Tuesday, March 31, 2020

Federal Court Orders Appeal Rights on “Observation Status” Issue for Certain Medicare Hospital Patients

Dana Ritchie

In a decision issued on March 24, 2020, Judge Michael P. Shea of the U.S. District Court in Hartford, Connecticut found that certain Medicare beneficiaries who are placed on “observation status” at hospitals, rather than being admitted as “inpatients,” have the right to appeal to Medicare. The case, Alexander v. Azar, is a nationwide class action case filed by the Center for Medicare Advocacy that went to trial in August 2019. The ruling finds that as a matter of constitutional due process, patients who are initially admitted as inpatients by a physician, but whose status is later changed to observation by their hospital, have the right to appeal to Medicare and argue for coverage as hospital inpatients.

The decision opens the door to medically necessary services in skilled nursing facilities that Medicare beneficiaries might otherwise have to forgo because they cannot afford to pay for it themselves. The distinction between being labeled a hospital “inpatient” versus being placed on observation status is important because Medicare only covers subsequent care in a skilled nursing facility for patients who were hospitalized as inpatients for three or more consecutive days. Patients in observation status are considered “outpatients” and thus ineligible for coverage of care at nursing facilities. You can read the full press article about this on the Center for Medicare Advocacy’s website here.

As a result of this case, the Secretary of HHS must establish a procedure to allow certain Medicare beneficiaries to challenge decisions by hospitals to place them on observation status. The court outlines the beneficiaries who will be eligible to challenges these decisions:

All Medicare beneficiaries who, on or after January 1, 2009:

  1. have been or will have been formally admitted as a hospital inpatient; 
  2. have been or will have been subsequently reclassified as an outpatient receiving “observation services”; 
  3. have received or will have received an initial determination or Medicare Outpatient Observation Notice (MOON) indicating that the observation services are not covered under Medicare Part A; and 
  4. either 
    • (a) were not enrolled in Part B coverage at the time of their hospitalization; or 
    • (b) stayed at the hospital for three or more consecutive days but were designated as inpatients for fewer than three days, unless more than 30 days has passed after the hospital stay without the beneficiary’s having been admitted to a skilled nursing facility. Medicare beneficiaries who meet the requirements of the foregoing sentence but who pursued an administrative appeal and received a final decision of the Secretary before September 4, 2011, are excluded from this definition. 

The federal government may appeal this decision of the District Court but has not formally done so at this time. In addition, the ruling has no effect on the current waiver of the 3-day stay requirement that CMS issued under the public health emergency and the section 1812(f) waiver. 

VA Referrals to SNF During COVID-19 Emergency

Dan Ciolek and Dana Ritchie

Per an email to AHCA from the Veterans Administration (VA), Community care has halted non-urgent, non-emergent VA referrals to the community. However, referrals for geriatrics and extended care services (including all nursing home referrals) will continue but they are being clinically reviewed using guidance provided to the VA facilities and community care network (CCN) contractors “The community care office should carefully evaluate and prioritize referrals that are urgent/emergent and medically necessary based on clinical triage.”

NOTE: The VA and TriWest have delayed the deployment of CNN throughout Region 4 as Montana and Eastern Colorado will deploy June 8, 2020 and the remainder of Region 4 by August 31, 2020, so referrals in these regions for post-acute care would continue to be via local VA contracts or veterans care agreements (VCAs).

The following are useful web links to access updated VA information.
  • The VA provider latest news webpage is here.
  • The VA COVID-19 webpage  is here.
  • The Optum CCN Network COVID-19 webpage is here
  • The TriWest Network provider webpage is here.

A Virtual Continuing Education Opportunity that Delivers Variety, Flexibility, and Quality

Dave Kyllo

AHCA/NCAL has the online courses to help administrators, directors, and nurses meet their continuing education (CE) needs! The AHCA/NCAL 2019 Convention Education sessions are available to members and non-members in a package offering 70 online NAB and ANCC (nurses) approved courses. 

There are more than enough online courses in the package to meet most license requirements. Topics include those related to clinical practice, workforce, assisted living, technology, dementia care, and more!

The package is online, available 24-hours a day and the interface is easy. After purchasing the package, you choose a course, view the webinar, take and pass the quiz, print your CE certificate, and then self-report the course information to your NAB profile or nurse board.

The package costs $200. Once the package is purchased, access to the courses will be available until September 1, 2020. The package is for individual use only and access cannot be shared. Single courses are not available. You can access the package here.

Wednesday, March 25, 2020

CDC Releases COVID-19 Guidance for Retirement Communities and Independent Living

The Centers for Disease Control and Prevention (CDC) released guidance for retirement and independent living communities, including assisted living communities that do not provide medical services. AHCA/NCAL has learned that the CDC will be releasing guidance for assisted living communities in the coming days. Until that guidance is published, we strongly recommend that members follow AHCA/NCAL’s previously issued recommendations on visitors, communal dining and events. 

The CDC guidance for retirement communities and independent living is similar to AHCA/NCAL’s guidance in that they suggest canceling all public or non-essential group activities and events, cleaning and disinfecting all areas, screening visitors when appropriate and possible and posting information related to COVID-19.

In recognizing the home-like environment of these residences, the guidance also highlights asking residents to self-monitor, asking residents to ensure they have needed medications, etc. The guidance also recommends that providers work with the local department of health if a positive case of COVID-19 were to be found in the building. It is key to note that the guidance covers retirement communities, assisted living communities that are a less medical model, and CCRCs. Again, we recommend that members utilize AHCA/NCAL’s more robust guidance as well. 

For additional questions, please email COVID19@ahca.org and visit www.ahcancal.org/coronavirus for more information and resources.

The LTC Career Center Offers National Exposure for Your Job Listings

Dave Kyllo

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. 

Open positions can be posted on the AHCA/NCAL Long Term Care Career Center for $350 per 30-day posting. Rates for posting job vacancies are reduced for 60- and 90-day postings through November 30. This short video shows how easy it is to create an account and post a job vacancy. 

Posting on the site 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. 

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.   

March 31, 2020 PDPM Academy Open Discussion Forum Cancelled – PDPM Academy 2020 Subscriptions Still Available

Dave Kyllo

Due to the growing challenges providers are facing during the COVID-19 emergency and the need to free-up our virtual webinar technology calendar to provide essential COVID-19 related updates, AHCA is cancelling the scheduled upcoming AHCA PDPM Academy Open Discussion Forum (ODF) scheduled for March 31 from 3:00-4:00 PM EDT. 

Any updates related to the patient driven payment model (PDPM) during this crisis will be posted as they occur in the AHCA COVID-19 Email Updates that can be found on the left hand side of the AHCA COVID-19 resource page under the "Latest AHCA/NCAL Updates" header.

AHCA appreciates your understanding during this challenging time. Once we have passed this crisis, we will substitute this lost ODF session hour in your AHCA PDPM Academy 2020 subscription with a one-hour on-demand CE webinar related to PDPM.

If you have any immediate questions regarding PDPM, or if you have PDPM claims-related problems that your MAC is unable to resolve, please submit your questions to pdpm@ahca.org. COVID-19 questions should be sent to covid19@ahca.org.

AHCA SNF provider members can still register for the AHCA PDPM Academy 2020 Subscription – Building Optimal Operational Capacities©. This exclusive “SNF provider member only” subscription package includes:

  • Seven pre-recorded one-hour educational webinars with 1.25 NAB continuing education (CE) credits and accompanied by AHCA-developed guidance toolkits and other resources covering these topics:
    • Holistic person-centered care planning
    • Evidence-based approaches for improving mobility
    • Effective care transitions at admission and discharge
    • Trend Tracker and other sources to monitor the quality impact of PDPM
    • Managing residents with complex nursing and NTA needs
    • Restorative nursing and skilled maintenance nursing and therapy– Available On- Demand March 31 (see course description below)
    • One additional CE webinar (topic to be announced in the future)
  • Five live PDPM Academy Open Discussion Forums: (On-demand recordings of these forums are available to Subscribers)
  • Access to AHCA’s complete library of 2019 and 2020 PDPM Academy materials 

The 2020 subscription fee is $299 per individual and is available only to AHCA SNF provider members (or individual contracted employees if registering through the AHCA provider member).  The materials, toolkits, forums and webinars in the AHCA PDPM Academy 2020 Subscription package come from the nation’s top experts and are hundreds of dollars less than what private consultants are charging. 

The first on-demand CE course will be available March 31 and is titled Restorative Nursing and Skilled Maintenance Nursing and Therapy. Nearly one-third of SNF resident stays would be eligible for restorative nursing case-mix payment adjustments within the PDPM Nursing Component. Additionally, new flexibilities in therapy service delivery permitted under PDPM create incentives to develop more effective restorative nursing programs to all Medicare Part A residents, including those on an active therapy care plan. This module will highlight restorative nursing and skilled maintenance nursing and therapy best practices under PDPM. 

The Restorative Nursing and Skilled Maintenance Nursing and Therapy session is free with a PDPM Academy 2020 subscription. This educational session can also be purchased a la care at: https://educate.ahcancal.org/p/RestorativeNursingSkilledMaintenanceNursingandTherapy. More in-depth education on specific PDPM related best practices are available for purchase here: https://educate.ahcancal.org/PDPMCEWebinars. The a la carte registration price per individual for each PDPM Academy 2020 CE session is $150 for AHCA members and $650 for non-members. 

To access ahcancalED and register for an AHCA PDPM Academy 2020 Subscription, members need to login with their AHCA/NCAL usernames and passwords. For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail educate@ahca.org with your name and facility contact information. 

HCS Survey Deadline Extended


In light of what skilled nursing and long term care facilities are currently dealing with pertaining to COVID-19, Hospital & Healthcare Compensation Service (HCS) has extended the Nursing Home Salary & Benefits study deadline to Monday, May 18.

Questionnaires are available at https://www.hhcsinc.com/survey-questionnaires.html. Please contact Rosanne Zabka with any questions. 

NEW Video Tutorials Available to Assist with Coding Specific Section GG Items

Dan Ciolek

The Centers for Medicare & Medicaid Services (CMS) released three short video tutorials to assist providers with coding three specific Section GG items of the Minimum Data Set (MDS). These videos, ranging from 5 to 10 minutes, are designed to provide targeted guidance using simulated patient scenarios. To access the videos, click on the links below:

If you have technical questions or feedback regarding the training, please email the PAC Training mailbox. Content-related questions should be submitted to the Quality Reporting Program Help Desk.

Medical Review Audits During COVID-19

Dan Ciolek

AHCA is aware that several members are receiving additional development review (ADR) medical review documentation requests for Medicare Part A, Part B, and Medicare Advantage (MA) services from Medicare contractors and MA plans. Such requests have a limited response time and often require front-line clinical staff to provide the supporting documentation. While AHCA is awaiting clarification from CMS about possible audit relief, we recommend that providers receiving any ADRs immediately contact the contractor or MA plan and request an extension due to the COVID-19 crisis.   

CMS is Delaying Implementation of the October 1, 2020 MDS Update

Dan Ciolek

The Centers for Medicare and Medicaid Services (CMS) announced that they are delaying the Minimum Data Set (MDS) 3.0 v1.18.1 release, which had been scheduled for October 1, 2020. The MDS item sets are used by Nursing Home and Swing Bed providers to collect and submit patient data to CMS. This MDS data informs payment, quality, and the survey process.

This delayed release will eliminate the need for significant SNF MDS training during the upcoming months as well as avoid increased documentation nationwide. 

CMS staff continues to be actively engaged in discussions with AHCA and various other stakeholders, regarding the various changes, the impacts of these changes, as well as, the timeline to educate and train facility staff and update software and IT systems.

Federal Court Orders Appeal Rights on “Observation Status” Issue for Certain Medicare Hospital Patients

Dana Ritchie 

In a decision issued yesterday, March 24, 2020, Judge Michael P. Shea of the U.S. District Court in Hartford, Connecticut found that certain Medicare beneficiaries who are placed on “observation status” at hospitals, rather than being admitted as “inpatients,” have the right to appeal to Medicare.  The case, Alexander v. Azar, is a nationwide class action case filed by the Center for Medicare Advocacy that went to trial in August 2019.  The ruling finds that as a matter of constitutional due process, patients who are initially admitted as inpatients by a physician, but whose status is later changed to observation by their hospital, have the right to appeal to Medicare and argue for coverage as hospital inpatients.

The decision opens the door to medically necessary services in skilled nursing facilities that Medicare beneficiaries might otherwise have to forgo because they cannot afford to pay for it themselves.  The distinction between being labeled a hospital “inpatient” versus being placed on observation status is important because Medicare only covers subsequent care in a skilled nursing facility for patients who were hospitalized as inpatients for three or more consecutive days.  Patients in observation status are considered “outpatients” and thus ineligible for coverage of care at nursing facilities.  You can read the full press article about this on the Center for Medicare Advocacy’s website here

Tuesday, March 24, 2020

Medicare and Coronavirus: What You Need to Know

Seema Verma
Administrator, U.S. Centers for Medicare & Medicaid Services



Since older Americans are particularly vulnerable to coronavirus (COVID-19), I wanted to let you know the steps we’re taking to help our Medicare beneficiaries cope with the pandemic.

We’re warning Medicare beneficiaries that scammers may try to use this emergency to steal their Medicare number, banking information, or other personal data.

Unfortunately, scammers come out of the woodwork during times of uncertainty and change. So make sure you give your Medicare number only to your doctor, pharmacist, hospital, health insurer, or other trusted healthcare provider.

If someone calls you on the phone, says they’re from Medicare, and asks for your Medicare number or other personal information – just hang up.

Remember: Medicare never calls its beneficiaries to ask for or to “verify” Medicare numbers.

My agency finished removing Social Security numbers from all Medicare cards last year in order to reduce fraud and protect Medicare beneficiaries from identity theft. Even with this change, you should guard your Medicare card. Treat it like a credit card. Be sure to check your Medicare claim summaries for errors and questionable bills.

If you suspect Medicare fraud, please report it by calling Medicare’s toll-free customer service center at 1-800-MEDICARE (1-800-633-4227), or by visiting www.medicare.gov/fraud.

I also want to inform you what Medicare covers with regard to coronavirus.

If your doctor orders a COVID-19 test for you, Medicare covers all of the costs. You should not have any cost-sharing.

Medicare also covers all medically necessary hospitalizations. This includes extra days in the hospital for in-patients who were on the verge of being discharged, but were diagnosed with COVID-19 and had to stay longer under quarantine.

There's no vaccine for COVID-19 at this time. However, if one becomes available, Medicare will cover it.

If you have a Medicare Advantage Plan, you have the same benefits as people with Original Medicare. Medicare Advantage plans are now required to have the same cost-sharing for COVID-19 lab tests as Original Medicare: zero.

Medicare also recently expanded its coverage of telehealth services to enable beneficiaries across the country to receive a wider range of healthcare services from doctors without having to travel to a healthcare facility.

These changes allow beneficiaries to communicate with their doctors without having to physically go to a healthcare facility, thus cutting their risk of acquiring or spreading the virus. And frontline clinicians will be better able to stay safe themselves while treating people with Medicare.

Doctors, nurse practitioners, clinical psychologists, and licensed clinical social workers can deliver telehealth services via phone and video chat. Medicare beneficiaries can receive telehealth services in their home as well as in any healthcare facility, including a physician’s office, hospital, nursing home, or rural health clinic.

Telehealth services include routine office visits, mental health counseling, and preventive health screenings for cancer and other illnesses.

By helping healthcare institutions across the nation offer medical services remotely, telehealth helps free up hospital emergency departments and doctors’ offices to deal with the most urgent COVID-19 cases. For example, you can talk with a doctor about your diabetes management or prescription refill without having to go to his or her office.

During this emergency, Medicare will pay for telehealth services at the same rates as in-person services, giving doctors and other clinicians an incentive to use this alternative and reserve their offices to treat those who truly require in-person care.

We know many Medicare beneficiaries are concerned about the spread of coronavirus and the threat it poses to their well-being. That’s why we’ve taken these rapid steps to ensure that the Medicare program continues to protect our beneficiaries while maintaining trusted access to care in these uncertain times.

For additional COVID-19 questions, please email COVID19@ahca.org and visit www.ahcancal.org/coronavirus for more information and resources.

Wednesday, March 18, 2020

SNF Claims Incorrectly Cancelled January 26 - February 16

Dan Ciolek

From January 26 through February 16, 2020, a software issue caused many Skilled Nursing Facility (SNF) Medicare Part A claims to be incorrectly cancelled with a message that there was no three-day qualifying hospital stay. The Centers for Medicare & Medicaid Services (CMS) has informed AHCA that this issue has been corrected and was not caused by the recent implementation of the SNF Patient Driven Payment Model. CMS has provided the following guidance to receive correct payments.  Please share with your billing staff. 

If your claims were incorrectly cancelled, re-bill them in sequential order to receive payment.

Note:
  • Claims need to process in date of service order for each stay for the Variable Per Diem (VPD) to calculate correctly 
  • Submit claims in sequence and wait at least 2 weeks before billing subsequent claims 
  • Some of the affected claims with older dates of service will require a timely filing exception; enter “Resubmission due to non-qualifying stay” in the remarks field 
  • Contact your MAC to receive the Medicare Beneficiary Identifier (MBI) for deceased beneficiaries 


CDC Guidance on Use of Masks, Gowns, and Eye Protection to Conserve Supplies

The Centers for Disease Control and Prevention (CDC) issued today new guidance on the use of masks, gowns and face shields including suggestions on what to do if in crises shortages (which most all of you are in) and when your supplies are exhausted (see below for summary).

As all of you are coming to realize first-hand, the country does not have enough masks and gowns to meet the needs of health care providers, particularly if this pandemic persists for the weeks that experts predict. In order to significantly conserve masks and gowns, nursing homes and assisted living communities need to implement significant conservation steps right now by reviewing the crises capacity strategies in the new guidance issued today by CDC. We strongly urge you to start today in order to extend availability of your remaining PPE until such time as production and supply improves or we can obtain masks and gowns from other health care sectors and manufacturing.  

To help long term care providers take such actions, the CDC's new guidance will be helpful. These recommendations continue to protect from droplet exposure (which is how COVID-19 and most other respiratory viruses are spread). We believe these recommendations help preserve PPE supply given the dire shortage.

We understand that many of you are very close to running out of PPE and that any supplies you receive from your state or federal stockpile need to bridge the time until more masks and gowns become available. Therefore, we urge you to adopt these new guidelines from CDC as soon as possible and for some, that may mean coming up with more creative ways to use or make your own PPE.

Below are the highlights from the new CDC guidance on PPE use:

MASK SUMMARY 
  • Implement extended use of facemasks which allows the wearing the same facemask for repeated close contact encounters with several different patients, without removing the facemask between patient encounters.   
  • Restrict facemasks to use by HCP, rather than patients for source control. Have patients with symptoms of respiratory infection use tissues or other barriers to cover their mouth and nose. 
  • Implement limited re-use of facemasks, which is the practice of using the same facemask by one HCP for multiple encounters with different patients but removing it after each encounter. Discarded if soiled, damaged, or hard to breathe through. 
  • Prioritize facemasks for selected activities, such as: 
    • For provision of essential surgeries and procedures 
    • During care activities where splashes and sprays are anticipated 
    • During activities where prolonged face-to-face or close contact with a potentially infectious patient is unavoidable 
    • For performing aerosol generating procedures, if respirators  
GOWNS SUMMARY 
  • Shift gown use towards cloth isolation gowns 
  • Consider the use of coveralls  
  • Extended use of isolation gowns (disposable or cloth), such that the same gown is worn by the same HCP when interacting with more than one patient known to be infected with the same infectious disease when these patients housed in the same location (i.e., COVID-19 patients residing in an isolation cohort). This can be considered only if there are no additional co-infectious diagnoses transmitted by contact (such as Clostridium difficile) among patients. If the gown becomes visibly soiled, it must be removed and discarded as per usual practices. 
  • Re-use of cloth isolation gowns among multiple patients in a patient cohort area without laundering in between.  
  • Prioritization of gowns for the following activities: 
    • During care activities where splashes and sprays are anticipated, which typically includes aerosol generating procedures 
    • During the high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of healthcare providers, such as: dressing, bathing/showering, transferring, providing hygiene, changing linens, changing briefs or assisting with toileting, device care or use, wound care 
    • When No Gowns Are Available consider pieces of clothing as a last resort, preferably with  long sleeves and closures (snaps, buttons) that can be fastened and secured, particularly for care of COVID-19 patients as single use. Other options include:  
      • Disposable laboratory coats 
      • Reusable (washable) patient gowns 
      • Reusable (washable) laboratory coats 
      • Disposable aprons 
      • Combinations of pieces of clothing can be considered for activities that may involve body fluids and when there are no gowns available: 
        • Long sleeve aprons in combination with long sleeve patient gowns or laboratory coats 
        • Open back gowns with long sleeve patient gowns or laboratory coats 
        • Sleeve covers in combination with aprons and long sleeve patient gowns or laboratory coats  
Reusable patient gowns and lab coats can be safely laundered according to routine procedures.

EYE PROTECTION SUMMARY
  • Implement extended use of eye protection is the practice of wearing the same eye protection dedicated to one HCP for repeated close contact encounters with several different patients, without removing eye protection between patient encounters including for disposable and reusable devices.  
    • Eye protection should be removed and reprocessed if it becomes visibly soiled or difficult to see through.   
    • If HCP touches or adjusts their eye protection they must immediately perform hand hygiene. 
  • Prioritize eye protection for selected activities such as: During care activities where splashes and sprays are anticipated, which typically includes aerosol generating procedures or prolonged face-to-face or close contact with a potentially infectious patient is unavoidable 
  • Consider using safety glasses (e.g., trauma glasses) that have extensions to cover the side of the eyes 
  • Designate convalescent HCP for provision of care to known or suspected COVID-19 patients 
  • Selected options for Reprocessing and clean Eye Protection are provided.  

Registration Is Now Open for AHCA/NCAL Congressional Briefing!



Don’t miss this unique opportunity to come to Washington, D.C. and take action that will directly impact your centers back home.

Congressional Briefing is a chance to meet with your Representatives in person. With guidance and assistance from AHCA/NCAL, you’ll have everything you need to effectively advocate and fight for the quality care you provide.

You’ll also get the latest news about what’s happening on the Hill, network with colleagues, hear from exciting speakers, and earn CEs.

It’s more important than ever to make sure that your Members of Congress understand the challenges you face on a daily basis.

Learn more and register today.

Visit CB.ahcancal.org.


Official Sponsor
Medline

Contributing Sponsors
Navigator, Reliant Rehabilitation

Keep Current with an AHCA PDPM Academy 2020 Subscription: Two New Subscription Events on March 31

Dave Kyllo

AHCA SNF provider members can now register for the AHCA PDPM Academy 2020 Subscription – Building Optimal Operational Capacities©. This exclusive “SNF provider member only” subscription package includes:
  • Six pre-recorded one-hour educational webinars starting in March 2020 with continuing education (CE) credits and accompanied by AHCA-developed guidance toolkits and other resources covering these six topics:
    • Holistic person-centered care planning
    • Evidence-based approaches for improving mobility
    • Effective care transitions at admission and discharge
    • Trend Tracker and other sources to monitor the quality impact of PDPM
    • Managing residents with complex nursing and NTA needs
    • Restorative nursing and skilled maintenance nursing and therapy – Available On- Demand March 31 (see course description below)
  • Six live PDPM Academy Open Discussion Forums: Next Forum is March 31 from 3 p.m. to 4 p.m. EDT. (On-demand recordings of these forums are available to Subscribers)
  • Access to AHCA’s complete library of 2019 and 2020 PDPM Academy materials 
The first on-demand CE course will be available March 31 and is titled Restorative Nursing and Skilled Maintenance Nursing and Therapy. Nearly one-third of SNF resident stays would be eligible for restorative nursing case-mix payment adjustments within the PDPM Nursing Component. Additionally, new flexibilities in therapy service delivery permitted under PDPM create incentives to develop more effective restorative nursing programs to all Medicare Part A residents, including those on an active therapy care plan. This module will highlight restorative nursing and skilled maintenance nursing and therapy best practices under PDPM.  This session is free with a 2020 PDPM Academy subscription.

The 2020 subscription fee is $299 per individual and is available only to AHCA SNF provider members (or individual contracted employees if registering through the AHCA provider member). The materials, toolkits, forums and webinars in the AHCA PDPM Academy 2020 Subscription package come from the nation’s top experts and are hundreds of dollars less than what private consultants are charging. 

To access ahcancalED and register for an AHCA PDPM Academy 2020 Subscription, members need to login with their AHCA/NCAL usernames and passwords.  For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail educate@ahca.org with your name and facility contact information. 

Affordable Online Dementia Care Training That’s Perfect for New Staff & Ongoing Education

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. 

That 15% discount makes CARES very 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 Dementia Basics™ training with another training module and the cost is only $34 per staff member. 

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 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.

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.

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. 

Wednesday, March 11, 2020

2020 Census Procedures Outlined for Long Term Care (LTC) Facilities

Katherine Almendinger

The 2020 Census is underway and AHCA/NCAL is working closely with the Census Bureau to make sure the process goes smoothly and ease any burden on our members.

The Census Bureau has developed special procedures to count individuals living in “group quarters;” including college residence halls, residential treatment centers, skilled nursing facilities, group homes, correctional facilities and workers’ dormitories. Nursing facilities and group homes clearly fall under group quarters. In addition, Intermediate Care Facility for Individuals with Intellectual Disabilities (ICFs/ID) may have been classified as a group home or school for people with disabilities (GQ Type Codes). The status of assisted living and residential care facilities; however, is less clear.

During initial contact, Census workers classified assisted living facilities, residential care facilities and ICFs/ID as either housing units or group quarters, depending on the response from a representative of the facility. Facility representatives self-identified each facility. If an assisted living facility, residential care facility or ICF/ID was identified and classified as “housing units,” then by April 1, 2020, each resident in those settings will receive an invitation to participate in the 2020 Census. You will have three options for responding: on-line, by phone or by mail. If no one in the resident completes the form via on-line, by phone or mail, Census workers will follow up by conducting in-person visits. This is the same procedure the Census Bureau uses for enumerating all residential households.

Assisted living facilities are generally not considered to be group quarters (GQ). However, depending on the level of care provided, certain units, such as memory care units may qualify as group quarters under the definition: "Facilities licensed to provide medical care with seven-day, twenty-four-hour coverage for people requiring long-term non-acute care. People in these facilities require nursing care, regardless of age." Any portion of a facility that does not qualify as a group quarters, such as portions that include independent living and assisted living units, will be included in the housing unit operation. Each individual unit/apartment within the independent living or assisted living facility will receive an invitation in the mail asking that they respond via mail, online, or phone.

For those in housing units, if the individual in the facility is capable, they can fill out the census form, the 2020 Census Questionnaire, themselves. You may help complete the 2020 Census for someone else if asked, or if you are a legal guardian or executor. If this is the case, and you are knowledgeable about the address, please complete the questionnaire for the household. Please keep in mind that you are not responding for yourself. Answer the questions the way the person at this address would.

For group quarters, there are two phases: 1) 2020 Group Quarters Advance Contact (GQAC) (February 3 - March 6), and 2) 2020 Group Quarters Enumeration (GQE) (beginning April 2nd).

During the Group Quarters Advance Contact phase, which applies only to group quarters (including all nursing facilities and group homes), providers will have an opportunity to discuss by phone or receive a personal visit from a Census Bureau worker to discuss, understand, and prepare for enumeration. Providers will also be able to select an enumeration method. LTC facilities will have the following options:

  • Electronic Response Data Transfer (eResponse) – The group quarters administrator fills in a template with group quarters data and respondent level data for each person who is staying at the facility on Census Day (April 1, 2020).  The group quarters administrator electronically sends the census response data to the Census Bureau. Please note: The eResponse option is not available for service-based administrators.
  • In-Person Interview – A census worker conducts a face-to-face in-person interview with each person who is served or staying at the facility on April 1, 2020.
  • Drop-Off/Pickup of Questionnaire – A census worker leaves census questionnaires to be completed by or for each person who is staying at the facility on April 1, 2020. The census worker then picks up the completed questionnaires at an agreed-upon time.
  • Paper Response Data Collection – A census worker meets with the administrator of the facility to obtain a paper listing of census response data for each person who is served or staying at the facility on April 1, 2020.
  • Facility Self-Enumeration – A census worker swears in and trains the group quarters facility administrator and then leaves behind census materials so that the administrator can conduct the enumeration for each person who is living or staying at the facility on April 1, 2020. A census worker then returns to pick up the completed questionnaires at an agreed-upon time. Only military installation group quarters, correctional facilities, and health care facilities can select this option.

During the Group Quarters Enumeration phase, a Census Bureau worker will accept “administrative enumeration,” or Paper Response Data Collection, when counting group quarters if the facility representative determines that this the best procedure to use for their residents. In this case, the facility generates a paper listing of all the individuals in the facility, and the Census worker will develop a system of patient identification numbers from that list. If the individual in the facility is capable, they can fill out the census form, the Individual Census Questionnaire (ICQ), themselves. If the individual is incapable, the enumerator completes the form using administrative records; not medical records. No facility classified as a group quarters should feel compelled to use its own staff to complete the enumeration process. If the facility chooses to self-enumerate, the Census Bureau will provide staff training. Note: Please do not photocopy the ICQ. Each ICQ has a barcode that is unique.

When a Census worker arrives at your facility be aware of the following information:
  • Ask to see the worker’s badge to ensure the worker is from the Census Bureau. 
  • Rest assured that Census information is confidential and protected by law.  
  • Census data is used only for statistical purposes and is public only after 72 years. 
  • None of the information requested by the Census Bureau is protected health care information under the Health Insurance Portability and Accountability Act (HIPAA) (Informational Group Quarters Health Care Facility Manager Letter). 
In light of the current COVID-19 (or Coronavirus) Outbreak across the United States and Abroad, the Census Bureau is committed to taking all precautions to protect the health of both your residents and our census takers. As indicated above, there are five methods of enumeration for group quarters facility managers to consider. While the facility manager may have selected an enumeration method that required face-to-face contact with your residents, there will be an opportunity for facility managers to change that enumeration method to one that will reduce the need for face-to-face contact. During the 2020 Census Group Quarters Enumeration starting April 2, 2020 through June 5, 2020, census takers will began contacting the facilities that were contacted during the Advance Contact operation to confirm their method of enumeration. At that time, your facility manager may choose one of the methods that reduces the need for face-to-face contact. These include: drop off/pick up of questionnaires, paper response data collection, and electronic response data transfer (eResponse).

Please visit the Census Bureau's website at https://2020census.gov/gq for more information about the 2020 Census Group Quarters operation. Please visit their website at https://2020census.gov/en/important-dates.html for more information about the 2020 Census for those facilities or units that identify as housing units.

If you have any questions or concerns, please contact Dora Durante from the Census Bureau or 301-763-9371; or Katherine Almendinger from the American Healthcare Association.

AHCA/NCAL Guidance: Taking Reasonable Efforts to Prevent COVID-19 From Entering Your Long Term Care Facility

We urge members to adopt these additional best practices when possible based on the growing data about the high mortality rate among the elderly over the age of 80 with chronic disease, who comprise the majority of our residents. Waiting until the virus starts to spread in the community, has been shown in prior viral epidemics to be too late.
Centers should review their infection prevention and control policies and procedures for droplet precautions among residents and staff.
  • Assemble your Emergency Preparedness and Operations teams and prepare strategically for a potential spread of the virus.
  • Messaging to the people we serve is best received when the tone is calm, reassuring, and direct. It is important to emphasize both how the entire community is preparing, as well as how individuals can prepare at home.
  • Communication with resident families is especially important during this time. 
  • Staff communication is also important. 
  • Prepare for media inquiries. 
What You Can Do Now

Follow everyday preventive actions such as:
  • Washing your hands
  • Using alcohol-based hand sanitizers
  • Covering your cough
  • Staying home when you are sick 
Providers should contact their state and local health departments if they are unable to place orders for equipment they need. It’s important to note that CDC does not recommend masks for the general public at this point because we need to prioritize that equipment for health care providers.

Due to the very serious impact COVID-19 will continue to have on our elderly population and those with underlying conditions, centers should ask families and visitors to avoid visiting your facility at this time, and limit entrance of non-essential individuals (see our guidance above). Help families connect with residents through alternative methods, such as calling, texting, video chat or social media. 

Prepare Staff
  • It’s important that any staff who are sick stay home. CDC has detailed guidance on this.
  • Acknowledge the current situation and share only verified facts. 
  • Refresh staff with reminder trainings on hand hygiene, proper use of personal protective equipment, and their responsibility to stay home when sick.
  • Reassure staff that it is a similar approach to closures due to weather emergencies – something they are more familiar and comfortable with.
For more resources, visit www.ahcancal.org/coronavirus.

AHCA Offers Two Great Ways to Train High-Quality CNAs

Danielle Levitan

How to Be a Nurse Assistant and CNAonline
Providing Modern Solutions to the Workforce Challenges You Face Today


As you strive to respond to the demands that COVID-19 the corona virus is placing on your staff today, the need for highly skilled, certified, compassionate nurse assistants is more critical than ever. The quality of care you are able to provide depends on it. AHCA’s How To Be a Nurse Assistant training curriculum and CNAonline.com are two options to help you address your frontline staff shortages. Both programs produce highly trained CNAs who elevate the quality of resident care in the centers where they work.

How to Be a Nurse Assistant has been successfully training and preparing students for certification for more than 30 years and has nearly a 100% pass rate. Currently in its 7th edition, the curriculum includes a student textbook, student workbook, skills DVD, and an online instructor website subscription. Learn more about its unique patient-centered care approach and order your training materials here. Place your order during the month of March, and you’ll get 20% off when you use promo code HTB2020.


CNAonline.com is a unique hybrid nurse assistant training program that blends online coursework and in-person clinical and skills training. It’s a flexible and affordable way to offer nurse assistant training in areas where training options are limited. Students and instructors have access to the online content 24 hours a day, and classes can start anytime. CNAonline.com uses the How To Be a Nurse Assistant curriculum. For more information on how to get started, please visit CNAonline.com, or call 502-221-7765.

Tuesday, March 10, 2020

COVID-19 Special Edition of Your Top-Line Released





Kiran Sreenivas

On Monday, March 9, a COVID-19 special edition of Your Top-Line 2020-Q1 was released for skilled nursing centers.

The publication contains a summary of the three memos released by the Centers for Medicare and Medicaid Services (CMS) on March 4, 2020. The second memo (OSO-20-12-ALL) is most directly connected to the infection control data provided in the special edition Top-Line. The memo outlines how CMS is prioritizing survey inspections for infection control practices pertinent to containing COVID-19.

Three Year History of Your Infection Control Deficiencies 

This special edition Top-Line contains a summary of your center’s survey history on infection control. This includes F-tags F880, F881, F883, F441, and F334 over the past three survey cycles, which is roughly the past three years.

The image below is an example of what that summary looks like.


If your center has had an F880 deficiency on infection prevention and control, the text from the latest inspection report is also included in the Top-Line.

COVID-19 Resources

The Top-Line also includes links to COVID-19 resources, such as AHCA/NCAL’s dedicate webpage (www.ahcancal.org/coronavirus) and the CDC’s (www.cdc.gov/coronavirus/2019-ncov/).

AHCA/NCAL has also setup an email box (COVID19@ahca.org) for questions.

Finally, ahcancalED has pulled out relevant modules and resources from the Infection Preventionist Specialized Training (IPCO) and is offering them free of charge here.

Access Your Center’s Top-Line Today Through LTC Trend Tracker

Once you are a registered user of LTC Trend Tracker, you will receive an email whenever a new publication is released. If you missed the email on March 9 or it got caught in a spam filter, you can always access current and historic Top-Lines within LTC Trend Tracker.

This COVID-19 special edition of Your Top-Line can be found in the first quarter of 2020 edition (2020-Q1).

For help accessing or using LTC Trend Tracker, visit the Resource Center or email help@ltctrendtracker.com

Updated ICD-10 Trainings & New ICD-10 Update Courses Available for SNFs

Dave Kyllo

AHCA has partnered again in 2020 with the American Health Information Management Association (AHIMA) to offer two updated online in-depth ICD-10 trainings  and two new 2.5-hour update trainings for staff with ICD-10 coding experience/knowledge. 

The Patient Driven Payment Model (PDPM) relies on rapid and accurate patient assessment and diagnosis, and on MDS and ICD-10 coding to determine payments for each SNF patient. Incorrect or insufficient coding can significantly impact the payment rate for each patient. 

More than 40,000 ICD-10 codes can be used to report the primary reason for a SNF stay on the PDPM MDS assessment.  Building ICD-10 coding proficiency and capacity are essential to ensure proper reimbursement for needed care and services. 

The 2020 ICD-10 trainings are:

  • AHCA/AHIMA ICD-10 Training for PDPM – Full Length Coding and Documentation Training 16 CNEs for nurses or 16 AHIMA CEUs for Health Information Management (HIM) professionals upon completion. Intended for New SNF Staff (or staff interested in a full re-fresher) with Responsibilities for MDS and Billing.   $499 AHCA Member | $599 Non-Member  
  • AHCA/AHIMA ICD-10 Training for PDPM– Full Length Training for Non-Coding Roles 4 CNEs or 4.5 NAB administrator CEs or 4 AHIMA CEUs upon completion. Intended for New SNF Staff (or staff interested in a full re-fresher) Who Need Knowledge About ICD-10-CM Coding to Support Other SNF Staff (e.g., Administrators, Regional Managers, etc.)   $199 AHCA Member | $249 Non-Member  
  • AHCA/AHIMA ICD-10 Coding Updates for PDPM and Expanded Case Examples -- Updates Only Version  2.5 CNEs or 3 NAB administrator CEs or 2.5 AHIMA CEUs upon completion.  Short Update Training on CMS Changes to PDPM ICD-10-CM Codes. Intended for Experienced  SNF Staff with Responsibilities for MDS and Billing.  $99 AHCA Member | $149 Non-Member   
  • AHCA/AHIMA ICD-10 General Updates for PDPM and Expanded Case Examples for Non-Coding Roles -- Updates Only Version 2 CNEs or 2.25 NAB administrator CEs or 2 AHIMA CEUs upon completion. Short Update Training on CMS Changes to PDPM ICD-10-CM Codes Intended for Experienced SNF Staff Who Need Knowledge About ICD-10-CM Coding to Support Other SNF Staff (e.g., Administrators, Regional Managers, etc.)   $99 AHCA Member | $149 Non-Member   

Participants must pass a short test at the end of each module for all courses with a score of 70 or greater to receive CNEs/CEUs.

To register for any of the four ICD-10 courses, go to ahcancal.org/icd10.

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

New Examples Showing How Cleary Energy is Saving AHCA/NCAL Members Money from Unnecessary Utility Bill Overpayments

Dave Kyllo

Cleary Energy  is an AHCA/NCAL preferred provider and has recouped on average 4% to 8% savings on utilities for long term care facility customers. Here are some fresh examples of how nursing facility, assisted living and ID/DD members have saved with Cleary Energy: 

  • Cleary Energy worked with Kentucky Electric Company to find the most beneficial rate for a nursing facility. As a result, a new meter was installed and the utility rate was changed producing an annual savings of $24,000. Total savings of $72,000.
  • Cleary Energy performed an audit for a small Kansas assisted living community.  As a result, the facility received a retroactive savings on electric, natural gas, and water of $6,000 with an annual savings continuing at $200 a month. Total savings of $13,200.
  • Cleary Energy performed an audit for a small group of Tennessee IDD’s.  The IDD’s received a retroactive refund of $4,300 on their water bill with an ongoing monthly savings of $1,200. Total savings of $7,900.

Three out of four long term care facilities are being overcharged for one or more of their utilities. Providers don’t receive better service or any other benefit for overpaying utility companies. The good news is that putting an end to the overpayments is easy.

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

The program is designed to save AHCA/NCAL members significant money on their utility bills without adding new expenses to their budgets.  Cleary Energy guarantees savings or its auditing services are free. Cleary Energy’s fees are based on facility savings on their utility bills. 

AHCA/NCAL member facilities enter into an audit agreement with Cleary Energy, which is a shared savings agreement that lasts for a period of three years. If no refund, savings or credits are received, the AHCA/NCAL member facility owes nothing to Cleary Energy for conducting the audit and AHCA/NCAL members will have the peace of mind of knowing that their facilities are not being overcharged for their utilities.   

The process for engaging Cleary Energy to conduct a utility audit is easy.  Most of the information Cleary Energy needs for an audit comes directly from the utilities or suppliers. 

Cleary Energy’s long term care experience sets the company apart with over 40 years of long term care operational experience. That in-depth knowledge enables Cleary Energy to find the greatest costs savings on utility expenses for AHCA/NCAL members because Cleary Energy knows where to look for savings. 

Take advantage of this unique no-risk opportunity to save on utility costs. Contact Cleary Energy today in one of the three ways listed below. 

www.ClearyEnergy.com
Email:  AHCA-NCAL@ClearyEnergy.com
Phone: (203) 416-6568

AHCA Launches New Tool Giving AHCA Member SNFs Powerful Hospital Referral Data

Dave Kyllo

AHCA today launched a groundbreaking SNF-centered report using hospital, SNF and other post-acute care claims to track patient flow and availability in the SNF’s market area, broken out by clinical categories relevant to the Patient Driven Payment Model (PDPM). The report is called P3©.

The P3© reports are user-friendly and contain powerful marketplace data for AHCA-member SNFs that previously has not been readily available at an affordable price. This report helps AHCA-member SNFs understand their market hospitals' patient mix and discharge practices so the SNF can hone clinical competencies and programming to deliver high-value care under PDPM.

The format of the P3© report is an easy-to-use Excel workbook with four data tabs:

  • Hospital Referral Data: shows discharge patterns from the top 5 hospitals by volume in the SNF’s market; state and national benchmarks; the top SNFs receiving patients from the top 5 hospitals in the market; and, the top 5 hospitals referring to a SNF facility by volume.
  • SNF Length of Stay and Referral Data: shows the LOS for the SNF compared to state and top SNF benchmarks, as well as a summary of the settings the SNF discharges patients to.
  • Market PDPM Data: shows the market’s hospital discharge volume by PDPM category. 
  • Top Hospital PDPM Data: shows hospital discharge volume by PDPM category for the hospital from which the most referrals are received.

The one-year P3© subscription includes four quarterly reports for the member SNF building and the report can be shared with up to five other individuals. In addition to the reports, each subscription includes access to supporting and complementary educational material available through educate.ahcancal.org/p3.

A one-year subscription to the P3©  report is offered at the 2020 introductory price of $750 per SNF per year, plus state and local taxes.  All P3© payments must be made by credit card.  AHCA members may purchase  P3© reports for any SNF in the U.S. 

AHCA/NCAL members must be registered for LTC Trend Tracker to access P3©, including any of the additional individuals given access to the P3© reports.  Members who are already registered in LTC Trend Tracker may simply go to the AHCA/NCAL Data Solutions platform, DataSolutions.ahcancal.org, and log in using their LTC Trend Tracker credentials.  From there, facility members can select and pay for the subscription fee for the SNFs they want to view – one SNF per $750 registration. 

AHCA/NCAL members who have not yet registered for LTC Trend Tracker can register here:   https://www.ahcancal.org/research_data/trendtracker/Pages/default.aspxx.  If members are unsure of whether they have registered for LTC Trend Tracker or have questions about registering, they should email: help@ltctrendtracker.com.

Member questions about P3© may be directed to AHCA’s customer service email: DataSolutions@ahca.org.

Wednesday, March 4, 2020

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

Dave Kyllo


Gero Nurse Prep is on sale through April 30! Save $100 off the regular registration fee by using promo code 2020RN (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.

To learn more about Gero Nurse Prep and ANCC Board certification, watch this video and check out AHCA/NCAL Gero Nurse Prep today.

COVID-19 Webinar Recording Available Now!

Cristina Crawford

The recording to AHCA/NCAL's COVID-19 webinar on March 3 is now available here. Please note that there are two versions, depending on which web browser you are using.

This is a critical issue for long term care as evidenced by the more than 13,000 people who participated in the webinar.

Please continue to check AHCA/NCAL's website for the latest information and resources that AHCA/NCAL has to share about COVID-19. Please email COVID19@ahca.org with any additional questions regarding this virus.

Thank you for everything you are doing to keep our residents, families and staff safe.


AHCA’s ID/DD Providers Hit the Hill

Dana Ritchie

AHCA’s Intellectual and Developmental Disabilities (ID/DD) Residential Services Providers annual Hill Fly-In event occurred last Wednesday at the AHCA offices in DC. AHCA provided one-pagers and talking points for registrants to take to the Hill on issues ranging from Medicaid to the workforce. Rep. Chris Stewart of Utah spoke with the group, along with a panel of former Congressional staffers.  Post the event, the ID/DD providers hit the Hill. AHCA’s ID/DD Comm Chair, Holly Jarek, is pictured here meeting with Rep. Joe Kennedy III of Massachusetts. If you have any questions about this important member event or are interested in attending next year, please contact AHCA’s Senior Director of Not for Profit & Constituent Services, Dana Ritchie.



Life Safety Tips for Compliance with the Most Common Life Safety and Health Care Facilities Code Deficiencies

Sara Rudow

AHCA is providing members with a resource on tips for tackling the most common Life Safety Code (NFPA 101- 2012 edition) and Health Care Facilities Code (NFPA 99-2012 edition) deficiencies and suggestions on how to correct possible deficiencies in your facilities. These tips were developed by members of AHCA’s Life Safety Committee based on deficiencies frequency cited across the country.

For example, the leading deficiency in 2019 was K353- Sprinkler System Maintenance and testing, cited for more than 40% of providers. The tip sheet provides a bulleted checklist of some of the items you should check to help sustain compliance. For example, are you ensuring you have a supply of spare sprinklers, 6 per type of sprinkler in the facility?

Each of the top ten deficiencies was cited in over 10 percent of nursing centers in 2019. From fire drills to cooking facilities, review these tips to determine actions you may need to take in your centers to prevent and correct potential deficiencies with these Life Safety Tips.

2020-2021 NCAL Elections and Solicitation for Candidates

Christy Herle

The 2020-2021 election cycle has officially opened for NCAL members in good standing interested in running for the NCAL Board of Directors. The NCAL elections are for three officer positions (Chair, Vice Chair, Secretary/Treasurer) and seven At-large Representatives. NCAL members interested in running for a NCAL Board position may obtain the necessary candidacy materials online. Applicants must complete and electronically submit by close of business on May 6, 2020. Candidates will submit completed materials by sending an e-mail to Christy Herle.

The NCAL elections will take place during the second Council of States meeting at the AHCA/NCAL 71st Annual Convention & Expo, October 4 - 7 in Austin, TX. Once the application phase has ended, the AHCA/NCAL Credentialing Committee will conduct a certification process for each candidate. Once certification occurs, NCAL will announce the slate of candidates to the membership. If you have further questions, contact Christy Herle.

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

Dave Kyllo

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

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

Whether sending important documents on tight deadlines or shipping small packages, FedEx Express gets shipments where they need to go, when they need to get there. Your AHCA/NCAL membership gets you the most out of shipping options, and PartnerShip can help lead the way.

Here are a few things to know in order to take full advantage of FedEx Express services.

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

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

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

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


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

Stay PDPM Savvy! Register Today for Your AHCA PDPM Academy 2020 Subscription

Dave Kyllo

AHCA SNF provider members can now register for the AHCA PDPM Academy 2020 Subscription – Building Optimal Operational Capacities©. This exclusive “SNF provider member only” subscription package includes:

  • Six pre-recorded one-hour educational webinars starting in March 2020 with continuing education (CE) credits and accompanied by AHCA-developed guidance toolkits and other resources covering these six topics:
    • Holistic person-centered care planning
    • Evidence-based approaches for improving mobility
    • Effective care transitions at admission and discharge
    • Trend Tracker and other sources to monitor the quality impact of PDPM
    • Managing residents with complex nursing and NTA needs
    • Restorative nursing and skilled maintenance nursing and therapy
  • Six live PDPM Academy Open Discussion Forums (January 28 Open Forum recording is available to Subscribers)
  • Access to AHCA’s complete library of 2019 and 2020 PDPM Academy materials 

The 2020 subscription fee is $299 per individual and is available only to AHCA SNF provider members (or individual contracted employees if registering through the AHCA provider member).  The materials, toolkits, forums and webinars in the AHCA PDPM Academy 2020 Subscription package come from the nation’s top experts and are hundreds of dollars less than what private consultants are charging. 

To access ahcancalED and register for a AHCA PDPM Academy 2020 Subscription, members need to login with their AHCA/NCAL usernames and passwords. For assistance obtaining AHCA/NCAL usernames and passwords, please e-mail educate@ahca.org with your name and facility contact information. 

The Proof is in the Outcomes: RNs Trained in Gerontological Nursing Get Better Results!

Dave Kyllo

Research conducted by AHCA/NCAL in 2019 shows that SNFs that employ at least one American Nurses Credentialing Center (ANCC) Board certified RN experienced:

  • Higher average SNF VBP Performance Scores (44.2 versus 34.4 national average) 
  • 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 developed and managed by UNMC’s College of Nursing 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 went on sale this week through April 30! Save $100 off the regular registration fee by using promo code 2020RN (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.” 

AHCA/AHIMA Launch New Online ICD-10 Trainings for SNFs

Dave Kyllo

AHCA has partnered again this year with the American Health Information Management Association (AHIMA) to offer two updated online in-depth ICD-10 trainings and two new 2.5-hour update trainings for staff with ICD-10 coding experience/knowledge.

The Patient Driven Payment Model (PDPM) relies on rapid and accurate patient assessment and diagnosis, and on MDS and ICD-10 coding to determine payments for each SNF patient. Incorrect or insufficient coding can significantly impact the payment rate for each patient.

More than 40,000 ICD-10 codes can be used to report the primary reason for a SNF stay on the PDPM MDS assessment. Building ICD-10 coding proficiency and capacity are essential to ensure proper reimbursement for needed care and services.

The 2020 ICD-10 trainings are:

  • AHCA/AHIMA ICD-10 Training for PDPM – Full Length Coding and Documentation Training 16 CNEs for nurses or 16 AHIMA CEUs for Health Information Management (HIM) professionals upon completion. Intended for New SNF Staff (or staff interested in a full re-fresher) with Responsibilities for MDS and Billing. $499 AHCA Member | $599 Non-Member  
  • AHCA/AHIMA ICD-10 Training for PDPM– Full Length Training for Non-Coding Roles 4 CNEs or 4.5 NAB administrator CEs or 4 AHIMA CEUs upon completion. Intended for New SNF Staff (or staff interested in a full re-fresher) Who Need Knowledge About ICD-10-CM Coding to Support Other SNF Staff (e.g., Administrators, Regional Managers, etc.) $199 AHCA Member | $249 Non-Member   
  • AHCA/AHIMA ICD-10 Coding Updates for PDPM and Expanded Case Examples -- Updates Only Version 2.5 CNEs or 3 NAB administrator CEs or 2.5 AHIMA CEUs upon completion. Short Update Training on CMS Changes to PDPM ICD-10-CM Codes Intended for Experienced  SNF Staff with Responsibilities for MDS and Billing. $99 AHCA Member | $149 Non-Member   
  • AHCA/AHIMA ICD-10 General Updates for PDPM and Expanded Case Examples for Non-Coding Roles -- Updates Only Version 2 CNEs or 2.25 NAB administrator CEs or 2 AHIMA CEUs upon completion. Short Update Training on CMS Changes to PDPM ICD-10-CM Codes Intended for Experienced SNF Staff Who Need Knowledge About ICD-10-CM Coding to Support Other SNF Staff (e.g., Administrators, Regional Managers, etc.) $99 AHCA Member | $149 Non-Member   

Participants must pass a short test at the end of each module for all courses with a score of 70 or greater to receive CNEs/CEUs.

To register for any of the four ICD-10 courses, go to ahcancal.org/icd10.

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