UPDATE Weekly

Mark Parkinson, President and CEO of the American Health Care Association (AHCA), will lead a discussion about the challenges facing long term care providers in Washington. The Trump administration and many leaders in Congress have reforming the nation’s entitlement programs and Medicare as high priorities. There will likely be more clarity about these issues and others by the time NCHCFA members arrive in Greensboro on February 26th. Parkinson will bring us the latest from Capitol Hill and what we can look for under new leadership at the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS). The meeting will be on Monday, February 26th at 10:45 AM, as part of the Annual Business Session and attendance is limited to NCHCFA members only.

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Register today to attend the NCHCFA Annual Convention and Expo February 26 – March 1, 2017 at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center in Greensboro, NC! Don’t miss the opportunity to earn up to 17.0 hours of educational credit for North Carolina Nursing Home Administrators, as well as up to 16.0 hours of Nursing CE credit! The advanced registration deadline is Friday, February 10th. To obtain an additional brochure visit the Member Center of the Association’s Web site at http://www.NursingHomesNC.com.

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On October 21, 2016, the Centers for Medicare & Medicaid Services published the newest version of Chapter 5 of the Quality Improvement Organization (QIO) Manual. In this revised chapter are changes to the Quality of Care review process effective February 1, 2017:

• Providers will now have 14 calendar days (prior to February 1, they were allowed 30 days) to send in the medical record once a medical record request is received. Because of these tightened time frames, KEPRO encourages providers to fax medical records rather than sending them via mail. The Quality of Care department at KEPRO has its own dedicated fax number, which will be listed on the medical record request.
• After the medical records are received, KEPRO has 30 days to complete the review. Providers that wish to provide a response when they receive an inquiry from KEPRO will also have a shortened time frame, which will be noted on the inquiry letter.
• Medicare beneficiaries, or their representatives, will have the opportunity to request a second review if they disagree with the original findings, similar to the current process in place for providers.

For further information, please visit http://www.keproqio.com.

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Each month, the Division of Medical Assistance (DMA) publishes the Medicaid Bulletin. The February 2017 Medicaid Bulletin is now available. The February Medicaid Bulletin contains information about a variety of topics, including:

• Affordable Care Act Fee Increase for Provider Enrollment
• New American Dental Association Procedure Codes
• Update on Clinical Coverage Policies
• Re-credentialing Due Dates for Calendar Year 2017
• Upload Documents in NCTracks Provider Portal
• Medicaid and N.C. Health Choice Provider Fingerprint-based Criminal Background Checks
• Payment Error Rate Measurement (PERM)

The 2017 Medicaid Bulletins Web page includes the current and past bulletins.

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The Centers for Medicare and Medicaid Services (CMS) has opened registration for “Looking Ahead: The IMPACT Act in 2017 MLN Connects® Call” to be held on Thursday, February 23, 2017 from 1:30 to 3:00 PM ET. The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) requires the reporting of standardized patient assessment data by Post-Acute Care (PAC) providers, including skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, and long term care hospitals. During this call, CMS experts will discuss goals, requirements, progress to date, and key milestones for 2017. A question and answer session will follow the presentation. To register or for more information, visit MLN Connects Event Registration.

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As of July 1, 2016, electronic submission of staffing data through the Payroll-Based Journal (PBJ) is mandatory for all long term care facilities. You have up to 45 days after the end of the quarter to submit data for Federal Fiscal Quarter 1 (October 1, 2016-December 31, 2016.) The final submission file for this quarter is due on February 14, 2017. Providers are encouraged to submit early to avoid system delays. Please note that an updated policy manual and FAQ are now posted on the PBJ Web site.

CMS has added an indicator to the Nursing Home Compare Web site that shows whether a facility has complied with the PBJ reporting requirement. If the indicator is green, the facility has submitted data through PBJ. If the indicator is gray, the facility has not submitted any data through PBJ.

For questions related to software or technical requirements, please e-mail NursingHomePBJTechIssues@cms.hhs.gov. For questions related to PBJ policies, please e-mail NHstaffing@cms.hhs.gov.

PBJ Web site link: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html

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Norovirus outbreaks across the country are bringing misery to millions of families. There have been widespread reports of school closings from the illness, also known as the winter vomiting disease, the stomach bug or stomach “flu.” However, Norovirus is not related to influenza. Norovirus is extremely infectious and can spread quickly in closed places like daycare centers, nursing homes and schools. The virus is primarily passed on via physical contact with contaminated food, liquid, objects or direct contact with infected individuals. Common symptoms of Norovirus include nausea, vomiting, diarrhea and stomach pain.

North Carolinians should take steps that prevent illness from occurring or spreading. The Centers for Disease Control and Prevention (CDC) recommends the following steps to prevent the spread of Norovirus:

• Use soap and water to wash hands.
• Wash fruits and vegetables and cook seafood thoroughly.
• Do not prepare food for others or provide healthcare while you are sick, and for at least three days after symptoms stop.
• Use a chlorine-bleach solution to clean surfaces contaminated with bodily fluids.
• Wash contaminated laundry thoroughly.

North Carolina’s Division of Public Health’s Communicable Disease Branch works closely with local health departments and long term care facility staff to implement control measures that limit spread of Norovirus infection. These steps include:

• Using bleach-based products for cleaning the facility.
• Ensuring that staff don’t work while ill.
• Limiting group activities to prevent further spread.
• Encouraging staff and visitors to wash hands with soap and water instead of hand sanitizers.

For more information about Norovirus, please visit, http://epi.publichealth.nc.gov/cd/diseases/norovirus.html or the North Carolina Statewide Program for Infection Control & Epidemiology guide to Norovirus prevention in healthcare settings.

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The North Carolina Health Care Facilities Association would like to thank our 2017 Gold Convention Hosts for supporting the upcoming Annual Convention & Expo. Be sure to visit them on Tuesday, February 28th during EXPO 2017 – Mardi Gras – Laissez Les Bon Temps Rouler:

Blue Ridge Pharmacy at booths 425 & 524
Healthcare Services Group at booths 527 & 529
Medipack Pharmacy at booths 315 & 414
Neil Medical at booths 301, 303, 400 & 402
NH Med Services at booths 415 & 514
Poyner Spruill LLP at booth 302
PruittHealth at booths 317, 319, 321, 323, 325, 416, 418, 420, 422 & 424
QMX Mobile Health at booth 328
Southern Pharmacy at booths 501 & 503

The North Carolina Health Care Facilities Association would also like to thank our 2017 Silver Convention Hosts for their support: American Medical Technologies, Broad River Rehab and Dixon Hughes Goodman LLP.

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Alliant Quality will offer a Webinar on Tuesday, February 14th, 2017, at 1:00 PM aimed at enhancing Person Centered Care for nursing home residents with dementia. Jennifer Brock, LNHA – Task Lead, Post-Acute Care and Walter Coffey, Director, Leading Age GA, will lead this 1 hour Webinar.

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

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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) 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 Leighann Sauls at Leighann.Sauls@area-F.hcqis.org or call (919) 745-4730.

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Alliant Quality, the QIN-QIO (Quality Innovation Network-Quality Improvement Organization) for North Carolina is seeking central North Carolina skilled nursing facilities interested in collaborating on the Special Innovation Project (SIP) Improving Access to Palliative Care in the Long Term Care Facility.

Palliative care focuses on comfort and improving quality of life. A team of professionals helps residents and families navigate through the health care system and make health care decisions that are right for them. Goals of this project not only include providing quality of life and satisfaction for residents of skilled nursing facilities (SNFs), but also provision of services that minimize risks of potentially avoidable transfers to acute care.

Often, nursing home residents lack advance directives that would assist them at the end of life. When a resident without an advanced directive suffers a worsening of their clinical condition, a cascade of care is put into motion and can trigger unwanted emergency room visits and admissions, which can lead to other complications. The provision of palliative care services for SNF residents supports person-directed care in a proactive way to honor the patient and their choices.

Alliant Quality, in partnership with SNFs and palliative care organizations, will develop customized education and learning sessions for SNF leaders to better understand palliative care and its beneficial role for the residents whom they are caring for each day. This educational offering will be pilot-tested in central North Carolina with SNFs who are interested in this Special Innovation Project offered through the Center for Medicaid & Medicare Services.

Participating SNFs will have the opportunity to:

• Receive free training programs designed to improve their SNF staff competency and knowledge related to end-of-life care
• Join a learning network with experts on palliative care in the SNF setting
• Partner with palliative care providers in order to improve the quality of life of their residents
• Implement low-burden measurement strategies that monitor resident and family satisfaction with end-of-life care
• Improve rates of avoidable acute care transfers and hospital admission and readmission rates

For more information, contact:
Jennifer Judson RN, BSN
Project Lead, Palliative Care
Office: (678) 527-3473
Jennifer.Judson@alliantquality.org

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Bernie Dana draws on his 28 years of experience as an executive and consultant, his academic training and research in quality management, and his involvement in the AHCA/NCAL National Quality Award program in developing this practical guide to creating a quality management system in your organization. He begins with the crucial role of leadership and the basics of quality that will enable leaders and supervisors to shift from the inspection-oriented and crisis management thinking that is often embedded in long term care. He then provides practical guidelines for developing six essential elements of a quality management system that will be the foundation for continuous performance improvement. This new edition provides a step-by-step process for developing a long-range plan and creating and using a balanced scorecard of key measures to assess organizational performance. This is a companion book to Continuous Quality Improvement.

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

Product # 6816
AHCA Members (on-line price) $34.95

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If you were unable to attend one of our sessions on the introduction to the new regulations, the notebook used in the training is now available for purchase (Polly Welsh’s Powerpoint presentation). E-mail Donna Snyder to order a notebook for your facility at donnas@nchcfa.org. The cost is $25.00 plus tax and shipping.

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Quality Improvements Help Baldrige Award Winners Grow, Improve

http://www.hhnmag.com/articles/7921-quality-improvements-help-baldrige-award-winners-grow-improve

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NFL games have a halftime that is 12 minutes long, but for the Super Bowl it is 30 minutes.

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