UPDATE Weekly

It is time, once again, for the NCHCFA “Fabulous 50” awards! This time-honored event provides the opportunity to acknowledge front line, unlicensed personnel who have demonstrated outstanding achievements in the long term care profession. The Fabulous 50 awards program honors individuals who are the backbone in our facilities because of the support they provide to our residents. A panel of judges from the Education and Programs Committee will select ten nominees from each district. Each of the award recipients will be honored at a dinner and awards presentation in their district. The deadline to receive completed nominations is Tuesday, September 3rd. Please encourage your facility to participate in this special award program.

The dates for the 14th Annual Fabulous 50 Celebrations are:

District I – October 15, 2013, Grand Bohemian Hotel, Asheville
District II – October 21, 2013, Hilton Charlotte University Place, Charlotte
District III – October 24, 2013, Grandover Resort, Greensboro
District IV – October 29, 2013, Mad Boar Restaurant, Wallace
District V – November 4, 2013, Renaissance North Hills Hotel, Raleigh

To fill out nomination forms on-line, visit the Member Center of the Association Web site at http://www.NursingHomesNC.com. Click on “News & Updates”, select “2014 Fabulous 50 Nomination Packet” and choose “Survey Monkey”. If you have any questions about the Fabulous 50 awards, call the Association office at (919) 782-3827. Pictures for nominations submitted online may be e-mailed to kareno@nchcfa.org or mailed to the Association office.

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NCHCFA thanks all individuals that participated in the Summer Symposium evaluation raffle. Congratulations to Lisa Lee of Crabtree Valley Rehab for winning a new iPad! Again, we appreciate your valuable input.

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On July 31, 2013, CMS issued a final rule (CMS-1446-F) outlining fiscal year (FY) 2014 Medicare payment rates for skilled nursing facilities (SNFs). The FY 2014 SNF PPS payment rates and policies will be effective on October 1, 2013.

The major provisions of the final rule are summarized below.

Changes to payment rates under the SNF Prospective Payment System (PPS) for FY 2014

Based on the changes contained within this final rule, CMS estimates that aggregate payments to all SNFs will increase by $470 million, or 1.3 percent, for FY 2014 relative to payments in FY 2013. Most North Carolina SNFs will not see the same type of increases due to decreases in the wage index figures.

Revise and rebase the market basket

The Medicare statute requires CMS to establish a SNF market basket index that reflects changes over time in the prices of an appropriate mix of goods and services included in covered SNF services. CMS is rebasing and revising the SNF market basket for FY 2014 and subsequent years to reflect more recent data. The current SNF market basket reflects data from FY 2004 and CMS is updating the SNF market basket using data from FY 2010.

Reporting of distinct therapy days

CMS is adding an item to the Minimum Data Set (MDS) to record the number of distinct calendar days of therapy provided by all the rehabilitation disciplines to a beneficiary over the seven-day look-back period. CMS is clarifying that the qualifying condition for the Medium Rehab Category requires five distinct calendar days of therapy. Similarly, CMS is clarifying that the qualifying condition for the Low Rehab Category requires three distinct calendar days. Currently, the number of days for each therapy discipline reported on the MDS is summed without regard to the number of separate and unique days per week during which the patient receives therapy services across all rehabilitation disciplines. This results in some residents qualifying inappropriately for an RM or RL Resource Utilization Group (RUG).

NCHCFA has prepared an Excel spreadsheet that calculates the newly released Medicare rates. To calculate the rates for your facility, once you have downloaded the file from the Member Section of the NCHCFA Website at http://www.NursingHomesNC.com, select the appropriate county from the selection box. If your county is not listed, you are a Rural County for rate purposes.

If you have any questions on the new Medicare rates or the use of the Medicare rate calculation file, please contact Sam Clark at samc@nchcfa.org.

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The American Health Care Association (AHCA) is proud to announce some exciting updates to help you maximize your LTC Trend Tracker experience:

• Data Download: LTC Trend Tracker now allows you to track facility-level progress in just a matter of 3 simple clicks. This new feature called “LTCTT Data Download” allows organizations to access multiple facilities’ level information in one excel spreadsheet. The user can benchmark data for QMs, antipsychotic use, hospital readmissions and turnover.
  Administrators, DONs, and corporate level staff can use this feature for QA/PI goal setting, benchmarking towards other facilities, and in discussions with referral sources. In addition, you will have access to your baseline information to gauge you own progress and determine what next steps need to be taken.
  Learn how to use LTCTT Data Download in 3 simple clicks by reading our help document. And start taking advantage of this new feature by logging in today!
• Claims-Based Hospital Readmission Information: Due to the new, risk-adjusted hospital readmission measure in LTCTT – OnPoint-30 – LTC Trend Tracker will be removing the claims-based rehospitalization widgets on August 31st.
  OnPoint-30 allows users to look at the most recently-available MDS data which is more current and risk-adjusted compared to claims-based data. Come August 31st, users will no longer be able to access the widget labeled “data range 2000-2010.”
• LTCTT User Group Meeting at AHCA Convention: Coming to Convention? AHCA will hold an LTCTT user meeting on Tuesday, October 8th from 4:00 p.m. – 5:00 p.m. Participants will be able to learn more about new features and provide feedback on how to improve the tool. To learn more about the user meeting, please email Peggy Connorton at pconnorton@ahca.org.

You don’t have to wait until October to learn all the benefits of LTC Trend Tracker. Login today!

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As previously announced, all nursing centers must be fully sprinklered by August 13, 2013. During a meeting of the AHCA Life Safety Committee during which the committee met with Jim Merrill, Life Safety Specialist with CMS, numerous questions were posed related to full sprinklering which require clarification from CMS.

On February 7, 2013, CMS issued a Notice of Proposed Rulemaking (NPRM) related to providing extensions for the date of full sprinklering under very specific criteria. The final rule related to the extension will not be published until after the August 13th deadline. According to Thomas Hamilton: CMS is doing its utmost to make sure the final rule is issued prior to a center incurring a very serious remedy imposition that is required by statute or regulations. CMS does not want to close nursing centers due to their inability to be fully sprinklered [if the center meets the criteria included in the proposed rule]. Mr. Hamilton’s recommendation to centers that believe they meet the extension criteria contained in the NPRM: “Be concerned but don’t panic.”

CMS provided AHCA with the following information related to both of the topics above:

1) According to CMS records, about 1,300 centers nationwide are either not sprinklered or are partially sprinklered. Of that number, fewer than 200 centers are not sprinklered at all.

2) There will NOT be an “army of surveyors” that will descend on nursing centers on August 13 to inspect for full sprinklering. Surveyors will determine full sprinklering on the date of the next standard survey for a center or if a complaint has been filed related to a center being not fully sprinklered.

3) If a center is not fully sprinklered on the date of the standard or sprinkler-related complaint survey that occurs after August 13th, the center will receive a citation (at a level of F or higher, depending on the circumstances) and will be found to be not in substantial compliance. Such a citation will start the regulatory clock – that is, if the center is not in substantial compliance at 3 months, there will be a Denial of Payment on New Admissions and if not in substantial compliance at 6 months, de-certification.

4) A Survey & Certification Memorandum (S&C Memo) that includes a Q&A section is expected to be released in the next several weeks. This memo and the Q&A section will include information related to the questions that AHCA posed to CMS during our meeting with Mr. Merrill in June.

5) Mr. Hamilton requested that nursing centers who believe they meet the extension criteria contained in the NPRM should contact their State Survey Agency and their Regional Office: CMS Central Office may attempt to collect PRIOR to publication of the final rule to assist in processing such extensions requests as quickly as possible.

AHCA appreciates that CMS has provided this information and they look forward to receiving the promised S&C Memo. If you have any questions, please contact Lyn Bentley at lbentley@AHCA.org.

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Palmetto GBA announces their 2013 Part A/B Fall Tour Workshop where they will discuss Medicare coverage and billing updates, as well as clinical and documentation information affecting the Medicare provider community.

The 2013 Fall Tour is for all Part A/B provider specialties and is recommended for administrators, billers, physicians, nurses and other healthcare professionals that submit claims to Medicare. It will provide insight for new, intermediate and advanced staff.

Part A Coverage and Billing topics will include:

•Claims Error Rate Testing (CERT)
•RAC
•Appeals
•Provider Enrollment
•Remittance Advice
•ICD-9 vs. ICD-10
•DRG Billing and Documentation
•Important Palmetto GBA Tips and Reminders

Part B Coverage and Billing topics will include:

•Incident To
•Proper Billing of Drugs and Biological Information
•Appeals
•Commonly Used Modifiers
•Online Provider Services (OPS)
•National Correct Coding Initiative (NCCI) (common bundles, etc.)
•Additional Documentation Request (ADR)/Medical Review (conducting self-audits)
•Face-to-Face Requirements
•Common Denials/Responses (CERT)
•ICD-10 Updates
•Important Palmetto GBA Tips and Reminders

Additional information on these workshops, including locations, dates and times can be found by clicking here.

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With the August 2013 List of Excluded Individuals and Entities (LEIE) update, OIG is in its last month of 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 online 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.
• 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 Website 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 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.

Visit, http://oig.hhs.gov/exclusions/exclusions_list.asp to download the July files.

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We would like to correct some incomplete information that appeared in Update Weekly #1731 concerning the Reporting of Information to the N.C. Cancer Registry.

The article reads: “We reached an agreement with the N.C. Division of Public Health to report only a limited number of fields for each nursing home resident with a cancer diagnosis, as opposed to all of the fields normally reported by hospitals and physicians. The principle information reported is: Resident’s Name, Address, Date of Birth, Gender, Cancer Site, and Date of Diagnosis, if known. This is a simplified process that is more appropriate and less time consuming in the nursing home setting.”

The article should have read: “The number of required fields has decreased from 25 to 18 in the reporting program. The 18 fields include: Last name, first name, social security, date of birth, race, sex, street address at diagnosis, city at diagnosis, zip, primary cancer site, ICD-9 code, reporting facility, NPI (national provider identifier – for reporting facility, referred from facility and managing physician), vital status (if the patient is living or deceased).”

One of the essential required fields is the Social Security Number. This important identifying information is required by law because it makes it possible to identify duplicate cases reported from different facilities so that cancer is not overestimated for the State of North Carolina. Further, this data is also matched with many other treatment datasets to better understand the causes and quality of care of our citizens to ensure the cancer burden is accurately measured.

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

Governor Bobby Jindal Confirmed as Closing Keynote Speaker! Governor Bobby Jindal has been serving as the Governor of Louisiana since 2008. As Governor, he has focused on issues involving the state’s health care, education, and transportation systems, as well as encouraging workforce development and continuing recovery efforts in areas devastated by hurricanes such as Katrina and Rita. He has also been concerned with comprehensive ethics reform. In his career, he has served a number of public offices and has faced many challenges in disaster recovery efforts, as well as issues concerning Medicare and Medicaid. Jindal will share his experiences and perspectives on these issues.

Advance registration for this year’s event continues through September 9.

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This three-part DVD training series includes must-have background information for feeding assistants (Getting Started, 20 minutes), specific job responsibilities and procedures (Proper Feeding Techniques, 18 minutes), and helps prepare employees in case problems or emergencies arise (Problem Behavior and Emergencies, 14 minutes).

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

Product # 6790D
AHCA Members (on-line price) $99.00

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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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Pole-vaulting granny: It’s ‘never too late’

http://www.cnn.com/2013/07/19/health/flo-meiler-senior-games/index.html?hpt=he_bn8

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The tongue of a mature Blue Whale has approximately the same mass as that of an entire adult elephant.

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