UPDATE Weekly

During the recent legislative session, the General Assembly passed Senate Bill 542, Drug Testing for LTC Applicants and Employees. The bill mandates pre-employment drug testing in nursing homes and adult care homes. Senate Bill 542 specifies that an offer of employment by a nursing home to an applicant is conditioned upon screening for controlled substances. The complete text of the new law can be read at http://www.ncleg.net/Sessions/2013/Bills/Senate/PDF/S542v5.pdf. Section 1 of the new law applies to adult care homes (GS 131D) and Section 2 applies to nursing homes (GS 131E). The new requirements become effective October 1, 2013.

NCHCFA has concerns about the unintended consequences of this legislation and the burden it will place on providers to comply. It is particularly frustrating knowing that drug screening is a part of most providers’ employment policies. The law adds additional requirements to the hiring process. We are investigating whether the new requirements could violate federal privacy provisions of the federal Equal Opportunity Act. NCHCFA plans to ask the General Assembly to repeal the provisions impacting skilled nursing providers or enact changes making the law consistent with current employer practices. We are seeking legal advice to determine whether the law does indeed conflict with existing federal law and whether that could lead us seeking a delay in implementation until the Legislature returns to Raleigh in May 2014. In the meantime, we recommend providers seek advice from their legal counsel since the law, as currently written, takes effect on October 1, 2013.

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While there has been much publicity about the delays in implementing certain requirements of the new Patient Protection and Affordable Care Act (ACA), there is one rapidly approaching deadline that no employer should ignore. Employers must provide their current employees with a health insurance exchange notice no later than October 1, 2013. This applies to all employers engaged in interstate commerce or with at least $500,000 of sales per year, regardless of whether or not an employer offers its employees health care coverage.

Under the ACA, each state is required to have a web-based health insurance exchange. These exchanges will serve as health insurance marketplaces where individuals and small businesses may purchase health plans if there is no employer-sponsored health plan or if the employer-sponsored health plan is unaffordable or fails to offer essential health benefits. The exchanges will open for enrollment by October 1, 2013 for coverage starting January 1, 2014.

The health insurance exchange notice must provide employees with information necessary to make informed decisions about their health insurance. The notice must explain what the web-based exchange is; include information about the premium subsidies that may be available if an employer’s plan is unaffordable or does not provide minimum value; and explain the consequences if an employee decides to purchase a qualified health plan through the exchange instead of employer-sponsored coverage. (The notice does not, however, need to explain what insurance options may be available online.) The notice may be distributed electronically or via hard copy, and while there is no requirement to obtain an employee’s signature, employers may want to track delivery and receipt of the notice. Additionally, after October 1, 2013 employers are required to provide notices to new hires within 14 days after the date of hire.

The United States Department of Labor has issued two model exchange notices: one for employers who offer a health plan and one for employers who do not. Part B of the model notices requires the employer to enter certain information before use, including name, Employer Identification Number (EIN) and address and (for employers who do provide coverage) contact information about health coverage, whether all or only some employees receive health coverage, whether coverage is offered to dependents and if so, which ones, whether coverage meets the minimum value (60 percent) standard and whether the cost of coverage is intended to be affordable.

These model notices can be accessed at:

http://www.dol.gov/ebsa/pdf/FLSAwithplans.pdf (for employers with plans) and

http://www.dol.gov/ebsa/pdf/FLSAwithoutplans.pdf (for employers without plans)

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As reported by the Centers for Medicare and Medicaid Services (CMS), North Carolina leads the nation in the reduction of the use of antipsychotic medications. This reduction of 23 percent is the highest rate of reduction in the nation and well exceeds the CMS target of a reduction by 15 percent. A well-deserved congratulation to the staff of NC’s Nursing Facilities is echoed in an article published in the News and Observer on September 12, 2013. As the news spreads, NCHCFA and its membership continue as key members of state and regional collaborations as they build on the work that has proven so successful. To view the September 12 article, go to http://www.newsobserver.com/2013/09/12/3189766/nc-leads-nation-in-lowering-antipsychotic.html.

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The “Updated LEIE” database file reflects all OIG exclusion and reinstatement actions up to, and including, those taken in August 2013. This new, “Updated LEIE” (List of Excluded Individuals and Entities) is a complete database file containing all exclusions currently in effect. Individuals and entities that have been reinstated to the federal health care programs are not included in this file.

All the updated files are posted at http://www.oig.hhs.gov/exclusions/exclusions_list.asp.

Starting with this month’s update, LEIE files that do not contain the NPI, Waiver and Waiver States fields are no longer available.

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.

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Advance registration for the AHCA/NCAL Convention & Expo is now closed. If you wish to attend this year’s event, you can register in Phoenix. On-site registration will be available and opens Sunday, October 6th at 6:45 am. AHCA/NCAL housing is open and reservations will continue to be accepted through Friday, September 13. Download this year’s Convention & Expo Preliminary Program.

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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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NCHCFA would like to thank all facilities that submitted nominations for the 14th Annual Fabulous 50. We had a great response to help recognize front-line staff for their contributions. Nomination forms were judged yesterday by the Education and Programs Committee. As soon as all winners have been notified, the 2014 Fabulous 50 will be listed in UPDATE.

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

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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. Contact Jan Williams at janw@nchcfa.org to order one for your facility.

NCHCFA Members only: $35.00 plus tax and shipping

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Based on years of research, this practical guide illustrates the far-reaching benefits of empowered work teams in long-term care organizations and explains in everyday terms how to implement the concept. The authors present a fully-validated model for introducing the empowered work team concept to direct care staff, gaining support from the administration, and supervising the teamwork process over time. Hands-on tools include assessment forms, staff training materials, and step-by-step implementation guidelines. Guidance and troubleshooting tips are provided in the resource’s final chapter. Facility and program administrators, directors of nursing, staff supervisors, and team leaders will find this guidebook an invaluable tool for nurturing a more effective and motivated staff and, as a result, an improved care environment.

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

Product #8250
AHCA MEMBERS $34.95

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A Multitasking Video Game Makes Old Brains Act Younger.

http://www.nytimes.com/2013/09/05/technology/a-multitasking-video-game-makes-old-brains-act-younger.html

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Hippopotomonstrosesquipedaliophobia is the fear of long words.

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