UPDATE Weekly

On July 31, CMS issued a final rule outlining FY 2015 Medicare payment rates for skilled nursing facilities (SNFs) under the Prospective Payment System (PPS). The American Health Care Association (AHCA) has prepared an overview of the final rule that can be read by clicking here.

In addition, AHCA has updated their SNF PPS Rate Calculator to reflect the final rule and has posted the file at http://www.ahcancal.org/facility_operations/medicare/Pages/SNFPPS.aspx. On this same site, you will also find instructions on using the tool to estimate your facility’s Medicare impact.

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The NC Health Care Facilities Association will be hosting a seminar on UPCOMING HOSPICE REGULATIONS. This seminar will be presented by Cindy DePorter, MSSW, Assistant Section Chief, Acute and Home Care and Quality Evaluative Systems, Nursing Home Licensure and Certification, DHSR. There are new hospice regulations and a new tag added. Nursing homes can be cited if their contract with hospice does not have certain components (ie a written communication log with hospice.) Ms. DePorter will review the upcoming new regulation and interpretative guidance for hospice in nursing homes and review the regulatory expectations of the relationship between hospice and nursing homes.

Brochures with registration forms will be mailed today! You may also register on-line at http://www.NursingHomesNC.com and click on UPCOMING HOSPICE REGULATIONS! Members may be invoiced. Non-members need to pay at time of registration. There is a room block at the Sheraton Greensboro if overnight rooms are needed. Identify yourself as being with the group NC Facilities Health Care Association to receive our special group rate!

November 12, 2014
Sheraton Greensboro
3121 High Point Road
Greensboro, NC 27407
(800) 242-6556

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The NCHCFA Annual Convention and Trade Show will be held February 15-18, 2015 at the Sheraton Four Seasons Hotel/Koury Convention Center in Greensboro, NC! Brochures outlining specific program information will be mailed in December.

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Earlier this week, Mark Parkinson, AHCA President and CEO, was in the Oval Office to attend President Obama’s signing into law the Improving Medicare Post-Acute Care Transformation Act (IMPACT) of 2014. IMPACT sets the stage for a site neutral payment system and supports AHCA’s Quality Initiative. This law has four components:

1. The incorporation and use of standard assessment tools across all post-acute settings (i.e., IRFs, LTCH, SNFs, and Home Health)
2. Public reporting of a set of quality measures related to post-acute care, many of which align with AHCA’s Quality Initiative, such as rehospitalizations, staff turnover and customer satisfaction
3. Funding to support CMS’s use of payroll data to evaluate staffing
4. Reports from HHS and MedPAC on how to better measure quality and reform payments in post-acute care settings

In addition, the President issued an Executive Order to make changes to the CMS Five- Star Quality Rating System. Historically AHCA has not supported Five-Star. Although AHCA continues to have concerns and criticisms about the program, it has helped our members to improve their ratings over time.

The President’s Executive Order directs CMS to:

• Implement auditing of MDS data among a sample of centers in each state starting in January 2015;
• Use payroll data to validate staffing information and report turnover and retention;
• Adjust the scoring methodology by giving higher weight to quality and staffing measures that independent sources have verified;
• Ensure the survey inspections in each state are completed in a more timely manner; and
• Add additional quality measures to Five-Star, specifically rehospitalizations, discharge back to community and antipsychotic use.

Most of these recommendations align with AHCA’s current position that quality measures and staffing information should be accurate and consistent with IMPACT or other existing laws. The Executive Order also indicates a greater recognition of the importance of our Quality Initiative’s four goals (reduce rehospitalizations, reduce antipsychotics, decrease staff turnover and increase customer satisfaction) and the significant progress our membership has made in these areas.

AHCA will work with the Administration and CMS staff to ensure the Executive Order is implemented in a manner that is fair to our members. NCHCFA in coordination with AHCA will keep you informed as we learn more on how these changes will impact you. The AHCA Board has made it very clear that we oppose any change in Five Star that arbitrarily lowers members’ ratings.

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Registration for the upcoming Liberty Healthcare Regional Provider Trainings is open. Providers may register for any location by accessing the Liberty Healthcare Web site homepage at http://www.nc-pcs.com. Under PCS News, registrants can click on Agenda Posted: Oct 13 – 30 Provider Training Seminars and select the location to complete the registration process.

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The American Health care Association (AHCA) is pleased to reveal a new and improved on-line platform for LTC Trend Tracker. This more user-friendly version gives you more information up-front, allows you to create and save custom reports, and offers you additional options in choosing your peers to benchmark against.

It still offers a central place for all the data CMS collects on skilled nursing centers. It still provides exclusive, in-house reports to help you gain even more insight on hospital readmissions and discharges to the community. And it still lets you benchmark yourself to your peers locally, regionally and nationally. It just does it better.

Registration for LTC Trend Tracker will be closed until October 15th. To be notified when registration opens up in October, go to http://www.ahcancal.org/research_data/trendtracker/Pages/Register.aspx and complete the proper form for your organization type. This will allow your organization to pre-register for the new LTC Trend Tracker.

If you have questions about this process, please contact the LTC Trend Tracker team at help@ltctrendtracker.com.

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The American Health Care Association (AHCA) recently received information from CMS that the Medicare Part B therapy manual medical review (MMR) program that has been in a ‘pause’ since the end of February 2014 will not be resuming in the immediate future. CMS intends to “…restart the therapy conversations with the industry sometime in November.” NCHCFA will keep you up to date as new information emerges. Below is a brief background of this issue.

Background:
Medicare Part B therapy, including physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) services, including that provided in skilled nursing and assisted living settings, have been subject to annual per-beneficiary financial limitations (caps) in various forms since 1999. However, since 2006, beneficiaries were eligible for unlimited exceptions to the cap limits if the services were attested to as being medically necessary. However, to the continued growth in spending, Congress enacted a mandatory manual review (MMR) process for any claims with services furnished above $3,700 per year for PT and SLP services combined, and a separate $3,700 threshold for OT services. The therapy MMR program reviews were administered by Medicare Administrative Contractors (MACs) from October 2012-March 2013. In April 2013, CMS reassigned therapy MMR reviews to Recovery Audit Contractors (RACs).

In February 2013, CMS announced a ‘pause’ in RAC review activities, including therapy MMR while CMS completed the procurement process for new RAC contractors. However, that procurement process has been delayed indefinitely due to legal protest challenges. Recently, CMS announced that due to the procurement delays, it had issued contract modifications to the current RACs so that they could resume limited reviews. Specifically, CMS stated, ” Most reviews will be done on an automated basis, but a limited number will be complex reviews of topics selected by CMS.“

Since the therapy MMR program began, AHCA has been engaged in periodic meetings with CMS and other therapy stakeholders, most recently in early August 2014, discussing issues and potential solutions. In addition, AHCA recently contacted CMS regarding whether therapy MMR was included in the limited resumption of RAC review activities, and if so, how would the reviews be conducted. Today CMS responded via email that they “… believe it’s time to restart the therapy conversations with the Industry sometime in November, so these type conversations can happen again. In the interim, there’s nothing new to report outside of what’s on the CMS website, and specifically, no manual medical reviews.” In addition, AHCA commented that the recently released CMS RAC Report to Congress did not provide sufficient detail related to the impact of therapy MMR. CMS responded, “planning is underway to drill down into information referenced in the Report to Congress (and gather specifics behind the Outpatient Therapy Reviews). We used our standard process, which does not break out therapy services separately. The next step is to begin analyzing the results, so that we can ultimately share that information with you and others.“

Reference links:
CMS Therapy Cap MMR Page
CMS RAC Program Recent Updates
CMS FY2013 RAC Report to Congress

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Below is a listing of the 2015 Fabulous Fifty recipients. NCHCFA would like to thank all facilities that submitted nominations. We had a tremendous response to help recognize front-line staff for their contributions. Each of this year’s recipients will be honored at the Awards program in their district. The 15th Annual Fabulous Fifty Special Recognition Awards program will be at the following locations:

The dates for the 15th Annual Fabulous 50 Celebrations are

District I – October 16, 2014, Grand Bohemian Hotel, Asheville
District II – October 21, 2014, Hilton Charlotte University Place, Charlotte
District III – October 23, 2014, Grandover Resort, Greensboro
District IV – October 28, 2014, Mad Boar Restaurant, Wallace
District V – October 30, 2014, Renaissance North Hills Hotel, Raleigh

District I
Jill Clayton– Givens Highland Farms
Darlene Cullins– Skyland Care Center
Samuel Green- Smoky Mountain Health & Rehab Center
Deborah Griffiths- Grace Heights Health & Rehab Center
Mary Littrell- Autumn Care of Waynesville
Lauren Montella- Pisgah Manor Health Care Center
Jessica Moore- Universal Health Care-Fletcher
Sally Sadberry- Autumn Care of Drexel, Drexel
Becky Summerlin- Lenoir Healthcare Center
Belinda Winston- Silver Bluff Village

District II
Crystal Benfield- Trinity Ridge
Maureen Benton- Peak Resources-Gastonia
Terry Davidson- Big Elm Rehab & Living Center
Annie Evans- Westwood Hills Nursing & Rehab Center
Denise Hazelwood- Brian Center-Lincolnton
Jimmy Sigmon- Trinity Ridge
Barbara Sinclair- Carrington Place Nursing Center
Sharon Thompson- Peak Resources-Charlotte
Lanay Wade- PruittHealth-Town Center
Keisha Wright- Conover Nursing & Rehab Center

District III
Deborah Curtis- Pine Ridge Health & Rehab
Earlene Holt- Peak Resources-Alamance
Reather Massenburg- Hillcrest Convalescent Center
Margaret McKay- The Oaks
Leone Parker- Universal Health Care-Ramseur
Betty Riddle- Peak Resources-Alamance
Tracy Snow- Village Care of King
Irene Stackhouse- Blumenthal Nursing & Rehab
Cindy Wilson-The Graybrier Nursing & Retirement Center
Troy Younger- Peak Resources-Treyburn

District IV
Annie Brice- Westfield Rehab & Health Center
Beverly Brightman- Croatan Ridge Nursing & Rehab
Constance Bryant- Universal Healthcare-Brunswick
Genara Gaskill- Riverpoint Crest Nursing & Rehab
Joanne Hamlin- Liberty Commons Rehab Center
Beverly Johnson- Golden Years Nursing Home
Hermetta Judge- Pender Memorial Hospital Skilled Care
Mary Lee- Liberty Commons-Columbus County
Kathleen Oxendine- Highland Acres Nursing & Rehab
Robin Woodland- Village Green Rehab & Health Care

District V
Marshall Curmon- PruittHealth-Farmville
Arnetta Freeman- Ayden Court Nursing & Rehab
Joe Jones- South Village
Ruth Morgan- Universal Healthcare-Oxford
Frederick Patrick- Universal Healthcare-Greenville
James Price- Capital Nursing & Rehab
Judy Stevens- Franklin Oaks Nursing & Rehab
Joyce Troy- Universal Healthcare-Fuquay-Varina
Teresa Wooten- Longleaf Neuro Medical Treatment Center
Angela Wynn- Barbour Court Nursing & Rehab

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This new edition continues to provide nurses with the most comprehensive, current, and reliable information available so they can develop the skills to efficiently and effectively respond to disasters or public health emergencies. Meticulously researched and reviewed by the world’s foremost experts in preparedness for terrorism, natural disasters, and other unanticipated health emergencies, the text has been revised and updated with significant new content, including 10 new chapters and a digital adjunct teacher’s guide with exercises and critical thinking questions.

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

Product # 8320
AHCA Members (on-line price) $110.00

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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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Life expectancy in the U.S. hits a record high

http://www.usatoday.com/story/news/nation/2014/10/08/us-life-expectancy-hits-record-high/16874039/

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If every star in the Milky Way was a grain of salt, they would fill an Olympic sized swimming pool.

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