UPDATE Weekly

The Department of Health and Human Services (DHHS) presented its interim report on the implementation of Medicaid Reform to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice on Tuesday, March 1.

DHHS said its plan “transforms the state from a fee-for-service, or volume-based system to a pre-paid health plan which is valued based. This system will promote community-based, comprehensive care management that integrates behavioral health as well as physical health to ensure beneficiaries are reaching and maintaining the highest level of health possible. The new plan is also designed to provide more accurate and responsible budgeting each year.”

Highlights from DHHS’s report include the following:

• A recommendation to exclude from Prepaid Health Plan (PHP) enrollment medically needy beneficiaries, beneficiaries who are eligible only for emergency services, members of federally recognized tribes, individuals who are presumptively eligible for Medicaid, refugees, all individuals during the time of retroactive eligibility, and the Program of All- Inclusive Care for the Elderly (PACE) enrollees;
• A recommendation to increase the potential number of regional PHPs from 10 to 12;
• A recommendation for dividing the state into six regions for purposes of regional PHP coverage based on current utilization and provider referral patterns, among other factors;
• No recommended changes to the current process of county Division of Social Services (DSS) Medicaid eligibility determinations;
• An indication that the state plans to utilize the services of an enrollment broker to provide education, outreach and enrollment activities to help beneficiaries first select a primary care provider/practice – if they do not already have one – and then choose and enroll in a PHP with consideration for current provider relationships.

DHHS must still create performance measures, and it is still examining potential rate floors and other provider protections. DHHS expects to submit its actual waiver application to Centers for Medicare and Medicaid Services (CMS) by June 1, 2016, and it currently estimates that PHPs will begin operating on July 1, 2019.

Over the next two months, DHHS will hold a series of listening sessions across the state to gather feedback from citizens and other stakeholders.

While the Skilled Nursing benefit is included in the Medicaid Reform plan, DHHS’s draft waiver does not include plans for persons dually eligible for Medicaid and Medicare (“dual eligibles”). The waiver does, however, indicate that DHHS expects to develop those plans in the future and report them to CMS via a proposal to amend the waiver. This will be done in consultation with the Dual Eligibles Advisory Committee later this calendar year. Dual Eligibles will likely not be enrolled in PHPs until 12-24 months after PHPs begin operating.

Medicaid beneficiaries will continue receiving services in the way they do now until reform is implemented.

The full report can be found by clicking here, and the full draft waiver can be found here. A copy of the proposed regional map is below.

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Over 600 members and 500 trade members from across North Carolina and the southeast recently attended the Association’s Annual Convention and Expo held in Greensboro, NC. The highlight of the 2016 Convention was recognizing the North Carolina Health Care Facilities Association 2016 Special Award recipients:

District I Nurse Aide of the Year – Elisa Farmer – Skyland Care Center
District II Nurse Aide of the Year – Annie Sam – White Oak Manor / Charlotte
District III Nurse Aide of the Year – Jacob Crawford – The Oaks
District IV Nurse Aide of the Year – Bridget White – Riverpoint Crest Nursing & Rehab Center
District V Nurse Aide of the Year – James White – Elizabeth City Health and Rehabilitation
2016 Riley W. Clapp Outstanding Service Award – Clarence Williams-Golden LivingCenter/Tarboro

Elisa Farmer received the Twelfth Annual J.R. Garrett, Jr. Direct Care Worker of the Year Award!

The North Carolina Health Care Facilities Association would like to thank our Gold Convention hosts of the 2016 Annual Convention and Exposition in Greensboro, North Carolina for their support: Blue Ridge Pharmacy, Healthcare Services Group, Inc., Legacy Consultant Pharmacy, Medipack Pharmacy, Neil Medical Services, NH Med Services, PruittHealth, and Southern Pharmacy Services.

The North Carolina Health Care Facilities Association would also like to thank our 2016 Silver Convention Hosts for their support: Dixon Hughes Goodman LLP, Performance Foodservice, Smith Moore Leatherwood LLP, and TMC.

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NCHCFA thanks all individuals that participated in the 2016 Convention and Exposition evaluation raffle. Congratulations to Turner Prickett of Signature Health Care of Chapel Hill and Dan Carr of Encore Rehabilitation Services for winning a $100.00 American Express gift card! Again, we appreciate your valuable input.

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The American Health Care Association (AHCA) invites you to attend a special AHCA Webinar to learn more about the Centers for Medicare & Medicaid Services’ (CMS) addition of new quality measures that will be posted on Nursing Home Compare and used in the Five-Star Quality Rating System.

On Friday, March 4 at 11:00 AM ET, AHCA will brief its members on the changes on a special Webinar. There will be ample time for questions from members. Members will be asked to type in their questions via the Webinar’s chat feature.

To register in advance for the Webinar go to http://webinars.ahcancal.org/session.php?id=17674.

For those unable to participate on Friday, this Webinar will be recorded and posted on AHCA’s Five-Star Web page.

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Register today for Dementia Care for America’s Heroes: Understanding Dementia and Developing Skills for Positive Outcomes! This program will be held on March 24th, 2016 in Greensboro, NC and presented by Heather McKay, MS, OT/L, Dementia Care Specialist. Our dementia care teams are supporting clients who have dementia for a decade or longer. Recognizing changes throughout this long disease can feel like detective work. Heather McKay, Occupational Therapist and Dementia Care Specialist will present a full day seminar that goes beyond the basics to address brain changes with dementia, communication challenges, the timeline of this disease and why people do what they do in every stage. Along with practical, ready-to-use communication techniques and hands-on skills that are safe for caregivers and those they support, participants will learn about the progression in 5 stages and strategies that work to support people at every stage. Participants will learn specific ways of grading their help to match a person’s changing needs and foster more positive interactions throughout the progression of dementia. Leaders will learn ways to engage and coach team members and support the whole team with objective competency measures that are helpful throughout the progression of dementia.

This program offers 5.5 contact hours for nursing home administrators. The North Carolina Health Care Facilities Association is a Registered Sponsor of continuing education with the NC State Board of Examiners for Nursing Home Administrators. Comments regarding the Registered Sponsor Course may be addressed to: NCBENHA, 3733 National Drive, Suite 110, Raleigh, NC 27612. NCHCFA will issue a certificate of completion for 5.5 education contact hours for nurses.

Register on-line through our Web site http://www.NursingHomesNC.com today!

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The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum is scheduled for Thursday, March 3, 2016 AT 2:00 PM ET. It is suggested that participants dial-in at least 15 minutes before call start time. In addition to CMS announcing the addition of new quality measures (QMs) that will be posted on Nursing Home Compare and used in the Five-Star Quality Rating System, the agenda includes:

I. Opening Remarks

II. Announcements & Updates

• Nursing Home Compare
• SNF Payment Models Research update
• Quality Improvement and Evaluation System (QIES) Extended Maintenance Downtime in March
• Electronic Staffing Data Submission Payroll-Based Journal (PBJ) Update
• Nursing Home Strategic Plan Development

III. Open Q&A

Electronic submission of staffing data through the PBJ is required of all Long Term Care Facilities in 2016. ALL nursing homes will need to register to submit data in order to meet this requirement and maintain compliance. Please follow the below instructions to register:

• Obtain a CMSNet User ID for PBJ Individual, Corporate and Third Party users, if you don’t already have one for other QIES applications (https://www.qtso.com/cmsnet.html) (many users may already have this access for MDS submission).
• Obtain a PBJ QIES Provider ID for CASPER Reporting and PBJ system access (https://mds.qiesnet.org/mds_home.html)
• Training: PBJ Training Modules for an introduction to the PBJ system and step by step registration instructions are available on QTSO e-University, select the PBJ option https://www.qtso.com/webex/qiesclasses.php. Questions regarding PBJ policy issues should be directed to NHStaffing@cms.hhs.gov. Questions regarding the PBJ Data Specifications should be directed to NursingHomePBJTechIssues@cms.hhs.gov. Software developers or vendors that provide services such as automated payroll or time and attendance systems that will support electronic submissions should use this address. More Information is available at http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html

To participate, dial (800) 837-1935 and reference Conference ID 38431613. Encore is an audio recording of this call that can be accessed by dialing (855) 859-2056 and entering the Conference ID. Encores for ODFs held on Thursdays can be accessed the following Monday. The recording is available for 3 business days.

For ODF schedule updates and e-mailing list registration, visit http://www.cms.gov/OpenDoorForums.

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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 Quality Assurance Performance Improvement (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 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 Lisa Klemis. For more details, e-mail Jennifer Brock at Jennifer.Brock@area-F.hcqis.org or call (678) 527-3417.

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100 Essential Forms for Long Term Care provides convenient access to a compilation of essential long term care forms that offer easy-to-understand descriptions of implementation processes and timing, and can be used as-is or customized to meet the particular needs of nursing home staff.

The updated content found in this new edition will help long term care facilities stay compliant with recent regulatory changes and ensure quality resident care is always provided. This valuable resource contains 100 of the most commonly utilized forms in long term care facilities, including:

• Clinical assessment forms
• Survey readiness assessments
• Documentation forms
• MDS tools
• Regulatory forms
• Accountability reports
• Quality Assessment and Performance Improvement (QAPI) forms

This comprehensive book will help long term care providers:

• Gain immediate access to the most essential, commonly used long term care forms
• Enhance the efficiency of staff procedures
• Improve documentation accuracy
• Address documentation needs and concerns for every department

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

Product #8357
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 Donna Snyder at donnas@nchcfa.org. The price is $35.00 (tax and shipping included).

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What motivates us at work? More than money.

http://ideas.ted.com/what-motivates-us-at-work-7-fascinating-studies-that-give-insights/

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Nobody actually knows who invented the first fire hydrant because its patent was burned in a fire.

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