UPDATE Weekly

The Centers for Medicare and Medicaid Services (CMS) recently announced there were errors in their Part B Physician Fee Schedule pricing files for seven of the eight new codes for physical therapy and occupational therapy evaluations that were introduced on January 1, 2017. These errors have resulted in underpayments for certain codes from January through March 2017. The CMS pricing file will be corrected on April 1, 2017 and applied retroactively.

The following therapy codes are affected:

• 97161 – PT Eval Low Complex 20 min
• 97161 – PT Eval Med Complex 30 min
• 97163 – PT Eval Med Complex 45 min
• 97165 – OT Eval Med Complex 30 min
• 97166 – OT Eval Med Complex 45 min
• 97167 – OT Eval Med Complex 60 min
• 97168 – OT Re-Eval Est Plan Care

Because CMS has instructed that corrections to past payments be corrected only upon request, providers’ therapy and billing staff should review these procedure price corrections to evaluate the scope and amount of underpayments. Medicare Administrative Contractors will not automatically correct claims already processed prior to April 1st, rather, only those erroneously paid claims that providers bring to their attention.

Due to these changes, the American Health Care Association (AHCA) has posted an updated CY 2017 AHCA therapy pricing file on their Web site.

AHCA extends thanks for the efforts of Tony Marshall, President and CEO of the Georgia Health Care Association, for updating this data file. Detailed information related to how the CY 2017 AHCA therapy pricing file was constructed is posted on the Long Term Care Leader Blog.

Contact Dan Ciolek, AHCA Associate Vice President, Therapy Advocacy, with any questions.

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The NCHCFA Annual Summer Symposium will be August 9-11, 2017 at the Embassy Suites Resort in Myrtle Beach, SC. Brochures outlining specific program information will be available in June.

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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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NCHCFA Districts are scheduling their spring meetings.

District II
Royal Park Nursing & Rehab of Matthews
2700 Royal Commons Lane
Matthews, NC 28105
May 10, 2017
10:00 AM – 2:00 PM

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

District V
Universal Health Care / Fuquay-Varina
410 Judd Parkway
Fuquay-Varina, NC 27526
May 23, 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 meetings, this will be open to any employees of your facility who may benefit from attending.

These programs will offer 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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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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The latest edition of MLNConnects, the official CMS news from the Medicare Learning Network is out. In this edition, there are articles on Medicare ACOs, emergency preparedness requirements training call, a new NPI booklet, a revised SNF consolidated billing web-based training course and others. To access this resource, click here.

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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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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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This book offers CNAs the support of trained and experienced mentors to guide their way as they develop into quality health care professionals. Implementing this program can help you reduce your facility’s CNA turnover rate, save money and build a more competent staff. You’ll have happier residents and a higher quality facility as a result!

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

Product #6706
AHCA MEMBERS $59.95

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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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For leadership lessons, CIOs can learn a lot from athletes.

http://www.healthcareitnews.com/news/leadership-lessons-cios-can-learn-lot-athletes

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”Wrap rage” is the common name for heightened levels of frustration resulting from the inability to open a package.

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