UPDATE Weekly

The Empira Fall Prevention program is a combination of nationally recognized evidence-based, fall-prevention practices and practical applications from numerous research studies. At the completion of their three-year program, Empira nursing facilities have collectively achieved a twenty to thirty percent (20% – 30%) reduction in the prevalence of resident falls. These findings, coupled with a significant reduction in the number of repeated falls, makes this presentation one that you will want to attend!

Presented by Sue Ann Guildermann, this in-depth session will cover the implementation of a comprehensive fall prevention and reduction program.

The cost to attend this seminar is $195 for members and $390 for non-members. This fee includes handouts, snacks, and lunch. NOW YOU CAN REGISTER AND PAY ON-LINE! TO REGISTER, GO TO http://NursingHomesNC.com AND CLICK ON FALLS PREVENTION. 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! SPACE IS LIMITED! REGISTER TODAY!

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The national theme for the 2013 National Nursing Home Week (NNHW) is Team Care. NNHW will be observed in skilled nursing facilities throughout America, Beginning Mother’s Day, May 12th and continuing through May 18th, 2013.

NNHW’s theme recognizes residents and patients in long term and post-acute care settings, the dedicated staff who care for them, and the value of care planning where everyone “pitches in” for optimal outcomes. The observance is an opportunity to involve families, community members, youth, and others in a community-wide show of support and respect for these individuals and the staff who provide care or support services. Activities are designed to foster intergenerational contact, strengthen family relationships and to encourage volunteerism by individuals and local organizations.

Stay tuned for the planning guide, full of fun activity ideas to celebrate the week at your community. Themed products and merchandise developed by the American Health Care Association (AHCA) coming soon! For details visit http://www.nnhw.org and participate on Facebook. E-mail inquiries should be sent to nnhw@ahca.org. Please inform your staff of the date and theme!

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Recently, Senate Republican Leader Mitch McConnell (KY) selected American Health Care Association (AHCA) Board of Governors Chairman Neil L. Pruitt, Jr., to serve on the newly-created Commission on Long Term Care. The following is part of the statement released by AHCA to celebrate Mr. Pruitt’s selection.

“I am humbled and honored by this selection,” said Pruitt, Chairman and CEO of UHS-Pruitt Corporation. “I’ve seen firsthand how post-acute care has evolved through the years and become a vital partner in the long term care continuum. But we’ve never lost sight that it all hinges on quality. We have an opportunity with this Commission to reach new pinnacles in caring for our nation’s seniors, and that means also finding ways to keep Medicare and Medicaid financially sound. I’m excited at the prospect for real progress, and look forward to working with my fellow commissioners.”

Created by the American Tax Relief Act of 2012 as a result of the fiscal cliff negotiations, the 15-member Commission is chartered with developing a plan to establish, finance and properly implement a high-quality system that ensures the availability of long term care services for seniors and persons with disabilities.

Specifically, the Commission has six months to address challenges facing the long term care workforce as well as the present demands on the profession, including:

• The role of Medicare, Medicaid and private insurance and their interaction;
• Improvements in existing programs necessary to ensure the continued availability of long term services and supports;
• Proper training and development of the workforce to ensure quality care;
• Gaps in federal and state structures that prevent the delivery of these services.

A full bio of Mr. Pruitt is can be found here.

The full press release is available by clicking here.

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Now that Governor McCrory has put his signature on HB 4 several changes to the unemployment insurance program will be coming.

HB 4 was recommended as a comprehensive measure to pay down the $2.4 billion debt owed by North Carolina to the federal government for payment of unemployment benefits. HB 4 also reforms the unemployment insurance system to prevent future insolvency by reducing future unemployment benefits and implementing programs to return unemployed workers to work.

Under federal law certain entities, non-profit and governmental, are allowed to directly reimburse the unemployment insurance system for benefits paid. HB 4 does not change that. It will, however, require all of those entities to maintain a balance in a reserve account equal to one percent of its taxable wages.

For the complete text of the new state law, click here.

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NCTracks, the replacement multi-payer Medicaid Management Information Systems (MMIS), is scheduled to begin full fiscal agent operations on July 1, 2013. Prior to going-live, there is a Provider Operational Preparedness (POP) period which involves multiple activities with the provider community to assist with go-live preparations. One of the activities during POP is the claim-adjudication comparison by providers. This activity affords providers the opportunity to experience the claim adjudication aspects of the NCTracks system.

DHHS has extended to opportunity to participate in this comparison period to all nursing facilities in the state. You will have the opportunity to prepare for the claim comparison activity through remote early training activities (more information will be available at a later date). You can engage in POP activities remotely, from your own facilities.

As a POP participant, you will continue to submit claims through the legacy systems during the POP period, just as you do today; however, these claims will also be processed in NCTracks–enabling you to compare your current Remittance Advices (RAs) with those from the new system. No payments will be generated through NCTracks during this period, and NCTracks’ processing of these claims will not affect any recipient incremental benefits or prior-approval authorizations.

The NCTracks Project Team will communicate to the POP participants the differences between the legacy and the Replacement MMIS, and research questions or concerns. The February 28, 2013 check-write has been designated as the POP claim comparison date. You should retain your legacy RAs from the February 28 check-write for claim comparison with the NCTracks RA.

Please notify DHHS within 5 business days whether or not you will participate in this activity by registering at http://ncmmis.ncdhhs.gov/pop.asp. Registration opens Thursday, February 21.

Please submit questions to POPParticipants@dhhs.nc.gov.

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The Affordable Care Act tools on the American Health Care Association (AHCA) Web site have been updated and reorganized in order to ensure that these tools for will be easier to find, simple to use and informative.

A few of the tools you may be interested in today:

• AHCA’s latest Webinar: Employer Responsibility Under the Affordable Care Act
• Implementation Timeline (PDF)
• Elder Justice Act tools and templates

Please take a moment to visit the new Affordable Care Act site.

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Over 700 members and 600 trade members from across North Carolina and the southeast recently attended the Association’s Annual Convention and Expo held in Greensboro, NC. The highlight of the 2013 Convention was recognizing the North Carolina Health Care Facilities Association 2013 Special Award recipients:

District I Nurse Aide of the Year – Jamie Green – Elderberry Health Care
District II Nurse Aide of the Year – Shelia Dalton – Sardis Oaks
District III Nurse Aide of the Year – Johnnetta McKeithan – Peak Resources/Treyburn
District IV Nurse Aide of the Year – Mike Wilson – Highland House Rehab & Healthcare
District V Nurse Aide of the Year – Corey Fields – Heritage Healthcare of Farmville
Riley W. Clapp Outstanding Service Award – Liddie Howard – Peak Resources/Alamance

Corey Fields received the Ninth Annual J.R. Garrett, Jr. Direct Care Worker of the Year Award!

The photos from the Chairman’s Evening Extravaganza – A Night at the Academy Awards are now available! To view and order photographs, please visit http://www.PhotoSpecialties.com and use the password: NCHCFA and then click on “A Night at the Academy Awards.”

The North Carolina Health Care Facilities Association would like to again thank the Corporate Sponsors of the 2013 Annual Convention and Exposition in Greensboro, North Carolina for their support: UniHealth Home Health, United Hospice, United Medical and United Pharmacy.

The North Carolina Health Care Facilities Association would like to again thank the hosts of the 2013 Annual Convention and Exposition in Greensboro, North Carolina for their support: Healthcare Services Group, Inc., LTC Properties, Inc., Legacy Consultant Pharmacy, Medipack Pharmacy, Neil Medical Group, Poyner Spruill LLP, and Southern Pharmacy Services.

Congratulations Neil Medical Group for winning the 2013 Best Booth Contest during Expo 2013!

Will you get credit for your Convention CEU’s? Please check your Convention materials to be sure you didn’t forget to turn in your CEU form so it can be processed. If you still have the form in your possession, please mail it to Jan Williams at the Association office as soon as possible. A signed copy will be returned to you for your records.

If you are interested in viewing the PowerPoint presentations from the NCHCFA Annual Convention, they are on-line by clicking here.

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The Survey and Certification Group (SCG) is offering three training programs on care of persons with dementia and unnecessary antipsychotic medication use. The first two became available January 19, 2013. A third installment in this series is in development and will be completed this spring. Content includes:

• How to identify whether a systematic, individualized approach was implemented for a resident with dementia.
• How to identify that a systematic process is in place and has been followed for persons with dementia in the facility.
• How to evaluate the role of the resident, consultant pharmacist, physician/NP/PA, medical director, direct care staff, family and other members of the interdisciplinary care team.
• How to identify other associated tags related to care of persons with dementia and unnecessary medication use.

The third installment of the training will address how to cite severity and other aspects of deficiency citations in more detail, based on new guidance at F309, Care of Residents with Dementia, and revised guidance at F329 that is in development.

The first video program is 40 minutes in length. The second self-study is estimated to take 45 minutes to 1 hour.

How to Access these Videos for Non-Surveyors: If you are a provider or do not wish to receive credit for viewing the program follow the instructions below.

• Go to http://surveyortraining.cms.hhs.gov.
• Click on the “I am a Provider” tab.
• Click on the “Reduction in Unnecessary Medications in Nursing Homes” at the menu at the top of the screen.
• Click on the program that you wish to view.

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The US Department of the Treasury is requiring that all federal benefit and non-tax payments be paid electronically effective March 1, 2013. The American Health Care Association (AHCA) held a Webinar that discussed how providers can comply with the new regulation in their facilities with their residents. This free, ninety-minute Webinar was recorded and is available for viewing at http://webinars.ahcancal.org/index.php.

Learning Objectives:

1. Understand new rules requiring federal benefit payments to be made electronically by March 1, 2013;
2. Learn how the rules will affect NF’s current benefit deposit procedures;
3. Identify the role of financial institutions;
4. Discuss various NF scenarios and understand the actions necessary for compliance; and
5. Know how NF’s can help convert residents’ funds to direct deposit.

Because of the processing that may be required to convert those SNF residents that are now receiving paper checks, it is recommended that all required paperwork be completed as soon as possible. Changes may also be needed in your admissions policies and procedures. DO NOT DELAY. Additional information on this new requirement can be found at http://www.godirect.org.

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Last week the American Health Care Association (AHCA) publicly praised bipartisan legislation that would permanently repeal caps on therapies seniors receive in skilled nursing centers.

Created as a part of the Balanced Budget Act of 1997, the therapy cap places an annual $1,900 financial limit on payment for outpatient therapy services under Medicare Part B. Physical therapy and speech language pathology services are under a combined cap and another cap is applied to occupational therapy. Created out of a need to balance the federal budget, the cap policy was not based on data and was applied without consideration for quality of care or clinical judgment. This legislation would permanently end these limitations and ultimately protect the frail, elderly and persons with disabilities from the adverse and potentially onerous effects caused when they either suspend or cutback on therapy because they reach the arbitrary cap.

The full press release can be found on the AHCA/NCAL Web site.

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The NC House has tentatively approved a bill that would block federal Medicaid expansion and let the federal government run an on-line health care exchange. The legislation would prevent the state from expanding Medicaid from covering another 500,000 people in the state. The expansion is a part of the Affordable Care Act, and is intended to ensure that health insurance coverage is extended to all people. The expansion would cover those who are not currently eligible but whose incomes are less than 138 percent of the federal poverty level. Although the federal government would cover the entire cost for the newly included populations, states would have to pick up 10 percent in the subsequent years. The bill would also leave it to the federal government to run a health insurance exchange, rather than have the state run its own or create a state-federal hybrid. The House took up the bill, a version of which has already passed the Senate.

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The Division of Medical Assistance has announced the registration portal for the February 2013 Personal Care Services (PCS) Regional Training sessions is now open.

The target audience is licensed home care providers and licensed adult care providers (including combination facilities with ACH beds). This training is designed for billing staff, owners, operators, and supervisory staff.

The morning session, conducted by The Carolinas Center for Medical Excellence, will run from 9:00 AM to 12:00 Noon, with an hour and half for lunch on your own. The afternoon session, conducted by HP Enterprise Services, is scheduled from 1:30 PM to 4:00 PM and is on the NC Electronic Claim Submission-Web Tool Training. The remaining trainings are:

• Monday, February 25 – Asheville
• Tuesday, February 26 – Charlotte

Attendance at each location will be limited to 400 – 500 people. Please note that on-line registration for each location will close when the session is full. If you are unable to register for a session at the location of your choice, please consider registering for another session. The sessions are unable to accommodate onsite registrations or walk-ins.

For additional information and registration, click here.

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In 2013, there is no ‘prior authorization’ process in place for outpatient therapy services over the $3700 thresholds. Once a claim is received that has outpatient therapy services that exceed the $3700 threshold, the claim will suspend and the provider will receive an additional development request (ADR). The ADR letter will request medical documentation to demonstrate the medical necessity for additional outpatient therapy services over the threshold. Once the documentation is received, it will be reviewed by the medical review department nursing staff and a decision on the processing of the claim will be made. Once that decision is made, the claim will adjudicate according to that decision.

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Important information for residents and families. It 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 Members: $30.00 per 100 brochures plus tax and shipping

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

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Facebook Benefits Older Adults By Giving Them Cognitive Boost, study says.

http://www.huffingtonpost.com/2013/02/19/facebook-benefits-older-adults-cognitive-boost_n_2716655.html

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Upon being presented with their award, Oscar winners must sign an agreement stating that if they should ever wish to sell their statuettes they must first offer them to the Academy for $1. If they refuse, they cannot keep their trophy.

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