UPDATE Weekly

Earlier this week, Congress passed a one year doc fix. This fix will prevent physician fee schedules from being reduced. The same bill also extends the therapy cap exception, introduces a value based hospital readmission policy, and delays ICD-10 implementation. A more complete summary of the bill content can be viewed by clicking here.

None of these items become law until the President signs the bill. Once this has been done, we will announce it in UPDATE.

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As announced in an earlier issue of UPDATE, the Department of Health and Human Services submitted their detailed plan for reforming the State’s Medicaid program to the General Assembly for consideration. The report’s recommendations will require legislative approval and it is likely the General Assembly will make modifications.

Last year’s proposal centered on establishing 3-4 Community Care Entities that would manage all Medicaid services statewide. The CCE’s would then contract with private for profit or not for profit managed care companies (MCOs). The final plan rolled out abandons the MCO in favor of North Carolina based physician and hospital led Accountable Care Organizations (ACOs). The entire Medicaid reform report can be found at http://www.ncdhhs.gov/pressrel/2014/DHHS_Medicaid_Reform_Legislative_Report-2014-03-17.pdf. The section on LTSS reform begins on page 33.

Medicare ACOs have been around for several years. It is believed that if the ACO model is adopted for North Carolina, it will be similar to the existing model used for Medicare ACOs. Although nursing homes cannot form an ACO, they do have the option of participating in existing ACOs. The American Health Care Association has a free ACO contracting guide available for facilities interested in ACOs. The three sections of the guide can be accessed by clicking here.

NCHCFA will also be scheduling an ACO workshop later this year to educate providers on the various aspects of ACOs.

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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. This session will:

• 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.
• Identify the top 10 disturbances to sleep.
• Provide five operational actions a long term care provider can do to prevent sleep disturbance.

The cost to attend this seminar is $195 for members and $390 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 RESTORING QUALITY SLEEP. You may also download a brochure. 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!

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National Nursing Home Week® (NNHW), which begins on Mother’s Day, May 11 and ends May 17, 2014, is a special week in the year. This year’s theme revolves around the “Aloha Spirit” from the Hawaiian culture — it encompasses the qualities of being patient, kind, respectful, and compassionate. We hope you will join others during this week to honor and entertain everyone you serve, and the staffs that care for them! This special attention will make for a remarkable week, especially if you order NNHW-themed gear to spice up the festivities. Visit Facebook (http://www.Facebook.com/NursingHomeWeek) and “Like” us. Be sure to post your favorite pictures to the Facebook page so others can enjoy your fun and creativity

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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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Earlier this week, NCTracks recently updated information that may be beneficial to nursing home providers. Please see the summaries below.

Requesting Retroactive Approval for LTC

A new User Guide, “How to Request Retroactive Approval for LTC,” is now available. The guide explains both:

• How to submit a request for LTC Retroactive approval on the initial PA request
• How to submit a request when there is an approved Long Term Care PA in NCTracks and the provider needs PA approval for retroactive dates

The new guide can be found on the Provider User Guides and Training page of the NCTracks Provider Portal.

Update of PML in NCTracks

Many providers have inquired about the Patient Monthly Liability (PML) information in NCTracks. Often, the PML is correct, but when the claim was adjudicated and denied, the PML was not available in NCTracks. Providers that have claims that were denied for PML during 2013 should resubmit them for processing now that the PML has been updated.

Issues List Posted on Provider Portal

A list of current issues has been posted under Quick Links on the NCTracks Provider Portal home page at https://www.nctracks.nc.gov/content/public/providers.html. The list includes a brief explanation of the issue, the type(s) of providers affected, the status of the issue (Open/Closed), and comments/resolution of the issue. The list is not intended to include every issue, but rather the prevalent ones impacting multiple providers. The “Issues List” will be updated regularly and providers are encouraged to check the list before contacting the Call Center, in case it may be a known issue.

Next Provider Help Center will be April 22 in Hickory

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, please 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 AM to 12:00 PM and 1:00 PM to 4:30 PM at the Catawba DSS, 3030 11th Avenue Dr. SE, Hickory, NC 28602.

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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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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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Each month the Medicare Advisory is published to provide Medicare Part A participating providers with the latest Medicare information. The April issue, as well as past issues, can be accessed by clicking here.

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How can you measure the effectiveness of quality improvement efforts? Read this book and find out! Chapters cover preparing to collect data, data collection, understanding variation, run and control charts, control chart case studies, developing improvement strategies, and using patient surveys for CQI. An appendix shows five ways to calculate control limits.

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

Product #6912
AHCA MEMBERS $58.00

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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 Member:$30.00 per 100 brochures plus tax and shipping

Non-Members:$60.00 per 100 brochures plus tax and shipping

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One family’s agonizing decision: Teen photographer movingly chronicles his own family’s despair as they prepare to send disabled brother to live in a care home.

http://www.dailymail.co.uk/news/article-2592677/One-familys-agonizing-decision-Teen-photographer-movingly-chronicles-familys-despair-prepare-send-disabled-brother-live-care-home.html

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On April 3, 1973 the first portable cell phone call is made. General Manager of Motorola’s Communications Systems Division called his rival at AT&T’s Bell Labs from the streets of New York City.

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