UPDATE Weekly

On Monday, President Obama signed a two-year budget deal that will increase spending limits and avert a default. Called the Bipartisan Budget Act of 2015, it also increases the debt limit and offsets higher discretionary spending through various spending cuts and revenue increases. Passage of the budget allows the Federal Government to continue meeting its spending obligations while avoiding a fiscal faceoff between Congress and the Administration.

Specifically, the bipartisan budget:

• Increases discretionary spending by $80 billion above sequester spending caps, funding the government through FY 2017 (September 2017).
• Suspends the debt ceiling until March 2017.
• Includes a cap on Medicare Part B premium increases, providing relief to beneficiaries facing an increase next year and in 2017, if necessary.
• Extends the solvency of the Social Security disability insurance trust fund.

The President applauded the Democrats and Republicans who came together to pass a responsible, long-term budget agreement that “reflects our values, grows our economy and creates jobs.”

The American Health Care Association (AHCA) is pleased with the final form of this legislation, even though it contains a pay-for that impacts our profession: an extension of the Medicare sequester at its current rate for an additional year, to 2025. While it is unfortunate that Congress continues to use this pay-for when funding options are needed, immediate cuts that further erode already slim SNF margins would have been a far worse option. Real threats — such as a cut to bad debt reimbursement or an elimination of the provider assessment — are not in the legislation.

Despite the extension of the Medicare sequester, AHCA believes the budget ultimately will serve our profession well and bring much-needed stability to the government funding situation. They will remain vigilant.

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Each month, the Division of Medical Assistance (DMA) published the Medicaid Bulletin. This publication, containing information vital to the Medicaid provider community, is only available on-line. The November issue contains important information on changes in how SNF rate letters and patient rosters will be made available to providers starting January 1, 2016. Here is a hint – They will no longer be mailed.

Due to changes in the DMA Web site, the 2015 Medicaid Bulletins are now available by clicking here.

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The NCHCFA Annual Convention and Trade Show, The Art of Caring, will be held February 21-24, 2016 at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center in Greensboro, NC! Call the Sheraton at (800) 242-6556 to make your room reservation. Identify that you are with “NC Health Care Facilities Association 2016” to receive the group discounted rate. Brochures outlining specific program information will be available in December.

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The rule, issued on October 29, 2015 was published in the Federal Register on November 3, 2015, and comments are due to CMS 60 days following the publication date (January 4, 2016). Although this proposed rule results in no changes to skilled nursing center requirements, the changes will have a direct impact on the information facilities receive from hospitals upon transfer. AHCA believes the proposed changes will be helpful in improving the quality of information.

When a patient is transferred to a skilled nursing center from a hospital, the discharge information proposed must include:

1. Advance directive, if applicable;
2. Course of illness/treatment;
3. Diagnoses;
4. Laboratory tests and the results of pertinent laboratory and other diagnostic testing;
5. Reconciliation of all discharge medications with the patient’s pre-hospital admission/registration medications (both prescribed and over-the-counter);
6. All known allergies, including medication allergies; and
7. Numerous other specified data.

To view the display copy go to: PROPOSED RULE

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On October 1, CMS opened registration for the voluntary period to participate in electronic submission of payroll data, including staff start and end dates (for calculating staff retention and turnover), and census data. The voluntary period from October 1, 2015 until required submission of this data beginning on July 1, 2016 is the ONLY time that providers will have the opportunity to “test” the process and determine how their payroll system interfaces with the Payroll-Based Journal.

AHCA believes that CMS is unlikely to make any significant changes to the process or the system and strongly encourages members to consider registering for the voluntary submission period and submitting their data during the voluntary period.

Important information from CMS about the registration process including links for on-line training as well as to other Payroll-Based Journal resources is available on the Staffing Data Collection PBJ Website.

The Affordable Care Act requires CMS to collect electronic staffing data from nursing centers. The Act requires this data to be auditable and verifiable. The information is intended to collect direct care staff (employed and contracted), employee turnover and tenure, and must include census data and case mix. Earlier this year, CMS announced they would require this information to be submitted by all nursing centers starting in July 2016.

When the required submission process begins, CMS will continue to require providers to submit Forms CMS 671 & CMS 672 at the time of survey. The data from these Forms will be used in calculating the Staffing Domain of the Five Star Rating System until late 2017 or early 2018.

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The 2016 Quality Award application year has started. Completing applications can take months and the opening of the ITA window is a great time to begin the process. Bronze, Silver and Gold applications are on the Quality Award Website now.

The AHCA/NCAL National Quality Award Program recognizes member skilled nursing care centers and assisted living communities for quality care and performance excellence. The program sets high standards based on the Baldrige Performance Excellence criteria. The program has three distinct levels; members must receive an award at each level to progress to the next.

WHY PARTICIPATE?
Performance Improvement

The AHCA/NCAL National Quality Award Program is designed to encourage continuous learning and help members:

• Increase efficiency and effectiveness of their performance improvement system
• Validate and secure the links between continuous improvement, quality, and customer satisfaction
• Link mission, goals, and customer expectations
• Assess and maximize the organization’s strengths
• Apply systematic approaches that produce consistent results
• Receive customized feedback to drive change

Superior Outcomes

AHCA/NCAL research has demonstrated that Silver and Gold recipients (2012-2014) have superior performance in a number of key outcome areas:

• lower rates of readmissions and antipsychotic use
• higher five-star ratings
• higher average occupancy rates

To learn more about all of the 2016 AHCA Quality Award Program, click here.

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Register today for the North Carolina Health Care Facilities Association’s “The Future of SNF Payment Models and Post-Acute Regulatory Reform.” There is little debate that the country’s healthcare economy is undergoing unprecedented reform which is rapidly shifting provider reimbursements to a system that rewards quality, efficiency and collaboration. The SNF providers that wish to thrive in this new economy stand at a tipping point whereby the strategies and tactics they employ today will profoundly impact their opportunity for success in the years to come. As regulatory payment methodologies shift from volume to value, many SNFs are finding themselves behind the curve relative to the pace of change. Please join us on the critically important topics of:

• Bundled Payments
• Comprehensive Care for Joint Replacement (CCJR)
• SNF Value Based Purchasing
• Referral Source Alignment
• Quality Measure (Five Star Rating, QAPI, etc…)
• Medicaid Managed Care

This information will be presented by Dixon Hughes Goodman, LLC in Greensboro, NC on November 10th, 2015 at The Sheraton Greensboro/Four Seasons. 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 The Future of SNF Payment Models and Post-Acute Regulatory Reform. 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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Alliant Quality wants to encourage SNFs to keep signing up for the National Collaborative – or SPACE. Alliant recommends having as much time as possible to get started on QAPI improvement work and improving facility quality measures in a systems approach to improve their five star and composite scores.

Alliant Quality is the Medicare Quality Innovation Network (QIN)-Quality Improvement Organization (QIO) for North Carolina. Under contract with the Centers for Medicare & Medicaid Services (CMS), Alliant Quality invites your nursing home to participate in a collaborative designed to ensure that every nursing home resident receives the highest quality of care.

The Collaborative offers an exciting opportunity to learn from high performing nursing homes regarding their processes as they pertain to consistent/permanent staff assignment, teamwork and communications, leadership, regulatory compliance, clinical models, and quality of life indicators. The Collaborative aligns national nursing home quality initiatives and partnerships such as the Advancing Excellence in America’s Nursing Homes Campaign, The Partnership to Improve Dementia Care, and Quality Assurance Performance Improvement (QAPI). Targeted focus areas will include increasing mobility, decreasing unnecessary use of antipsychotics in residents with dementia, decreasing potentially avoidable hospitalizations and decreasing healthcare acquired infections and conditions.

When ready to register, click here for the Participation Agreement and fax or e-mail it back to Lis Klemis. For more details, e-mail Jennifer Brock at, Jennifer.Brock@area-F.hcqis.org or call (678) 527-3417.

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High-quality clinical care comes from high-quality education. Prove the value of your staff development program with help from author and staff development expert Adrianne E. Avillion, DEd, RN, in this new groundbreaking book. Avillion offers clear guidance to help you put your program’s worth into quantifiable terms and align staff development with your organization’s goals. Educators of all levels will be able to evaluate the effect of training on retention, staff competency, and patient outcomes.

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

Product # 8333
AHCA Members (on-line price) $99.00

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

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A Crowning Achievement – Meet Ms. Alabama Nursing Home 2015 – Sylvia Holland

http://anha.org/meet-ms-alabama-nursing-home-2015-sylvia-holland/

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Snow is actually colorless, but light does not pass through it easily and is reflected. It is the light reflected off a snowflake’s faceted surface that creates its white appearance.

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