UPDATE Weekly

This will be the last issue of UPDATE for this year. UPDATE will not be published on December 25th, 2013 or January 1st, 2014, but will resume its normal schedule on January 8th, 2014. The staff of the North Carolina Health Care Facilities Association wishes you Happy Holidays!

[Return to top]

The NCHCFA Annual Convention and Trade Show will be held February 23-26, 2014 at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center in Greensboro, NC! It’s time for Chair Cheryl Clapp-Coleman to pass the torch! Come help her celebrate like a champion. Join Cheryl and the Board of Directors in Olympic Village for the official gala of the 2014 Winter Olympics! As part of Package One and Three registrations, plan to attend this international affair. There will be food, fun and entertainment from around the world. The band Soul Fish is back by popular demand and will play all the greatest tunes from your favorite decade.

You will not need your passport to enter this international pavilion! Start the evening in Sochi, Russia with a regional refreshment before you head to the Krasnaya Polyana slopes. Represent team USA and ski like Lindsay Vonn on the Alpine Downhill Challenge or snowboard like Shaun White on Thunder Mountain. Once you have worked up an appetite, visit Hamburg, Germany for an imported surprise while continuing your tour through Europe. You do not have to go through customs when you return to the United States! Visit New York and challenge a colleague to a game of Air Hockey and recreate the 1980 Lake Placid, “Miracle on Ice” before you enjoy some American food and fun.

Will you make it to the medals podium? Come dressed as an Olympic athlete from the past or present, or as a spectator from your favorite country! Great prizes will be awarded for the best dressed male and female. Heavy hors d’oeuvres will be served. You will not want to miss this global event. To view the entire 2014 Annual Convention & Expo schedule CLICK HERE! Registration materials will be available this week.

Reminder, call the Sheraton at (800) 242-6556 to make your room reservation. Identify that you are with “NC Health Care Facilities Association 2014 Convention” to receive the group discounted rate.

[Return to top]

NCTracks will observe the Christmas holiday on Tuesday, December 24, 2013, and Wednesday, December 25, 2013, and New Year’s Day on Wednesday, January 1, 2014. The NCTracks Call Center will be closed on those days. In keeping with the posted checkwrite schedule, there will be no checkwrite the week of Christmas. There will be checkwrites on December 17, 2013 and December 31, 2013.

The checkwrite schedules for 2013 and 2014 can be found under the Quick Links on the Provider Portal home page at https://www.nctracks.nc.gov/content/public/providers.html.

[Return to top]

As a reminder, the budget bill passed by the legislature and signed into law by the Governor requires that Medicaid payments to most providers (including nursing homes) be reduced by 3% effective January 1, 2014. The Division of Medical Assistance (DMA) intends to implement this as a 3% rate reduction and will post a public notice prior to the January 1st effective date. The withheld funds can be “earned back” in the future through a shared savings program. Details of the “earning back” process have not been finalized, but will be developed over the next several months.

[Return to top]

The Center for Medicare Advocacy has announced that the Medicare Policy Manuals have been revised pursuant to the Jimmo vs. Sebelius Settlement. The Jimmo case ended a longstanding practice denying Medicare coverage to people who had “plateaued,” or were “chronic,” or “stable,” or “not likely to improve.” The Manual revisions, which clarify that improvement is not required to obtain Medicare coverage, were published by the Centers for Medicare & Medicaid Services (CMS) on Friday December 6, 2013. They pertain to care in Inpatient Rehabilitation Facilities (IRF), Skilled Nursing Facilities (SNF), Home Health care (HH), and Outpatient Therapies (OPT). In the Transmittal announcing the revisions, CMS states that:

No “Improvement Standard” is to be applied in determining Medicare coverage for maintenance claims that require skilled care. Medicare has long recognized that even in situations where no improvement is possible, skilled care may nevertheless be needed for maintenance purposes (i.e., to prevent or slow a decline in condition). The Medicare statute and regulations have never supported the imposition of an “Improvement Standard” rule-of-thumb in determining whether skilled care is required to prevent or slow deterioration in a patient’s condition. Thus, such coverage depends not on the beneficiary’s restoration potential, but on whether skilled care is required, along with the underlying reasonableness and necessity of the services themselves. The manual revisions now being issued will serve to reflect and articulate this basic principle more clearly.

There is also a Medicare Learning Network (MLN) article that states that even if no improvement is expected, under the SNF coverage standard, skilled therapy services are covered when an individualized assessment of the patient’s condition demonstrates that skilled care is necessary for the performance of a safe and effective maintenance program to maintain the patient’s current condition or prevent or slow further deterioration. Skilled maintenance therapy may be covered when the particular patient’s special medical complications or the complexity of the therapy procedures require skilled care.

As announced in previous issues of UPDATE, the American Health Care Association (AHCA) will be reviewing the change request and the MLN Matters article in a December 19th Webinar.

The MLN Matters Number MM8458 can be read by clicking here. To read the associated change request, click here.

[Return to top]

The latest edition of The Pulse of CMS from the Atlanta Regional Office has been released. This edition features articles on Important ICD-10 Facts, the DMEPOS Recompete process, the health insurance marketplace and others. Click here to read this edition.

[Return to top]

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

[Return to top]

Important information for residents and families. This brochure outlines what physical restraints are, when they should be used, rules and regulations concerning restraints, and making decisions about using them.Contact Jan Williams at janw@nchcfa.org to order brochures for your facility.

NCHCFA Members: $30.00 per 100 brochures plus tax and shipping.

[Return to top]

Does Purell Breed Superbugs? The dirty truth (and the good news) on hand hygiene.

http://www.motherjones.com/environment/2013/12/germophobia-superbug-hygiene-soap-bacteria

[Return to top]

Your teeth start growing six months before you are born.

[Return to top]