UPDATE Weekly

Pat Boyer, RN, MSM, NHA of Boyer & Associates will present Essentials for Medicaid & Medicare Using the MDS 3.0! In 2012, CMS implemented changes to the RAI manual that have affected your MDS process and your reimbursement system. This workshop will cover those changes. We will also look closely at internal processes to ensure accurate completion of Change of Therapy assessments. In addition, Pat will review how the RUGs III system will crosswalk to the MDS 3.0 so that facilities can maintain their Medicaid Case Mix reimbursement.

Learning Objectives:

• Identify how the 2012 changes will affect your MDS system and what is in store for 2013
• Discuss how to monitor therapy services in the new reimbursement environment
• Determine strategies for managing Medicare Reimbursement and the new rules
• Describe strategies for appropriate management of Medicaid Reimbursement using the MDS 3.0
• Describe strategies for appropriate management of Medicare Part A Reimbursement using the MDS 3.0

YOU MAY REGISTER AND PAY ON-LINE! Please visit http://NursingHomesNC.com and click on Essentials for Medicaid & Medicare Using the MDS 3.0!

• June 19th – Sheraton Imperial, Durham, NC
• June 20th – Hilton Charlotte University Place, Charlotte, NC

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Make plans today to join your colleagues for the NCHCFA Summer Symposium. The three-day event will be August 6-8, 2013 at the Marriott Grande Dunes Resort, Myrtle Beach, SC. Call the Marriott Resort at (800) 228-9290 to reserve your overnight room. Identify yourself as a NC Health Care Facilities Association Convention attendee! To make your reservation on-line, visit http://tinyurl.com/2013symposiumreserve. Please note that when our room block is full, rooms will be on a first come, first served basis at prevailing published rates.

Please call the Association office at (919) 782-3827 with any questions. Brochures will be available very soon!

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Capitol Connection is published several times each month by the American Health Care Association. Each issue contains information that may positively impact your facility. The May 28th issue includes important information on the Affordable Care Act requirements and other items helpful in running an effective facility. To access the latest issue, as well as past issues, click here.

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Mark your calendar today for the North Carolina Health Care Facilities Association’s “Falls Prevention-Train the Trainer” with Sue Ann Guildermann! This comprehensive two-day program will cover Empira’s comprehensive fall prevention and reduction program in more detail. If you missed Sue Ann’s one-day seminar in March, you will NOT want to miss this two-day program!

This two-day course will be held November 13-14, 2013 in Greensboro, NC. Brochures will be mailed this fall! You must attend both days to receive credit.

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CMS released two new S&C Memoranda (with attachments) related to new guidance on improving care for persons with dementia and reducing antipsychotic drug use in nursing facilities:

1. S&C: 13-35-NH: Advanced Copy: Dementia Care in Nursing Homes: Clarification to Appendix P State Operations Manual (SOM) and Appendix PP in the SOM for F309 – Quality of Care and F329 – Unnecessary Drugs –

http://nursinghnc.webfactional.com/files/2013/05/SC13-35-01_NH_Partnership_to_Improve_Care_of_resident_with_dementia.pdf

http://nursinghnc.webfactional.com/files/2013/05/SC13-35-02_NH_Partnership_Attach_A_-_SOM_Appendix_P.pdf

http://nursinghnc.webfactional.com/files/2013/05/SC13-35-03_NH_Partnership_Attach_B_-_SOM_Appendix_PP.pdf

http://nursinghnc.webfactional.com/files/2013/05/SC13-35-04_NH_Partnership_Attach_C_-_Surveyor_Checklist.pdf

2. S&C: 13-34-ALL: Release of Mandatory Surveyor Training Program on Care of Persons with Dementia and Unnecessary Antipsychotic Medication Use – Release of Third Video

http://nursinghnc.webfactional.com/files/2013/05/SC13-35-04_NH_Partnership_Attach_C_-_Surveyor_Checklist.pdf

S&C: 13-35-NH references revisions to surveyor guidance. CMS notes revised highlights and re-emphasizes key principles in the nursing facility regulations including:

• Person–Centered Care
• Quality and Quantity of Staff
• Thorough Evaluation of New or Worsening Behaviors
• Individualized Approaches to Care
• Critical Thinking Related to Antipsychotic Drug Use
• Interviews with Prescribers
• Engagement of Resident and/or Representative in Decision-Making

Updates to Appendix P (provided in Attachment A to this memorandum) include changes to the resident sampling process for the traditional survey (changes to QIS were included in the recent 10.1.3 release), intended to ensure that the survey sample includes an adequate number of residents with dementia who are receiving an antipsychotic medication.

Updates to Appendix PP (provided in Attachment B to this memorandum) include:

• A new section of interpretive guidance at F309 related to the review of care and services for a resident with dementia
• Revisions to the antipsychotic medication section of Table1at F329
• New severity example at the end of the interpretive guidance at F329 (Unnecessary Drugs)

A surveyor checklist that may be used in either the traditional or QIS process (modeled after the Critical Element pathways) is also provided as Attachment C to this memorandum. This checklist is not part of the SOM.

The second memorandum, S&C: 13-34-ALL, provides information about the third and final training video in the three-part series of mandatory surveyor trainings CMS has prepared on this topic. The first two modules of the training program were released earlier this year. This third installment of the training addresses how to cite severity level and other aspects of deficiency citations in more detail, based on the new guidance at F309, Care of Residents with Dementia, and revised guidance at F329 referenced in S&C: 13-35-NH. This training module is 35 minutes in length and will be available after May 31st. The memorandum provides instructions for accessing this content.

Yesterday you received a memorandum regarding these releases from Cindy H. Deporter, MSSW; NC Department of Health and Human Services; Branch Manager Quality Evaluative Systems Nursing Home Licensure and Certification; Division of Health Service Regulation. Please refer to that memo for additional information.

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Federal regulations require that Medicare- and Medicaid-certified nursing homes have written emergency plans and provide employees with emergency preparedness training. Most nursing homes nationwide met Federal requirements for written emergency plans and preparedness training. However, the Office of Inspector General (OIG) identified many of the same gaps in nursing home preparedness and response that they found in their 2006 report. Emergency plans lacked relevant information-including only about half of the tasks on the CMS checklist. Nursing homes faced challenges with unreliable transportation contracts, lack of collaboration with local emergency management, and residents who developed health problems. LTC ombudsmen were often unable to support nursing home residents during disasters; most had no contact with residents until after the disasters. Survey Agencies reported making some efforts to assist nursing homes during disasters, mostly related to nursing home compliance issues and ad hoc needs.

To read the recommendations as well as the CMS Emergency Preparedness Checklist, click here. To access additional information from the OIG report, click here.

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Helping providers understand the tasks they need to perform in order to assist with a smooth transition to the NCTracks system on July 1, 2013, including how and when to do them, a checklist has been prepared and can be found at http://ncmmis.ncdhhs.gov/communication.asp.

In addition, a Special Bulletin has been published which provides key information about CSC and NCTracks that will be an important resource to providers beginning July 1, including:

• Contact information
• Hours of operation
• Checkwrite schedule
• AVRS functionality
• Information available on the new Provider Portal

The bulletin also includes reminders about important activities providers need to perform before July 1. All providers are encouraged to read the Special Bulletin. If you have any questions, please contact the Office of Medicaid Management Information System Services (OMMISS) Provider Relations at OMMISS.providerrelations@dhhs.nc.gov.

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Palmetto GBA will host the J11 Part A Medicare Quarterly Updates, Changes and Reminders Webinar on June 11, 2013 at 10:00 AM ET. The quarterly update Webinars are intended to provide ongoing, scheduled opportunities for providers to stay up to date on Medicare requirements.

To register for this Webinar, go to the Please register on the Palmetto GBA J11 Part A Event Registration Portal at http://www.palmettogba.com/event/pgbaevent.nsf/Home.xsp.

This Webinar is designed to provide pertinent updates, changes and reminders to assist the provider community in staying compliant with Medicare rules and regulations and will include:

• New and updated Change Requests (CRs)
• Changes to current billing requirements
• Hot Billing Topics
• Top CERT errors

The Audio for the presentation will be broadcasting through your computer.

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Hurricane history teaches that a lack of hurricane awareness and preparation are common threads among all major hurricane disasters. By knowing your vulnerability and what actions you should take, you can reduce the effects of a hurricane disaster. Please review the plans that your facility will implement in case of a hurricane and make sure your employees are familiar with their role in case of a disaster.

The National Hurricane Center has some Hurricane Preparedness Week resources available at http://www.nhc.noaa.gov/prepare.

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Mark your calendar now and plan to attend four value-packed days of learning and networking in Phoenix, AZ, October 6-9, 2013! Choose from over 60 sessions in 11 education tracks ranging from advocacy to finance to person-centered care to quality improvement. Take advantage of terrific networking opportunities, outstanding educational programming, and fabulous entertainment, all in a beautiful location. Visit http://www.AHCAconvention.org for event details and registration information! Early bird discount ends July 19, 2013!

Legendary Band Foreigner to Perform at the AHCA/NCAL Convention & Expo

This year’s Gala Dinner & Show features the legendary rock band Foreigner! The event is likely to sell out so be sure to purchase your tickets early. Tickets can be purchased when you register for your convention package. If you have already registered for convention, you can make edits to your registration package to purchase tickets on-line.

Cold as Ice…Juke Box Hero…I Want to Know What Love Is… these songs were all over 1980s rock radio. At the band’s core is founder Mick Jones, whose stylistic songwriting, indelible guitar hooks, and multilayered talents continue to escalate Foreigner’s musical influence. The music felt as if it came from a different place, which inspired the band’s name.

Don’t leave Phoenix early — you don’t want to miss this show schedule for Wednesday evening, October 9th.

The Gala is an opportunity to celebrate, network with new friends, and have an evening of fun. This is a black tie optional event. Purchase your tickets today.

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This book explores 28 challenging cases which 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 $59.95

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The notebook used in the October 2012 training is available for purchase. Contact Jan Williams at janw@nchcfa.org or (919) 782-3827 to order one for your facility. The cost is $25 plus tax and shipping.

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The article references some remarkable studies about the effect of loneliness on physical and mental health. These seem to indicate that loneliness impairs health by raising stress hormones and increasing inflammation.

http://www.huffingtonpost.com/enid-borden/senior-loneliness-hunger_b_3306180.html?utm_hp_ref=aging

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For decades, Memorial Day continued to be observed on May 30, the date General John A. Logan, leader of an organization for Northern Civil War veterans, called for a nationwide day of remembrance. But in 1968 Congress passed the Uniform Monday Holiday Act, which established Memorial Day as the last Monday in May in order to create a three-day weekend for federal employees; the change went into effect in 1971. The same law also declared Memorial Day a federal holiday.

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