UPDATE Weekly

Register today for the NCHCFA Annual Convention and Expo, February 15-18, 2015 at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center, Greensboro, NC. Don’t miss the opportunity to earn up to 14.5 hours of educational credit for North Carolina Nursing Home Administrators, as well as up to 13.5 hours of Nursing CE credit! The advanced registration deadline has been extended to Friday, February 6th. To obtain an additional brochure visit the Member Center of the Association’s Web site at http://www.NursingHomesNC.com.

Reminder, call the Sheraton at (800) 242-6556 to make your room reservation. Identify that you are with “NC Health Care Facilities Association 2015 Convention” to receive the group discounted rate.

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Earlier this week, the President released his FY2016 budget proposal. There is no question that a President’s budget wields considerable influence on how our government sets and defines its priorities, as well as to what Congress should subsequently pay attention. However, Congress must implement any changes through the legislative process.

As it regards our profession, this budget looks similar in many ways to past years. The Administration did not include cuts to provider taxes.

When it comes to Medicare, however, the budget’s proposed cuts are ill advised. This year’s budget does propose significant cuts to Medicare, including reducing the market basket, cutting bad debt reimbursement and more. The proposed cuts are particularly outrageous given the recent reports from MedPAC that our centers operate on a thin 1.9% margin. AHCA will continue to oppose these deep cuts, and do not expect them to become law. In the past, our profession has worked with the White House and Congress to offer better ways of finding Medicare savings, and we will continue to do so.

Below is a short summary of the budget provisions in the President’s FY2016 budget that have direct impact on our profession.

Medicare

Post-acute care (PAC) market basket cuts: The budget reduces market basket updates for all PAC providers, but accelerates SNF cuts beginning with a -2.5% update in FY2016 and a reduction to -0.97% in FY2023. This is projected to save $102.1 billion from 2016-2025.

Reduce Medicare coverage of bad debts: The President proposes reducing bad debt payments from 65% to 25% for all eligible providers over three years beginning in 2016. This proposal will save approximately $31.1 billion from 2016-2025. This proposal was included in the President’s FY2015 budget.

Implement bundled post-acute care payment: Beginning in 2020, 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 2022. This proposal is projected to save $9.3 billion from 2016-2025.

Implement value-based purchasing for PAC providers: 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 SNFs, beginning in 2017. At least 2% of payments must be tied to the quality and efficiency of care in the first two years of implementation, and at least 5% beginning in 2019. This proposal has no budget impact.

Strengthen the Independent Payment Advisory Board (IPAB): 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 $20.9 billion from 2016-2025.

Encourage appropriate use of inpatient rehabilitation facilities: The President proposes adjusting the standard for classifying a facility as an inpatient rehabilitation facility (IRF) by requiring that at least 75% of patient cases admitted to an IRF meet one or more of 13 designated severity conditions beginning in 2016. The current standard is set at 60%. This proposal is projected to save $2.2 billion from 2016-2025.

Medicaid

Provider Assessments not cut in the President’s Budget: As was the case last year, the President’s budget does not propose reducing or eliminating the provider assessments (provider tax). Since Congress is likely to consider such cuts as an area to save money, it is a positive that the President did not include it in his recent budget.

Structural changes for delivery of long term services and supports: The budget includes a number of proposed changes that would promote the use of home and community based services. These proposals were not included in last year’s budget. It is important to note that even if these options were to be passed into law, states would have to choose to include them in their Medicaid program.

Other

Strengthening program integrity: The budget includes new investments in program integrity totaling $201 million in FY2016 and $4.6 billion over ten years. These investments include continuing to fund the full Health Care Fraud and Abuse Control discretionary cap adjustment, increasing mandatory Medicaid Integrity Program funding, and providing more funding to recovery auditors to undertake more corrective actions that will help reduce improper payments. In total program integrity investments would yield an estimated $21.7 billion in savings to Medicare and Medicaid over ten years.

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

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The Education and Programs committee needs your help! We hope you will join us and participate in celebrating the Association’s 60th Anniversary during the NCHCFA Diamond Jubilee. Please submit photographs, articles, interesting facts, important dates, individual corporate and/or facility historical details, and any additional information that reflects back on the last 60 years in long term care. The more photographs the better! A special slideshow presentation will be shown during the Diamond Jubilee Celebration in Greensboro, NC. In addition, this information will be used for many years to come as a permanent historical record of NCHCFA and the story of our membership.

The committee’s goal is to have at least one historically significant detail from all NCHCFA members! Don’t miss this special opportunity to commemorate our founding leaders and extraordinary members from the past, present, and future. Please submit items by Friday, February 6th. Information can be sent to:

NCHCFA
Attn: Allison Boyette
5109 Bur Oak Circle
Raleigh, NC 27612
allisonb@nchcfa.org

We thank all members that have submitted information, but 100% MEMBERSHIP PARTICIPATION is needed. Members of the Education and Programs Committee will be reaching out to members that have not submitted information in the coming weeks. If you have any questions please call (919) 782-3827 or e-mail allisonb@nchcfa.org.

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The North Carolina Health Care Facilities Association would like to thank our 2015 Gold Convention Hosts for supporting the upcoming Annual Convention & Expo – NCHCFA Diamond Jubilee Celebration. Be sure to visit them on Tuesday, February 17th during Expo 2015 – Voyage Through the Decades.

Blue Ridge Pharmacy – Booths 500 & 502
Healthcare Services Group – Booths 427 & 429
Legacy Consultant Pharmacy – Booth 516
Medipack Pharmacy – Booth 233
Neil Medical – Booths 301, 303, 400 & 402
NH Medical Services – Booths 229 &231
Poyner Spruill, LLP – Booth 302
PruittHealth – Booths 323, 325, 327, 329, 422, 424, 426 & 428
Southern Pharmacy Services – Booths 409 & 411

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The American Health Care Association (AHCA) invites you to attend a special Webinar to learn more about the Payment Reform Initiative that they are undertaking. Three dates and times are scheduled (see below). The content of each Webinar will be identical.

Webinar participants will gain a clear understanding of:

• Congressional and Administration efforts that make it critical for AHCA to develop its own vision for payment reform before an untenable reform package is imposed upon the profession
• The Medicare concept — a SNF-Stay Bundle — crafted by the member-driven Task Force
• Medicaid and Managed care components still in development

AHCA staff also will provide an overview of the guide a member work group is developing to help individual members understand the potential impacts of the Medicare concept. Finally, AHCA staff and member leadership also hope to hear member questions and suggestions from participants on the Payment Reform Initiative.

We hope you can participate on one of the three Webinars. The same information and material will be presented during each:

• February 6, 2015 – 1:30 p.m. – 3:00 p.m. Eastern time
• February 11, 2015 – 1:00 p.m. – 2:30 p.m. Eastern time
• February 18, 2015 – 11:00 a.m. – 12:30 p.m. Eastern time

To ensure an open and free flowing dialogue as well as member comfort with questions and frank discussion, these identical presentations, subsequent question, and answer sessions will not be recorded.

Friday, February 6, 2015, 1:30PM – 3:00PM EST
https://ahcancal.webex.com/ahcancal/j.php?MTID=mc60e6ea54d5bda591b2d34c0d2f11c81
Meeting number: 736 721 794
Meeting password: ahca
To participate by phone, dial (888) 601-3884 and use Participant Passcode 278593.

Wednesday, February 11, 2015, 1:00PM – 2:30PM EST
https://ahcancal.webex.com/ahcancal/j.php?MTID=m59dd08ca44d0a0970fbfa1bd9c945da0
Meeting number: 735 801 768
Meeting password: ahca
To participate by phone, dial (888) 601-3884 and use Participant Passcode 278593.

Wednesday, February 18, 2015, 11:00AM – 12:30PM EST
https://ahcancal.webex.com/ahcancal/j.php?MTID=m19e745d7d29604309d81118952fb3588
Meeting number: 733 390 890
Meeting password: ahca
To participate by phone, dial (888) 601-3884 and use Participant Passcode 278593.

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The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for Thursday, February 12, 2015 at 2:00 PM ET. The planned agenda includes:

I. Opening Remarks
II. Announcements & Updates

o Nursing Home Compare
o Errata Document clarifying A1900: Admission/Entry and Reentry in the RAI
User’s Manual – posted to the Nursing Home Quality Initiative’s Webpage
http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment Instruments/NursingHomeQualityInits/MDS30RAIManual.html

III. Open Q&A

To participate on the call, dial (800) 837-1935 and reference Conference ID 12529597. Encore is an audio recording of this call that can be accessed by dialing (855) 859-2056 and entering the Conference ID beginning the following Monday. The recording expires after 3 business days.

For ODF schedule updates and E-Mailing List registration, visit the CMS Website at http://www.cms.gov/OpenDoorForums.

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ICD-10 coding will be implemented in just months. Is your facility ready for the transition? Nationally recognized coding expert Karen Fabrizio, RHIA, CHTS-CP, CPRA, AHIMA Approved ICD-10-CM/PCS Trainer, will help you train with her new, comprehensive ICD-10 coding training manual. Specific to long-term care, this manual gives detailed coding training and how-to guidance for the top diagnoses in the long-term care setting. ICD-10 is a complex new coding set, so it is crucial your facility is prepared.

This book provides:

• In-depth coding how-to for the most commonly documented diagnoses in the long-term care setting
• Guidance on how to properly document and code in ICD-10 to ensure appropriate coding on claims
• Quiz questions, examples, and sample scenarios to help train staff
• A detailed understanding of how long-term care providers in particular can best conquer ICD-10 complexities
• “How to” chapters that focus on each diagnostic area

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

Product #8347
AHCA MEMBERS $149.00

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This DVD, Mobility and Safe Movement of the Elderly, Improving Your Skills to Prevent Injuries and Reduce Falls, by Teepa Snow, MS, OTR/L., FOTA, Dementia Care & Training Specialist, was developed in conjunction with Wake Allied Health Education Center, Durham Technical Community College and the University of North Carolina School of Medicine, Office of Information Systems. The content is formatted in separate segments in order to customize the delivery of content to your learning objective. Handouts developed by Teepa accompany each video and may be reproduced. To order, e-mail your request to Jan Williams at janw@nchcfa.org. The price is $35.00 (tax and shipping included).

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How Can QIS Methods Improve Everyday Care?

http://www.providermagazine.com/archives/2015_Archives/Pages/0215/How-Can-QIS-Methods-Improve-Everyday-Care.aspx

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The Association Board has been chaired by thirty-three different people, including several children of past Chairmen.

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