UPDATE Weekly

After publishing public notices and posting the same notice on their Web site, the Division of Medical Assistance has implemented the legislated 3% withhold to Medicaid rates for dates of services January 1, 2014 and after. For nursing facilities, the 3% reduction is being applied to the direct and indirect rate components. The fair rental value and provider assessment portions of the rate are not being reduced.

The 3% withheld from the rates will be used to fund a “shared savings” program through which providers can earn back an amount of the withheld funds by meeting certain defined standards. The standards by which providers will be evaluated have not yet been established. As legislated, the shared savings programs must be in place by July 1, 2014 with the “shared savings” payments to providers starting no later than January 1, 2015.

Click here to read the public notice for the legislated 3% withhold. The Medicaid rates effective January 1, 2014 have been posted and can be viewed by clicking here. An Excel spreadsheet that can calculate the new Medicaid rate for any Medicaid CMI is posted in the Member Section of the Association Web site at http://www.NursingHomesNC.com.

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NCHCFA members have a unique opportunity to have facility specific questions addressed by NCTracks, the new multi-payer Medicaid Management Information System for the North Carolina Department of Health and Human Services (NCDHHS), during the 2014 Annual Convention & Expo.

On Tuesday, February 25th representatives from NCTracks will provide a brief progress report of the Medicaid claims processing system as it continues to develop and improve since its implementation July 1, 2013 for Package One attendees during “Reimbursement Hot Topics” and for Package Two attendees during “Billing Office Staff Day-Navigating NCTracks.”

If your Medicaid Billing Staff have a specific question and/or concern they would like addressed live during “Navigating NCTracks,” please e-mail Sam Clark at samc@nchcfa.org and include “NCTracks Question” in the subject line. In addition, NCTracks representatives have been invited to stay onsite after the program to assist Package Two Billing Staff attendees with additional questions regarding submitting Medicaid claims through NCTracks.

This will be a very detailed and informative program for Billing Office Staff. Reminder, if a facility registers two staff members for Package Two, a nursing assistant or Billing Office Staff member may attend Package Two at NO CHARGE!

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In December 2013, the FDA posted important new guidance for consumers and providers related to bed rail safety. It includes descriptions of safety concerns, recommendations for providers, and suggestions for filing complaints. This posting can be accessed at:

http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/BedRailSafety/default.htm

There are no changes to the bed rail guidance for hospital bed rails that was released in 2000 and updated in 2010. There is expanded information about adult portable bed rails.

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The main changes are outlined below and the section pertinent to skilled nursing facilities (SNFs) follows.

Major Organizational Changes from prior QIO SOW

• QIOs are to be regional, covering 3 to 6 states, and called Quality Innovation Networks (QIN–QIOs).
• Contract cycle is extended to 5 years (from3 years).
• Family and beneficiary complaint investigation shifted to five (5) Beneficiary and Family Centered Care QIOs (BFCC-QIOs) covering the entire country.

The Skilled Nursing Facility 11th Scope of Work, Task C.2: Reducing Healthcare-Acquired Conditions in Nursing Homes section can be accessed clicking here. Summary information on SOW is as follows:

• Recruit 75% of SNFs in each state with oversampling of 1 STAR facilities

o QIOs must collect from all SNFs

• Who participate, a signed statement that the nursing home will actively participate in the Collaborative, including data submission and data sharing.
• Who elect not to participate, a signed statement that they decline to participate and why.

• The QIN-QIO shall have a targeted focus on:

o increasing mobility among long-stay residents,
o decreasing unnecessary use of antipsychotics in dementia residents,
o decreasing potentially avoidable hospitalizations,
o decreasing Health Care Acquired Infections (HAIs) such as Methicillin – resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C.Diff), and vaccinations, such as pneumonia and influenza,
o decreasing other Healthcare Acquired Conditions (HACs) such as: urinary tract infections, pressure ulcers, physical restraints, and ensuring an “injury and violence free living” environment as noted in the National Prevention Strategy, and
o improving resident satisfaction.

• The QIN-QIO’s efforts related to beneficiary satisfaction shall focus on the nursing home systems that impact quality, such as consistent/permanent staff assignment, communications, leadership, regulatory compliance, clinical models, and quality of life indicators.
• The QIN-QIO shall recruit residents/beneficiaries and their family-members for participation as a part of the QIN-QIO’s Peer-Coach activity. In addition, the QIN-QIO shall include residents/beneficiaries and/or family members in at least two quality improvement activities initiated or performed by the QIN-QIO under Task C.2.
• QINs will conduct two collaboratives: NNHQCC Collaborative(s) I and II shall commence in Year 1 and Year 3 of the contract term, respectively, and each Collaborative shall last for 18 months.

• NNHQCC will use the Quality Assurance &. Performance Improvement (QAPI) model as the framework for nursing home quality improvement.
• QIN-QIO shall recruit nursing homes to act as “Peer-Coaches” for other nursing homes in the collaboratives if they are a high-performing nursing home, defined as being in the top 10% of the National Nursing Home Composite Quality Measure (to be provided by CMS).
• QIOs will work to attain a score of six or better on the National Nursing Home Composite Quality Measure (TBD).
• Improve the rate of mobility among long-stay nursing home residents.
• Reduce the use of unnecessary antipsychotic medication in dementia residents.

• The QIN-QIO shall create or engage with other Learning Area Networks such as, Advancing Excellence in America’s Nursing Homes Local Area Networks for Excellence (LANEs), Long Term Care Ombudsmen, nursing homes, HHS and CMS agencies, and others committed to nursing home excellence.

Timeline:
• RFP released December 5, 2013
• Proposals due to CMS February 14, 2014
• Notification Awards expected July 2014
• Work begins August 2014
• Contracts are for five years

To view the entire scope of work and all documents, click here: https://www.fbo.gov/index?s=opportunity&mode=form&id=dff522bababb6b9859bb783c08db6074&tab=core&_cview=0

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An update/change to RFB page 21, file topic: Infection Control, addressing how long normal saline can be used after it has been opened, has been published based on recommendations made by the North Carolina Statewide Program for Infection Control and Epidemiology, UNC Chapel Hill School of Medicine.

This update can be found at http://www.ncdhhs.gov/dhsr/nhlcs/pdf/rfb_infectioncontrol.pdf and states “Many sterile solutions used for irrigation (i.e., normal saline and sterile water solutions) are labeled as single-use by the manufacturer and contain no preservatives to prevent microbial growth after opening. After opening the container, its contents should be used promptly to minimize the possibility of bacterial growth and pyrogen formation. Any unused portion of irrigating solutions should be discarded and not stored for later use. Facilities should consider using smaller bottles in some situations to prevent waste. Facilities should follow the manufacturer’s instructions for use and maintaining and discarding this solution.”

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Register today for the NCHCFA Annual Convention and Expo, February 23-26, 2014 at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center, Greensboro, NC. 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. Don’t miss the opportunity to earn up to 16 hours of educational credit for North Carolina Nursing Home Administrators, as well as up to 14 hours of Nursing CE credit! The advanced registration deadline is Friday, February 7th. To obtain an additional brochure visit the Member Center of the Association’s Web site at http://www.NursingHomesNC.com.

The North Carolina Health Care Facilities Association would like to thank the 2014 Convention Hosts for supporting the upcoming Annual Convention & Expo. Be sure to visit them at the booths listed below:

Healthcare Services Group, Inc. – Booths 429 & 431

Medipack Pharmacy – Booth 530

NH Med Services – Booth 528

Don’t miss the Chairman’s Evening Extravaganza – A Night in Olympic Village on Monday, February 24th. 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! You will not want to miss 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 Julia Mancuso 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 of 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.

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Election of officers and members of the Board of Directors will be conducted on Sunday afternoon, February 23rd, during NCHCFA’s Business Meeting. The business meeting will be held in conjunction with NCHCFA’s Annual Convention in Greensboro. All persons seeking an office or a position on the Board of Directors should have their name submitted to the Nominating Committee by Friday, February 7th. The nomination must be submitted in writing or e-mailed and include the candidate’s full name, the office being sought and the facility or company of employment. Please mail or e-mail the information to the attention of:

By Mail:
Nominating Committee
North Carolina Health Care Facilities Association
5109 Bur Oak Circle
Raleigh, NC 27612

By Email:
Karen Outland, NCHCFA, kareno@nchcfa.org

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Palmetto GBA announces the Skilled Nursing and Consolidated Billing Webcast on January 16, 2014, from 10:00 to 11:00 AM ET. Palmetto will review the different areas subject to SNF Consolidated Billing as well as some tips for submitting your SNF claims.

To register for this event, click here.

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It isn’t too early to remind you that on October 1, 2014, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA); which includes all nursing facilities, and assisted living facilities where home care services are provided. The Centers for Medicare & Medicaid Services (CMS) has instructed all providers to develop an implementation strategy now that includes an assessment of the impact on the organization, a detailed timeline and a budget. Long-term care providers must understand the implications and make the successful transition from ICD-9 to ICD-10 or claims will not be processed. In September, the American Health Care Association (AHCA) recorded a one-hour Webinar: ICD-10-CM: What is it? Why? And What Next? The Webinar is free for AHCA members and can be found at http://webinars.ahcancal.org/session.php?id=11516.

In addition to this resource, CMS has a special resource page on this topic, providing links to both documents and learning videos, at http://www.cms.gov/Medicare/Coding/ICD10/index.html?redirect=/ICD10.

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A Webinar on improving dementia care in nursing homes has been scheduled to take place on Wednesday, February 26; 2-3:30 PM ET. To register, go to http://www.eventsvc.com/blhtechnologies. Space may be limited, register early.

The CMS National Partnership to Improve Dementia Care in Nursing homes was developed to improve dementia care through the use of individualized, comprehensive care approaches. The partnership promotes a systematic process to evaluate each person and identify approaches that are most likely to benefit that individual. The goal of the partnership is to continue to reduce the use of unnecessary antipsychotic medications, as well as other potentially harmful medications in nursing homes and eventually other care settings as well.

During this MLN Connects Call, a CMS subject matter expert will discuss the critical role of both state and federal surveyors in the implementation of the partnership. Additional speakers will be presenting on the importance of leadership, as well as the strong correlation that exists between proper pain assessment and antipsychotic medication use. A question and answer session will follow the presentation.

Agenda:
• Role of surveyors
• Importance of leadership
• Proper pain assessment
• Next steps

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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. 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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Music brings the past alive for memory-impaired.

http://www.northcarolinahealthnews.org/2014/01/06/music-brings-the-past-alive-for-memory-impaired

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The top three destinations in the United States to ring in the New Year are Las Vegas, Disney World and New York City.

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