Provider In-Person Training Event, August 13 and 14, 2019

The Centers for Medicare and Medicaid Services (CMS) will be hosting a 2-day SNF quality reporting program (QRP) in-person ‘Train the Trainer’ event for providers on August 13 and 14, 2019, at the Four Seasons Hotel, 200 International Drive, Baltimore, MD 21202. This event will be open to all SNF providers, associations, and organizations. 

Like the May 2019 SNF QRP Provider Training, the primary focus of this 'Train-the-Trainer’ event will be to provide those responsible for training staff at SNFs with information about:

  • The transition to the Patient Driven Payment Model (PDPM) which becomes effective on October 1, 2019.
  • A review of SNF QRP changes and updates to the Minimum Data Set (MDS) 3.0 Version 1.16.0, which became effective October 1, 2018.
  • An overview of the eleven SNF QRP Quality Measures.
  • An interactive session on the use of reports to identify opportunities for process improvement and utilize information contained in reports available via the Certification And Survey Provider Enhanced Reports (CASPER) system to develop quality improvement plans.

During this event, presenters will incorporate additional information into their presentations based on questions received from participants during the May training.  A full agenda can be accessed here.  Training will start at 8:00 a.m. EDT and end at 5:15 p.m. EDT on Tuesday, August 13.  On Wednesday, August 14, training will start at 8:30 a.m. EDT and end at 3:30 p.m. EDT. Following the training on August 14, there will be an optional “We Want to Hear From You” session from 3:30 to 4:30 p.m. EDT.

Registration for this in-person training is limited to 250 people on a first-come, first-serve basis. CMS has negotiated a discounted room rate of $149 per night with the hotel for a limited number of rooms.  To receive the room discount, you must reserve your sleeping room with the hotel no later than 6:00 p.m. EDT on July 22, 2019. Instructions to reserve a hotel room at the discounted rate will be sent to you in a confirmation email once you register for the training.  When registering, please enter your name as you would like it to appear on your name tag and Completion of Certificate. 

For those not able to attend in person, a URL to access the webcast will be provided prior to the event

Whether you participate in-person or via the webcast, CMS asks that you register for this event.  CLICK HERE to register ** Requests for reasonable accommodations must be received at least 5 business days prior to the beginning of the event (no later than Tuesday, August 6, 2019) and can be emailed to Chandler Bishop at PACTraining@EconometricaInc.com with a copy to Stacy.Cole@cms.hhs.gov.**  If you have questions or need additional information regarding the logistics of this training session, please email the PAC Training mailbox at PACTraining@econometricainc.com.

Wednesday, July 3, 2019

Taking the Initiative: Achieving Customer Satisfaction Success

The AHCA/NCAL Quality Initiative is a national, multi-year e ffort to further improve quality of care in America’s long term and post-acute care centers. Since the launch of the Initiative in 2012, members have been challenged to meet measurable targets in key areas such as hospitalizations, customer satisfaction, functional outcomes, and antipsychotics usage.

Sarah Schumann, Director of Operations at Brookside Inn in Colorado, shares the key to their success with the customer satisfaction CoreQ survey. With more than 95% satisfaction, Brookside Inn finds communicating in all respects – with residents, staff, and families – as a crucial factor for achieving success with AHCA/NCAL’s Quality Initiative Customer Satisfaction measure. Watch here.


Tuesday, July 2, 2019

#WhyICare: Jessicah Michira, Director of Nursing

Cristina Crawford and Rachel Reeves

AHCA/NCAL’s #WhyICare workforce campaign broadcasts the stories of individuals who work in long term care, sharing what inspires them about their careers and how they got to where they are today.

This week, we’re pleased to introduce Jessicah Michira’s story. Jessicah is the Director of Nursing at the Lorelton Assisted Living in Delaware. Starting out as a CNA, Jessicah came to find that her position was more than just a job. Her passion and motivation to make a difference led her to rise as a leader in long term care and encourage others to do the same. Click here to watch and share Jessicah’s story.



Follow us on Facebook and Twitter to hear more stories as we continue to release new #WhyICare videos in the coming weeks.  Click here to see more #WhyICare videos on YouTube.

AHCA/NCAL Members Have a No-Risk Opportunity to Stop Overcharges on Water, Sewer, Gas, Electric & Telecom 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. Cleary Energy is an AHCA/NCAL preferred provider and has recouped on average 4% to 8% savings on utilities for long term care facility customers by ending the overcharges.

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

The program is designed to save AHCA/NCAL members significant money on their utility bills without adding new expenses to their budgets.  Cleary Energy guarantees savings or its auditing services are free.  Cleary Energy’s fees are based on facility savings on their utility bills. 
AHCA/NCAL member facilities enter into an audit agreement with Cleary Energy, which is a shared savings agreement that lasts for a period of three years.  If no refund, savings or credits are received, the AHCA/NCAL member facility owes nothing to Cleary Energy for conducting the audit and AHCA/NCAL members will have the peace of mind of knowing that their facilities are not being overcharged for their utilities.   

The process for engaging Cleary Energy to conduct a utility audit is easy.  Most of the information Cleary Energy needs to complete an audit comes directly from the utilities or suppliers. 
Cleary Energy’s long term care experience sets the company apart. The founder of Cleary Energy has 40 years of long term care experience and has spent the last seven years specializing in finding energy cost savings for skilled nursing, assisted living and senior living centers.  That in-depth knowledge of long term care operations enables Cleary Energy to find the greatest costs savings on utility expenses for AHCA/NCAL members because Cleary Energy knows where to look for savings. 

Cleary Energy has been finding huge savings for AHCA/NCAL members, so now is the time to take advantage of this unique no-risk opportunity to save on utility costs.  Contact Cleary Energy today in one of the three ways listed below. 

Take the ICD-10 Coding Training Designed for PDPM Success!

Dave Kyllo

The October 1 PDPM implementation date is less than three months away 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. 
Connections July 3, 2019


The PDPM Clock is Ticking…AHCA’s Virtual Training Prepares SNFs for PDPM

Dave Kyllo

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

Did you miss the in-person PDPM training in your state or attend the training but feel like you could benefit from taking the course again?  AHCA’s Virtual PDPM Training prepares AHCA SNF members for PDPM and mirrors the in-person trainings that have been held for AHCA provider members in almost every state earlier this year. The virtual training allows AHCA SNF members to learn about the critical steps necessary on the pathway to success under PDPM.

Included with the virtual training is access to all materials on AHCA’s PDPM Academy. The PDPM Academy is where updates, tools, webinars and other supporting materials are housed. AHCA SNF members who attend the Virtual PDPM Training will also be able to join in free monthly PDPM Academy webinars hosted by AHCA. 

With less than three months left before PDPM implementation, AHCA’s Virtual PDPM Training can set your facility up for success. This training is available to AHCA SNF provider members only. The cost for the training – whether first time or repeated - is $350. The training has been approved for 8 NAB CE credits. 

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

CMS Announces New Training Event — Updated Section GG Web-Based Training Course

Dan Ciolek
 
On June 26, the Centers for Medicare & Medicaid Services (CMS) posted a notice offering a web-based training course on how to properly code of Section GG of the Minimum Data Set (MDS) assessment. Accurate reporting of Section GG Self-Care and Mobility items is critically important for provider success in implementing the new Skilled Nursing Facility Prospective Payment System (SNF PPS) Patient Driven Payment Model, as well as the SNF Quality Reporting Program (QRP). This 45-minute course is intended for providers in the following care settings: Skilled Nursing Facilities (SNFs), Long-Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), and Home Health Agencies (HHAs); and is designed to be used on demand anywhere you can access a browser. The course is divided into the following four lessons and includes interactive exercises that allow you to test your knowledge in real life scenarios:
  • Lesson 1: Importance of Section GG for Post-Acute Care
  • Lesson 2: Section GG Assessment and Coding Principles
  • Lesson 3: Coding GG0130.Self-Care Items
  • Lesson 4: Coding GG0170.Mobility Items
SNF Providers may find this timely training resource useful for PDPM transition training of nurses, certified nursing assistants, and therapists. Click here to access the training.
 
If you have technical questions or feedback regarding the training, please email the PAC Training mailbox. Content-related questions should be submitted to the Quality Reporting Program Help Desk for your care setting.

New Member Resource - Opioid Use: What Do We Do and How?

Holly Harmon

The AHCA Clinical Practice Committee has developed and launched a new resource for members, Opioid Use: What Do We Do and How?  This resource is available on ahcancalED

The use of opioid medications to manage chronic pain is complex and challenging, especially in long term care and post-acute settings. As the care of individuals with chronic pain in these settings increases, it will be imperative to understand concerns, challenges and opportunities surrounding this issue. This program focuses on the foundation of pain management and how optimal pain management can help prevent opioid abuse.

This multi-part resource offers “Steps to Opioid Reduction” which covers steps by which any center can safely and effectively attempt to reduce opioids in individuals who are on opioids as well as “Appropriate and Safe Use of Opioids As Part of Effective Pain Management” which covers key processes and practices of pain management including (but not limited to) the use of opioids in that context.

Visit ahcancalED today and check out Opioid Use: What Do We Do and How?