UPDATE Weekly

Last week, President Obama released his FY2015 budget proposal. Regarding the nursing home profession, this budget looks similar in many ways to past years. The American Health Care Association is happy to see that the President did not propose any cuts to the provider tax, as had been proposed in some previous years. This year’s budget does propose significant cuts to Medicare, including reducing the market basket, cutting bad debt reimbursement and more. AHCA will continue to strongly oppose the deep Medicare cuts suggested in this budget. The proposed cuts are particularly outrageous given the recent MedPAC report that verified our centers operate on a thin 1.8 percent margin. AHCA will continue to oppose these arbitrary, deep cuts and AHCA doesn’t expect them to become law.

It is important to note that introducing budgets such as this is largely a formality in the legislative process, but the President’s budget does signal Administration priorities and priorities for many Congressional Democrats. In addition, many of the provisions that affect our profession have little detail to analyze and are broadly worded. Even in light of these facts, we do expect hearings to be held on the President’s budget in the House and Senate Budget committees as well as in the House Ways and Means and Senate Finance committees this week.

Below is a short summary of the budget provisions in the President’s FY2015 budget that have direct impact on our profession:

Post-Acute Care Market Basket Cuts
The budget reduces the home health, IRF and LTCH market basket update by 1.1% each year 2015 through 2024, with the floor set at a rate freeze. The budget reduces market basket updates for SNFs, but accelerates SNF cuts beginning with a -2.5% update in FY2015 and a reduction to -0.97% in FY2022. This is projected to save $97.9 billion from 2015-2024.

Reduce Medicare Coverage of Bad Debts
The President proposes reducing bad debt payments from 65% generally to 25% for all eligible providers over three years beginning in 2015. This proposal will save approximately $30.8 billion over 10 years.

Hospital Readmissions
The budget connects SNF payments to reduced hospitalizations. Beginning in 2018, payments to SNFs with high preventable readmission rates would be cut by up to 3%. This is projected to save $1.9 billion in the next 10 years.

Therapy Multiple Procedure Payment Reduction and Therapy Caps
The President’s budget notes the already-enacted reduction to Medicare payments to physicians when multiple therapies are provided to the same patient on the same day. The budget notes that reduction is estimated to save $2.4 billion over 10 years. The budget also notes the already-enacted extension for the exceptions process for outpatient therapy caps. While both items are noted, nothing new is proposed for either area.

Equalize Payment for Certain Conditions Commonly Treated in IRFs and SNFS
The budget’s proposals include adjusting payment updates for certain post-acute care providers and equalizing payments for certain conditions commonly treated in IRFs and SNFs, which is estimated to save $1.6 billion over 10 years. Specifically, the President’s budget proposes to reduce payment disparities in the IRF and SNF settings for three conditions beginning in 2015: hips and knees, pulmonary conditions, and other conditions as determined by the Secretary.

Implement Bundled Post-Acute Care Payment
Beginning in 2019, at least half of the payments for LTCHs, IRFs, SNFs and home health services would be bundled. Payments would be bundled for at least half of the total payments for post-acute care providers. A permanent and total cumulative 2.85 % cut would be applied by 2021. This is projected to save $8.7 billion from 2015-2024.

Value-Based Purchasing
While it is budget neutral, it is important to note that the President’s budget implements a value-based purchasing program for several additional provider types, including home health, SNFs, ambulatory surgical centers and hospital outpatient departments beginning in 2016. At least 2% of payments must be tied to the quality and efficiency of care.

Strengthen the Independent Payment Advisory Board
The budget requires IPAB cuts to take effect when Medicare spending growth exceeds Gross Domestic Product (GDP) +.5%. Current law is GDP +1%. This is estimated to save $12.9 billion over 10 years.

Medicaid
As was the case last year, there are no proposals to reduce or eliminate the provider assessment authority in the President’s budget.

As always, AHCA will continue to provide the latest information on the President’s budget proposal, as well as other developments on Capitol Hill. If you’d like to read more about the President’s budget, you can view it online at http://www.whitehouse.gov/omb/budget.

If you have specific questions for AHCA, please contact Government Affairs at (202) 898-6338.

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NC Health Care Facilities Association presents ICD-10-CM Essentials for Long Term Care March 19, 2014 in Greensboro, NC! Being taught by Pathway Health Services, this one-day seminar will have the following objectives:

• Learn structure, organization, and unique features of ICD-10.
• Understand basic coding guidelines.
• Demonstrate ability to look up and code basic diagnoses.
• Understand how coding relates to billing.
• Relate coding guidelines to all types of care.
• Know basic disease classification and how to use resource books.
• Be able to determine primary diagnosis.

PLEASE NOTE: Per the instructor, the ICD-10 coding manual is NOT needed for this one-day seminar as previously printed in the registration brochure!

The cost to attend this seminar is $185 for members and $370 for non-members. This fee includes handouts, snacks, and lunch. YOU CAN REGISTER AND PAY ONLINE! TO REGISTER, GO TO http://NursingHomesNC.com AND CLICK ON ICD-10-CM Essentials for Long Term Care. You may also download a brochure! Members may be invoiced. Non-members must submit payment online or mail with registration. Registration is open to anyone who would like to attend!

Location and Dates
March 19, 2014
Sheraton Greensboro at Four Seasons
3121 High Point Road
Greensboro, NC 27407

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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NC Health Care Facilities Association presents RESTORING QUALITY SLEEP-IMPROVING RESIDENT CARE AND QUALITY OF LIFE. This seminar will be offered in Charlotte on April 23rd and again in Chapel Hill on April 24th and will be presented by Sue Ann Guildermann with Empira – Back by popular demand! This session will cover the following:

• Restate the key components of the Empira Fall Prevention program.
• Explain the process that leads to the Empira Restorative Sleep Vitality Program.
• Discuss the etiology of sleep and wake in human beings.
• Identify the key components of the Empira Restorative Sleep Vitality Program.
• The top 10 disturbances to sleep.
• Five operational actions a long-term care provider can do to prevent sleep disturbance.

Brochures will be mailed next week!

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Not for Profit organizations, especially trade associations, rely heavily on the volunteer time of its membership. One important way to make a difference is by serving on one of NCHCFA’s committees. Members have until March 15th to volunteer to serve on one of NCHCFA’s committees: Standards and Ethics, Provider Relations, Education and Programs, Quality Advisory, and Payment for Services. Click here for a description of the committees. Click here for the sign-up form for all committees.

All committee assignments are for a two-year term beginning at the time of appointment and ending February 29, 2016. Appointments are made by Chair, Kevin Cox. Only representatives from member facilities in good standing are eligible to serve. Committees generally conduct two in-person meetings per year and others as needed by conference call. When submitting your request, please choose more than one committee and rank selections in order of preference. Each committee is limited to 20 people.

Members currently on committees will need to go through the sign-up process.

If you volunteer to serve on a committee, please make the commitment to participate. We promise to be respectful of your time and busy schedules.

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The NC State Board of Examiners for Nursing Home Administrators will offer the 2014 Preceptor Seminars on April 28-29, 2014 and April 29-30, 2014 at the Kingston Plantation, Myrtle Beach, SC. You will need to choose the first seminar dates for Renewal Preceptor certification and the second seminar dates for Initial Preceptor Certification and Continuing Education Only. The seminars will be open to all nursing home administrators seeking continuing education credits and/or preceptor certification. This is the only Preceptor Seminar being planned for 2014 by the NC State Board of Examiners for Nursing Home Administrators.

Click here to download more information along with the registration form.

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Submissions are open for the 2014 AHCA Quality Initiative Recognition Program! Skilled nursing members have the opportunity to be recognized for demonstrating achievement of the AHCA Quality Initiative goals. Members have until Thursday, May 1, 2014 to submit their data qualifying them for recognition. All members recognized through the program will be honored at AHCA/NCAL’s 2015 Quality Symposium in Austin, Texas, and additional honors will be bestowed to those achieving multiple goals.

Learn more about the recognition levels, eligibility requirements and submission steps on AHCA’s website. Please e-mail qualityinitiative@ahca.org with any questions about the Recognition Program.

While nursing centers do not need to submit data for their hospital readmissions and antipsychotic use, centers must submit staff turnover data and customer satisfaction results to AHCA by May 1, 2014.

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AHCA is conducting its annual, nationwide staffing survey to examine retention and turnover rates for nursing center employees. The 2013 Staffing Survey is open to all nursing centers in the U.S., which are asked to complete and return the survey by Thursday, May 1, 2014. Individual center and company responses to the survey will be kept confidential. Published results will appear in the aggregate form only. NCHCFA member centers that wish to be recognized for their nursing staff turnover results through AHCA/NCAL’s 2014 Quality Initiative Recognition Program must participate in the AHCA 2013 Staffing Survey. Submit your staffing data today!

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The NCTracks team will be offering another in-person Provider Help Center on April 22 in Hickory. NCTracks staff from provider enrollment, provider relations, claims, and prior approval will be available to assist NC providers with questions or concerns regarding NCTracks. No appointment is necessary. Providers will be assisted on a first come, first served basis.

For providers to get the most out of these sessions, NCTracks requests that you bring specific examples of issues. The more details that can be provided about the problems, such as screen shots, NPI numbers, TCNs (claim numbers), denial codes, etc., the more help the NCTracks team will be able to provide.

The Provider Help Center will be held on April 22 from 9:00 a.m. to 12:00 p.m. and 1:00 p.m. to 4:30 p.m. at the Catawba DSS, 3050 11th Avenue Dr. SE, Hickory, NC 28602.

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On February 28th, CMS issued a Survey and Certification Emergency Preparedness Initiative: S&C Emergency Preparedness Checklist Revision. The revisions were made to the recommended CMS Emergency Checklist. According to the Survey & Certification Memorandum, the information is current policy and is in effect for all healthcare facilities. Highlights of the changes:

• Detailed guidance for patient/resident tracking, to include that the facility should have a plan for when a patient/resident is determined to be missing during an evacuation
• Quantity of water a facility should transport during an evacuation
• Expectation of collaboration with Healthcare Coalitions and Local Emergency Personnel
• Reference is made to use FEMA in updating existing emergency plans and using FEMA’s best practices and guidance when updating emergency plans.

To read the S&C letter, click here.

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The “Updated LEIE” database file reflects all OIG exclusion and reinstatement actions up to, and including, those taken in February 2014. 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://oig.hhs.gov/exclusions/exclusions_list.asp.

Please note that LEIE files that do not contain the 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.

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The photos from the Chairman’s Evening Extravaganza – A Night in Olympic Village are now available! To view and order photographs, please visit http://www.PhotoSpecialties.com and use the password: NCHCFA and then click on “NCHCFA Chairman’s Evening Extravaganza.”

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Poor sleep in old age prevents the brain from storing memories

http://www.sciencedaily.com/releases/2013/01/130127134212.htm

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Sony began selling VCRs in 1970 capable of recording television shows. However, Sony was sued by the film studios for copyright piracy. The Supreme Court backed Sony.

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