UPDATE Weekly

According to data from the Centers for Medicare & Medicaid Services (CMS) almost 7% of North Carolina nursing facilities have not yet registered in the Payroll Based Journal (PBJ) system. CMS staff are considering what penalties to impose on nursing facilities who have not shown a good faith effort to comply with this Requirement of Participation. The deadline is November 14, 2016 for nursing facilities to submit July – September 2016 data. It is likely that simply registering by the deadline will NOT be sufficient to reflect a facility’s “good faith effort.”

Electronic submission of staffing data through the Payroll-Based Journal (PBJ) is required of all long term care facilities in 2016. July 1 began the first date of data collection. All nursing homes are required to register to submit data to prepare to meet this requirement and maintain compliance. To register in the PBJ system:

• Step 1: Obtain a CMSNet User ID for PBJ Individual, Corporate and Third Party users, if you don’t already have one for other Quality Improvement and Evaluation System (QIES) applications (https://www.qtso.com/cmsnet.html) (many users may already have this access for MDS submission).
• Step 2: 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 instruction are available on QIES Technical Support Office (QTSO) e-University, select the PBJ option https://www.qtso.com/webex/qiesclasses.php More information is available on the PBJ Website. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html

The American Health Care Association (AHCA) has several PBJ resources which can be accessed by clicking here.

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Earlier this month, the Centers for Medicare & Medicaid Services (CMS) published four new payment models and refinements to a current model through a notice of proposed rulemaking to further advance care coordination for Medicare fee-for-service (FFS) beneficiaries, which will begin on July 1, 2017.

Three new episode payment models (EPMs) would test making participants financially accountable for the quality and cost of episodes of care helping achieve the goal of higher quality at a lower cost for the following episodes:

• An acute myocardial infarction (AMI), including both medical therapy and percutaneous coronary intervention (PCI),
• A coronary artery bypass graft (CABG), and
• A surgical hip/femur fracture treatment, excluding lower extremity joint replacements (SHFFT).

The Cardiac Rehabilitation (CR) incentive payment model for EPMs and Medicare FFS participants would test financial incentives for Inpatient Prospective Payment System (IPPS) hospitals that encourage the management of beneficiaries following an AMI or CABG toward greater utilization of CR services. Lastly, CMS is proposing refinements to the Comprehensive Care for Joint Replacement (CJR) model.

The Center for Medicare & Medicaid Innovation (CMS Innovation Center) will host a Webinar to present various aspects of the Advancing Care Coordination through Episode Payment Models (EPMs); Cardiac Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model proposals on Wednesday, August 31, 2016, from Noon – 1:00 PM ET. Registration for this Webinar is now open. The agency can answer questions on details of proposed policies, but cannot speculate on final rule decisions.

CMS will accept comments on the proposed rule until October 3, 2016, and will respond to comments in a final rule. The proposed rule can be found on the Federal Register.

To learn more about these efforts, please review the fact sheet and press release.

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Congressional Quarterly (8/22, Young, Subscription Publication, 967) reports the Centers for Medicare and Medicaid Services (CMS) plans to release the final version of a proposed rule update by September 30. The article mentions the American Health Care Association (AHCA) as one of the “organizations that helped drive the debate over the proposed rule.” David Gifford, AHCA’s senior vice president for quality and regulatory affairs, said, “We anxiously await to see if CMS took into consideration any of the several thousand comments they received and how they will phase in the proposed changes once finalized.”

NCHCFA will work with the Division of Health Service Regulation to develop provider training once the final version is been released.

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The NC Health Care Facilities Association presents “Keeping and Growing Your Staff: Quantifying the Amount and Causes of Turnover and Developing a Plan to Reverse It.” In today’s world of constantly having to do more with less, are you unnecessarily spending too much money recruiting and training staff just to have them leave? Do you know exactly what staff instability is costing your nursing center in terms of time, money and quality? Tools exist that can help you have solid data. Come learn what tools you can add to your toolbox, what is causing this never ending cycle and things to consider when developing a plan to address it. In this session, you will learn how to develop a plan for implementing strategies to correct turnover and instability in your nursing center.

This information will be presented by Gail Patry, RN, Chief Program Officer for Healthcentric Advisors and Marguerite McLaughlin, Sr. Director of Quality Improvement at the American Health Care Association (AHCA). This seminar will be offered in Charlotte on September 28th and Raleigh on September 29th. Click here to register on-line! Click here to download a brochure/registration form! Don’t wait! Register today!

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Please plan to join your friends and colleagues in beautiful Pinehurst, North Carolina, on September 15 and 16 for the 5th Annual Autumn Classic Golf Tournament. The event will begin Thursday with golf, a reception, dinner and program held at the world famous Pine Needles Lodge and Golf Club. The 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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On August 5, 2016, the Centers for Medicare and Medicaid Services (CMS) issued a memorandum on the subject: Protecting Resident Privacy and Prohibiting Mental Abuse Related to Photographs and Audio/Video Recordings by Nursing Home Staff (S&C: 16-33-NH). It specifies that included in a resident’s right to be free from all types of abuse, including mental abuse, is a right to be free from abuse facilitated or caused by nursing center staff taking or using photographs or recordings in any manner that would demean or humiliate them. In addition, the memorandum discusses facility and state responsibilities related to the protection of residents.

It also specifies that 30 days after the release of the memorandum and at the time of the next standard survey (both Traditional and Quality Indicator Surveys (QIS), the survey team will request and review facility policies and procedures that prohibit staff from taking, keeping, and/or distributing photographs and recordings that demean or humiliate a resident(s). The survey team may request to see written policies that include this information.

The memorandum reiterates residents’ rights to privacy and confidentiality, as well as to freedom from all forms of abuse – including mental abuse – noting that unauthorized and/or the taking or use of demeaning or humiliating photographs or recordings violate these rights. It provides examples of conduct that can cause mental abuse, including nursing home staff taking photographs or recordings of residents that are demeaning or humiliating using any type of equipment (e.g., cameras, smart phones, and other electronic devices) and keeping or distributing them through multimedia messages or on social media networks.

The memorandum provides specific expectations related to the review and revision of nursing centers’ abuse prevention policies and procedures, as well as staff training. Nursing centers must include abuse related to the taking and posting of unauthorized and/or demeaning photographs or videos in their investigative processes. Finally, it includes surveyor investigative protocol to ensure compliance with these requirements.

The American Health Care Association (AHCA) has developed Social Media Guidance for Nursing Care Centers and Assisted Living Communities to provide resources on how to effectively manage social media, review social media policies, conduct social media training, and investigate social media abuses. The guidance provides specific examples and suggested center responses to ensure residents’ rights are protected. It is available on the AHCA/NCAL Web site under Legal Resources. Please note you must log in to view the document.

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Join the North Carolina Culture Change Coalition for a workshop challenging your understanding of diversity in the realm of caring for seniors. This event is open to all assisted living and nursing home staff, members of the Quality Improvement Organization (QIO), Ombudsmen, etc.

Through this workshop, participants will be able to:

• Recognize attitudinal barriers, stereotypes and fears that affect how we interact and feel about people with disabilities.
• Recognize attitudinal barriers, stereotypes and fears that affect how we interact and feel about people in the LGBTQ (Lesbian, Gay, Bi-Sexual and Transgender) community.
• Describe techniques for embracing a diverse cultural staff and resident-body as an asset to a LTC community.

Cost: $50 per person
Continuing Education Hours: 5.5 (Pre-approval submitted for NH & AL Administrators and Nurses)

Dates & Locations:

• October 6th – Nash Community College; 522 N Old Carriage Road, Rocky Mount, NC 27804
• October 12th – Trinity Village; 1265 21st Street NE, Hickory, NC 28601
• October 19th – Levine Senior Center; 1050 Devore Lane, Matthews, NC 28105
• October 26th – Coastline Convention Center; 503 Nutt Street, Wilmington, NC 28401

Time: 8:30 AM – 4:00 PM

Lunch & snacks will be provided

Speakers:

• Paige Averett, Ph.D., MSW – Associate Professor at East Carolina University’s School of Social Work and internationally recognized expert on LGBT aging, families, and children.
• Lyndall Hare, Ph.D. – Concierge Gerontologist coaching organizations and training professionals working in the field of aging.
• Cindy Deporter, MSSW – State Survey Agency Director for NC Division of Health Service Regulation (DHSR)
• Tammy Wade and Frances Robinson – Regional Employment Services Specialists for Vocational Rehabilitation with the NC Division of Vocational Rehabilitation.

Registration must be submitted by September 16, 2016.

Have questions? Please contact:
Carolyn Hill at chill371@nc.rr.com or Alice Carroll at alicecarroll@friendshomes.org.

To register, click here.

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It’s time to register for the North Carolina Directors of Nursing Administration Long Term Care, Inc. (NCDONA) conference! The 21st Annual NCDONA Multistate Conference will be held at the Hilton Myrtle Beach Resort from September 14 – 17, 2016. There will be opportunities for multiple continuing education credits for Directors of Nursing as well as Administrators. Visit http://ncdonaltc.com/register to register today! Seating is limited so do not wait to reserve yours!

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As you know, motion picture showings within senior living and health care communities have always required a public performance license in accordance with the U.S. Copyright Act. Over time, public awareness of intellectual property rights has grown along with enforcement of federal copyright law. As a result, the American Health Care Association and the National Council for Assisted Living (AHCA/NCAL), and all other leading industry associations have entered into a new agreement with Motion Picture Licensing Corporation (MPLC).

The 2016 Agreement better educates members on the need for copyright compliance when motion pictures and other audiovisual programs are shown in senior living and health care communities, and secures the greatest possible discount for member facilities on the Umbrella License®.

AHCA/NCAL is pleased to announce that all associations have collectively negotiated a special introductory discount of almost 40% for qualifying member facilities that secure an Umbrella License before December 31, 2016.

Adopted in 1976, the U.S. Copyright Act, Title 17 of the United States Code, establishes that the public performance of copyrighted motion pictures and other audiovisual programs that are legally available and intended for personal, private use only, such as DVDs and other digital formats, whether streamed or downloaded (hereinafter referred to as “Videos”), is illegal without a public performance license.

This legal requirement applies equally to for and non-profit senior living and health care communities, even if no admission fee is charged. It does not matter who plans or conducts the exhibition. Residents playing movies for other residents in communal areas also fall under copyright control and can expose the entire community to substantial fines.

The 2016 Agreement establishes guidelines for the licensing of motion picture exhibitions in all senior living and health care communities regardless of the level of care provided or the license status of the community.

The Agreement states:

• All communities, regardless of their type or license status, must obtain licensure for exhibitions of Videos transmitted over a closed circuit television system or in-house channel.
• All communities, regardless of their type or license status, must obtain licensure for exhibitions of Videos in common areas such as a theater, lounge, or community room.
• Assisted living, nursing and rehabilitation units receive a reduced rate on the license. Minimum fees are waived for campuses that are strictly nursing, assisted living, or rehabilitation.
• AHCA/NCAL has secured a special introductory rate of only $2 per unit for all assisted living, nursing, and rehabilitation units licensed before December 31, 2016. This discount reflects a savings of almost 40% off standard license fees and cannot be combined with any other discounts.
• Members of AHCA/NCAL receive a 10% discount on standard Umbrella License fees.

The complete terms of the 2016 Agreement are available online for AHCA/NCAL members. If you operate assisted living, nursing or rehabilitation units, AHCA/NCAL strongly encourages you to secure an Umbrella License prior to December 31, 2016 to ensure the lowest possible license fee. Please visit the AHCA/NCAL Web site for the application brochure. Contact MPLC directly at (800) 462-8855 or online at http://www.mplc.org for assistance with pricing and any questions about the 2016 Agreement and the Umbrella License.

Please feel free to contact AHCA/NCAL at (202) 842-4444 with any questions about motion picture licensing requirements within our profession.

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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, contact information is on the Participation Agreement. For more details, e-mail Jennifer Brock at Jennifer.Brock@area-F.hcqis.org or call (678) 527-3417.

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Summer is flying by and before you know it, fall will be settling in. Now is the time to register for this year’s AHCA/NCAL 67th Annual Convention & Expo, and make your plans to join us in Nashville in October. AHCA/NCAL has so many exciting things planned. From education sessions and networking events to good food and entertainment, you will not want to miss a thing.

Experience one of the largest Expos, supporting the needs of long term and post-acute care. Attendees have exclusive access to meet one on one with the business community. These specialists stand ready to share solutions that drive efficiency without sacrificing quality.

If you have been too busy to submit your registration, or haven’t made up your mind on attending, don’t wait any longer. Commit now and register today! You can still register at the advance registration rate. After September 21, on-site fees apply!

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It is time once again to acknowledge front line, unlicensed personnel who have demonstrated outstanding achievements in the long term care profession. This awards program honors individuals who are the backbone in our facilities because of the support they provide to our residents. A panel of judges from the Education and Programs Committee will select a Nurse Aide winner from each of NCHCFA’s five districts. In addition, one recipient in a non-nursing discipline will receive the Riley W. Clapp Outstanding Service Award. Each of the award recipients will be honored at the Annual Awards Gala during the Annual Convention and Expo on Tuesday, February 28, 2017 in Greensboro, NC.

To fill out nomination forms online, visit the Member Center of the Association Web site at http://www.NursingHomesNC.com. Click on “News & Updates”, select “2017 NCHCFA Annual Awards Nomination Packet” and choose “Survey Monkey”. If you have any questions, call the Association office at (919) 782-3827. Pictures for nominations submitted online may be e-mailed to karenl@nchcfa.org or mailed to the Association office. Click here to download and print the nomination packet. Nominations received in the Association office after Friday, October 21, 2016 will not be considered.

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Developed to fill a widely-recognized gap in management and leadership skills needed to improve the quality of long term care, this resource is based around learning modules that were site-tested in three types of long term care settings and revised based on the resulting feedback.

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

Product #8398
AHCA MEMBERS $85.00

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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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Medication Reconciliation Makes Transitions Safer – A thoughtfully designed and strictly followed review process can spare patients avoidable hospital readmissions.

http://www.providermagazine.com/archives/2016_Archives/Pages/0816/Medication-Reconciliation-Makes-Transitions-Safer.aspx

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1909 was the first year a prize (a collectible picture book) was put into a box of cereal.

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