UPDATE Weekly

The mandatory deadline for the compliance with the Payroll Based Journal Reporting (PBJ) Requirement is only weeks away, on July 1st. Even though North Carolina nursing homes have registered for PBJ submission at a much higher rate than a vast majority of other states, there is still work to be done to prepare. The American Health Care Association (AHCA) has heard from several members expressing concern about the trials and tribulations of registering and entering this data. The electronic toolkit below includes a list of resources currently available at your disposal as a valued NCHCFA and AHCA member. No matter where you are in the process, the toolkit below includes resources that will help you take the steps necessary for compliance. You may also find these documents and other resources at the PBJ Resources page on ahcancalED.

PBJ Toolkit

• PBJ Checklist: A one page checklist that outlines the major steps that nursing centers should take to be compliant
• Archived Webinars
o 11/23/15 Electronic Staffing Data Collection and the Payroll Based Journal
o 3/24 Submit or Face the Consequences: Mandatory Staffing Data Collection Starting July 1st
o 4/29 How I Plan on Succeeding with the Payroll Based Journal
• FAQ Sheets:
o April 4: A list of frequently asked questions collected and answered from the 3/24 AHCA webinar
o May 5: A list of frequently asked questions collected and answered from the 4/29 AHCA webinar
• Vendor List of vendors with a PBJ solution: A listing of time & attendance and payroll vendors who have solutions to submit data to Centers for Medicare & Medicaid Services (CMS). This list is updated periodically.

We encourage you to review this list and take advantage of these tools in your journey of compliance. For questions, please feel free to contact Sam Clark at samc@nchcfa.org. You may also contact AHCA staff directly at staffdatacollection@ahca.org.

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The NC Health Care Facilities Association presents “A National Update-Proposed Regulations and the Changing Definition of Quality.” Long term care leaders are equipping themselves for a new climate, a new day in healthcare. Changes on a federal level include:

• Additions to Five Star
• New Quality Measures
• Progress on the Improving Post-Acute Care Transformation (IMPACT) Act
• Electronic staffing data collection
• Changes to the Requirements of Participation and a new survey process

These changes will allow us to reevaluate our systems and find new opportunities to drive quality and improving care for our residents. Discover how to navigate this new environment and become Quality Change Agents. Learn how a systems approach and American Health Care Association’s (AHCA) resources can provide solutions for your organization. Leave this session with tools, ideas and a fresh perspective on how to move forward in these changing times. Topics will include:

• Identify changes that will occur over the next three years and the impact they will have on your setting
• Actions and best practices that will help you and your organization be a top performer
• Recognizing the resources and support that AHCA/NCAL provides

This information will be presented by Lyn Bentley, MSW, VP of Quality and Regulatory Affairs and Marguerite McLaughlin, Sr. Director of Quality Improvement at AHCA. This seminar will be in Greensboro, NC on June 21st, 2016. Click here to register on-line! Click here to download a brochure/registration form! Don’t wait! Register today!

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The US Department of Labor (DOL) announced today its new overtime rule. According to the DOL, the rule will:

• Raise the salary threshold indicating eligibility from $455/week to $913 ($47,476 per year).
• Automatically update the salary threshold every three years, based on wage growth over time.
• Strengthen overtime protections for salaried workers already entitled to overtime.
• Provide greater clarity for workers and employers.

The final rule will become effective on December 1, 2016, giving employers more than six months to prepare. The final rule does not make any changes to the duties test for executive, administrative and professional employees.

The DOL says this rule will impact more than 150,000 workers in North Carolina.

Additional information about the rule from the DOL can be found here.

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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. Brochures will be available in June!

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It’s here and it’s hot! This year’s AHCA/NCAL Convention & Expo Preliminary Program is now available on-line! You can even read it on your mobile devices. Take a look at what Nashville has in store for you October 16-19 in this easy-to-access, easy-to-read flip book.

This year’s Convention & Expo offers national keynote speakers, valuable education, professional networking, exciting exhibits staffed with experts ready to help your company excel, and music, of course! In the spirit of the Grand Ole Opry, the Gala Dinner & Show (separate ticketed event) features three artists, each with their own unique style and sound. You’ll enjoy an evening with award-winning county artists Charlie Daniels, Jo Dee Messina, and Phil Vassar.

Once you preview the electronic Preliminary Program, you’ll be inspired to register for the AHCA/NCAL Convention & Expo. Early bird registration and savings continue through July 22.

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Earlier this month, OSHA released a final rule on injury and illness electronic recordkeeping. The final rule has two main elements, electronic submission and updates to how employers inform employees to report work-related injuries or illnesses. This final rule becomes effective on January 1, 2017, except for § 1904.35 (relating to employee involvement in the record-keeping system) and § 1904.36 (prohibiting an employer from discriminating against an employee for reporting an illness or injury), which become effective on August 10, 2016.

Electronic Submission

The final rule requires electronic submission of Part 1904 recordkeeping records to OSHA depending on the employer’s size and industry.

• Employers with 250 or more employees (including part-time, seasonal or temporary workers) in each establishment to electronically submit their 300, 300A and 301 forms to OSHA on an annual basis;
• Employers with more than 20 but less than 250 employees in certain identified industries (which includes assisted living, nursing centers, ICFs/IID, and group homes for individuals with disabilities) to electronically submit their 300A form on an annual basis; and
• Employers who receive notification from OSHA to electronically submit their 300, 300A and 301 forms to OSHA.

OSHA will then post the data from employer submissions on a publically accessible Web site. According to the final rule, OSHA does not intend to post any information that could be used to identify individual employees.

Employers with more than 250 employees and those employers in identified industries, including assisted living, nursing centers, ICFs/IID, and group homes for individuals with disabilities must submit this information for 2016 to OSHA on July 1, 2017.

Employer Injury Reporting Policies

The final rule requires employers to develop employee injury and illness reporting requirements that meet specific criteria. Specifically, employers must inform employees of the following:

• Procedures for reporting work-related injuries and illnesses promptly and accurately. According to the final rule, a procedure is not reasonable if it would deter or discourage employees from reporting injuries or illnesses;
• Employees have the right to report work-related injuries and illnesses;
• Employers are prohibited from discharging or in any manner discriminating against employees for reporting work-related injuries or illnesses.

There are two effective dates in the final rule. The most immediate effective date will be August 10, 2016 for the provisions regarding employee injury reporting policies. Specifically, the requirements to inform employees they have a right to report a work-related injury and the prohibition from discharging or otherwise discriminating against employees for reporting work-related injuries or illnesses. These provisions will be effective 90 days after publication in the Federal Register. The second effective date is identified above and relates to the recordkeeping and submission requirement.

If you have additional questions, please contact Lyn Bentley.

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This is part of a series featuring one element of the 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 will feature the element of Organizational Foundation: Principles of Person-Centered Care

Key Takeaways: Principles of Person-Centered Care

 Primary purpose of care is to support individuals in living as satisfactory and fulfilling a life as possible, in the face of their illnesses and impairments.
 Be aware of each individual’s preferences, issues, and risks and tailor recommendations and actions accordingly.
 Residents make choices and actively participate in their care planning which is used as a foundation for everyday person-centered care.
 Competent clinical reasoning and effective diagnosis facilitate truly individualized care by enabling interventions tailored to underlying causes.

Probing Questions for Team Reflection and Discussion:
1. How do we get to know each resident’s preferences and risks and tailor our interventions accordingly?
2. Do care plans reflect each individual’s wishes and offer flexibility for change?
3. How can we support each individual in living life to the fullest extent they desire?

Visit the AHCA Clinical Practice Website to learn more about the element of “Organizational Foundation: Principles of Person-Centered Care” 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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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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Join Alliant’s 30 minute, monthly series on the 1st Wednesday of the month. The next call, Patient Centered-Multidisciplinary Medication Management: A Coordinated Approach, is scheduled:

June 1st, 2016
1:00 PM ET
To join this call: (800) 706-9233

How do you meet patients and residents needs to insure that they get the medication they require after discharge? Join Alliant to hear how others are doing this successfully! Be ready to discuss these questions:

1. Are there key questions to ask patients so that you can identify those who may have difficulty obtaining meds?
2. How do you overcome the fear of asking about income and resources?
3. How do you effectively partner with prescribers to create realistic care plans given the resources of the patient?

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KEPRO is the BFCC-QIO authorized by the Medicare program to review medical services provided to Medicare beneficiaries in CMS Areas 2, 3, and 4. KEPRO reviews medical records to determine whether services delivered to these beneficiaries meet medically acceptable standards of care, are medically necessary, and are delivered in the most appropriate setting.

Several times a year, KEPRO publishes Case Review Connections to provide information to Medicare providers. The latest edition can be read by clicking here.

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Raising the Bar on Service Excellence concentrates on five crucial leadership actions that will shift your organization from good to great. The author pushes the reader from theory into action. Each chapter features case examples and concludes with specific leadership action steps that will bring the organization closer to living the mission, vision, values, and brand promise you envision.

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

Product #8075
AHCA MEMBERS $24.95

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Important information for residents and families… This brochure outlines what physical restraints are, when they should be used, rules and regulations concerning restraints, and making decisions about using them. To order, e-mail your request to Donna Snyder at donnas@nchcfa.org.

• NCHCFA Member: $30.00 per 100 brochures plus tax and shipping
• Non-Members: $60.00 per 100 brochures plus tax and shipping

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Are You an Effective Leader? How to Master the Four Styles of Situational Leadership

https://www.allbusiness.com/4-styles-situational-leadership-104655-1.html

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It is estimated that two-thirds of the people on earth have never seen snow.

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