Wednesday, October 30, 2019

#WhyICare: Aaron Rebuck, Marketing Liaison

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 Aaron Rebuck, Marketing Liaison. As a marketing liaison, Aaron tells stories to help prospective residents and family members better understand long term care services. Aaron has the opportunity to get to know the residents within his facility intimately, sharing their adventures and accomplishments with the world. Click here to watch and share his 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.

Nursing Facilities Should Have Two Infection Preventionists Trained by November 28 to be ROP 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 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 so that if one specially trained individual leaves, the facility won’t 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. 

Connections October 30, 2019

SNFs with Board Certified RNs Achieve Better Outcomes and Receive Fewer Deficiencies

Dave Kyllo

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

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

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

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

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

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

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

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

Gero Nurse Prep & ANCC Board Certification Boost Assisted Living RN Skills!



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

Board certification makes a difference. NCAL’s 2018 Nurse of the Year Amanda Garcia’s nursing career as an assisted living RN at The Kensington in Fort Madison, Iowa is filled with accomplishments. She was the first in her county to become a facilitator and instructor for end-of-life care. She has trained staff at the local hospital and Iowa State Penitentiary in dementia care. She also received the Distinguished Director of Nursing in Leadership Award from the Iowa Center for Assisted Living, and, The Kensington received the Silver – Achievement in Quality Award through the AHCA/NCAL Quality Award Program.

In between all that, Garcia studied for and passed the American Nurses Credentialing Center (ANCC) board certification exam in gerontological nursing – the gold standard in demonstrating knowledge and expertise in gerontological nursing. She credits the AHCA/NCAL Gero Nurse Prep on-line training course in preparing her to pass the exam.

“The course is amazing and prepares you very well to take the exam,” Garcia said. “It was a real confidence booster that I do know what I’m talking about.” She said that the Gero Nurse Prep course was more intensive than she expected. “There is so much that is different and more to learn with the geriatric population.” The Gero Nurse Prep case studies pushed the envelope in using her critical thinking skills, she explained. Ninety-six percent of Gero Nurse Prep students who take the ANCC Board certification exam in gerontological nursing pass on their first try.

Statistics back up Garcia’s Gero Nurse Prep learning experience. Gero Nurse Prep students see a dramatic 24 percent average increase between their pre- and post- course test scores. Registered nurses who are interested in increasing their knowledge of gerontological nursing practice can complete the AHCA/NCAL Gero Nurse Prep course receive 30 nursing contact hours, and increase their skills and knowledge of geriatric nursing. RNs are also well prepared to sit for the ANCC Board certification test should they choose to pursue the “RN-BC” credential.

AHCA/NCAL Gero Nurse Prep provides tremendous value at the $590 AHCA/NCAL member 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 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 and check out AHCA/NCAL Gero Nurse Prep today.

Tuesday, October 29, 2019

Take a Free Test Drive of the CARES® Online Dementia Training Program & 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. 

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

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. 

Get 20/20 PDPM Vision with AHCA’s 2020 PDPM Academy

Dave Kyllo
 
Now that the Patient Driven Payment Model (PDPM) system is in effect for skilled nursing facilities, AHCA is looking to 2020 and how the association can help members thrive during the first full year PDPM is in effect.  AHCA soon will launch its new 2020 PDPM Academy and the existing PDPM Academy resources will be archived and no longer updated at the end of 2019.   

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

  • Virtual in-depth training modules on PDPM best practices (including role-specific modules);  
  • Monthly webinars; 
  • Additional tools and resources
  • AHCA’s analyses of CMS’s technical changes and updates to PDPM; and,
  • Discounted pricing to in-person 2020 PDPM Academy workshops. 

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

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

For Continued Success, Get Involved in Managed Care


The Population Health Management Summit is a great place to start.


Managed care is going to continue to grow, and you need to know what you can do to grow with it. Visit PHM.ahcancal.org to learn more, and make the commitment to secure quality care for your residents and your organization.

Housing Reservation Deadline Is Only Two Weeks Away!
Deadline: November 8

The Unique Networking Opportunities Are Priceless

Forming new partnerships will put you in the driver's seat as you steer towards a more successful and profitable future in managed care. One priceless aspect of the PHM Summit is the unique networking opportunities available. All attendees will participate in facilitated sessions that will help to develop nontraditional partnerships between organizations such as:

  • LTC providers and health plans 
  • Legal consultants and provider-owned integrated care networks 
  • Senior housing with services and health plans

Additional networking opportunities will also take place throughout the summit. Review the full agenda for more details.

CE accreditation has been requested.

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

Antibiotics Awareness Week is November 18-24 – Are You Ready?

Pamela Truscott, MSN, RN, DNS-CT, QCP

The Centers for Disease Control and Prevention (CDC) have announced that November 18-24, 2019 is U.S. Antibiotic Awareness Week (USAAW).  You are encouraged to help spread the word about the appropriate use of antibiotics to effectively treat infections, combat antibiotic resistance, and protect patients. 

The CDC has also prepared the USAAW Be Antibiotics Aware Partner toolkit! The toolkit contains a variety of social media content, key messages, graphics, and much more to help you and your center prepare for USAAW. 

In addition, are you prepared for the Requirements of Participation Phase III component that requires an Infection Preventionist in your center?  To ensure proper compliance, check out the American Health Care Association’s (AHCA) Infection Prevention and Control Officer (IPCO) Training.  You can find all the information about this course here.  As a reminder, the RoP Phase III goes into effect November 28, 2019.  Don’t delay, get your facility ready for Phase III by enrolling in the IPCO Training today.

AHCA/NCAL Convention Videos Showcase Members Delivering Quality Care

Earlier this month, AHCA/NCAL hosted its 70th Annual Convention & Expo in Orlando, Florida.

At this year’s Convention, AHCA/NCAL premiered a variety of new videos to attendees that showcased how centers and communities, and their staff, provide the best possible care for their residents. We encourage you to take a moment and watch these videos to hear the incredible stories of our profession’s staff and residents:

Taking Flight – Every day assisted living and senior living communities are helping residents connect with the past and look toward the future. Check out how Covenant Living and the Ageless Aviation Dreams Foundation helped retired Navy pilot Jim take flight in a World War II-era biplane.

Food by Norma Gay  - "Food is What Brings us together." Take a look at how Gay Pearson brings all of long term care together with her compassionate cooking for residents.

2019 AHCA/NCAL National Quality Award Program - Learn about the Quality Award Program and how it generates quality excellence among our members.

2019 Gold Quality Award Recipients – Learn about this year’s 5 outstanding Gold Quality Award recipients.

#WhyICare – Hear a compilation of stories collected this year from caregivers across the country on why they love their career in long term and post-acute care.

Mark Parkinson Opening General Session Speech – AHCA/NCAL President and CEO Mark Parkinson speaks to the importance of sharing all the acts of kindness and positive stories taking place in our facilities each and every day.

Michael Wylie Opening General Session Speech – Past AHCA Chair Michael Wylie shares his personal story on why he cares.

Quality Award Examiner Deadline Nov 7

Meghan Karstetter

It’s your last chance to join an elite group of professionals making a national impact on long term care performance by serving as a National Quality Award Examiner! AHCA/NCAL is seeking Senior and Master Examiners to evaluate 2020 Silver and Gold National Quality Award applications.

Serving as an Examiner is an incredible opportunity for professionals currently applying for a Quality Award and interested in continuous quality improvement. Examiners review Quality Award applications and are offered the following benefits:

  • Opportunities for networking and professional development 
  • Develop a marketable skillset and invaluable knowledge
  • In person and virtual education in Baldrige Excellence Framework from content experts
  • Learn best practices to bring back to your own organization
  • Earn Continuing Education Units (CEUs)
  • Attend AHCA/NCAL’s Quality Summit or Convention at a discounted rate 

The deadline to apply is next Thursday, November 7, 2019 at 8 pm ET. Please share this opportunity with anyone who may be interested! Learn more about the role, the timeline and responsibilities here: www.ahcancal.org/examiners

Please do not hesitate to reach out to us at qualityaward@ahca.org with questions.

Quality Award Intent to Apply Deadline Next Week

Don’t miss the opportunity to save on your Quality Award application fee for 2020! The Intent to Apply (ITA) deadline is coming up next week on Thursday, November 7. While not mandatory, applicants who submit an ITA payment will save money on their overall application, and no paperwork is needed to submit the ITA.

Submit your ITA payment by logging in to the Quality Award Portal. We encourage members to log in to the Portal before the deadline to avoid any technical log in issues. Before submitting an ITA payment, please review the application packets in full which are available at ahcancal.org/qualityaward. In addition, Quality Award survey eligibility is now updated with Nursing Home Compare data from October here.

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

Submit Your Data for the Quality Initiative Recognition Program!

The 2020 AHCA/NCAL Quality Initiative Recognition Program will honor member centers and communities that have achieved one or more of the AHCA/NCAL Quality Initiative goals. The recognition will take place at the AHCA/NCAL Quality Summit in Grapevine, Texas, March 9-11, 2020.

The deadline to submit your Quality Initiative data in LTC Trend Tracker is November 21, 2019. Nursing centers must submit customer satisfaction data, and all other data is automatically uploaded. Assisted living members must submit data for all of the NCAL goals.

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

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

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

Trauma-Informed Person-Centered Thinking and Support

Register Now

November 18, 2019 2:30 PM - 4:00 PM EST

The National Center on Advancing Person-Centered Practices and Systems will be hosting a webinar to engage in person-centered practices, including person-centered planning, it is essential to see the whole person. This whole person view must include acknowledgment and consideration of a person’s life experiences, which may – and often do – include experiences of trauma. Person-centered practices and trauma-informed approaches share key values, including collaboration, mutual trust, informed choice, and empowerment. However, we lack the tools to apply trauma-informed principles to the person-centered planning process, and to intentionally engage in trauma-informed person-centered practices. This webinar will explore the intersection of trauma and person-centered thinking, planning, and practice. It will emphasize actionable steps people can take to ensure that we consider trauma when we engage in person-centered thinking, planning, and practices.

Speakers for this Event:

· Karyn Harvey

· Cath Cave

· Tanya M. Richmond

· Aimee Ortiz-Day

· Michael Smull

NCAPPS is an initiative from the Administration for Community Living and the Centers for Medicare & Medicaid Services to help States, Tribes, and Territories to implement person-centered practices. NCAPPS webinars are open to the public, and are geared toward human services administrators, providers, and people who use long-term services and supports. All NCAPPS webinars will be recorded and archived at https://ncapps.acl.gov.

Wednesday, October 23, 2019

CMS Confirms Exploring the Possibility of Eliminating MDS Section G Items from SNF 5-Day and OBRA Assessments beginning FY 2021

Dan Ciolek

Recently AHCA has been receiving reports from members and state affiliate staff that they are hearing from state Medicaid officials and other sources that Centers for Medicare and Medicaid Services (CMS)  officials are stating that it is possible that the Minimum Data Set (MDS) Section G Activities of Daily Living (ADL) items may be eliminated from the Skilled Nursing Facility Prospective Payment System (SNF PPS) 5-Day and OBRA Comprehensive and OBRA Quarterly assessment types. 

AHCA was aware that CMS was exploring the possibility of this occurring as the concept has been discussed in recent rulemaking and technical expert panel (TEP) discussions to reduce the confusion and burden associated with two different sections of the MDS (Sections G and GG) being used to report a resident’s function, but with vastly different scoring methodologies.  No formal timelines had been discussed to date.  We were also aware that CMS had contracted with RTI to conduct a study to determine if section GG would be reliable and valid to use with long-stay residents. 

In response to an AHCA request for clarification of the status of Section GG on the MDS, CMS stated that it is true that the Agency is considering retiring Section G items from the PPS 5-Day, and OBRA assessments effective October 1, 2020 if current analysis indicates it would be appropriate to use Section GG exclusively for short and long-stay residents.  CMS sees this as reducing reporting burden.  Regardless of the decision, the MDS Optional State Assessment (OSA) would continue to include Section G items beyond October 1, 2021 for a period yet to be determined to permit other payers (some Medicaid, some VA, TRICARE, and some Medicare Advantage) to continue with RUGs or other methodologies that rely on Section G item data.

In other words, providers should be prepared that further changes to the SNF PPS and OBRA MDS assessment types related to Section G items may be implemented as early as October 1, 2020, and that at that time, the OSA will be the only MDS assessment type that will be able to generate a RUGs-based payment classification.  Typically, the first indicator of formal proposed changes to the MDS are revealed with the CMS release of draft MDS technical specifications and draft MDS Manual guidance that are posted after the new year.  AHCA will provide updates on this topic as more information becomes available.   

CMS Confirms Error in PDPM SNF PPS Interrupted Stay MDS Coding Edit – Provides Work-Around Instructions Until a Software Fix is Released

Dan Ciolek

Recently AHCA has been receiving questions from members that have been receiving Minimum Data Set (MDS) “error” messages when attempting to code the MDS for an Interrupted Stay in MDS Item fields A0310G1 and A2400 per instructions provided the MDS-RAI Manual v1.17.1 (October 2019).  The Centers for Medicare and Medicaid Services (CMS) has acknowledged that there is a consistency edit error in the data submission specifications provided to software vendors.  Until CMS can fix the coding, they are instructing providers to complete Interrupted Stay MDS assessments using the following “work-around”.

Work-Around Instructions:  When a provider determines that MDS Item A0310G1 = 1, then providers should code MDS Item A2400 = 0 until further instructions are provided when the fix is implemented.

Tuesday, October 22, 2019

CMS Releases August 2019 SNF PDPM/MDS/QRP Provider Training YouTube Videos

Dan Ciolek

The Centers for Medicare & Medicaid Services (CMS) released 13 YouTube videos recorded during a 'Train-the-Trainer' event which occurred in Baltimore, Maryland on August 13 and 14, 2019.  This event was to provide those responsible for training Skilled Nursing Facility staff with information to understand and adopt new data standards associated with the implementation of the Minimum Data Set (MDS) 3.0 Version 1.17.1, which became effective on October 1, 2019. During this event, presenters incorporated additional information into their presentations based on questions received from participants during the May 2019 SNF QRP Provider Training. Topics included:
  • The Patient Driven Payment Model (PDPM) which became effective on October 1, 2019.
  • Detailed guidance for completing MDS Sections GG, as well as to updated items in MDS Sections A, I, J, and O, including PDPM coding case examples.
  • 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.
Complete instructions for coding the MDS items are located in Chapter 3 of the MDS-RAI manual v1.17.1 (October 2019) that can be accessed here.
 

New Population Health Management Summit for Long Term and Post-Acute Care Leaders

December 9-10, 2019
InterContinental Washington, DC – The Wharf
 
 
Hotel Reservation Deadline: November 8

Join AHCA/NCAL and LTC/PAC providers, health plans, regulators, and investors for a two-day intensive on all the latest in population health management.
  • Discuss the ways in which PHM models are improving quality and outcomes while reducing costs
  • Learn new strategies to expand and improve your leadership capabilities in PHM
  • Network with peers and nontraditional partners
  • Gain a deeper understanding of CMS’ view of provider-led PHM efforts
You’ll learn from expert speakers and each other at this unique event. With a focus on leadership, you’ll gain a deeper understanding of PHM strategies that can take your organization to the next level.

The Keynote Speaker is Dan Mendelson, Founder of Avalere Health.


Find out more about the summit and register today.

Visit phm.ahcancal.org for more details.

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

CMS Releases New Training Video Resources for Coding MDS Item GG0130A. Eating

Dan Ciolek

The Centers for Medicare & Medicaid Services (CMS) released a short video tutorial on October 17, 2019 to assist providers with coding the Minimum Data Set (MDS) GG0130A. Eating item. This item impacts the Skilled Nursing Facility Prospective Payment System (SNF PPS) Patient Driven Payment Model (PDPM) resident classification per-diem rates as well as the SNF Quality Reporting Program (QRP) self-care outcomes measures.  This 6-minute video is designed to provided targeted guidance using simulated patient scenarios.  It could be useful for nursing, nursing assistant, and therapy staff training purposes.  Complete instructions for coding the MDS GG0130A item are located in Chapter 3 of the MDS-RAI manual v1.17.1 (October 2019) that can be accessed here.

AHCA Has Your PDPM Education Solutions

Dave Kyllo

The new payment system known as the Patient Driven Payment Model (PDPM) took effect October 1 transforming the way skilled nursing facilities are reimbursed for Medicare Part A stays.  AHCA offers virtual training on PDPM and ICD-10 coding. 

AHCA SNF members who did not attend an in-person PDPM Academy training hosted by an AHCA state affiliate earlier this year are encouraged to take 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. 

AHCA members can also access their facility's personal Top-Line PDPM report here. This report is a snapshot of previous coding practices for ICD-Coding on MDS assessments. Use this step-by-step guide to access your reports.

Providers Share #WhyICare at Convention

Rachel Reeves

"Sharing our stories" was a common theme throughout the 70th AHCA/NCAL Convention & Expo, and attendees got personal at the #WhyICare selfie station in the Expo Hall last week. Visitors wrote down their own personal reason for why they love working in long term and post-acute care and then took a selfie. 

Check out some of the signs and selfies...






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. Join the conversation by downloading and printing a copy of the selfie sign, write down your story, take a selfie, and post it online with #WhyICare.

For workforce resources to help LTC organizations and individual professionals, visit www.ahcancal.org/workforce

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.

Board Certified RNs Make a Positive Difference in SNF Performance

Dave Kyllo

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

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

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

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

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

Tuesday, October 15, 2019

This Is Your Chance – Sign Up for a NCAL Committee!

Katherine Preede 

NCAL wants you to participate on a NCAL Committee! Nominate yourself to serve on one or more of the following committees: NCAL Quality Committee, NCAL Finance and Policy Committee, AHCA/NCAL Workforce Committee, and the AHCA/NCAL Customer Experience Committee. Sign up before October 21!

All NCAL members are highly encouraged to participate in this process. In an effort to create diverse and widespread representation, appointments to specific committees may be limited to one participant per state and company. To assist in the process, individuals should choose two committees and rank their selections in order of preference. To submit your nominations, please complete the Survey Monkey. We hope you will take this opportunity to be an active member!

If you have any questions regarding this process, please contact Katherine Preede.

Sunday, October 13, 2019

Preventing the Spread of Novel or Targeted Multidrug-resistant Organisms (MDROs) in Nursing Homes through Enhanced Barrier Precautions

Date: Thursday, October 24, 2019
Time: 2:00pm–3:00pm (ET)
A few minutes before the webinar begins, please click the link below to join:
https://zoom.us/j/535497188

Or join by iPhone one-tap:
US: +16468769923,,535497188# or
+16699006833,,535497188#

Or join by Telephone:
US: +1 646 876 9923 or +1 669 900 6833

Webinar ID: 535 497 188
In the United States, nursing homes provide complex medical care to residents at high risk of acquiring multidrug-resistant organisms (MDROs). Through outbreak responses to novel or targeted MDROs, the Centers for Disease Control and Prevention (CDC) and public health partners have found that gaps in infection prevention practices, such as inadequate use of gowns and gloves, contribute to the spread of MDROs. In nursing homes, it can be challenging to implement the contact isolation precautions used in hospitals when caring for patients with MDROs.

CDC recently introduced a new approach called Enhanced Barrier Precautions to help address these challenges. Enhanced Barrier Precautions are recommended for preventing the transmission of novel or targeted MDROs in nursing homes involved in a public health containment response. Enhanced Barrier Precautions fall between Standard and Contact Precautions, and require gown and glove use for certain residents during specific high-contact resident care activities that have been found to increase the risk for MDRO transmission.

During this COCA Call, clinicians will learn about Enhanced Barrier Precautions, with a detailed discussion of the residents and high-contact resident care activities for which they apply.

Please note: The slides for this presentation will be posted on the call page under the “Call Materials” tab as soon as they are available.


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 September 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.

Secure Your Umbrella License with the Motion Picture Licensing Corporation

Lilly Hummel

AHCA/NCAL and other leading industry associations negotiated an agreement with the Motion Picture Licensing Corporation (MPLC) for member savings on MPLC’s Umbrella License®, the most comprehensive copyright license available for senior living and health care communities to show movies. The license provides access to content from nearly 750 rightsholders, ranging from major Hollywood and independent studios to faith-based and foreign language producers.

Once licensed, an unlimited number of movies may be shown. Movies can be secured from any legal source whether rented, purchased, or borrowed via DVD, stream, or downloaded. However, unlicensed exhibitions may subject your community to substantial fines for copyright infringement. If your community currently shows movies, please secure the required license to ensure copyright compliance.

As AHCA/NCAL has advised in the past, the 2016 Agreement establishes guidelines for the licensing of motion picture exhibitions in all senior living and health care communities regardless of the level of care provided or the license status of the community. The Agreement states that:

  • All communities, regardless of their type or license status, must obtain licensure for exhibitions of Videos transmitted over a closed circuit television system or in-house channel.
  • All communities, regardless of their type or license status, must obtain licensure for exhibitions of Videos in common areas such as a theater, lounge, or community room. This includes:
    • Affordable housing facilities and units.
    • Assisted living, nursing and rehabilitation facilities and units.
    • Independent living facilities and units.
    • Adult day services centers.
    • Assisted living, nursing and rehabilitation units receive a reduced rate on the license. Minimum fees are waived for campuses that are strictly nursing, assisted living, or rehabilitation. Effective in 2019, the rate per sleeping unit is $3.45, with a 10% member discount available.
  • Affordable housing units receive a reduced rate on the license.

Please contact MPLC directly at (800) 462-8855 or online at seniorliving.mplc.org for assistance with pricing or to ask any questions about the Umbrella License.

If your senior living community operates assisted living, nursing or rehabilitation units, and held an Umbrella License prior to October 2016, AHCA/NCAL encourages you to provide MPLC with updated unit counts for the aforementioned units prior to your renewal date. Longstanding licensees are eligible for reduced pricing for any assisted living, nursing, or rehabilitation units/rooms added during this renewal year only. Thereafter, the license requirement remains, but units will be priced at a higher fee.

Delivering the Distinct Feeling of Fall with Mood Media

Dave Kyllo

Whether it’s Nat King Cole’s “Autumn Leaves” or The Kinks’ “Autumn Almanac,” members can keep music at the core of fall celebrations 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 $27.99 per month or less than $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).

Get Your Staff Up to Speed Fast with AHCA’s Online PDPM Education Courses

Dave Kyllo
 
The new payment system known as the Patient Driven Payment Model (PDPM) took effect October 1 transforming the way skilled nursing facilities are reimbursed for Medicare Part A stays.  AHCA offers virtual training on PDPM and ICD-10 coding. 

AHCA SNF members who did not attend an in-person PDPM Academy training hosted by an AHCA state affiliate earlier this year are encouraged to take 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. 

AHCA members can also access their facility's personal Top-Line PDPM report here. This report is a snapshot of previous coding practices for ICD-Coding on MDS assessments. Use this step-by-step guide to access your reports.

Find Your Next LTC Hero On the LTC Career Center & Save $100

Dave Kyllo

Now through November 30, 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 LTCHERO. That’s $100 off the regular low AHCA/NCAL rate of $350. Rates for posting job vacancies are reduced for 60- and 90-day postings through November 30.   

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 look for jobs on this national network built for health care employers to reach health care professionals.  This short video shows how easy it is to create an account and post a job vacancy. 

The $250 sale price for a 30-day posting gives even more value because employers who utilize the LTC Career Center  receive free bonus exposure through rotating job listings on AHCA’s home page – the web site where long term care professionals go for news and information.  In addition, employers that post vacancies through the AHCA/NCAL LTC Career Center get extra value through free rotating listings on the Long Term Care Career Center home page. 

Of course, the LTC Career Center is always free for job seekers and the LTC Career Center  features many of the best positions the long term care profession has to offer.  Graduates and experienced health care professionals utilize the Health Care Career Network to find the best health care openings. 

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

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

Updates to the OMHA Case Processing Manual

Lilly Hummel

The Office of Medicare Hearings and Appeals (OMHA) has published a  revised chapter of the OMHA Case Processing Manual (OCPM). Chapter 16 on Decisions has been revised effective October 9, 2019.

Effective July 8, 2019, OMHA also revised the following chapters:

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.

Wednesday, October 9, 2019

Cultural Competence: What it Means for Person-Centered Thinking, Planning, & Practice

Register Now

Tuesday, October 29, 2019 - 3:00PM - 4:00PM EST

Georgetown University National Center for Cultural Competence and the National Center on Advancing Person-Centered Thinking, Planning, and Practice, NCAPPS will be hosting a webinar, which is the is the second in a four-part series that explores cultural and linguistic competence as it relates to person-centered thinking, planning, and practice.

Cultural competence is widely recognized as essential to the delivery of high quality and effective services and supports by policy makers, health, mental health and social service professionals, educators, and researchers. There is a solid base of evidence that cultural competence improves access, utilization, outcomes, and satisfaction in health and human service delivery systems. While this evidence is compelling, many organizations have struggled to integrate cultural competence into their person-centered thinking, planning, and practice. This webinar will:
  1. Describe a framework for cultural competence and at the individual and organizations levels
  2.  Provide a “real life” example of an organization that values and practices cultural competence
  3. Highlight personal narratives of individuals who will share what culturally competent services mean to them
  4. Describe how cultural competence and person-centered thinking and practice are integrally linked
 NCAPPS webinars are open to the public, and are geared toward human services administrators, providers, and people who use long-term services and supports. All NCAPPS webinars will be recorded and archived at https://ncapps.acl.gov. You can find the archives and resources from the first in the series here. 

Key Facts on Nursing Assistants Employed in Nursing Homes

Dana Ritchie

PHI released a report last month entitled, “U.S. Nursing Assistants Employed in Nursing Homes: Key Facts (2019).”  According to the PHI website, the research brief “provides the latest annual snapshot of U.S. nursing assistants employed in nursing homes, including key demographics and a variety of wage and employment trends.  This year’s research found that 581,000 nursing assistants support older people and people with disabilities in nursing homes.”  The brief also includes that “nursing homes will need to fill nearly 680,000 nursing assistant job openings between 2016 and 2026.” More key takeaways on nursing assistants can be found in the brief here.  

CMS Releases Medicare General Information, Benefit Policy, and Claims Processing Manual Updates Related to PDPM Implementation

Dan Ciolek 

This week, the Centers for Medicare and Medicaid Services (CMS) issued sub-regulatory guidance related to the Skilled Nursing Facility Medicare Part A Prospective Payment System (SNF PPS) Patient Driven Payment Model (PDPM) in recent Program Manual update transmittals.  The Medicare General Information, Eligibility, and Entitlement Manual PDPM transmittal contains minor updates to certification guidance.  The Medicare Benefit Policy Manual PDPM transmittal contains minor updates to the SNF benefit period and benefit days sections in chapter 3, and major changes to the SNF PPS guidance in Chapter 8.  Finally, the Medicare Claims Processing Manual PDPM transmittal provides substantial updates to the chapter 6 SNF PPS claims processing instructions.  AHCA has conducted a preliminary review of these updates and will be highlighting key observations later this week.  We will also be highlighting key points during the upcoming “Week 2 of PDPM Implementation Status Update” all-member webinar on Friday, October 11, 2019 from 3:00-4:00 PM eastern.  You may register for the webinar here

AHCA/NCAL Announces New Population Health Management Summit for Long Term and Post-Acute Care Leaders

Danielle Levitan
 

Join AHCA/NCAL for a new opportunity to dive into hot topics in population health management (PHM).

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

The PHM Summit will bring together LTC/PAC providers, health plans, regulators, and investors for a two-day intensive to explore the ways LTC/PAC providers are driving change and integrating new models of care within their organizations using population health management (PHM) strategies. With an emphasis on leadership, you will:
  • Discuss the ways in which PHM models are improving quality and outcomes while reducing costs
  • Learn new strategies to expand and improve your leadership capabilities in PHM
  • Network with peers and nontraditional partners
  • Gain a deeper understanding of CMS’ view of provider-led PHM efforts
Learn more about the summit and register today.

Visit phm.ahcancal.org for more details.

Host Sponsors: MatrixCare, Medline
Contributing Sponsor: Compass Total Benefit Solutions

#WhyICare: Josh Theis, Senior Executive Director

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 Josh Theis, Senior Executive Director. Originally seeking a degree in business administration, Josh decided he wanted to pursue a more rewarding career path. After speaking with his professor about becoming a healthcare administrator, he switched his major and fell in love with the long term care profession. Today, Josh impacts the lives of so many people on a daily basis. Click here to watch and share his 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 Submits Comments to CMS Regarding Therapy and Telehealth Provisions in Physician Payment Proposed Rule

Dan Ciolek

On September 27, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) submitted public comments to the Centers for Medicare and Medicaid Services (CMS) in response to the proposed rule briefly titled “Medicare Program; CY 2020 Revisions to Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; [CMS-1715-P]” which can be found here.  Briefly, this proposed rule updates payment policies and payment rates associated with many services furnished under the Medicare Part B benefit that impact residents of skilled nursing facilities and assisted living residences.  The AHCA/NCAL comments letter focused on concerns related to the following three subject areas: 1) provisions related to the implementation of physical therapist assistant and occupational therapy assistant payment adjustment modifiers, 2) provisions related to adjustments in physician evaluation and management payments, and 3) provisions related to telehealth services in skilled nursing facilities (SNFs).

With regard to the specific proposed policies, AHCA/NCAL voiced grave concern with CMS’ proposed application of the CQ/CO modifier when outpatient physical therapy and occupational therapy services are furnished “in whole or in part” by a physical therapist assistant (PTA) or occupational therapy assistant (OTA) and how this policy, if finalized as proposed, will negatively affect Medicare beneficiary access and add administrative burden.  Additionally, AHCA/NCAL voiced concern about proposed changes to physician evaluation and management (E&M) payments that would result in a negative eight percent adjustment to outpatient therapy payment rates beginning CY 2021.  Finally, with regards to telehealth policy, AHCA/NCAL requested that the Secretary of Health and Human Service consider revising existing obsolete SNF telehealth frequency limitations promulgated through prior rulemaking as well as consider approaches to improve telehealth access to currently excluded geographic locations and to rehabilitation services furnished by  physical, occupational, and speech therapy professionals. 

During the comment period, AHCA/NCAL coordinated efforts with other professional, provider, and beneficiary organizations submitted joint letters and were able to secure meetings with CMS officials to provide additional details and examples related to these concerns, as well as to offer suggested alternative policy approaches.  Additionally, thousands of comment letters from AHCA/NCAL members and other therapy providers were submitted with a consistent message requesting revision of the proposed policies before finalization.  The final rule is typically published in November. 

Tuesday, October 8, 2019

Board Certified RNs Boost Financial and Clinical Performance in SNFs

Dave Kyllo

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

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

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

Gero Nurse Prep is on sale through November 30!  Save $100 off the regular registration fee by using promo code RNHERO (all caps).  AHCA/NCAL Gero Nurse Prep provides tremendous value at this AHCA/NCAL member $590 sale price.   That’s less than $20 per contact hour for outstanding nursing education that makes a measurable difference on so many fronts.  For RNs interested in pursuing Board certification through ANCC, there is an additional and separate cost of $395.
 
To learn more about Gero Nurse Prep and ANCC Board certification, watch this video. For an even deeper dive into competent geriatric nursing, listen to this free AHCA/NCAL webinar “Competent Geriatric RNs – The New Driver of Financial Performance.” 

In addition, members attending the 2019 AHCA/NCAL convention in Orlando can meet with University of Nebraska and Gero Nurse Prep staff to learn more about the impact of Board certified RNs have on quality in long term care settings.  Stop by Booth #2321 in the Expo Hall to learn more.   

Struggling with PDPM? AHCA’s Online PDPM & ICD-10 Education Can Help

Dave Kyllo
 
The new payment system known as the Patient Driven Payment Model (PDPM) took effect last week.  PDPM transforms the way skilled nursing facilities are reimbursed for Medicare Part A stays.  Some of the changes that began October 1 include: 
  • The PDPM system relies on more than 180 MDS item fields that completely transforms the previous RUG-based 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 now directly ties to reimbursement.  
  • Simply accepting the hospital’s ICD-10 code or using the ICD-10 code that seem most appropriate does not work under PDPM.  Assuming the admitting physician has the correct diagnosis and code does not work either. MDS Coordinators and billing staff now 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 understand and effectively communicate about arriving at the reason for SNF care and define the clinical basis for admission using appropriate ICD-10 codes that map to PDPM. 
  • Primary diagnosis tied to accurate ICD-10 coding matters more than ever under PDPM.  CMS now has a much clearer way to monitor whether SNF care is really needed.  Accurate ICD-10 coding minimizes 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 who did not attend an in-person PDPM Academy training hosted by an AHCA state affiliate earlier this year are encouraged to take 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. 
 AHCA members can also access their facility's personal Top-Line PDPM report here. This report is a snapshot of previous coding practices for ICD-Coding on MDS assessments. Use this step-by-step guide to access your reports.