UPDATE Weekly

The September 2015 Medicaid Bulletin is now available on the N.C. Division of Medical Assistance (DMA) Web site. In addition to articles about NCTracks, the September Medicaid Bulletin includes information about a variety of topics, including:

• Changes in DMA Credit Balance Reporting
• ICD-10 FAQs and Crosswalk
• NCTracks Provider Trainings
• Changes in Crossover Claims
• Provider Instructions for Informal Reconsideration Review

The Medicaid Bulletin Web page includes links to the current bulletins, as well as previous bulletins.

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The regulations governing skilled nursing facilities are under revision for the first time in nearly 25 years. The proposed changes are many and substantive, but they are not final yet.

NCHCFA’s objective is to impress upon CMS just how important these changes are to skilled nursing facilities in North Carolina. To be effective, we need you and as many individuals in your organization as possible to submit comments to CMS on these proposed changes.

We are asking that every administrator, director of nursing, corporate officer, support staffer, everyone with a vested interest in the future of this profession carefully review these proposed changes. NCHCFA will also be submitting comments, but the Association’s comments alone will not be enough.

We do not need form letters; we are asking you to write in your own words. CMS needs to hear directly from you since you are the experts in long term care. In order for comments to maintain credibility, NCHCFA recommends including your name, position and LTC years of experience in the comments.

Your first assumption may be that the rule changes will only mean bigger challenges, but that may not be the case for all changes. A thoughtful and analytical assessment of the proposed regulations is necessary to assess both the costs and the benefits of the intended changes. To make an impact on the final rule, CMS needs to hear from each of us.

Although the proposed changes are very broad, you should not feel like you must address every issue. Focus on a few items that will have the greatest impact on your residents, your staff, or your facility.

Resources to help you:

• Mark Parkinson Video
• Dr. David Gifford Video
• Len Russ Instructional Video
• Instructions
• Topics for Comment
• Sample Comments
• Template Letter for Assisted Living Members
• Mark Parkinson’s Comment Letter to CMS
• See comments already submitted
• Submit a Comment Electronically
• Submit a Comment by Mail
• Log Your Submission
• Summary of SNF RoP Proposed Rule
• SNF RoP Proposed Rule Full Text
• Side-by-Side Comparison of Proposed and Current Regulations

It is often easy to throw up our hands in frustration and think Washington will never pay attention to what one constituency has to say, but your participation will have an impact on the final CMS rule.

If you have any questions regarding the proposed changes or this effort, please do not hesitate to contact either Polly Welsh, pollyg@nchcfa.org, or Eric Kivisto, erick@nchcfa.org, or (919)782-3827.

Submit your comments today! The deadline is September 14 at 5:00 p.m.

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As of today, 3,419 comments on the Requirements of Participation Proposed Rule have been sent to CMS, with many coming from NCHCFA members. AHCA is compiling a database of those who have submitted a comment to CMS – either electronically or by mail – on the Requirements of Participation Proposed Rule and will recognize those individuals with a special badge ribbon at AHCA/NCAL’s annual convention this October in San Antonio, Texas.

Many NCHCFA members have commented directly to CMS so the AHCA database is not reflective of North Carolina’s efforts. We realize this is another step to take, but we are asking NCHCFA members to please click here and provide the requested information so that AHCA may count your submission.

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Register today for A Blueprint for a Fall Prevention Program presented by Sue Ann Guildermann. This seminar will be held on September 30th at the Doubletree by Hilton in Greensboro, NC. After the educational event, attendees should be able to design a falls prevention program that is founded on root cause analysis to include:

1. Three types of root causes for resident falls in skilled nursing facilities;
2. Three types of interventions from the National Center for Patient Safety and
3. Appropriate interventions to prevent and/or reduce resident falls in skilled nursing facilities.

The cost to attend this seminar is $185 for members and $370 for non-members. This fee includes handouts, lunch, and breaks. YOU CAN REGISTER AND PAY ON-LINE! TO REGISTER, GO TO http://NursingHomesNC.com AND CLICK ON A Blueprint for a Fall Prevention Program. Members may be invoiced. Non-members must submit payment online or mail with registration. Registration is open to anyone who would like to attend!

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Please plan to join your friends and colleagues in beautiful Pinehurst, North Carolina, on September 16th and 17th for the Fourth Annual Autumn Classic Golf Tournament. The event will begin Wednesday with golf, a reception, dinner and program held at the world famous Pine Needles Lodge and Golf Club. The Pinehurst Autumn Classic is being sponsored by the NC Health Care Facilities Association to benefit our political action committee (PAC). You do not have to play golf to participate! Click here for registration materials.

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ICD-10 becomes effective on October 1, 2015! Providers who do not use ICD-10 for billing services provided after October 1, 2015 will not be paid!

CMS has posted a complete list of the 2016 ICD-10-CM valid codes and code titles on the 2016 ICD- 10-CM and GEMs Web page. The file is named icd10cm_codes_2016.txt. This file will be useful for physician offices and other providers who want to check to make sure that they are reporting all characters in a valid ICD-10-CM code. The codes are listed in tabular order (the order found in the ICD-10-CM code book). This list should assist providers who are unsure if additional characters are needed, such as the addition of a 7th character in order to arrive at a valid code. A similar list of the 2016 ICD-10-PCS valid codes and code titles is available on the 2016 ICD-10 PCS and GEMs Web page. The file is named icd10pcs_codes_2016.txt.

You can access complete versions of both ICD-10-CM (diagnoses) and ICD-10-PCS (procedures), as well as the General Equivalence Mappings (GEMs) and Reimbursement Mappings on the 2016 ICD- 10-CM and GEMs and 2016 ICD-10-PCS and GEMs Web pages.

The “ICD-10-CM/PCS ICD-10-CM/PCS Myths and Facts” Fact Sheet (ICN 902143) was revised and is now available in hard copy format. This fact sheet is designed to provide education on the International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS). It includes the following information: ICD-10-CM/PCS compliance date; use of external cause and unspecified codes in ICD-10-CM; responses to myths on ICD-10-CM/PCS; and resources.

The “ICD-10-CM/PCS The Next Generation of Coding” Fact Sheet (ICN 901044) was revised and is now available in hard copy format. This fact sheet is designed to provide education on the International Classification of Diseases, 10th Edition, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS). It includes the following information: ICD-10-CM/PCS compliance date; use of external cause and unspecified codes in ICD-10-CM; Current Procedural Terminology and Healthcare Common Procedure Coding System codes; ICD-10-CM/PCS — an improved classification system; ICD-10-CM/PCS examples; structural differences between International Classification of Diseases, 9th Edition, Clinical Modification and ICD-10-CM/PCS; and resources.

Prepare for the transition to ICD-10 on October 1, 2015. MLN Connects videos are available on coding basics, testing, home health, and more:

• ICD-10 Coding Basics
• Coding for ICD-10-CM: More of the Basics
• Medicare’s Testing Plan for ICD-10 Success

Visit the ICD-10 Medicare Fee-For-Service Provider Resources Web page for a complete list of Medicare Learning Network educational materials.

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The “Updated LEIE” (List of Excluded Individuals and Entities) database file reflects all OIG exclusion and reinstatement actions up to, and including, those taken in August 2015. This new “Updated LEIE” 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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They say things in Texas are bigger and better. The AHCA/NCAL 66th Annual Convention & Expo is shaping up to be just that, all from historic and beautiful San Antonio. Experience the food, the landmarks, and the fun of this Texas-sized destination, while you network, learn, and enjoy yourself at this must-attend event. This is not just a networking and educational event: this helps AHCA/NCAL further their mission to deliver solutions for quality care. The 66th Annual AHCA/NCAL Convention & Expo is a chance to share your knowledge and learn from your peers, your contemporaries, and experts in long term and post-acute care. The fact that it takes place in San Antonio, one of the southwest’s most colorful and entertaining cities, just makes it even better!

Register now! Additional savings are available when multiple people register from the same facility. There is something for everyone at the 66th Annual AHCA/NCAL Convention & Expo.

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Learn what it takes to effect real culture change within residential care settings while reducing the administration of psychotropic drugs in the symptomatic treatment of dementia. Dr. G. Allen Power, board-certified internist, geriatrician, nursing home practitioner, and Eden Alternative™ Educator, challenges all care providers working with individuals with dementia to undertake a true operational change. You will learn how to embrace more humanistic, enlightened practices that address the most common challenges in caring for people who live with dementia. Overcome communication challenges, minimize anxiety and depression, root out the causes of wandering, and gain insights into paranoia and delusions so that you can learn to treat individuals with dementia as the human beings that they are rather than letting their dementia define them.

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

Product # 8249
AHCA Members (on-line price) $32.95

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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 Donna Snyder at donnas@nchcfa.org. The price is $35.00 (tax and shipping included).

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Linked: Knowledge of palliative care and less end-of-life disruption

https://news.brown.edu/articles/2015/03/palliative

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The widest highway in the world is Interstate 10 in Texas, which at its widest point is 26 lanes.

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