UPDATE Weekly

Please continue to make contact with members of the General Assembly. Before the House and Senate Conference Committee can begin negotiating the budget bill, they must first resolve their differences over the revenue (tax) package. This means there is more time for you to make important contacts with your Legislators. We expect the budget negotiations to last at least two more weeks. They need to hear how cuts to Medicaid are particularly harmful to skilled nursing facilities ability to retain staff and provide the quality care your residents need and deserve. Links on how to contact members of the General Assembly can be found here and useful talking points can be found by going to here. The importance of your participation in our Call to Action efforts cannot be understated. We need 5-10 people from each member facility to contact their House and Senate members NOW. If these Medicaid cuts are adopted, North Carolina will have the lowest average rates in the Southeast! Your staff and residents deserve better! Please forward any responses you receive from your Legislators to kareno@nchcfa.org.

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On July 1, the new NCTracks Medicaid claims processing system was activated. During this initial phase of the transition, providers may have questions on any of the functions of the new system. The July Medicaid Bulletin has information on:

• Receiving e-mail alerts through NCTracks,
• Getting your NCTracks questions answered,
• NCTracks provider claims and billing assistance seminars, and
• NCTracks provider field representatives.

The July issue of the Medicaid Bulletin can be accessed by clicking here. Older issues can be accessed here.

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Register today to attend the second annual NCHCFA Summer Symposium, August 6-8, 2013 at the Marriott Grande Dunes Resort, Myrtle Beach, SC for the most up to date information affecting long term care. You can register and pay on-line. Visit http://www.NursingHomesNC.com & click on Second Annual Summer Symposium Registration! Administrators and registered nurses will be able to earn up to 14.0 hours of continuing education. Early registration ends Friday, July 19th.

The North Carolina Health Care Facilities Association would like to thank the 2013 Summer Symposium Hosts for supporting this year’s event:

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Before you break for summer vacation, don’t forget to register for the AHCA/NCAL 64th Annual Convention & Expo. Held October 6-9 in Phoenix, this is an event you don’t want to miss. The Convention & Expo brings together thousands of long term and post-acute care professionals from across the country and creates excellent opportunities for networking and learning.

Early bird registration ends July 19th so don’t wait any longer! When you register before the early bird deadline, you’ll save $100 off the Premium and Full meeting registration packages. Additional savings are offered on other registration packages as well.

For a complete list of education sessions, speakers, expo information, and event schedules, visit the Convention & Expo Website.

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The Medical Review Department of Palmetto GBA will perform service-specific targeted medical reviews on Skilled Nursing Facility (SNF) claims, for the 14 Lower Resource Utilization Group (RUG) Codes. This review is aimed at ensuring accurate documentation that supports the level of SNF services billed. In previous reviews of this type, the primary reason for denial of these services was because the documentation submitted does not support the billed level of skilled services.

If a provider receives an Additional Development Request (ADR), submit the requested medical record information to Medical Review within 30 days of receipt of the ADR.

Providers should ensure the accuracy of their billing and send the following documentation when responding to the ADRs:

• Hospital discharge/transfer summary
• Physician certification/recertification of the need for skilled daily post-hospital care in a skilled nursing facility
• All physician’s orders, nurses’ notes, rehab orders/notes, and actual minutes of rehab therapy to support the billing and look back periods under review
• Documentation should include all therapy evaluations and plans of care to support the billing and look back periods under review
• Any additional documentation to support medical necessity of services for the billing and look back periods under review
• Submitted documentation should include any notes related to the assessment reference date(s) and look back period(s) and can extend back as far as 30 days prior to the billing period under review

Results of the targeted medical reviews will be posted to the Hospitals/Articles section of the Palmetto GBA J11 Part A Web site following completion of the review process.

If you have any questions regarding the reviews for SNF 14 Lower RUG Codes, or questions about general coverage criteria, medical review documentation requests, status of claims in the system, receipt of documentation by Medical Review, or claim denials, please contact the J11 Part A Provider Contact Center at (866) 830-3455.

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With the July 2013 List of Excluded Individuals and Entities (LEIE) update, OIG continues the transition to the upgraded Online Exclusions Database and the LEIE Downloadable Databases. In June 2013, OIG added new information to the LEIE — the National Provider Identifier, a Waiver, and Waiver State. Also, the on-line search of the LEIE has been redesigned.

Important notices related to these changes include:

• From June 2013 through August 2013, OIG will post downloadable LEIE Files without the new fields and files with the new fields. This will allow users time to work with the new fields while still having access to the files to which they are accustomed. In September 2013, only the file with the new fields will be available.
• This month, OIG begins offering the monthly supplement files with the new fields. However, OIG strongly recommends that users download the entire LEIE database with the three new fields at least once during the transition period from June to August 2013. The Monthly Supplement files only contain information about new exclusions or reinstatements that occurred in a single month. It does not – and will not – offer NPI and Waiver information for the thousands of records already in the LEIE before the latest LEIE upgrade.
• OIG now only archives monthly supplement files for the previous 12 months. Older material is no longer available on the Web site or via phone call to Exclusions staff, although the downloadable LEIE gives users the latest information on excluded individuals or entities. The Monthly Supplement files dated May 2013 or before will not include the National Provider Identifier and Waiver fields.
• Instructional videos explaining how to use the online database and the downloadable files are now available.
• OIG has added NPIs to LEIE records starting in 2008 and will include NPIs in LEIE records on a forward-going basis. Please note that not every individual or entity that is excluded has an NPI to add. Therefore, many records will not include information in the NPI field.

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Register now for the free “Back to Basics with EHR Adoption” Webinar scheduled for Wednesday, August 14 from 12:30 – 1:00 PM EDT. This is the final session in CCME’s six-part Electronic Health Record (EHR) adoption Webinar series. This Webinar covers what needs to be done after you go live on your EHR. CCME will discuss the importance of the system selection and review the process steps involved in choosing the right EHR for your practice.

To register, click here.

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Mark your calendar today for the North Carolina Culture Change Coalition’s training “ALIVE INSIDE” with Music and Memory founder Dan Cohen. This comprehensive program will cover the Music and Memory program in detail and help you to let the power of music move you to make a difference. Save the date for your region:

• October 1 – Durham
• October 2 – New Bern
• October 16 – Statesville

Contact Becky Wertz at becky.wertz@dhhs.nc.gov or (919) 855-4580 for additional information.

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On Monday, July 15, The Carolinas Center for Medical Excellence (CCME) will launch a redesigned and reorganized Web site featuring enhanced site navigation and functionality, Web page content, and visuals. The strategy behind this refresh was to build on the site’s current content management system to incorporate multimedia; improve design features and functions to better organize our areas of service; and make the site’s layout more straight-forward to our visitors.

“Web sites are often a person’s first impression of an organization,” said Melinda Postal, CCME communications director. “We believe the updated Web page content and overall Web site refresh better speaks to who we are as an organization, what we offer our clients, and our commitment to excellence.”

The following are a few the changes visitors will notice:

• A wider content interface that will better accommodate visitors using a variety of browsers and devices
• A new, large rotating Web banner on the homepage features up-to-date information and company announcements
• Recognizable icons and logos to link visitors to CCME’s other Web sites and social media sites
• Newly named tabs with drop down menus for visitors to see internal page organization
• A video player featuring our collaborative work

Please visit CCME’s corporate Web site at http://www.thecarolinascenter.org on Monday, July 15, to explore the new content and features it has to offer.

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On June 7, The Centers for Medicare & Medicaid Services (CMS) announced the rollout of Quality Assurance and Performance Improvement (QAPI) materials to help nursing homes establish a foundation to support and sustain QAPI. This is the first step in meeting the Patient Protection and Affordable Care Act requirement for CMS to develop a technical assistance program to help nursing homes establish best practices in quality.

You may access the full rollout announcement at http://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/Downloads/060713QAPIMaterialsforNursingHomesRollout.pdf. The memo will also direct you to the CMS QAPI Web site where the above QAPI tools and other resources can be found at http://go.cms.gov/Nhqapi.

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CMS recently released new surveyor guidance to assess compliance with F309 and F329 as they relate to residents with dementia and use of antipsychotic drugs. AHCA is offering a series of 6 brief, fast-moving and content-rich Webinars to help your nursing center ensure that you are well-prepared for these changes. Webinars will be grounded in a Quality Assurance Performance Improvement (QAPI) approach and provide strategies for achieving compliance with the new guidance. Each Webinar is 30-minutes or less and will be available on-demand.

The first Webinar in the series – The Good, the Bad and the QAPI is now available. Watch Capitol Connections for updates on when these upcoming Webinars are available:

• What’s Up Doc? – Getting the physicians and pharmacists on board in the nursing center’s effort to reduce off-label use of antipsychotics.
• Mining for Family Gold – Engaging families and obtaining helpful approaches for providing care for their family member with dementia.
• Frontline Workers or “Special Ops” – Ways to engage front-line workers in the nursing center’s efforts to provide the highest quality of care for residents with dementia.
• CNAs – The Keys to Success (Session designed for CNAs) – Differentiating between behaviors and unmet needs; reviewing ways to individualize care; and recognizing appropriate responses to offer to survey teams when asked about the patients the CNA cares for.
• Quality is Our Business Model – Relate current QA&A practices to QAPI principles and ways to organize current QA&A work to transition to a QAPI approach.

To register, click here.

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The Centers for Medicare and Medicaid Services (CMS) is launching a new instrument for 2013 called the Medicare Administrative Contractor Satisfaction Indicator (MSI). The MSI is a tool that measures your satisfaction with the Medicare claims administrative contractor(s) that serve you. This measuring tool will provide the best opportunity for you to rate your satisfaction with your MAC. Your input will help your MAC to improve the services that they offer you. Participation is voluntary, but you must register if you would like to take the MSI. A random sample will be drawn from the registry.

If you are a Medicare FFS provider or you represent a Medicare FFS provider and are interested in participating, take a moment to register your contact information by completing the application. It will take about one minute to complete.

For more information visit the CMS MSI Web site. Let your voice be heard!

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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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Does your facility need an extra copy of the Membership Directory around the office? This informative guide lists the NCHCFA Board of Directors, member facilities (by facility, administrator and district), staff contacts, and the NCHCFA trade members. Order yours today! Contact Jan Williams at janw@nchcfa.org to order one for your facility. Contact Jan Williams at janw@nchcfa.org to order one for your facility.

NCHCFA Members only: $35.00

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Collaboration Improves Care – A nursing home learning initiative boosts staff satisfaction while improving resident care and quality of life.

http://www.providermagazine.com/archives/2013_Archives/Pages/0713/Collaboration-Improves-Care.aspx#magazine-article

A friendly competition at City Hall proved just how serious these seniors are about their video game league.

http://safetyharbor.patch.com/groups/around-town/p/mayor-ayoub-challenges-senior-wii-bowlers

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After the Japanese attack on Pearl Harbor in 1941, the U.S. currency in circulation in Hawaii was replaced with special bills with the word “Hawaii” on them. In case of a Japanese invasion, these special notes would become worthless, preventing the Japanese from holding millions of American dollars.

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