UPDATE Weekly

Yesterday, the Joint Legislative Oversight Committees on Health and Human Services and Information Technology met with representatives of the NC Department of Health and Human Services. Legislators are concerned that many providers, including nursing facilities, have been negatively impacted by claims processing issues in the new system, NCTracks. NCTracks has been plagued by claims processing “defects” and delays since it went live on July 1st.

Providers expressed concerns about the increasing amount of Medicaid receivables and increase in claims denials since the system went live. Representatives of NCTracks and DHHS stated that most of the issues are directly related to lack of provider participation in trainings on the new system.

Articles on the Joint Committee meeting can be found at http://www.newsobserver.com/2013/10/08/3265489/dhhs-meeting-with-legislators.html and other news outlets.

NCHCFA continues to work with NCTracks and DHHS in order to get resolution to the problems impacting the processing of nursing home claims. As progress is made, it will be announced in our weekly newsletter, UPDATE.

Handouts from the meeting can be accessed here. As of Wednesday afternoon, the audio recording of the meeting had not been posted.

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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. This finding, coupled with a significant reduction in the number of repeated falls, makes this presentation one that you will want to attend! If you missed the one-day seminar in March of this year, you will not want to miss this one!

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

The cost to attend this seminar is $315 for members and $630 for non-members. This fee includes handouts, snacks, and lunch for two days. YOU CAN REGISTER AND PAY ONLINE! TO REGISTER, GO TO http://NursingHomesNC.com AND CLICK ON FALLS PREVENTION-TRAIN THE TRAINER. 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!

Location and Dates
November 13-14, 2013
Sheraton Greensboro at Four Seasons
3121 High Point Road
Greensboro, NC 27407
Reservations need to be made by October 21st! Please call (800) 242-6556 and specify that you are with NC Health Care Facilities Association to receive our special room rate!

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NCHCFA posted the Medicare rate calculation file our Web site the day after the final rule was released. A few weeks later, the American Health Care Association (AHCA) posted their rate calculation tool. Earlier this week, Palmetto GBA posted their SNF RUG rates.

The Palmetto GBA rates can be found by clicking here. The AHCA Medicare Rate Calculator can be accessed by clicking here. The NCHCFA rate spreadsheet can be found in the Member Section of the Association Web site at http://www.NursingHomesNC.com.

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NC is one of the first three states in the United States that are accepting electronic Plans of Corrections (POC). Below is the information for your facility to sign up so that starting November 1st your POC will be available electronically through a secure CMS system. This is for facilities that are certified for Medicare and Medicaid only at this time. Please follow the instructions below to sign up, which includes watching a webinar and also for requesting the proper passwords to be able to send your POC electronically.

DHSR has also set up a special e-mail address, DHHS.DHSR.EPOC@dhss.nc.gov, to direct questions and also to notify DHSR you have completed and received your CMSNet account. Please remember that this needs to be completed by November 1st. After that date, any surveys DHSR conducts will have citation statements electronically sent to the facility. DHSR is asking that facilities establish an e-mail address that will be stable, checked regularly and not affected by staff turnover.

ePOC Registration Instructions:
Start on the CMSNet page of the QTSO website, https://www.qtso.com/cmsnet.html. On that page scroll down to ePOC Access Request Forms link. The ePOC forms page will display. On the ePOC forms page, select the Steps to Access ePOC Application link. This document is all inclusive detailing the need to request the CMSNet account first, then how to register online for the ePOC access and finally how to access the ePOC system. Users should follow the steps in the document.

Webinar Registration:
The ePOC Webinars are now available on the QTSO Web site, http://www.qtso.com. To access the Webinars, go to the Online Training section of QTSO and select the ePOC link. An e-mail will be sent with a password to access the Webinar after registering your name and e-mail address. A media player capable of running a Windows Media file will be needed to run the Webinars.

If you have questions, Cindy DePorter, Shonda Kelly and Sharon Harwood will be answering questions from the special e-mail account that has been set up, DHHS.DHSR.EPOC@dhss.nc.gov.

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The “Updated LEIE” database file reflects all OIG exclusion and reinstatement actions up to, and including, those taken in September 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. Please note that LEIE files that do not contain the National Provider Identifier (NPI), Waiver and Waiver States fields are no longer available. 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 NPI and Waiver fields.

Instructional videos explaining how to use the on-line 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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The North Carolina Culture Change Coalition is accepting culture change grant applications from every certified nursing home.

The Coalition has made major changes to its grant program in accordance with new rules from CMS which took effect in 2012. Facilities will apply for grants using the updated RFA, which is available throughout the year. Once the coalition receives the proposal, trained members will review the application to make sure it meets CMS criteria. Each section of the application will be scored on the basis of incomplete, needs improvement, acceptable, or exceptional. Any section of the proposal receiving an incomplete or needs improvement will be sent back to the facility, and a trained coalition member will mentor the facility to help refine the section(s). Once all sections meet the acceptable or exceptional score, DHHS will help the facility convert the application into CMS’s required format and will then send the application to CMS for review. CMS has 45 days to make a determination on the application and may contact the facility for further information if necessary. Approval or denial is made by CMS and all decisions are final.

While this represents a major change in the method for reviewing grant proposals, the Coalition is willing to work with any eligible facility wishing to use CMP money to fund enhancement projects so they have the best chance of having their application approved by CMS. The revised RFA became available in early April and was sent to the administrators of all eligible North Carolina facilities. If you have any questions about the program, or need assistance with the application process, please contact Becky Wertz, becky.wertz@dhhs.nc.gov.

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This book explores 28 challenging cases 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.

NCHCFA Members only: $35.00 plus tax and shipping

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Health care should be a team sport.

Read more here: http://www.ted.com/talks/eric_dishman_health_care_should_be_a_team_sport.html

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Because of the gravitational pull effecting tree growth, the theoretical maximum height a tree can grow is between 400 and 426 feet, approximately 50 feet taller than any tree currently in existence.

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