UPDATE Weekly

Yesterday in the NC Senate, bill S324 was introduced to completely repeal the certificate of need (CON) laws in North Carolina. This is not the first time that a proposal to repeal the CON laws has been introduced, but none of the previous bills were ever passed by the legislature. As a reminder, the certificate of need laws regulate the availability of health care resources, and most importantly to us the number and location of licensed nursing facility beds. As in the past, NCHCFA will maintain our position against the repeal of CON laws regulating nursing facilities. As this issue develops, updated information will appear in our weekly newsletter, UPDATE, and our Web site.

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All NCHCFA Members received by e-mail today a brief comprehensive survey regarding NCHCFA’s future Annual Convention & Expo, Summer Symposium, and educational programs. Our goal is to present informative and enjoyable programs and we take feedback from our members very seriously as we plan for future events. It is imperative that we get 100% participation from our membership so that we can better serve you. You can also complete this survey by clicking here.

The deadline to complete this survey is Friday, March 31, 2017. We appreciate your time and thank you very much for your feedback! We value your comments and look forward to providing you the highest quality educational programing in the future.

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Earlier this week, the Department of Health and Human Services (HHS) issued an interim final rule delaying the effective date of the final rule, “Advancing Care Coordination through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model.”

The initial final rule, published on January 3, 2017, implements three new mandatory bundled payment models – Coronary Artery Bypass Graft (CABG); Acute Myocardial Infarction (AMI); and Surgical Hip and Femur Fracture Treatment (SHFFT) – in a variety of healthcare markets across the country. The effective date of the new mandatory EPMs originally was July 1, 2017. The interim final rule delays the effective start-date of the three new EPMs for three months, to October 1, 2017. HHS is seeking comment on the appropriateness of the delay and is specifically requesting feedback on delaying the start-date even further to January 1, 2018. Other components of the original final rule are also delayed to October 1, including the cardiac rehabilitation incentive payment program and modifications to the Comprehensive Care for Joint Replacement (CJR) demonstration.

According to the rule, HHS is delaying the rule “to allow time for additional review, to ensure that the agency has adequate time to undertake notice and comment rulemaking to modify the policy if modifications are warranted, and to ensure that in such a case participants have a clear understanding of the governing rules and are not required to take needless compliance steps due to the rule taking effect for a short duration before any potential modifications are effectuated.” The rule specifically references the “Regulatory Freeze Pending Review” executive memorandum signed by President Trump on January 20, 2017.

HHS Secretary Tom Price has previously stated his preference for delivery system and payment reform demonstrations that are voluntary as opposed to mandatory. This interim final rule signals that the agency is willing to reconsider its approach to broad, mandatory payment demonstrations.

Comments on the interim final rule will be due 30 days from the date of publication in the Federal Register, which will occur in the next few days. The American Health Care Association (AHCA) plans to submit comments, again advocating for a full withdrawal of the final rule. Please contact James Michel at AHCA with any questions or comments on this rule or AHCA’s response.

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Pat Boyer, RN, MSM, NHA of Boyer & Associates will present Essentials for Medicaid & Medicare Using the MDS 3.0! CMS has made many changes in the MDS and RUGs system over the years. Now in 2017, we are still challenged with correct coding of the MDS and what documentation supports the coding to ensure proper reimbursement. This training will discuss the MDS “Hot Spots” that are being identified in RAC review and other medical review activity. Participants are encouraged to submit questions and concerns prior to the workshop to karenL@nchcfa.org if there are specific issues they would like addressed. Discussion will also address the financial implications of the RUGs system, SNF VBP, the Quality Measures and identify strategies you can implement to make sure you maintain accurate reimbursement.

Learning Objectives:
• Identify the status of the RUGS IV and MDS systems and any changes that have occurred in the last few years
• Determine how the MDS drives the Quality Measures and SNF VBP
• Discuss MDS “Hot Spots” being reviewed by RACs and Medical Reviewer
• Describe strategies for appropriate management of Medicare Part A Reimbursement using the MDS 3.0

YOU MAY REGISTER AND PAY ON-LINE! Please visit http://NursingHomesNC.com and click on Essentials for Medicaid & Medicare Using the MDS 3.0!

• April 19th – McKimmon Center, Raleigh, NC
• April 20th – Hilton Charlotte University Place, Charlotte, NC

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The NC State Board of Examiners for Nursing Home Administrators (NCBENHA) will offer the 2017 Preceptor Seminars on April 24-25, 2017 and April 25-26, 2017 at the Kingston Plantation, Myrtle Beach, SC. You will need to choose the first seminar dates for Renewal Preceptor certification and the second seminar dates for Initial Preceptor Certification and Continuing Education Only. The seminars will be open to all nursing home administrators seeking continuing education credits and/or preceptor certification. This is the only preceptor seminar being planned for 2017 by NCBENHA. The deadline to register is April 14th!

Click here to download more information along with the registration form.

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The California Association of Health Facilities and the American Health Care Association have put together a Skilled Nursing Facility (SNF) and Intermediate Care Facility for Individuals with Intellectual and Developmental Disabilities (ICF/IID) Emergency Preparedness CMS Final Rule summaries that can be found here. The rule was released on Friday, September 16, 2016, and can be found here. Providers will need to comply by November 2017. Members impacted by the rule include SNFs, Nursing Facilities and ICF/IIDs. This final rule is not applicable to Assisted Living Providers. Finally, the AHCA Emergency Preparedness Final Rule Webinar Series that you might find of assistance can be found here.

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The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for Thursday, March 23, 2017 from 2:00 PM to 3:00 PM ET. It is recommended that participants call in at least 15 minutes before call start time.

**This Agenda is Subject to Change**
I. Opening Remarks
II. Announcements & Updates
• March SNF VBP reports
• PBJ Update
• Policy Questions should be sent to NHStaffing@cms.hhs.gov
• Technical Issues/Questions should be sent to NursingHomePBJTechIssues@cms.hhs.gov
• PBJ Web site: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html
III. Open Q&A

To participant on the call, dial (800) 837-1935 and reference Conference ID 57582259.

Encore is an audio recording of this call that can be accessed by dialing (855) 859-2056 and entering the Conference ID. Encores for ODFs held on Thursdays can be accessed the following Monday. The recording is available for 3 business days.

For ODF schedule updates and E-Mailing List registration, visit the CMS Website at http://www.cms.gov/OpenDoorForums.

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The toolkit is based on the experiences of more than 450 long-term care facilities across the country that participated in an AHRQ-funded project and successfully reduced CAUTIS. The new toolkit uses strategies from AHRQ’s Comprehensive Unit-based Safety Program (CUSP), which has reduced CAUTIS as well as central line-associated bloodstream infections in hospitals. The toolkit combines clinical interventions and best practices for infection prevention with behavior change elements that promote leadership involvement, improvement in safety culture, teamwork, and communication, and sustainability. Its user-friendly educational modules, guides, and tools can help your facility advance from the “what to do” to the “how to do it.” The modules are customizable to local needs. They include: Using the Comprehensive Long-Term Care Safety Toolkit; Senior Leader Engagement; Staff Empowerment; Teamwork and Communication; Resident and Family Engagement; Sustainability; Indwelling Urinary Catheter Use and Care; and Urine Culturing and Antibiotic Stewardship.

To Access the toolkit:
https://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/index.html?utm_source=ahrq&utm_medium=generic&utm_term=&utm_content=2&utm_campaign=AHRQ_cauti4ltc_2017

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District III and IV have scheduled their Spring meetings.

District III
Clapp’s Convalescent Nursing Home
500 Mountain Top Drive
Asheboro, NC 27203
May 16, 2017
10:00 AM – 2:00 PM

District IV
Trinity Grove
631 Junction Creek Drive
Wilmington, NC 28412
May 11, 2017
10:00 AM -2:00 PM

Speakers are pending. If you have a subject you would like addressed by Association staff, please contact Eric Kivisto, erick@nchcfa.org.

District meetings allow participants to feel more interactive and create a comfortable atmosphere, promoting valuable and productive conversation. Due to size considerations, we will be limiting the number of attendees to 50 individuals but, unlike the previous district meeting, this will be open to any employees of your facility who may benefit from attending.

These programs will offers 3.5 contact hours for nursing home administrators. The North Carolina Health Care Facilities Association is a Registered Sponsor of continuing education with the NC State Board of Examiners for Nursing Home Administrators. Comments regarding the Registered Sponsor Course may be addressed to: NCBENHA, 3733 National Drive, Suite 110, Raleigh, NC 27612.

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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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The registration limit has been reached for the April 6th Empowerment Leadership workshop, but a cancel list has been created. This workshop is an interactive, dynamic, developmental session focusing on what it truly means to serve others as a leader. Discuss what employees, customers, and others truly need from leaders. Learn how to operate most effectively in a leadership role using Servant Leadership core principles.

Based on the James Hunter book, “The Servant: A Simple Story About the True Essence of Leadership”, Servant Leadership is a set of behaviors and practices that turn the traditional “power leadership” model upside down; instead of the people working to serve the leader, the leader exists to serve the people. The goal of this workshop is to provide attendees with information and tools that are relevant, transformative, memorable, and actionable.

Some of the most successful companies, known for their positive and effective culture, develop and promote Servant Leadership. These include Starbucks, Southwest Airlines, Chick-Fil-A, SAS, and Nordstrom. Servant Leadership was found to have a significant effect on employee commitment.

This style of leadership is strongly correlated to employee satisfaction and, a considerable body of research has illustrated that Servant Leadership is associated with a variety of favorable employee outcomes, including:

• Improved psychological well-being
• Favorable job attitudes
• Improved job performance
• Decreased workplace deviance

This seminar will be facilitated by Mark Gogal, a Human Resources Leader with over 25 years of progressive, global, and diverse human resources experience, practical business partnering expertise, strong organizational and analytical skills, and proven strategic management experience. He has a multi-faceted background in developing and implementing core HR policies/practices to meet the changing business, legal and labor compliance environment. He has worked in a variety of industries in the public and private sectors including healthcare.

Mark is an enthusiastic, energetic, and passionate leader and presenter who truly enjoys developing others to reach their fullest potential both professionally and personally.

Although registration is now closed, NCHCFA will accept registrations for those interested in being added to the cancellation list. For the complete brochure and to add your name to the cancellation list, click here.

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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 Centers 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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National Nursing Home Week® is May 14-20, 2017! AHCA’s 2017 National Nursing Home Week® (NNHW) specialty products are now available for purchase. This year’s theme with logo, The Spirit of America, is featured on many of the available items. This theme underscores the bond between staff, volunteers and residents that capture the American spirit. 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.

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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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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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Why healthcare needs inspirational leaders and how to become one.

http://www.beckershospitalreview.com/hospital-management-administration/why-healthcare-needs-inspirational-leaders-and-how-to-become-one.html

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The name for the shape of Pringles is called a ‘Hyperbolic Paraboloid’.

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