UPDATE Weekly

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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As announced, under the SNF Prospective Payment Systems (PPS) final rule, nursing facility rates will be increasing an average of 2.4% effective October 1, 2016. Although the national increase will be 2.4%, nursing facilities in North Carolina will see increases ranging from almost .5% to over 4.5%. Facilities in two counties, Cumberland and Hoke, will experience rate decreases.

To assist you in determining your rates for October 1st, the American Health Care Association (AHCA) has updated their SNF PPS Rate Calculator to reflect the changes made in the final Medicare rule. Click here to access this Excel based tool and instructions on its use.

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The List of Excluded Individuals/Entities (LEIE) has been updated to reflect changes made in August 2016. For additional information on the LEIE and to access this updated information, click here.

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On September 2, 2016, the Centers for Medicare & Medicaid Services (CMS) issued S&C: 16-37-ALL regarding the revised OCR clearance process for new providers and Changes of Ownership (CHOW). The new process requires that providers electronically submit an attestation of compliance with the civil rights requirements to the OCR before the State Survey Agencies (SA) and Regional Offices (RO) may process requests for initial surveys or CHOWs. OCR’s confirmation that the attestation has been successfully submitted will meet the requirements for OCR clearance and eliminate the need for CMS ROs to issue provisional provider agreements.

New applicants for Medicare funding and current providers undergoing a CHOW will be responsible for submitting this attestation electronically via OCR’s online Assurance of Compliance portal. The provider will receive electronic verification from OCR of successful submission of the attestation.

OCR has begun receiving electronic attestations as of September 1, 2016.

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Last week, the Centers for Medicare & Medicaid Services (CMS) finalized a rule to establish consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and man-made disasters. These new requirements will require certain participating providers (nursing facilities included) and suppliers to plan for disasters and coordinate with federal, state tribal, regional, and local emergency preparedness systems to ensure that facilities are adequately prepared to meet the needs of their patients during disasters and emergency situations.

After reviewing the current Medicare emergency preparedness regulations for both providers and suppliers, CMS found that regulatory requirements were not comprehensive enough to address the complexities of emergency preparedness. CMS proposed policies to address these gaps in the proposed rule, which was open to stakeholder comments. After careful consideration of stakeholder comments on the proposed rule, this final rule requires Medicare and Medicaid participating providers and suppliers to meet the following four common and well known industry best practice standards.

1. Emergency plan: Based on a risk assessment, develop an emergency plan using an all-hazards approach focusing on capacities and capabilities that are critical to preparedness for a full spectrum of emergencies or disasters specific to the location of a provider or supplier.
2. Policies and procedures: Develop and implement policies and procedures based on the plan and risk assessment.
3. Communication plan: Develop and maintain a communication plan that complies with both Federal and State law. Patient care must be well-coordinated within the facility, across health care providers, and with State and local public health departments and emergency systems.
4. Training and testing program: Develop and maintain training and testing programs, including initial and annual trainings, and conduct drills and exercises or participate in an actual incident that tests the plan.

The final rule also includes a number of local and national resources related to emergency preparedness, including helpful reports, toolkits, and samples. Additionally, health care providers and suppliers can choose to participate in their local healthcare coalitions, which provide an opportunity to share resources and expertise in developing an emergency plan and also can provide support during an emergency.

These regulations are effective 60 days after publication in the Federal Register. Health care providers and suppliers affected by this rule must comply and implement all regulations one year after the effective date.

For more information please see a blog by Dr. Lurie, HHS assistant secretary for preparedness and response, and the CMS Survey & Certification – Emergency Preparedness Web page.

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District meetings are back by popular demand, and District III has scheduled their next meeting for October 26 at Clapp’s Convalescent Nursing Home, in Asheboro. The meeting will begin at 10:00AM and end at 2:00PM. One confirmed presenter, Judy Wilhide from Brandt Consulting out of Virginia, will discuss utilizing chart reviews to verify accurate coding and scheduling to ensure your QM stars are accurate. Judy can predict Quality Measure (QM) rating, offer tips for strategic planning to balance Resource Utilization Group (RUG) and QM implications of the Omnibus Budget Reconciliation Act (OBRA) and Prospective Payment System (PPS) Minimum Data Set (MDS) schedule. Several providers have used her several times and found her service very beneficial.

Other topics are open for discussion. If you have a subject you would like addressed by Association Staff, please contact Eric Kivisto, erick@nchcfa.org.

This meeting is limited to 50 attendees and registration will be on a first-come, first-serve basis. Unlike the previous district meeting, this will be open to any and all other employees at your facility who could benefit from attending. Please look for an e-mail with registration information in the next few weeks.

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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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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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The Rural Health Care Connectivity Act of 2015 was passed by Congress and enacted into law on June 22, 2016. The Act authorized eligible rural not for profit skilled nursing facilities (SNFs) to participate in the Rural Health Care Program (RHCP) to assist in payment for broadband expansion and expenses to facilitate and deliver health care services. It also mandated the Federal Communications Commission (FCC) to allow applications by eligible SNFs within 180 days of enactment. The FCC’s Universal Service Administrative Company (USAC) administers the universal service fund from the RHCP.

According to a recent press release from USAC, RHCP funding requests reached a historic high of $377.64 million in Funding Year (FY) 2015, and demand may exceed the $400 million funding cap in FY2016 (July 1, 2016 to June 30, 2017). To fairly distribute future RHCP funding if the funding cap is reached, the FCC just announced two additional filing window periods for FY2016. The next filing window period is from September 1 – November 30, 2016. If funding remains, the third filing window period will be from February 1 – April 30, 2017. Eligible health care providers are strongly encouraged to submit their funding requests by November 30, 2016, the last day of the upcoming FY2016 filing window period. For questions about the filing window periods, you can contact the RHCP Help Desk via email or at (800) 453-1546.

Suggested first steps are below for SNFs who are eligible and would like to apply for funds from the RHCP to allow reduced rates for broadband expenses:

• Become familiar with the overview of the RHCP and determine eligibility by visiting the USAC web site.
• Become familiar with the specific steps required in the application process.
• Sign up on USAC’s listserv to receive ongoing updates of activity and timeline requirements.
• Register for and listen in on the September 8th USAC New Funding Request Filing Window Periods + Other RHC Program Updates webinar being held at 2:00PM ET.
• Register for and listen in on the October 11th RHCP 101: Intro to the RHCP webinar being held at 2:00PM ET.

There are several preparatory steps that are required, and some can be time consuming. You might wish to hire a consultant with expertise in the FCC’s RHCP if you are seriously looking at submitting an application for either FY2016 or FY2017. You might also contact Dan Holdhusen, Director of Government Relations at The Evangelical Lutheran Good Samaritan Society, an AHCA member, who testified on behalf of SNF providers this past Spring at an Energy and Commerce Subcommittee on Communications and Technology hearing in support of the Rural Health Care Connectivity Act. Feel free to also contact AHCA’s Senior Director of Not for Profit and Constituent Services, Dana Halvorson, who has been closely following this matter.

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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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The countdown is on. Only one week remains to register for the 67th AHCA/NCAL Annual Convention & Expo at the Advance Registration rate. Hurry, you must register before the September 21st deadline. Thousands of your long term and post-acute colleagues from across the country have already confirmed their spot. What are you waiting for? Commit now and register today! After September 21st, on-site fees apply! If you miss the advance registration period, you may register on-site in Nashville, Sunday, October 16th. Registration will be open at 6:45AM.

Obtain all of the information you need online, including: speakers, education sessions, Expo Hall hours and exhibitors, along with the full schedule of networking opportunities and events.

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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 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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Hardwiring the invisible: Culture is a choice

http://www.mcknights.com/guest-columns/hardwiring-the-invisible-culture-is-a-choice/article/522030/

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At one point in the 1990s, 50% of all CDs produced worldwide were for AOL.

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