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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After some technical revisions, the House and Senate ratified Senate Bill 4. Governor McCrory is expected to sign the bill into law. As a result North Carolina will not expand its Medicaid program as allowed for in the Affordable Care Act, nor establish a state administered Health Insurance exchange.

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The NC State Board of Examiners for Nursing Home Administrators will offer the 2013 Preceptor Seminars on April 22nd and 23rd, 2013 and April 23rd and 24th, 2013 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 2013 by the NC State Board of Examiners for Nursing Home Administrators.

To register for your overnight rooms at Kingston Plantation, call 1-800-876-0010 or call (843)449-0006. The group’s special code is NBE. You can also book online at http://www.Hilton.com. Make sure that you are booking at the Embassy at Kingston Plantation. On the booking page, click on the box that says ADD SPECIAL CODE and then put NBE in the box marked “Group Code”. A block of rooms are reserved until March 23, 2013. Click Here to download more information along with the registration form.

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The five year phase-in for all nursing centers to be fully sprinklered is drawing to a close. ALL SNFs/NFs must be fully sprinklered by August 13, 2013. Click here to read a Life Safety Update prepared by AHCA’s Life Safety Consultant, Hughes Associates, Inc. Please note that we are still waiting for additional clarification from CMS on Item 1 on page 1. As soon as we receive this clarification we will post the information in UPDATE.

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AHCA is sponsoring a Webinar (Deconstructing Corporate Compliance & Ethics for Single Facilities and Small Regional Chains) on March 11, 2013, 2:00PM, ET, with Carol Rolf, partner in Rolf Goffman Martin Lang LLP, and General Counsel to AHCA’s Ohio affiliate, to discuss how providers move forward to design and implement an effective corporate compliance and ethics program by March 23, 2013, as mandated by the Affordable Care Act.

The learning objectives include:

1. Understand how a strong Corporate Compliance & Ethics Programs improves quality;
2. Know the first steps to take in developing a Corporate Compliance & Ethics Program;
3. Learn the 7 elements critical to implementing an efficient Corporate Compliance & Ethics Program; and
4. Focus specifically on screening and internal monitoring and auditing – both critical areas from the federal government’s perspective.

While large companies have had compliance programs for many years, smaller chains and single homes may not have yet established a formal plan. Given the fact that compliance is a concept well known and well-practiced in most nursing facilities, adoption of a “compliance program” should not be an overwhelming task. Rather, it is a matter of identifying what aspects of the program are already largely in place and which aspects need to be further developed and then designed into a program that makes sense for your organization. To register for the Webinar go to http://webinars.ahcancal.org/session.php?id=10512.

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On February 21, 2013, the Centers for Medicare & Medicaid Services (CMS) updated its Manual Medical Review Web site and directed the Medicare Administrative Contractors (MACs) to conduct prepayment review on the claims reaching the $3,700 threshold. CMS requested that MACs conduct these manual medical reviews within 10 days. CMS also indicated that this prepayment review was an interim measure and that it is developing a long term strategy to deal with manual medical review. The MACs were in essence floundering, and CMS had been considering:

1. A prior approval process similar to that used in 2012;
2. A strictly pre-payment review process for all claims above $3,700 without a prior approval process; and
3. A post-payment review process for some or all claims over $3,700.

The American Health Care Association (AHCA) had recommended to CMS that it choose the third option with additional safeguards to ensure whatever process is adopted operates in as efficient a manner as possible. AHCA does not believe that CMS prepayment directive will alleviate the process problems and may even exacerbate them. AHCA continues to communicate with CMS on this issue.

For more CMS information on the Therapy Cap Medical Review and Education, click here.

The statutory Medicare Part B outpatient therapy cap for Occupational Therapy (OT) is $1,900 for 2013, and the combined cap for Physical Therapy (PT) and Speech-Language Pathology Services (SLP) is also $1,900 for 2013. This is an annual per beneficiary therapy cap amount determined for each calendar year. Exceptions to the therapy cap are allowed for reasonable and necessary therapy services. Per beneficiary, services above $3,700 for PT and SLP services combined and/or $3,700 for OT services are subject to manual medical review. CMS is not precluded from reviewing therapy services below these thresholds.

The therapy cap applies to all Part B outpatient therapy settings and providers including:

• Therapists’ private practices
• Offices of physicians and certain nonphysician practitioners
• Part B skilled nursing facilities (Type of Bill (TOB) 42X, 43X,44X)
• Home health agencies (TOB 34X)
• Rehabilitation agencies (also known as Outpatient Rehabilitation Facilities-ORFs)
• Comprehensive Outpatient Rehabilitation Facilities (CORFs)
• Hospital outpatient departments (HOPDs) (TOB 12X or 13X)

CMS is developing a long term strategy to deal with manual medical review. However, in the interim, Medicare Administrative Contractors (MACs) will conduct prepayment reviews on the claims reaching the $3,700 threshold. CMS requested MACs conduct these manual medical reviews within 10 days. At this time, there is no advance request for an exception process. Additional information will be provided on the MAC Web sites.

You can contact CMS with questions about the therapy cap and new threshold via a designated e-mail box at therapycapreview@cms.hhs.gov.

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New Publication Available: Hospitality For Boomers – AHCA is excited to announce this highly informative resource is now part of their inventory. Start improving your community reputation, marketability, and profitability today with Hospitality for Boomers: How to attract residents, retain staff, and maximize profitability. Written by former restaurateur, health-care food service director, and current national Kind Dining® service trainer, Cindy Heilman, this quick read shares a unique service perspective and is full of hospitality tips. Please visit http://www.ahcapublications.org or call (800) 321-0343 to order this product. Fax orders may also be placed at (800) 869-5605.

Learn how to:

• Respect your diner’s experience
• Train your staff to excel
• Apply empathy daily
• Exceed your residents’ expectations
• Build your hospitality team
• Grow your employees personally and professionally
• Focus your leadership team
• And more!

Product #: 8274
Price: $19.95

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Spearheaded by physicians, Mount Sinai Hospital in New York has opened an emergency room dedicated to seniors.

http://dailynightly.nbcnews.com/_news/2012/04/22/11313904-emergency-rooms-designed-for-the-older-set?lite

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The Union ironclad, Monitor, was the first U.S. ship to have a flush toilet.

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