UPDATE Weekly

President Trump released his recommended budget for federal fiscal year 2018 on May 23rd. His recommendations call for $3.6 trillion in spending reductions over the next 10 years, with more than $800 billion of that amount coming from cuts to Medicaid. American Health Care Association/National Center for Assisted Living (AHCA/NCAL) President and CEO Mark Parkinson said this about the budget proposal: “AHCA/NCAL continues to review President Trump’s FY 2018 comprehensive budget. As the budget process continues on Capitol Hill, it is critical that Congress takes steps to ensure Medicaid funding will meet the needs of seniors and individuals with disabilities. Drastic Medicaid cuts like those included in this budget would jeopardize access to care for the most vulnerable in our society. Protecting the frail and elderly is important both today and in the coming years when demand will dramatically increase.” The President’s recommended budget is the first step in the budget process, and Congress will now develop a spending plan of its own. NCHCFA will keep you updated as the process continues.

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Make plans today to join your colleagues for the sixth annual NCHCFA Summer Symposium. The three-day event will be August 9-11, 2017 at the Embassy Suites Resort at Kingston Plantation, Myrtle Beach, SC. Call the Embassy Suites Resort at (800) 876-0010 to reserve your overnight room. Use group code “HCA” to identify yourself as a NC Health Care Facilities Association Convention attendee! To make your reservation on-line, visit http://tinyurl.com/summersymposium2017.

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In a recent survey of our member providers, the number one issue noted was staff retention and reducing employee turnover. We have been fortunate enough to secure a nationally recognized speaker on this topic, Cara Silletto, MBA, President of Crescendo Strategies. Crescendo Strategies is a firm committed to reducing the unnecessary employee turnover by bridging generational gaps and making leaders more effective in their roles. Cara currently sits in a unique spot for her specialty of bridging the great generational divide, because she is an early Millennial herself, born in 1981, yet she is equipped with an MBA and more than 14 years of experience learning the unwritten expectations of older managers and business owners in order to advance her own career. Workforce Magazine named Cara a “Game Changer” and Recruiter.com named her in their “Top 10 Company Culture Experts to Watch.” Cara is also the co-author of “What’s Next in HR.”

Click Here to watch a short video from Cara!

About the Program

Join us for our Workforce Summit, where we’ll tackle your staffing challenges head on! Come learn insights about the shifting demographics of the workforce, employees’ evolving expectations, and strategies for improving staffing stability and reducing unnecessary employee turnover. We’ll also dive into the mindset of your Millennial workers, those under 37, to explain exactly why they think and work so differently than previous generations. By the time you leave this workshop, you’ll discover the true cost of employee turnover, know how to assess your brand as an employer and walk away with realistic plans for improving your workforce woes.

Learning Objectives:

• Identify the current and shifting workforce demographics
• Discuss the evolution of employee expectations over the past decade
• Learn how generational differences impact the workforce and why today’s youngest generation of workers thinks and acts differently than previous generations
• Discover strategies for reducing unnecessary employee turnover and increasing staffing stability

Dates Offered:
June 27th – Charlotte, NC
June 28th – Raleigh, NC

CLICK HERE TO REGISTER NOW!
CLICK HERE TO DOWNLOAD AND PRINT THE BROCHURE!

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Last week, the Centers for Medicare & Medicaid Services (CMS) finalized the rule, “Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement Model (CJR). “The two new cardiac EPMs, the acute myocardial infarction (AMI) EPM and the coronary artery bypass graft (CABG) EPM, will be implemented in 98 selected markets across the country. The orthopedic surgical hip/femur fracture treatment (SHFFT) EPM will be added in the 67 markets currently participating in the CJR demonstration. The new start date for all three EPMs will be January 1, 2018.

This rule has gone through several iterations, each adjusting the timeline for the start date of the programs. The timeline is as follows:

• December 20, 2016 – CMS announces a final rule implementing the new cardiac and SHFFT EPMs with a July 1, 2017, start date.
• January 20, 2017 – The Assistant to the President and Chief of Staff, Reince Priebus, issues a memorandum titled, “Regulatory Freeze Pending Review,” instructing agencies to review rules finalized within the previous 60 days for potential changes.
• March 21, 2017 – CMS publishes an interim final rule with comment period (IFC) delaying the start date of the new EPMs to October 1, 2017, and asking for feedback on whether to delay further to January 1, 2018.
• May 18, 2017 – CMS publishes a final rule officially establishing the start date of the new EPMs at January 1, 2018.

CMS received numerous responses on the March IFC, including suggestions from commenters such as the American Health Care Association (AHCA), to delay the model indefinitely or to make it voluntary rather than mandatory. Ultimately, CMS did not concur with these recommendations and has chosen to keep the program mandatory for participating hospitals. AHCA also commented on aspects of the EPMs not related to the delay of the start date. CMS responded by saying that these comments were out of scope of the IFC and so did not directly address them, but the Agency did acknowledge that it may consider those comments in any future rulemaking on EPMs.

AHCA will continue to advocate to the administration our recommended principles for bundled payment models that work for skilled nursing centers. This includes making them voluntary rather than mandatory. They will also continue to keep members abreast of any new programs or changes to existing regulations the administration may decide to make.

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Make plans today to attend the sixth annual NCHCFA Summer Symposium August 9-11, 2017, at the Embassy Suites Resort at Kingston Plantation, Myrtle Beach, SC. Cindy Deporter, MSSW, State Agency Director, Assistant Section Chief Acute and Home Care Section, and Quality Evaluative Systems Manager, Nursing Home Licensure and Certification, DHSR, will present on Wednesday, August 9th at 1:00 PM. Topics to date include:

• New Interpretative Guidelines
• What to expect in November 2017
• New survey process

The content of this presentation will continue to be updated until August. Additional details will be available in June. You do not want to miss this informative program.

Ms. Deporter was appointed as Interim Assistant Section Chief of the Acute Home Care Section in July of 2013, overseeing approximately 2000 home care agencies, 269 certified home health care agencies, and 200 Hospice Agencies in North Carolina. She is also Branch Manager of Quality Evaluative Systems at DHSR. This section is responsible for Informal Dispute Resolution (IDR), Independent Informal Dispute Resolution (IIDR), Enhancement Coalition, Enhancement Grants, Civil Money Penalties (CMP), and the Quality Improvement Committee. Ms. Deporter also directs Quality Indicator Surveys (QIS), and leads Electronic Plans of Correction (ePOC) that are being implemented by CMS.

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Event Date: June 21, 2017 – 3:00 pm – 4:00 pm (EST)

The Improving Post-Acute-Care Transformation Act (IMPACT) of 2014 requires the standardization of patient assessment data reported in each post-acute care setting (Inpatient Rehab Facilities, Long Term Care Hospitals, Skilled Nursing Facilities and Home Health Agencies). Beginning October 1, 2016, skilled nursing facilities began collecting mandatory data items related to functional status at admission and discharge from the facility. The intent of the collection of data is to facilitate consistent communication and care processes between settings as well as provide the basis for comparing patient types, outcomes of care and costs associated with that care between settings and longitudinally. This Webinar will provide information on how to insure your facility meets the requirements for the functional measure currently included in the skilled nursing facility Quality Reporting Program.

Registration Link: https://educate.ahcancal.org/products/part-6-functional-outcomes

Learning Objectives:

1. Describe the functional measure implemented in the skilled nursing facility effective October 1, 2016.
2. Understand the definitions of the mandatory self-care and mobility items for skilled nursing facility.
3. Implement a process to validate whether your facility has successfully submitted information to meet the reporting threshold.

Presenter: Ellen R. Strunk, PT, MS, GCS, CEEAA, CHC
President and Principal Consultant, Rehab Resources and Consulting, Inc.

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This manual presents methods used to calculate quality measures that are included in the Centers for Medicare & Medicaid Services (CMS) Skilled Nursing Facility (SNF) Quality Reporting Program (QRP). This manual provides detailed information for each quality measure, including quality measure definitions, inclusion and exclusion criteria and measure calculation specifications. View the manual on the SNF Quality Reporting Program Measures and Technical Information Webpage; in the downloads section.

Please note: This manual is specific to the SNF QRP. The manual used to calculate measures for the Nursing Home Quality Initiative (NHQI) can be found in the downloads section of the NHQI Quality Measures Webpage.

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NCHCFA Districts have scheduled their spring meetings. The agenda will include the following topics/presentations:

Alliant Quality (QIN-QIO) – Alliant Quality will present an update on NC’s facilities’ quality measures including pressure ulcers, restraints, etc. They will also discuss the facility composite score.

Healthcare Preparedness Coalition – The Coalition will provide a brief presentation covering the CMS Emergency Preparedness Rule, to be implemented by November 2017, basic information regarding key considerations that challenge providers, and differences between urban and rural provider issues will be discussed.

NC Culture Change Coalition – The Coalition is involved in several activities, including a grant program with the North Carolina Division of Health Service Regulation (DHSR). Information will be presented concerning how to apply for grants, the application process, eligible projects, and more.

NC Works – NC Works will present information on how NC Works may assist facilities in filling positions and keeping employees and how facilities can become more involved with NC Works.

District I
Silver Bluff Village
100 Silver Bluff Drive
Canton, NC 28716
June 8, 2017
10:00 AM – 2:30 PM
For registration, click here

District meetings allow participants to interact with peers in a comfortable atmosphere, promoting valuable and productive conversation. Space will be limited to 50 individuals but, unlike the previous district meetings, this will be open to any employees of your facility who may benefit from attending. There is no cost to participate.

These programs will offer 4.0 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

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

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Last week, the American Health Care Association hosted two Webinars on topics of interest to nursing facilities. The first was part 2 of a Webinar series on the new emergency preparedness requirements. The second was an overview of the proposed Medicare payment reform from the Centers for Medicare & Medicaid Services. Click on the above links to access an on-demand copy of each video.

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It’s here and it’s hot! This year’s AHCA/NCAL Convention & Expo Preliminary Program is now available on-line! You can even read it on your mobile devices. Take a look at what Las Vegas has in store for you October 15th-18th, 2017 in this easy-to-access, easy-to-read flip book.

This year’s Convention & Expo offers national keynote speakers, valuable education, professional networking and exciting exhibits staffed with experts ready to help your company excel. The Gala Dinner & Show (separate ticketed event) is going to be a fantastic night of music, food, and fun that you will remember long after the Las Vegas night ends with Huey Lewis and the News headlining! Register early and save! Early bird registration and savings continue through July 21st.

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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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How to Prepare for the New CMS Rule for Emergency Preparedness

http://www.providermagazine.com/columns/Pages/2017/How-to-Prepare-for-the-New-CMS-Rule-for-Emergency-Preparedness.aspx

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The birthstone of May, the emerald, symbolizes success and love.

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