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.

Check Out These Exclusive AHCA/NCAL Member Savings Opportunities Next Week at the AHCA/NCAL Convention Expo in Orlando!

Dave Kyllo

AHCA/NCAL members receive special “member only” savings from select premier partners in AHCA/NCAL’s Preferred Provider Program.  Learn more about these exclusive savings programs by visiting these booths next Monday and Tuesday in the AHCA/NCAL Convention Expo Hall in Orlando at the 70th Annual AHCA/NCAL Convention and Expo.

HealthCap®  Booth #1903

HealthCap® is the premier AHCA/NCAL endorsed insurance program providing liability insurance to the senior care sector! 

HealthCap® clients have both lower claims frequency and lower claims severity than other major liability insurance carriers– two powerful reasons why AHCA/NCAL members rave about HealthCap®.  Another plus – AHCA/NCAL members receive a 10% discount on their HealthCap premiums.  The HealthCap® Resource and Education Center is now free and available to all AHCA/NCAL members!   Visit the HealthCap team to learn more.  

AHCA/NCAL Gero Nurse Prep  Booth #2321

Gero Nurse Prep and ANCC Board Certification Create RN Heroes Who Can Improve Key Clinical Outcomes, Reduce Survey Deficiencies and Increase SNF VBP Scores! 

Gero Nurse Prep prepares RNs for the ANCC Board Certification exam in gerontological nursing and increases geriatric nurse competency by 24% based on pre- and post-GNP course test scores.  Visit with Dr. Heidi Keeler to learn how Gero Nurse Prep can help strengthen your clinical performance, increase reimbursements and reduce survey citations.

AHCA/NCAL Insurance Solutions/Compass Total Benefit Solutions    Booth #2418

Discover the Affordable Health Plan Designed to Help AHCA/NCAL Members Recruit and Retain Staff and Reduce Expenses!

With premiums at $1 an hour for full-time employees, the Compass Minimum Essential Coverage plan delivers the health benefits employees want with no deductibles and low co-pays.  Employer contributions can range from 0 to 100% and there is no underwriting!  Stop by and ask the Insurance Solutions team how this plan can cut employee benefit costs and make your facility a more attractive and lucrative place to work and save on your overall health benefits expenses.     

Cleary Energy  Booth #2319

Take Advantage of Cleary Energy’s No-Risk Opportunity to Audit Your Utility Bills and Stop Wasteful Overcharges!

Most (75%) of LTC facilities are being overcharged on their utilities.  Cleary Energy has recouped on average 4% to 8% savings on utilities for long term care facility customers through its exclusive utility audit program. If no refund, savings or credits are received, AHCA/NCAL member facilities owe nothing to Cleary Energy for conducting the utility audit and you’ll know you’re not overpaying.  Stop by to meet Dennis Cleary and learn how easy it is to start saving on your facility utility bills and drop off a business card for a chance to win a “Bose Soundlink Bluetooth Speaker II.”

CARES® Online Dementia Training   Booth #1511

CARES® is the Only Online Dementia Care Training Endorsed by AHCA/NCAL and Recognized by CMS! 

CARES® delivers affordable, high quality, video-based online training for staff at all levels to meet state and federal training requirements.   CARES® is 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. CARES® is recommended by AHCA/NCAL to help reduce the off-label use of antipsychotics.

AHCA/NCAL Member Savings Program  Booth #2420

All AHCA/NCAL Members Receive Exclusive “Members Only” Savings Opportunities Through the AHCA/NCAL Member Savings Program. 

Members can save on outstanding educational programs, liability and health insurance, utility expenses, job postings and more.  Stop by Booth #2420 to learn more about the programs designed to deliver real-world solutions that improve clinical and financial performance.   

Tools To Prevent and Address Resident to Resident Mistreatment

AHCA/NCAL’s Survey/Regulatory Community has developed two new tools and a resource list to support assisted living communities and nursing centers prevent and address reported incidents of resident-to-resident mistreatment. The new member tools include a post-incident checklist and a provider self-assessment, as well as a compiled list of AHCA/NCAL resources. While mistreatment may or may not meet the definition of abuse, it would include negative and aggressive physical, sexual, or verbal interactions between long-term care residents that is unwelcome and has high potential to cause physical or psychological distress in the recipient.

Last year AHCA/NCAL published additional tools, also developed by the Survey/Regulatory committee, to support assisted living communities and nursing centers addressing adverse events. This new set of tools builds upon those resources. Members are encouraged to use and adapt these tools in a way that aligns with their unique culture, systems, and needs.

We thank the members of the Survey/Regulatory Committee for their hard work in developing these tools and hope you find them useful in improving organizations’ systems and responses to adverse events. Should you have any questions, please contact educate@ahca.org

November is National Family Caregiver’s Month

Dana Halvorson

November is National Family Caregivers Month, which is an annual observance to honor family caregivers across the country.  This month helps to raise awareness of family caregiver issues and celebrate the efforts of family caregivers.  The Theme for National Family Caregivers Month November 2019 is #BeCareCurious.  The focus is on encouraging family caregivers across the country to ask questions, explore options and share in the care decisions that affect the health and well‐being of their loved ones.  More details on this month can be found on the Caregiver Action Network’s webpage

Thursday, October 3, 2019

Your Top-Line PDPM Special Issue

research@ahca.org

On October 1, a new payment model, the Patient Driven Payment Model (PDPM), went into effect, replacing the long-standing RUGs system for reimbursement of Part A Medicare FFS claims under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS). The SNF benefit has not changed, but the way patients are classified for payment has changed substantially. One of the biggest changes and an important component of success under PDPM, is the role of ICD-10 coding.
 
To help our members better understand their ICD-10 coding practices, we have produced a PDPM Special Issue of Your Top-Line  available on LTC Trend Tracker. This special issue uses ICD-10 codes from your 2018 MDS assessments to show how your past coding practices would translate to case-mix categories under PDPM.
 
How do I use this publication?
ICD-10 coding will be more important now than it has ever been for SNFs. This resource is meant to provide a snapshot of how you have been coding ICD-10 fields on your MDS in the past. Do not worry if you have codes that do not map to PDPM on this report since that was not part of the system in place. Under PDPM, the primary reason for Part A FFS Medicare admissions will be the only ICD-10 code that needs to map to a PDPM category. The other codes you are using are still valid as comorbidities in the I8000 fields and may also be appropriate for non-Part A FFS Medicare patients as a reason for admission.
 
This snapshot will prepare you to think about what alternative ICD-10 coding practices your clinical team needs to come up with when filling out the 5-day PPS Assessment to ensure you do not leave money on the table. It helps you establish a baseline for not only ICD-10 coding practices, but also for a number of other elements of the MDS we anticipate CMS will monitor to see if and how providers are changing their behavior.
 
The figures included in the report also give you a sense of what base clinical categories your patients fall into under PDPM and how many SLP and NTA comorbidities you are capturing in your coding practices at this time.
 
If you are not feeling confident about your ability to correctly code ICD-10 under PDPM, AHCA has made many resources available to help you. These resources are listed below.
 
Click here to access the Your-Top Line: PDPM Special Issue Frequently Asked Questions document.

Click here to log in to LTC Trend Tracker to download this publication.
 
Click here to download the complete list of ICD-10 codes used in your building in 2018. Descriptions of all codes and whether they would require surgical modifiers or qualify as SLP or NTA comorbidities is also indicated.
 
Resources from AHCA:
Resources from CMS:
For additional questions about PDPM, please email pdpm@ahca.org.
 

Wednesday, October 2, 2019

It’s Not Too Late to Come to Convention

Register Today

The AHCA/NCAL Convention & Expo is coming up fast – October 13-16th in Orlando, Fl. Registration and housing are still open. Join thousands of your fellow long term care colleague for inspiring speakers, priceless networking, and creative solutions. Don’t forget your ticket to NCAL Day on Sunday, October 13 for a full-day of assisted living education. Then select from more than 70 education sessions the rest of the week on topics ranging from Workforce Solutions, Risk Management, Dementia Care and more.

Review the complete convention schedule and register now!

Gero Nurse Prep Fall Sale is On: Register Now and Strengthen Your Assisted Living RN Skills!

Dave Kyllo

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. 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.

Veterans Administration Community Care Network Payer Rates and Charges -- Effective 10/1/2019

Dana Ritchie and Daniel Ciolek

As you may have heard in previous AHCA correspondence, VA's new network of licensed healthcare providers is the Community Care Network (CCN).  The VA has posted the updated payer rates and charges associated with the CCN effective October 1, 2019 on their webpage here.  According to the VA, reasonable charges are based on amounts that third parties pay for the same services furnished by private-sector health care providers in the same geographic area.  In the past, VA used average cost-based, per diem rates for billing insurers.  Reasonable charges are calculated for inpatient and outpatient facility charges, and for professional or clinician charges for inpatient and outpatient care.  AHCA will be sure to keep our members apprised of any other updates around VA programs as we receive them.  If you have questions on the CCN or any VA related matters, please contact AHCA’s Dana Ritchie at dritchie@ahca.org

Become an Expert on the Patient-Driven Payment Model (PDPM) at Convention

Jon-Patrick Ewing

The AHCA/NCAL Convention offers a variety of opportunities to more fully understand PDPM and what it means for you. Beginning with a three-hour intensive on Sunday, October 13, you can participate in a PDPM track of learning that will allow you to learn all the relevant details, hear from experts who helped do the research and create PDPM, and fully understand the impact of PDPM on the way you manage your center and provide care. AHCA staff will also be available to talk with you and answer the questions you may have.

It's a priceless opportunity to quickly get all the facts and learn the tools and strategies you need now that the October 1st implementation deadline has passed.

Registration and housing is still open so click here to conveniently register online. Please note that on-site rates are now in effect.

The Gero Nurse Prep Fall Sale is On: Register Now and Strengthen Your RN Team!

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.      

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.

PDPM is Here and So Are Your PDPM Education Solutions

Dave Kyllo

The new payment system known as the Patient Driven Payment Model (PDPM) took effect yesterday.  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.
 

#WhyICare: Aaron Smith, 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 Aaron Smith, Executive Director. Aaron originally wanted to be an actor. His parents wanted him to be a pastor. Neither would be right. Once Aaron was introduced to senior care, he felt compelled to continue serving those in need and develop his leadership skills to affect change. 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.

CMS Issues Instructions Related to the Submission of HIPPS Codes to Report Medicare Advantage Encounters

Dan Ciolek

On September 26, 2019, the Centers for Medicare and Medicaid Services (CMS) issued updated guidance to Medicare Advantage (MA) plans regarding encounter data coding requirements associated with the implementation of the Payment Driven Payment Model (PDPM) on October 1.  The document, titled “Updated Information on Submission of Health Insurance Prospective Payment System (HIPPS) Codes to Medicare Advantage Encounter Data System – September 2019” is available to AHCA members here.

Providers should consider the following statements from the guidance that may be useful in conversations with MA plans about how CMS is providing flexibilities about whether to report legacy RUGs-based HIPPS codes or PDPM-based HIPPS codes to report MA encounters for dates of service starting October 1, 2019.      

“In order to allow providers and Medicare Advantage Organizations (MAOs) maximum flexibility in the submission of HIPPS codes on encounter data, CMS will accept the existing HIPPS codes as well as the new HIPPS codes.
  • SNF encounters with “from” dates on or after October 1, 2019 and HH encounters with “from” dates of service on or after January 1, 2020 may be submitted using the existing HIPPS codes or the new HIPPS codes.”

Tuesday, October 1, 2019

AHCA/NCAL National Quality Award Provides Proven Framework for Quality Improvement

qualityaward@ahca.org

This summer, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) announced that five long term and post-acute care providers earned the 2019 Gold – Excellence in Quality Award. The Gold award is the final of three distinct levels possible, and the most prestigious, through the AHCA/NCAL National Quality Award Program, which recognizes organizations nationally that serve as models of excellence in providing high-quality care.

The 2019 Gold – Excellence in Quality Award recipients are:
  • Christian Health Care Center, a skilled nursing and assisted living facility in Wyckoff, New Jersey; 
  • George E. Wahlen Ogden Veteran’s Home, a skilled nursing center in Ogden, Utah;
  • Parker at Stonegate, an assisted living community in Highland Park, New Jersey; 
  • The Villages Rehabilitation and Nursing Center, a skilled nursing center in Lady Lake, Florida; and  
  • Vista Pacifica Convalescent, a skilled nursing center in Jurupa Valley, California.
The AHCA/NCAL National Quality Award Program challenges member providers to achieve performance excellence through three progressive levels—Bronze, Silver, and Gold – and the 2020 program cycle has already started! Applications are now available on the Quality Award webpage, and you can submit your Intent to Apply Payment today to save money on your overall application fee and receive extra educational resources.

Why should you apply?
  • The program provides a proven framework that organizations can use to make improvements in clinical, quality or other operational outcome areas;
  • Quality Award recipients perform better than the national average on key quality metrics;
  • The program criteria prepares providers for regulatory demands such as CMS’ Quality Assurance/Performance Improvement (QAPI) requirements and the Medicare and Medicaid Requirements of Participation (RoP);
  • The award journey increases staff morale and engagement; and
  • It provides national, external validation of your quality and services – the perfect information to share with your consumers, stakeholders and referral partners.
The benefits are endless!

The deadline to submit an Intent to Apply payment is November 7, 2019 at 8 p.m. Eastern Time. More information about the AHCA/NCAL National Quality Award Program and key dates are available at ahcancal.org/qualityaward.

Become a Quality Award Examiner

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. Visit ahcancal.org/examiners to learn more.

Check Out Your Resident Profile on LTC Trend Tracker

Lonnita Myles

The LTC Trend Tracker publication, "Your Resident Profile," is a summary of your resident population based on diagnoses and special care needs, and the data is provided for 2017 and 2018 so your trends can be compared across years. This information will help determine what resources and direct care staff are needed to take care of your residents in both day-to-day operations and emergencies.

We are providing this information to help you begin the resident profile portion of the annual Facility Assessment required under CMS’s Requirements of Participation (§483.70(e)). You can find a template of a facility assessment from CMS’s Quality Improvement Organizations here: https://qioprogram.org/facility-assessment-tool

Have questions? Our research team is here to help at research@ahca.org.  Interested in accessing LTC Trend Tracker? Email help@ltctrendtracker.com.

Requirements of Participation – Phase 3: What’s the Latest Update?

Pam Truscott and Sara Rudow

In July, CMS issued a proposed rule that aims to ease some of the administrative and paperwork burdens of the Requirements of Participation (RoPs). The proposed rule includes changes to the current long-term care RoPs and survey process designed to reduce excessively burdensome and overly prescriptive regulations, while allowing centers to focus on providing high-quality care. AHCA has provided a detailed summary of the proposed rule here.

The proposed rule includes several changes AHCA has advocated for, such as reasonable restrictions on when facilities must send a copy of the transfer/discharge notice to the Long Term Care Ombudsman and requiring that providers receive a written notification for IIDR decisions, including the rationale for the independent reviewer’s recommendation and the written rationale for the final decision by CMS. 

CMS has proposed changes to elements of the Phase 3 requirements for the Quality Assurance and Performance Improvement (QAPI) program and the Compliance and Ethics program to make the requirements less prescriptive and more aligned with existing statute. It is important to know that until the proposed rule is finalized, facilities should prepare to implement all areas that are currently stated in the Phase 3 Requirements of Participation. Keep in mind that QAPI and Compliance and Ethics are keys to success for any organization.

Phase 3 requirements for culturally competent and trauma-informed care, infection preventionist, comprehensive training program, and call lights from the residents’ bedsides remain unchanged and will be fully in effect as of November 28, 2019. AHCA will continue to update members about any new information regarding the status of the proposed changes and Phase 3 implementation, including the release of CMS interpretive guidelines for these Phase 3 requirements.

To help centers navigate through the ROP Phase 3, AHCA has developed a number of resources which can be found on ahcancalED. You can find Phase 3 overview materials, including a video, summaries, and implementation checklists, as well as several resources related to behavioral health and trauma informed care, including a webinar on how to get started here. You can access toolkits and a webinar series on compliance and ethics here, and if you haven’t already signed up for AHCA’s IPCO course, now is the time! To see a complete listing of resources and tools available, visit ahcancalED.

If you have any questions, please send them to regulatory@ahca.org.

Announcing the 2020 Quality Initiative Recognition Program

Kiran Sreenivas

The Quality Initiative Recognition Program is back to honor member skilled nursing centers and assisted living communities for their work in achieving the goals of the AHCA/NCAL Quality Initiative.

Let’s celebrate the hard work you have done to measurably improve the lives of your residents and patients. All achievers will be recognized at the AHCA/NCAL Quality Summit in Grapevine, Texas, March 9-11, 2020.

Eligibility
 
Skilled nursing centers must achieve at least one of the AHCA Quality Initiative goals to be eligible for recognition:
  • Hospitalization: Safely reduce long-stay and short-stay hospitalizations by improving 10%, or maintain a rate of 10% or less
  • Customer Satisfaction: Improve long-stay and short-stay satisfaction by 10%, or achieve a rate of 90% or more
  • Antipsychotics: Safely reduce the off-label use of antipsychotics by 10%, or maintain a rate of 8% or less among long-stay residents, and maintain a rate of 1% or less in short-stay residents
  • Functional Outcomes: Improve short-stay functional improvement or long-stay worsening mobility by 15% - or maintain greater than 75% on short-stay functional improvement or maintain less than 12% on long-stay worsening mobility.
    *Note: Due to data availability, AHCA will not be measuring the original Quality Initiative Functional Outcomes goal for the 2020 Recognition Program and will instead be utilizing Nursing Home Compare’s short-stay functional improvement and long-stay worsening mobility measures.
Assisted living communities must achieve at least one NCAL Quality Initiative goals. The goals are:
  • Staff Stability: nursing and direct care staff turnover is 50% or less
  • Customer Satisfaction: 90% or more of residents and/or family members are satisfied with their experience
  • Hospital Readmissions: readmissions within 30 days of hospital discharges are 20% or less
  • Antipsychotics: off-label use of antipsychotics is 15% of residents or less
The more goals a skilled nursing center or assisted living community achieves, the higher the recognition level!

How to Participate
 
By November 21, 2019, nursing centers must submit customer satisfaction data in LTC Trend Tracker. All other data is automatically uploaded by LTC Trend Tracker.  
 
Assisted living members must submit data for all NCAL goals in LTC Trend Tracker by November 21, 2019.
 
If you need assistance with LTC Trend Tracker, please visit the Resource Center or email help@ltctrendtracker.com.
 
For more information, please visit the respective websites for skilled nursing centers and assisted living communities.