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 call the Association office at (919) 782-3827 with any questions. Brochures will be mailed to members in June!

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Providers will not need to split Medicaid prior approvals (PAs) over the ICD-10 transition date of October 1, 2015 in the same way you will need to split claims. NCTracks regrets any confusion from previous postings and they are delighted this will be easier than previously reported.

Medicaid PAs that span October 1st do not need to be split. If you have an approved PA request with a begin date before October 1st and an end date on or after October 1st, no action is required. It is possible for a claim to be submitted after October 1 with an ICD-10 code and the PA to be approved with an ICD-9 code.

The ICD-10 transition will not affect PAs because the diagnosis codes on PAs are not used to adjudicate claims. Instead, PAs are used by clinicians to see if the service to be provided is appropriate for the diagnosis.

Therefore, most PAs that span October 1st do not need to be split. However, the claim submitted for services rendered on or after October 1st must use ICD-10 codes.

All PA requests submitted to NCTracks on or after October 1st should use ICD-10 codes. Retroactive requests for PA for dates of service before October 1st should use ICD-9 codes.

Exceptions: The exceptions are the Sickle Cell and EHDI (Early Hearing Detection and Intervention) programs under the N.C. Division of Public Health. PA requests for Sickle Cell and EDHI services cannot span the October 1st implementation date. Providers must obtain a new PA for Sickle Cell and EDHI services rendered on or after October 1st. (NCTracks will automatically end date existing PAs for Sickle Cell and EDHI that extend beyond September 30th.)

Review of Claims:

With claims, when the date of service begins before the October 1st implementation of ICD-10 and ends afterwards, you must split them into two separate claims. A single claim cannot contain both ICD-9 and ICD-10 codes. For services rendered before October 1st, submit one claim using ICD-9 codes. For services rendered on October 1st and afterwards, submit a second claim using ICD-10 codes. This will only be required for situations in which the dates of service span the October 1 implementation date.

The exception is hospital inpatient claims. Inpatient claims with DRG pricing cannot be split. Instead, use the ICD code based on the discharge date. If the discharge date is September 30th or earlier, then hospitals will submit the claim with ICD-9 codes. If the discharge date is October 1st or later, submit the claim with ICD-10 codes.

NCTracks will not accept ICD-9 codes for claims with dates of service starting October 1st or later, per policy from the Centers for Medicare and Medicaid Services (CMS).

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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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The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for Thursday, May 14, 2015 at 2:00 PM ET. Items planned to be discussed during this call are:

• Proposed SNF PPS Rule:
http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-04-15.html
o Quality Reporting Program Proposed Rule Overview
o SNF Value Based Purchasing

• Electronic submission of staffing data announcement:
http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html

There will also be an open question and answer session.

To participate by phone, dial (800) 837-1935 and reference Conference ID 12753443. If you cannot attend the live conference, CMS will have an encore recording. 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:
http://www.cms.gov/OpenDoorForums.

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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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This DVD has two separate programs: Program 1 introduces everyone in the organization to the safety committee. It explains the role of the safety committee: to promote safety awareness and teamwork. It also explains six things every worker can do to support the goal of a safe, injury-free facility. Program 2 is aimed at the committee members, the administration, and middle managers. It explains the contribution an active, effective safety committee can make to a facility’s bottom line and covers the building blocks most successful safety committees have in common.

The companion Presenter’s Guide includes background information, sample questions and follow-up points for group discussion, sample in-service presentation outline, and copy-ready audience participation handouts.

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

Product #6858D
AHCA MEMBERS $159.00

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If you missed Upcoming Hospice Regulations seminar, the notebook/presentation is now available for purchase. To order, e-mail your request to Amy Suggs at amys@nchcfa.org. The cost is $25 plus tax and shipping.

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Nursing home residents are certain this tiny dog is from heaven.

http://www.upworthy.com/nursing-home-residents-are-certain-this-tiny-dog-is-from-heaven-after-seeing-her-in-action-i-agree

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On May 6, 1954, British runner Roger Bannister became the first person to run a four-minute mile.

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