UPDATE Weekly

NC Health Care Facilities Association is pleased to once again partner with Empira to present a full-day seminar for all long term care providers on UNDISTURBED SLEEP & ACTIVE DAYS – KEYS TO IMPROVE QUALITY OF LIFE OF OUR RESIDENTS. The goals of this grant-funded quality improvement project were to have residents sleep undisturbed throughout the night and be more physically active and engaged during the day. Learn how they changed operations in providing care and services to reach these goals. This session will be May 19th at the Hilton Charlotte University Place, Charlotte, NC and will cover the following:

• Restate the key components of the Empira Fall Prevention program.
• Explain the process that leads to the Empira Restorative Sleep Vitality Program.
• Discuss the etiology of sleep and wake in human beings.
• Identify the key components of the Empira Restorative Sleep Vitality Program.
• Identify the top 10 disturbances to sleep.
• Provide five operational actions a long term care provider can do to prevent sleep disturbance.

The cost to attend this seminar is $195 for members and $390 for non-members. This fee includes handouts, snacks, and lunch. YOU CAN REGISTER AND PAY ON-LINE! TO REGISTER, GO TO http://NursingHomesNC.com AND CLICK ON UNDISTURBED SLEEP & ACTIVE DAYS-KEYS TO IMPROVING QUALITY OF LIFE OF OUR RESIDENTS. You may also download a brochure here. Members may be invoiced. Non-members must submit payment on-line or mail with registration. Registration is open to anyone who would like to attend!

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Make plans today to join your colleagues for the fifth annual NCHCFA Summer Symposium. The three-day event will be August 9-11, 2016 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 “HFA” to identify yourself as a NC Health Care Facilities Association Convention attendee! To make your reservation on-line, visit http://tinyurl.com/summersymposium2016.

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Last Thursday, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2017 update.

We are pleased to report that the proposed rule includes a net market basket increase of 2.1 percent. CMS is holding off another year on a major overhaul of the payment system for SNF, and instead, proposing a PPS update tied with updates in quality measures. The FY 2017 proposed rule continues to advance the integration of payment policy and quality-related provisions with payment and quality reporting, producing new implications from the proposed rule for SNFs.

Specifically, the FY 2017 rule further develops proposals for implementation of the Protecting Access to Medicare Act of 2014 SNF rehospitalization program and includes the second set of proposed measures mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). Going forward, the profession will see additional quality provisions in its payment rules.

AHCA has also created a summary with highlights and a preliminary overview of the payment updates, the SNF value-based purchasing program proposed new components, and the IMPACT Act quality reporting additions.

Highlights

• The proposed rule provides for a net market basket increase for SNFs of 2.1 percent beginning October 1, 2016.
• The 2.1 percent market basket update reflects a full market basket increase of 2.6 percent reduced by 0.5 percentage points, in accordance with the multifactor productivity adjustment required by Section 3401(b) of the Affordable Care Act (ACA). No forecast error was incurred.
• The market basket 2.1 percent for FY 2017 for the SNF PPS is based on the IHS Global Insight, Inc. (IGI) first quarter 2016 forecast with historical data through fourth quarter 2015. This figure could change when CMS issues the final rule based on more recent IGI data.
• CMS estimates that the net market basket update would increase Medicare SNF payments by approximately $800 million in FY 2017.
• As noted above, a forecast error correction was not needed. Since the difference between the estimated and actual amount of change in the market basket index was below the 0.5 percentage point threshold in FY 2015, the payment rates for FY 2017 are not impacted by the current IGI data.
• In accordance with the Medicare Modernization Act (MMA), the per diem rate for SNF patients with Acquired Immune Deficiency Syndrome (AIDS) had been increased by 128 percent as of October 1, 2004. Under the CMS proposed rule, this add-on will remain in effect for FY 2017.
• As noted earlier, the Skilled Nursing Facility Value Based Purchasing (VBP) Program (SNF VBP) is discussed. Establishment of the program, which implements a 2 percent withhold to SNF Part A payments that can be earned back based on a SNF’s rehospitalization rate and level of improvement, is required by the Protecting Access to Medicare Act of 2014 (PAMA). CMS proposes that the performance period be based on the calendar year starting January 1, 2017.
• Additionally, CMS proposes four new measures for the Quality Reporting Program (SNF QRP). They are drug regimen review, average cost per Medicare beneficiary, rehospitalization rate, and discharge to community rate.

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At the end of March, the Division of Medical Assistance (DMA) had NCTracks re-process the Medicaid nursing facility claims from January 2015 to May 2015 to reconcile the retroactive case-mix freeze. It has been reported by several providers that when these claims were re-processed, the patient monthly liability was not always applied to the claims, causing an overpayment situation. NCHCFA has provided DMA with several examples of this situation. DMA is looking into this issue. NCHCFA will publish any additional information as we receive it. In the meantime, providers should be aware of this potential issue when posting the re-processed claim changes to their resident accounts.

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The Centers for Medicare & Medicaid Services (CMS) has established due dates by which the provider/supplier’s revalidation application must reach the Medicare Administrative Contractor (MAC) in order for them to remain in compliance with Medicare’s provider enrollment requirements. The due dates will generally be on the last day of a month (for example, June 30, July 31 or August 31). Please submit your revalidation application to Palmetto GBA by the established due date to avoid a hold on your Medicare payments and possible deactivation of your Medicare billing privileges.

The list is available at https://data.cms.gov/revalidation and includes all enrolled providers/suppliers. Those due for revalidation will display a revalidation due date, all other providers/suppliers not up for revalidation will display a ‘TBD’ (To Be Determined) in the due date field. This means that you do not yet have a due date for revalidation. Please do not submit a revalidation application if there is not a listed due date. All unsolicited revalidation applications will be returned without processing.

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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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Alliant Quality will offer two Webinars on Tuesday, May 24, 2016, first at 10:00 a.m. and again at 2:00 p.m. aimed at reducing the unnecessary use of antipsychotics in nursing home residents with dementia. Dr. Adrienne Mims, Vice President, Chief Medical Officer for Alliant Quality, and Mike Crooks, Alliant Pharmacy Lead, will be reviewing the Resident Prioritization Tool – to guide centers in prioritizing residents appropriate for reduction.

Register now by clicking https://qualitynet.webex.com.

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Over the next 13 weeks NCHCFA will feature one element of the AHCA Building Prevention Into Every Day Practice: Framework for Successful Clinical Outcomes.

Success in achieving positive resident/patient outcomes is even more critical now than ever before. The link between quality and payment in long term and post-acute care is growing stronger, as evidenced by the SNF Value Based Purchasing Program (VBP), Improving Post-Acute Care Transformation (IMPACT) Act, SNF Quality Reporting Program (QRP) and more. In addition, regulatory activity is intensifying through focused surveys on adverse events, dementia care and MDS. The Five-Star Rating system and Nursing Home Compare have been revised and will add items in the future as it broadens public reporting and transparency. Most importantly, consumers expect and deserve high quality care.

The entire framework outlines key elements from both an organizational and clinical nature that are critical to successful clinical and organizational outcomes. Positively, these elements reflect common denominators that cross multiple care situations. Therefore, instead of being yet another initiative or single focused project to achieve just one outcome, it is a way of acting, thinking, and being that will benefit multiple areas across an organization. Each element is addressed in detail throughout the framework.

This week we feature the element of Organizational Foundation: Culture of Safety:

Key Takeaways: Culture of Safety

 Safety is not compromised by other demands.
 Leadership engages and empowers patients, residents, families, staff, visitors and others to keep the culture of safety alive and well.
 Staff of all levels are encouraged to question and challenge work process and organizational decisions to support continuous learning and improvement.

Probing Questions for Team Reflection and Discussion:
1. Are patients, residents, family, staff, visitors and others engaged and empowered to keep the culture of safety alive and well? If so, how? If not, why not?
2. Do we live too much in “survey mode”?
3. How do we keep our “finger on the pulse” of the culture of safety and be vigilant to needs for improvement?

Visit the AHCA Clinical Practice Web-site to learn more about the element of “Organizational Foundation: Culture of Safety” and answers to these key questions:

What does this mean? Why is this important? What are some examples? What is my part (as an individual employee, manager or practitioner)? What can my organization do?

Start somewhere, pick one element and work through it with your team.

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Researchers at Brown University are conducting a short, 8-question, multiple choice national anonymous survey to learn about nursing center and assisted living policies regarding camera use in resident rooms.

As you know, there has been renewed attention in the media on the use of cameras in resident rooms in nursing centers or assisted living facilities. While there is no federal law, some states now have regulations allowing private individuals to install cameras in nursing center resident rooms, and others are considering adopting similar laws. This survey will help estimate how widespread the use of cameras is in resident rooms. It also will help provide information on how requests for cameras are handled by facilities, how staff feel about cameras observing their behavior, and the unintended negative consequences of using cameras in this way.

Please use the attached link to complete this short online survey even if your facility has no policy or doesn’t permit cameras in resident rooms. AHCA does not collect your name or the name of your facility. AHCA guarantees that your answers are entirely anonymous (e.g., they have no way to link your response to you or your facility).

Please follow this link to complete this 2-minute online survey: https://brown.co1.qualtrics.com/SE/?SID=SV_2hI3Hu084qiSuQl

You can read more information about the survey here. If you have any questions please feel free to contact Clara Berridge, PhD, MSW at Brown University at clara_berridge@brown.edu.

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National Nursing Home Week® is May 8-14, 2016! AHCA’s 2016 National Nursing Home Week® (NNHW) specialty products are now available for purchase. This year’s theme with logo, It’s a Small World with a Big Heart, is featured on many of the available items. To purchase National Nursing Home week specialty products including posters, balloons, t-shirts, buttons, and more, shop on-line or call 800-321-0343.

Members are encouraged to place orders early for best product selection (color, size, and available quantities). NNHW items are very popular and will sell out. Ask about t-shirt discounts when ordering.

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The Q4FY15 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2015 is now available!

Free-standing SNFs: Download PEPPER through the PEPPER Resources Portal. The SNF’s Chief Executive Officer, President, Administrator or Compliance Officer should:

1. Review the Secure PEPPER Access Guide.
2. Review the instructions and obtain the information required to authenticate access. Note: A new validation code will be required. A patient control number or medical record number from a claim for a traditional Medicare FFS beneficiary with a “from” or “through” date in September 1-30, 2015 will be required.
3. Visit the PEPPER Resources Portal.
4. Complete all the fields.
5. Download the PEPPER.

Hospital-based SNFs: PEPPER was uploaded to the AutoRoute_inbox of QualityNet account administrators and those with user accounts with the PEPPER recipient roles. The PEPPER file will be available for download in QualityNet for 60 days from the date it was uploaded. View instructions for downloading your PEPPER.

Revised in this release: The “Therapy RUGs” target area has been discontinued.

About PEPPER

PEPPER is an educational tool that summarizes provider-specific data statistics for Medicare services that may be at risk for improper payments. Providers can use the data to support internal auditing and monitoring activities. Visit the SNF Training and Resources page at http://PEPPERresources.org to access updated resources for using PEPPER, including recorded web-based training sessions, a sample SNF PEPPER and the current SNF PEPPER User’s Guide. PEPPER is distributed by TMF® Health Quality Institute under contract with the Centers for Medicare & Medicaid Services. Do you have questions or comments about PEPPER or need help obtaining your report? Visit TMF’s Help Desk to request assistance with PEPPER.

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New Publication Available: Hospitality For Boomers – AHCA is excited to announce this highly informative resource is now part of their inventory. Start improving your community reputation, marketability, and profitability today with Hospitality for Boomers: How to attract residents, retain staff, and maximize profitability. Written by former restaurateur, health-care food service director, and current national Kind Dining® service trainer, Cindy Heilman, this quick read shares a unique service perspective and is full of hospitality tips.

Learn how to:

• Train your staff to excel
• Apply empathy daily
• Exceed your residents’ expectations
• Build your hospitality team
• Grow your employees personally and professionally
• Focus your leadership team
• And more!

To order, visit http://www.AHCApublications.org or call (800) 321-0343. Fax orders may also be placed at (800) 869-5605.

Product #: 8274
Price: $19.95

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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 Donna Snyder at donnas@nchcfa.org. The cost is $25 plus tax and shipping.

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Be sincere when recognizing employees.

http://www.crainsdetroit.com/article/20160424/BLOG200/160429920/be-sincere-when-recognizing-employees

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At Disney World, each year visitors throw close to $18,000 in loose change into the fountains, wells, and attractions throughout the park.

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