UPDATE Weekly

Registration is now open for several instructor-led training courses for providers that will be held in February 2016. Following are details on the courses, and instructions for how to enroll:

Thursday, February 4th – 9:30 AM to 12:30 PM – Prior Approval – Institutional

This course will cover submitting Prior Approval (PA) Requests with a focus on Nursing Facilities, to help ensure compliance with Medicaid clinical coverage policy and medical necessity. It will also cover Prior Approval inquiry to check on the status of the PA Request. The course is being offered in-person at the CSC facility in Raleigh. It includes hands-on training and will be limited to 45 participants.

Thursday, February 4th – 1:00 PM to 4:00 PM – Submitting an Institutional Claim

This course will focus on how to submit an Institutional Claim via the NCTracks Provider Portal with emphasis on Long Term Care and Secondary Claims. At the end of training, providers will be able to enter an Institutional claim, save a Draft claim, use the Claims Draft Search tool, submit a claim, and view the results of a claim submission. The course is being offered in-person at the CSC facility in Raleigh. It includes hands-on training and will be limited to 45 participants.

Providers can register for these courses in SkillPort, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access SkillPort. Open the folder labeled Provider Computer-Based Training (CBT) and Instructor Led Training (ILT). The courses can be found in the sub-folders labeled ILTs: On-site and ILTs: Remote via WebEx, depending on the format of the course. Refer to the Provider Training page of the public Provider Portal for specific instructions on how to use SkillPort. The Provider Training page also includes a quick reference regarding Java, which is required for the use of SkillPort.

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Overnight rooms are still available for the NCHCFA Annual Convention and Expo at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center, Greensboro, NC. Call the Sheraton today at (800) 242-6556 to make your room reservation. Identify that you are with “NC Health Care Facilities Association 2016 Convention” to receive the group discounted rate.

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Register today for the NCHCFA Annual Convention and Trade Show, The Art of Caring, February 21-24, 2016 at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center in Greensboro, NC! Don’t miss the opportunity to earn up to 15.5 hours of educational credit for North Carolina Nursing Home Administrators, as well as up to 14.5 hours of Nursing CE credit! The advanced registration deadline is Friday, February 5th. To register or obtain an additional brochure visit the Member Center of the Association’s Web site at http://www.NursingHomesNC.com.

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Election of officers and members of the Board of Directors will be conducted on Monday, February 22nd, during NCHCFA’s Business Meeting. The business meeting will be held in conjunction with NCHCFA’s 2016 annual Convention in Greensboro. All persons seeking an office or a position on the Board of Directors should have their name submitted to the Nominating Committee by Friday, February 12th. The nomination must be submitted in writing or e-mailed and include the candidate’s full name, the office being sought and the facility or company of employment. Please mail or e-mail the information to the attention of:

By Mail:

Nominating Committee
North Carolina Health Care Facilities Association
5109 Bur Oak Circle
Raleigh, NC 27612

By Email:

Karen Lennon, NCHCFA, karenl@nchcfa.org

Nominating Committee: David Kidder (Chair), Cheryl Clapp-Coleman and Kevin Cox.

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Electronic submission of staffing data through the Payroll-Based Journal (PBJ) is required of all Long Term Care Facilities STARTING July 1, 2016. Voluntary submission of staffing data has already begun. ALL nursing homes will need to register to submit data in order to meet this requirement and maintain compliance. Please follow the below instructions to register:

• Step 1: Obtain a CMSNet User ID for PBJ Individual, Corporate and Third Party users, if you don’t already have one for other QIES applications (https://www.qtso.com/cmsnet.html)(many users may already have this access for MDS submission).
• Step 2: Obtain a PBJ QIES Provider ID for CASPER Reporting and PBJ system access (https://mds.qiesnet.org/mds_home.html)
• Training: PBJ Training Modules for an introduction to the PBJ system and step by step registration instruction are available on QTSO e-University, select the PBJ option https://www.qtso.com/webex/qiesclasses.php.

More information is available on the PBJ Website, https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html

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The North Carolina Health Care Facilities Association would like to thank our 2016 Gold Convention Hosts for supporting the upcoming Annual Convention & Expo – The Art of Caring. Be sure to visit them at the booths on Tuesday, February 23rd during Expo 2016 – The Art of Patriotism.

Blue Ridge Pharmacy – Booths 531 & 632
Healthcare Services Group – Booths 526 & 528
Legacy Consultant Pharmacy – Booth 520
Medipack Pharmacy – Booths 213 & 215
Neil Medical – Booths 301, 303, 400 & 402
NH Medical Services – Booths 417 & 516
PruittHealth – Booths 323, 325, 327, 329, 422, 424, 426 & 428
Southern Pharmacy – Booths 501 & 503

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On December 28, 2015, the Centers for Medicare & Medicaid Services (CMS) released a request for information (RFI) and statement of work (SOW) soliciting industry feedback on its plans to expand the Medicare Recovery Audit Contractor (RAC) program to Medicare Advantage (MA) organizations. Under the current program, CMS contracts with private RACs to audit providers’ Part A/Part B medical and billing records. CMS then pays RACs a contingency fee based on the amount of overpayments collected.

The draft SOW indicates that CMS is planning to incorporate RACs into its MA Risk Adjustment Data Validation (RADV) audit process. RADV audits seek to verify the accuracy of beneficiary diagnosis data submitted by MA plans, which is then used to calculate and risk-adjust monthly plan payments. The SOW indicates that errors and omissions in diagnosis data account for 9.5 percent of the improper payment rate for MA. By expanding the RADV audit process to incorporate RACs, CMS intends to increase the number of reviews from 30 audits a year (approximately 5 percent of all MA plans) to having “all MA contracts subject to” either a comprehensive or condition-focused RAC audit.

Plans selected to participate in a RADV audit are required to submit member medical records to validate diagnosis data. As the volume of audits increases under the MA RAC program, plans will be under immense pressure to obtain the documentation necessary to meet CMS’ standards and will likely request additional documentation from providers. This could create a significant burden.

However, under CMS’ RADV requirements, MA plans are not able to request this documentation from American Health Care Association (AHCA) members. Only documentation from physician offices, hospital inpatient and hospital outpatient settings can be submitted for evaluation; skilled nursing centers are explicitly excluded from the list of acceptable provider types. Therefore, beyond the requirements dictated by the plan/provider contract, facilities are under no obligation to provide additional documentation for purposes of RADV audits. AHCA members should monitor communications with MA plans to ensure that plans do not impose any undue burden to contracted facilities.

AHCA and NCHCFA continue to evaluate the RFI and SOW to identify potential downstream impacts for our members and will keep you informed of any developments.

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The Centers for Medicare & Medicaid Services (CMS) will host a Special Open Door Forum (SODF) on Understanding the IMPACT Act-Measure Alignment and IMPACT Outcomes on Tuesday, February 2, 2016 from 2:00 to 3:00 PM ET.

The purpose of this SODF call is to provide information and solicit feedback pertaining to the Improving Medicare Post-Acute Care Transformation Act of 2014 (commonly referred to as the IMPACT Act). The IMPACT Act mandates the standardization of patient assessment data across post-acute care settings including Skilled Nursing Facilities, Home Health Agencies, Inpatient Rehabilitation Facilities, and Long Term Care Hospitals in order to improve quality of care and quality of life.

This Special Open Door Forum will offer discussion on the history of the IMPACT Act, including discussion of what is the IMPACT Act, how CMS is standardizing quality measures and data items, and what is the Skilled Nursing Facility Quality Reporting Program (commonly referred to as the SNF QRP). This SODF will serve as a platform to update consumers, stakeholders, researchers, and advocates alike on the work around the IMPACT Act.

You may submit questions to PACQualityInitiative@cms.hhs.gov. You may follow along during the call from the PowerPoint slides that were posted to https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Post-Acute-Care-Quality-Initiatives/IMPACT-Act-of-2014/IMPACT-Act-Downloads-and-Videos.html.

To participate, dial (800) 837-1935 and reference conference ID # 17589814.

A transcript and audio recording of this Special ODF will be posted to the Special Open Door Forum Website at http://www.cms.gov/OpenDoorForums/05_ODF_SpecialODF.asp for downloading. For automatic e-mails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit http://www.cms.gov/opendoorforums.

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Alliant Quality wants to encourage SNFs to keep signing up for the National Collaborative – or SPACE. Alliant recommends having as much time as possible to get started on QAPI improvement work and improving facility quality measures in a systems approach to improve their five star and composite scores.

Alliant Quality is the Medicare Quality Innovation Network (QIN)-Quality Improvement Organization (QIO) for North Carolina. Under contract with the Centers for Medicare & Medicaid Services (CMS), Alliant Quality invites your nursing home to participate in a collaborative designed to ensure that every nursing home resident receives the highest quality of care.

The Collaborative offers an exciting opportunity to learn from high performing nursing homes regarding their processes as they pertain to consistent/permanent staff assignment, teamwork and communications, leadership, regulatory compliance, clinical models, and quality of life indicators. The Collaborative aligns national nursing home quality initiatives and partnerships such as the Advancing Excellence in America’s Nursing Homes Campaign, The Partnership to Improve Dementia Care, and Quality Assurance Performance Improvement (QAPI). Targeted focus areas will include increasing mobility, decreasing unnecessary use of antipsychotics in residents with dementia, decreasing potentially avoidable hospitalizations and decreasing healthcare acquired infections and conditions.

When ready to register, click here for the Participation Agreement and fax or e-mail it back to Lisa Klemis. For more details, e-mail Jennifer Brock at Jennifer.Brock@area-F.hcqis.org or call (678) 527-3417.

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Join Alliant Quality for a 30 minute Care Coordination Quick Call. This monthly series is the first Wednesday of the month at 1:00 PM. The next installment is February 3, focusing on Creating and Keeping a Coaching program going- Success Stories

Teleconference Number: (800) 747-5150
Access Code: 9963169

Questions to consider for this call:

a) How has technology played a role in successful transition of the patients?
b) With the Coleman Care Transition Intervention, how do the steps of transition management occur?
c) Do you have data that support how you are filling in the gaps you see in the delivery of care?
d) What changes does CMS require that has an impact on the effectiveness of coaching programs?
e) Is coaching effective to keep patients out of hospital for longer periods of time (>30 days)?

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When you have to replace an RN, the average cost is one hundred thousand dollars. By the time you find the right candidate, hire, train, and help them become productive, it could cost 150% of their base salary. It’s a lot less expensive to keep the employees you have, especially in a competitive market!

• Gero Nurse Prep prepares RNs for successful attainment of board certification as Gerontological Nurses, the gold standard of excellence.
• Employer support for continuing education and board certification can increase RN job satisfaction.
• Satisfied, well-trained, and committed RNs provide better quality care.
• RN satisfaction and a supportive workplace are linked to decreased turnover rates.

In addition to staff retention, your support of certification is an investment in your center’s performance, reputation, and residents. To learn more about these and other benefits of the course please go to http://geronurseprep.org.

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Improving the use of antibiotics in healthcare to protect patients and reduce the threat of antibiotic resistance is a national priority. Antibiotic stewardship refers to a set of commitments and actions designed to optimize the treatment of infections while reducing the adverse events associated with antibiotic use. CDC’s Core Elements of Antibiotic Stewardship in Nursing Homes provides practical ways for nursing homes to initiate or expand antibiotic stewardship activities. This recently released resource is designed to help nursing homes improve antibiotic prescribing practices and reduce inappropriate use to protect residents from the consequences of antibiotic-resistant infections, such as C. difficile.

Date: February 2, 2016 – 2:30pm – 4:00pm (EDT) Registration is now open: Click here to Register

Speakers: Nimalie Stone, MD, Medical Epidemiologist – Centers for Disease Control and Prevention
Leonard Russ, Principal Partner, Owner Administrator – Bayberry/CPR Associates

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This book covers 28 challenging cases that cover pivotal issues that most health care administrators and managers are likely to encounter at some point in their work – quality improvement, strategic planning, ethical dilemmas, organizational dynamics, cost-benefit analyses, resource utilization, and more. Providing an exceptional framework for decision-making and debate, Cases in Health Services Management is an outstanding casebook that provokes thought and discussion.

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

Product # 8248
AHCA Members (on-line price) $64.95

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If you missed Upcoming Hospice Regulations seminar, the notebook/presentation is now available for purchase. To order, e-mail your request to Donna Snyder at donnas@nchcfa.org. The cost is $25 plus tax and shipping.

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The Overlooked Way That Companies Can Make Workers More Loyal

http://www.huffingtonpost.com/entry/employee-happiness-loyalty_us_56a7d1ece4b0b87beec645dd

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The rumbling sound your stomach sometimes makes is called a “borborygmi.”

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