UPDATE Weekly

NC Health Care Facilities Association presents RESTORING QUALITY SLEEP-IMPROVING RESIDENT CARE AND QUALITY OF LIFE. This seminar will be offered in Charlotte on April 23rd and again in Chapel Hill on April 24th and will be presented by Sue Ann Guildermann with Empira – Back by popular demand! This session will:

• Restate the key components of the Empira Fall Prevention program.
• Explain the process that leads to the Empira Restorative Sleep Vitality Program.
• Discuss the etiology of sleep and wake in human beings.
• Identify the key components of the Empira Restorative Sleep Vitality Program.
• The top 10 disturbances to sleep.
• Five operational actions a long-term care provider can do to prevent sleep disturbance.

The cost to attend this seminar is $195 for members and $390 for non-members. This fee includes handouts, snacks, and lunch. YOU CAN REGISTER AND PAY ONLINE! TO REGISTER, GO TO http://NursingHomesNC.com AND CLICK ON RESTORING QUALITY SLEEP. You may also download a brochure. Members may be invoiced. Non-members must submit payment on-line or mail with registration. Registration is open to anyone who would like to attend!

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“Living the Aloha Spirit” is this year’s theme for National Nursing Home Week! The American Health Care Association (AHCA) will be adapting this theme to reflect how the profession and every skilled care center honors and practices the aloha spirit in order to sustain a quality and harmonious environment for residents, patients, families, staff and individuals who interact with the long term and post-acute care community in any capacity.

AHCA has put together a group of fantastic products that reflects this vibrant theme so that you and your staff can bring Hawaiian joy and happiness to your residents. Visit AHCA’s on-line store to view the colorful and fun product line for this special week! (Don’t wait until the last minute! National Nursing Home Week products are very popular and will sell out quickly!) National Nursing Home Week is May 11-17, 2014!

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The NC State Board of Examiners for Nursing Home Administrators will offer the 2014 Preceptor Seminars on April 28-29, 2014 and April 29-30, 2014 at the Kingston Plantation, Myrtle Beach, SC. You will need to choose the first seminar dates for Renewal Preceptor certification and the second seminar dates for Initial Preceptor Certification and Continuing Education Only. The seminars will be open to all nursing home administrators seeking continuing education credits and/or preceptor certification. This is the only Preceptor Seminar being planned for 2014 by the NC State Board of Examiners for Nursing Home Administrators.

Click here to download more information along with the registration form.

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During the NCHCFA Annual Convention, NCTracks presented the program “Navigating NCTracks” for facility billing staff on Tuesday, February 25th. During this session, NCTracks representatives responded to questions that they had received prior to the session. This information has now been posted to the NCHCFA Web site. Any new issues that were brought up during the session are still being researched. The posted information will be updated when the new information comes available.

To access the posted questions and responses, click here. Please share sure this valuable information with your billing staff.

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On Monday, the Department of Health and Human Services submitted their detailed plan for reforming the State’s Medicaid program to the General Assembly for consideration. The report’s recommendations will require legislative approval and it is likely the General Assembly will make modifications.

Last year’s proposal centered on establishing 3-4 Community Care Entities that would manage all Medicaid services statewide. The CCE’s would then contract with private for profit or not for profit managed care companies (MCOs). The plan rolled out on Monday abandons the MCO in favor of North Carolina based physician and hospital led Accountable Care Organizations (ACOs).

• North Carolina Medicaid services for physical health will be coordinated through accountable care organizations (ACOs) that share savings and losses with the State and are responsible for quality. ACOs’ coverage of the population and financial accountability will rise progressively; DHHS will benchmark progress.
• Enhance the state’s Medicaid mental health, substance abuse and intellectual/developmental disability service delivery system by combining existing LMEs into 3 statewide entities.
• Streamline and strengthen coordination of care for long-term services and supports (LTSS).

Although nursing facilities, and other long term care providers, would be able to participate in the ACO model, these services are excluded from the ACO formula because ACO providers initially would have limited impact on spending for these services.

The report acknowledges that North Carolina’s Medicaid beneficiaries who receive long-term services and supports (LTSS) remain simultaneously one of the most vulnerable and least coordinated of all Medicaid beneficiary populations. As a consequence, individuals with long-term support needs face a confusing and sometimes conflicting array of service networks, which are often location-specific, with varied enrollment procedures and coordination practices. To provide optimal long-term supports and services to Medicaid beneficiaries and to better integrate the care needs of the whole person, the report states that the essential aims of Medicaid reform as it relates to the LTSS population are:

• Beneficiaries receiving LTSS experience clear, responsive, user-friendly points of entry into the LTSS system.
• Beneficiaries are informed about all available LTSS options.
• The LTSS service delivery system facilitates opportunities to holistically support a person and strengthen coordination of care.
• LTSS workforce competencies around case management, options counseling, transition planning and integrated care are elevated.
• Information technology (IT) platforms effectively meet the short-range and long-term needs of the reformed LTSS system.

How these objectives are to be shaped for North Carolina’s long-range context, will be determined through a year-long strategic planning process. DHHS will lead this planning effort and will engage stakeholders – beneficiaries and families, state agency staff, providers and advocacy groups – to establish a strategic direction for long-term services and supports in the state.

The entire Medicaid reform report can be found at http://www.ncdhhs.gov/pressrel/2014/DHHS_Medicaid_Reform_Legislative_Report-2014-03-17.pdf. The section on LTSS reform begins on page 33.

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Since the state launched NCFAST the food stamp program has been experiencing deep backlogs. Due to a US Department of Agriculture funding threat, DHHS must resolve all backlogged cases within the federally required timeframe.

As an example of delays providers are experiencing, Liz Scott, with Wake County’s Health and Human Services, stated, “We are not current on Medicaid applications by any means. We have pulled staff to work on food and nutrition. We have had to prioritize what people are doing to meet certain deadlines.”

While Scott says they have been working around the clock tackling the food stamp issues, she admits the Medicaid applications have taken a back seat. Currently, Scott says there are 1,700 overdue Medicaid applications just in Wake County, but that does not include all the applications from HealthCare.gov.

Scott says they do have a plan in place to tackle this backlog. They are hiring additional workers and have several vacancies to fill. Unfortunately, they expect Wake County to be caught up in October, which is seven months away. This is just not a Wake County issue. North Carolina has received 40,000 Medicaid applications through HealthCare.gov.

A report done by WTVD in Raleigh on the Medicaid backlog can be viewed by clicking here.

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Submissions are open for the 2014 AHCA Quality Initiative Recognition Program! Skilled nursing members have the opportunity to be recognized for demonstrating achievement of the AHCA Quality Initiative goals. Members have until Thursday, May 1, 2014 to submit their data qualifying them for recognition. All members recognized through the program will be honored at AHCA/NCAL’s 2015 Quality Symposium in Austin, Texas, and additional honors will be bestowed to those achieving multiple goals.

Learn more about the recognition levels, eligibility requirements and submission steps on AHCA’s website. Please e-mail qualityinitiative@ahca.org with any questions about the Recognition Program.

While nursing centers do not need to submit data for their hospital readmissions and antipsychotic use, centers must submit staff turnover data and customer satisfaction results to AHCA by May 1, 2014.

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AHCA is conducting its annual, nationwide staffing survey to examine retention and turnover rates for nursing center employees. The 2013 Staffing Survey is open to all nursing centers in the U.S., which are asked to complete and return the survey by Thursday, May 1, 2014. Individual center and company responses to the survey will be kept confidential. Published results will appear in the aggregate form only. NCHCFA member centers that wish to be recognized for their nursing staff turnover results through AHCA/NCAL’s 2014 Quality Initiative Recognition Program must participate in the AHCA 2013 Staffing Survey. Submit your staffing data today!

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Last week providers received some relief when the Centers for Medicare & Medicaid Services (CMS) announced that it would “pause” reviews under its Recovery Auditor Contractor program. The reviews were principal culprits behind a monstrous backlog of audit appeals that has swamped the agency.

The original CMS announcement left open questions about whether the Manual Medical Reviews (MMRs) would be included. CMS has now clarified that the manual reviews are on hold as well. Additionally, CMS says that it’s tweaking its audits to address many provider concerns. The agency says its thinking about changing contracts so that auditors must:

Wait at least 30 days “to allow for a discussion” if a provider says that he or she will appeal an audit decision. Previously, auditors had to end talks when notified of an appeal and wait to be paid any contingency fees until after the second level of administrative appeals has concluded. Previously, auditors were allowed to take the cash even if a case was on appeal and adjust their document requests to a provider’s denial rates. Overall, advocates say they’re pleased with CMS’ new posture but still say the central problem isn’t so much the audit process as the audit policy itself.

“There’s no question this process has been both difficult and frustrating for our members and the beneficiaries we serve every day,” says Neil Pruitt, Jr., chairman and chief executive officer of PruittHealth and a board member of the American Health Care Association and the North Carolina Health Care Facilities Association. “I’m pleased we’re making some progress, and that CMS has attentively listened to our concerns, and wants to work with us to find a quick remedy. While the ‘pause’ is welcome, we will continue pushing the agency on the promised transparency and timeliness behind these reviews. I’m encouraged CMS shares that same commitment.”

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In response to provider requests, CMS has posted a listing of providers who have been sent a request to revalidate their Medicare enrollment information. The listing contains the name and national provider identifier (NPI) of each provider sent a letter, as well as the date the letter was sent. Lists of providers sent notices to revalidate their Medicare enrollment may be found on the CMS Web site on the Medicare Provider Supplier Enrollment Revalidation Page. From the page please select the Revalidation link and scroll down to the bottom of the page. Under downloads, all of the files are listed.

CMS will be updating this list monthly. If you are listed and have not received the request, please contact the Palmetto GBA Provider Contact Center at (855) 696-0705. For more information on revalidation of Medicare provider enrollment, see MLN article 1126 Further Details on the Revalidation of Provider Enrollment Information.

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Keep people with dementia fully engaged in daily life and help them maximize remaining functional skills by tapping into their innate abilities and interests. Engaging and Communicating with People Who Have Dementia is a trove of advice on how to identify people’s strengths and preferences and then use this knowledge to improve activity programming, communication, and functional independence.

To order, visit http://www.AHCApublications.org or call (800) 321-0343.

Product # 8311
AHCA Members (on-line price) $44.95

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Important information for residents and families. This brochure outlines what physical restraints are, when they should be used, rules and regulations concerning restraints, and making decisions about using them. Contact Jan Williams at janw@nchcfa.org to order brochures for your facility.

NCHCFA Member: $30.00 per 100 brochures plus tax and shipping
Non-Members: $60.00 per 100 brochures plus tax and shipping

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Alzheimer’s is more likely to strike women and puts more demands on women as caregivers.

http://www.usatoday.com/story/news/nation/2014/03/19/alzheimers-disease-caregiving/6566179

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Cotton candy was invented by a dentist.

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