UPDATE Weekly

The Intent to Apply deadline is Thursday, November 13, 2014 at 8 p.m. ET. The AHCA/NCAL National Quality Award Program provides a pathway for providers of long term and post-acute care services to journey towards performance excellence. The program is based on the core values and criteria of the Baldrige Performance Excellence Program. Member centers may apply for three progressive levels of awards: Bronze—Commitment to Quality, Silver—Achievement in Quality, or Gold—Excellence in Quality. Each level has its own distinct rigors and requirements for quality and performance excellence.

Applicants for the 2015 National Quality Award Program are strongly encouraged to submit the $75 Intent to Apply payment prior to the deadline. This is not mandatory; however, there are a number of benefits associated with submitting an Intent to Apply:

• The overall application fee is reduced by $200; and
• Applicants who submit the Intent to Apply will receive regular communications from Quality Award staff with deadline reminders, tips on applying for the award, and links to educational webinars.

For more information and to apply click on this link National Quality Award Program to go to the AHCA/NCAL Web site.

Please note that the Intent to Apply fee is non-refundable. Late payments will not be accepted.

Click here to start the process.

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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 (e.g., a written communication log with hospice.) Ms. DePorter will review the upcoming new regulations and interpretative guidance for hospice in nursing homes and review the regulatory expectations of the relationship between hospice and nursing homes.

You may register on-line at http://www.NursingHomesNC.com and click on UPCOMING HOSPICE REGULATIONS! Members can 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 Health Care Facilities 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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Last week, the District V Fabulous Fifty celebration was held October 30th at The Renaissance North Hills Hotel, Raleigh, NC. Representative Nelson Dollar hosted the event.

Recipients of the 2015 District V Fabulous Fifty honor are:

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

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PCS payment adjustments, with the exception of September 2014, were scheduled to be deducted from the first checkwrite of each month. The first checkwrite of November was yesterday, November 4th. However, the November 2014 PCS payment adjustment was communicated at different times on two different dates, both in the first checkwrite and November 12th. DHHS understands that some providers may be temporarily affected by this issue.

If the November 4th payment has caused a financial hardship that impacts your ability to meet fiscal obligations, a one-week payment advance may be provided. To request the advance, please send an e-mail to NCTracks_Hardships@dhhs.nc.gov and include:

1. Brief explanation of the circumstances of the financial hardship related to the PCS payment adjustment made November 4th
2. Agency name, billing number, NPI number
3. Contact information
4. Address where we should send the hardship payment
5. November’s payment adjustment amount

You will receive a response within 24 hours. Checks will be mailed within one day of approval. Please note that this payment advance will be deducted from the next week’s checkwrite on November 12th.

Going forward, payment adjustments will occur on the first checkwrite of each month, as intended. This means that the December payment adjustment will be December 2nd. Please disregard dates shared in prior communications. To determine the checkwrite dates for 2015, please go to https://www.nctracks.nc.gov/content/public/dms/public/pdf/2015-Checkwrite-schedule-DMA-1-0/2015%20Checkwrite%20schedule%20DMA%201.0.pdf.

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In a message from Mark Parkinson, AHCA President and CEO, upcoming changes to the Five Star rating system are discussed. To read about these changes, click here.

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In an effort to establish a comprehensive approach to Medicare Part A Skilled Nursing Facility (SNF) payment reform, CMS is expanding the scope of the SNF Therapy Payment Research project to examine potential improvements and refinements to the overall SNF Prospective Payment System (PPS). This expansion will allow for improvements in Medicare’s ability to pay adequately and appropriately for all services provided during a Medicare Part A SNF stay.

In the first phase of the project, the contractor reviewed past research studies and policy issues related to SNF PPS therapy payment and options for improving or replacing the current system of paying for SNF therapy services. See SNF Therapy Payment Models – Base Year Final Summary Report, April 2014.

In the second phase of the project, which is now in process, the contractor is using the findings from this Base Year Final Summary Report as a guide to identify potential therapy models suitable for further analysis. CMS is considering stakeholder comments and concerns as we continue to investigate alternative therapy payment approaches. Comments and feedback on the SNF PPS payment methodology may be submitted to SNFTherapyPayments@cms.hhs.gov.

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GMCF, the QIO for North Carolina, is now recruiting for the upcoming National Nursing Home Quality Care Collaborative (NNHQCC) entitled SPACE ~ Southern Partners Action Collaborative for Excellence ~ that will begin in April of 2015. GMCF is partnering recruitment efforts with NCHCFA for the 11th Statement of Work (11SOW). The Goals for the 11SOW include Reducing Healthcare-Acquired Conditions in Nursing Homes. GMCF will work with recruited nursing homes in alignment with the Nursing Home Action Plan to:

• Include residents and families in peer-coaching groups
• Support adoption of QAPI framework for quality improvement
• Continued reduction of off-label use of antipsychotics
• Focus on systems issues that affect quality (e.g., consistent staff assignment) as well as specific issues such as increasing mobility
• Reducing avoidable hospitalizations
• Decreasing HAIs

Benefits of participating are:

• Educational learning sessions offered throughout the year as well as technical assistance based on your nursing home specific goals
• Sharing of best practices and strategies from high performing nursing homes
• Assistance with implementation of Quality Assurance Performance Improvement (QAPI) including tools

To learn more about the CMS National Nursing Home Quality Care Collaborative, click here.

To learn more about the SPACE Nursing Home Quality Care Collaborative – Southern Partners Action Collaborative for Excellence Benefits, Expectations, and Commitments, click here.

If you are ready to register, click here for the Participation Agreement.

To accomplish this work, GMCF, along with NCHCFA, will recruit at least 75% of all nursing homes in North Carolina for two 18-month collaboratives. GMCF’s North Carolina based staff look forward to the opportunity to work with you over the next several years. For further information, please contact a Quality Advisor:

• Jeana Partington – jeana.partington@alliantquality.org
• Kellie Lewis – kellie.lewis@alliantquality.org
• Maria Fisher – maria.fisher@alliantquality.org

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Recently, the American Health Care Association (AHCA) received information from the Treasury Department about two Resident Trust Fund issues.

The first is that Social Security Administration (SSA) in Washington has received reports that some nursing homes may not be depositing resident SSA funds into resident trust accounts, but rather accounts payable accounts in which the residents’ money is commingled with the nursing homes expense account for supplies, etc. Federal law, implementing regulations and guidance require that these funds be deposited into a resident trust account as defined by Federal law. See OBRA ’87 (42 U.S.C. 42 USC 1396r(b)(4); regulations at 42 CFR Part 483; and CMS survey guidelines, F Tags at F156 through F162. These legal sources include guidance on mandatory management of funds if requested, interest bearing accounts, separate resident accounting and updating, an assurance of financial security and no charges for these services. In 2008, SSA had questioned its own authority to continue to permit the direct deposit of recipient benefit checks into various accounts including resident trust funds. AHCA overcame SSA concerns based on the stringency of the governing OBRA 87 law, regulations and guidance. Further, based on SSA’s determination that there were strict regulations and provider adherence, the Treasury Department has permitted, under its Go Direct program, direct electronic deposit of such benefits into Resident Trust Funds.

Secondly, the Treasury asked that providers be sure to follow the rules for representative payees if they are indeed representative payees. If a provider is not a representative payee then it has to get authorization from the resident or family to deposit funds into the resident fund account.

Resources: (1) Slides from the 2012 AHCA/Treasury Webinar on the Treasury Go Direct program. The slides provide guidance on Go Direct, the electronic direct deposit of federal benefits, Resident Trust Fund issues, and information on the role of Representative Payees. (2) Two web sites for Social Security Information on Representative Payees: http://www.socialsecurity.gov/payee and http://www.socialsecurity.gov/payee/documents/2011OrgGuide%20v3.pdf

In addition, the North Carolina Clinical Coverage Policy 2B-1 includes information on resident personal fund requirements in section 7.3.

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On October 31, CMS issued a Survey & Certification memorandum that provides additional information about the expansion of MDS Focused Surveys. The opening summary of the memorandum states: MDS / Staffing Focused Surveys: In mid-2014, the Centers for Medicare & Medicaid Services (CMS) piloted a short-term focused survey to assess Minimum Data Set, Version 3.0 (MDS 3.0) coding practices and its relationship to resident care in nursing homes in five states. CMS will expand these surveys in 2015 to be conducted nationwide. The scope of some or all of the focused surveys will also be expanded to include an assessment of the staffing levels of nursing facilities. This assessment will aim to verify the data self-reported by the nursing home, and identify changes in staffing levels throughout the year.

This memorandum provides background information and specific foci on Nursing Home Staffing, State Agencies Conduct of MDS/Staffing Focused Reviews, Training, Funding for State Agency Reviews and Enforcement Implications.

You will note that the memo states that surveyors will receive training to prepare them for this “specialized survey.” AHCA has asked CMS if this training will be available to providers and they have told us repeatedly that there is nothing “new” that providers will be expected to do: what is being reviewed is consistent with current requirements of participation.

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This book provides the theory, principles, methods, and tools for the nurse manager or leader of a long term care facility. It contains more than 150 guidelines, flow sheets, communication, assessment, and feedback procedures that can be implemented with little or no modification by directors of nursing in every type of long term care facility.

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

Product #6746
AHCA MEMBERS $84.95

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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. To order brochures for your facility, e-mail your request to Jan Williams at janw@nchcfa.org.

• 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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Achieving That Award Can Dovetail With QAPI Plans – Criteria from a national quality awards program align nearly seamlessly with the principles governing the federal quality initiative.

http://www.providermagazine.com/archives/2014_Archives/Pages/1014/Achieving-That-Award-Can-Dovetail-With-QAPI-Plans.aspx

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The current 50-star American flag was designed by a 17-year-old boy for a school project. He received a B- on the design.

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