UPDATE Weekly

Make plans today to join your colleagues for the fourth annual NCHCFA Summer Symposium. The three-day event will be August 26-28, 2015 at the Embassy Suites Resort at Kingston Plantation, Myrtle Beach, SC. Call the Embassy Suites Resort at (800) 876-0010 to reserve your overnight room. Use group code “HCF” to identify yourself as a NC Health Care Facilities Association Convention attendee! To make your reservation on-line, visit http://tinyurl.com/2015symposiumroomblock.

Please note that when our room block is full, rooms will be on a first come, first served basis at prevailing published rates. Please call the Association office at (919) 782-3827 with any questions. Brochures will be mailed to members in June!

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The Centers for Medicare and Medicaid Services (CMS) has released the Skilled Nursing Facility Prospective Payment System (SNF PPS) Notice of Proposed Rulemaking (NPRM). While the projected market basket growth rate of 1.4 percent is less than the profession had hoped, the reimbursement provisions of the rule contain no unexpected proposals. Of note, however, is that the FY 2016 NPRM marks the first year in which the profession will begin to see value-based purchasing provisions, quality reporting requirements, and health information technology sections in its annual NPRM.

Specifically, the FY 2016 NPRM discusses CMS’ proposed plans to implement the following:

• Protecting Access to Medicare Act of 2014 (PAMA) SNF Rehospitalization Value-Based Purchasing Program;
• Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) Quality Reporting Measures;
• Preliminary IMPACT Act health information technology data interoperability proposals; and
• Finally, the NPRM discusses proposed new staff reporting requirements.

As per the American Health Care Association’s (AHCA) historic practice, Association staff have prepared a summary of the 150-plus page rule. To view the summary, which includes staff contacts by section, click here. Additionally, AHCA has updated its SNF PPS Medicare rate calculator based on the FY 2016 NPRM. To view and utilize the calculator, please click here.

While changes in the wage indices used for rate setting vary county by county, it appears that Greene, Anson, New Hanover and Pender see the largest decreases while Gates, Franklin, Johnston, Wake, Iredell, Lincoln, and Rowan counties see the largest increases.

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The Association has updated their Excel spreadsheet which calculates Medicaid rates. The latest version reflects the Fair Rental Value (FRV) updates effective April 1, 2015. On April 1st, the FRV rates were updated to reflect items submitted on the Capital Data Surveys and two additional years of inflation. Facilities were not depreciated for FRV purposes last year.

The Excel rate calculator is located in the Member Section of the Association Web site at http://www.NursingHomesNC.com.

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The “Updated LEIE” database file reflects all OIG exclusion and reinstatement actions up to, and including, those taken in March 2015. 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 updated files are posted at http://oig.hhs.gov/exclusions/exclusions_list.asp.

Instructional videos explaining how to use the on-line database and the downloadable files are available as follows:

• On-line Database Video: http://oig.hhs.gov/exclusions/online.asp.
• Downloadable Database Video: http://oig.hhs.gov/exclusions/download.asp.

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On May 3, 2015, a new edit will be implemented in NCTracks to deny payment for certain supplies and equipment billed by individual practitioners when the Medicaid recipient is a resident in a Skilled Nursing Facility. The cost for these supplies and equipment is considered to be included in the Nursing Facility per diem paid to the facility. Nursing Facility services included in the per diem rate that are reimbursed to the facility may not be reimbursed to an individual practitioner for dates of service that a recipient is residing in a Nursing Facility.

See Section 5.4.1. and Attachment B of Clinical Policy No. 2B-1 for Nursing Facilities for a list of services included in the per diem rate that are reimbursed to a Nursing Facility. The policy can be found on the N.C. Division of Medical Assistance (DMA) Clinical Coverage Policy webpage at http://www.ncdhhs.gov/dma/mp/index.htm.

The new edit will affect claims submitted to NCTracks on or after May 3rd, regardless of dates of service. A new explanation of benefits (EOB) 01792 – MEDICAL SUPPLIES/EQUIPMENT ARE INCLUDED IN THE NURSING FACILITY PER DIEM PACKAGE will post to the paper Remittance Advice (RA) for claim details that fail the edit.

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Register today for the North Carolina Health Care Facilities Association’s “Audit Survival in Long-Term Care/The Roadmap to Success.” This program will provide strategies for managing the people, records, and processes for responding to an auditor’s request for records and appealing denials. The role each person plays during this process includes coordination, preparation, documentation, and tracking. Preventing denials in the first place is part of a comprehensive compliance program as an internal QA function.

Topics include, but not limited to the following:

• Audits impacting nursing homes
• Who may audit you
• How to respond to audit requests
• Appealing audits
• The parts your employees play
• How to reduce/prevent audits

This program will be presented by The Polaris Group on May 28th, 2015 at the Doubletree By Hilton in Greensboro, NC! Online registration is available by logging onto the Association Web site at http://www.NursingHomesNC.com and clicking on “Audit Survival in Long-Term Care/The Roadmap to Success.” Don’t miss it! Space is limited!

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“Bring on the Fiesta!” is this year’s theme for National Nursing Home Week! Speak the language of Familia, Vida and Amor during National Nursing Home Week 2015! Imagine an event that brings the long-term care (LTC) community of residents, rehab patients, families and care center staff together for a weeklong festival in 2015. Think of all the fun your LTC community can have, which is precisely why the American Health Care Association (AHCA) will designate National Nursing Home Week (NNHW) as “Bring on the Fiesta!” week. National Nursing Home Week products are selling out! Hurry and place your orders today and “Bring on the Fiesta!” Visit AHCA’s on-line store to place your order before it’s too late! National Nursing Home Week is May 10-17, 2015!

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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 Amy Suggs at amys@nchcfa.org. The price is $35.00 (tax and shipping included).

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Senior Citizens Boogie the Night Away at Their Own Prom.

http://www.huffingtonpost.com/2015/04/13/senior-citizen-prom_n_7042920.html

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A cow will produce about 200,000 glasses of milk in her lifetime.

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