UPDATE Weekly

As our members are aware, starting October 1, 2018, all Skilled Nursing Facility (SNF) Medicare Part A rates will be cut by 2 percent to fund an incentive payment pool. At that time, the Centers for Medicare & Medicaid Services (CMS) will adjust payments and return some amount to providers based on how well they do in managing hospital readmissions by meeting or exceeding performance standards. This CMS effort, the SNF Value Based Purchasing (VBP) Program, links financial outcomes to quality performance.

While the SNF VBP program does not affect payment until 2018, CMS is currently collecting rehospitalization data that will be used to determine how much centers earn back. Accordingly, we are running this 10-Part series to support members in reducing rehospitalizations.

This week is part two of the series, and we are featuring Discharge to Community: Creating Seamless Transitions.

A significant shift we’ve experienced in our communities relates to discharge to community. Our role is to create seamless transitions that return residents safely home – a departure from our “long stay” roots. Thus, skilled nursing centers are responsible for assisting individuals in improving functional independence and adequately preparing individuals for discharge from the center. Assuring individuals and their families can manage care needs after discharge is critical to preventing rehospitalizations. Check out this resource here to learn more.

For more information about the SNF VBP program and to access additional resources and tools, visit the AHCA SNF VBP Web site here. Take action today!

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In the revised skilled nursing facility prospective payment system booklet, you can learn about background elements of the SNF Prospective Payment System, SNF Quality Reporting Program, and SNF Value-Based Purchasing Program.

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CMS provided notifications to facilities that were determined to be non-compliant with the SNF Quality Reporting Program (QRP) requirements for Quarter 4 of CY 2016, which will affect their FY 2018 annual payment update (APU). Notifications of non-compliance were placed into facilities’ Quality Improvement and Evaluation Systems (QIES) – Certification and Survey Provider Enhanced Reporting (CASPER) system on July 14, 2017 and also mailed directly to providers. Providers that receive a letter of non-compliance may submit a request for reconsideration to CMS via e-mail, no later than 11:59 PM PST, August 13, 2017. If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notification letter and on the SNF Quality Reporting Reconsideration and Exception & Extension Webpage.

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On June 7, 2017, CMS posted new versions of the Important Message from Medicare (IM) form (CMS-R-193) and the Detailed Notice of Discharge (DND) form (CMS 10066) on the Beneficiary Notices Initiative Webpage. The associated instructions for use are also available.

The new IM form incorporates the following language related to discrimination – “For more information, call 1-800-MEDICARE (1-800-633-4227), or TTY: 1-877-486-2048. CMS does not discriminate in its programs and activities. To request this publication in an alternate format, please call: 1-800-MEDICARE or e-mail: AltFormatRequest@cms.hhs.gov.” The Detailed Notice also has new language related to discrimination. Both forms have new expiration dates.

CMS is requiring that the new version of these forms must be in use by August 28, 2017.

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Published in the Federal Register at Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities; CMS has corrected the ROP final rule implementation date as follows:

“On page 68869, we made a technical error in the regulations text for § 483.85(b). We incorrectly indicated that the operating organization for each facility must have in operation a compliance and ethics program by November 28, 2017. In the final rule (81 FR 68697) we indicated that all the requirements in § 483.85 would be implemented in Phase 3 (November 28, 2019). Therefore, we are revising paragraph § 483.85(b) to accurately indicate that the operating organization for each facility must have in operation a compliance and ethics program by November 28, 2019, and removing the reference to November 28, 2017.”

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Last week, the American Health Care Association (AHCA) held the last Webinar in its three-part series on the new emergency preparedness requirements. Each of the Webinars in this series can be accessed for on-demand viewing. Click each of the titles below for additional information and registration information. Each of the Webinars is free to AHCA and NCHCFA member facilities.

• Are You Ready for the New Emergency Preparedness Requirements? Originally presented on February 9, 2017.
• New Emergency Preparedness Requirements – Part II in the Webinar Series. Originally presented on May 17, 2017.
• Emergency Exercise Design In 60 Minutes or Less – Part III in the Webinar Series. Originally presented on July 13, 2017.
• AHCA also provided a summary of the interpretive guidance CMS released regarding Emergency Preparedness requirements.

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As you may have heard, earlier this week two additional US Senators announced they would not vote in favor of moving forward with the US Senate’s Repeal and Replace legislation. Following that news, Senate Majority Leader McConnell stated his intention to move in a different direction in the near future by reverting to a 2015 proposal simply to repeal the Affordable Care Act. That 2015 proposal, however, also seems not to have sufficient support at this time to pass. Given these developments it appears the effort to Repeal and Replace the Affordable Care Act has stalled for now. While there is still a possibility that legislation will move forward, or that this effort will be merged with a ‘must pass’ bill later, this risk of Medicaid being fundamentally restructured as outlined in the previous Senate drafts has decreased. Please see below message released Tuesday from AHCA President and CEO Mark Parkinson for additional details.

“The last 24 hours in Washington, D.C. have continued this year’s trend of unpredictability on Capitol Hill. Late last night, Senate Majority Leader Mitch McConnell pulled the proposed bill to repeal and replace the Affordable Care Act (ACA) after GOP Senators Jerry Moran (Kansas) and Mike Lee (Utah) announced they would not support it, joining Senators Susan Collins (Maine) and Rand Paul (Kentucky). The announcement from Lee and Moran means the Senate is short of the necessary 50 votes to pass the procedural vote that would have brought the bill to the Senate floor.

This legislation posed one of the biggest threats to Medicaid we’ve ever faced. The updated bill, which was released just last week, would have taken significant funding away from those whom Medicaid is designed to protect – including millions who depend on long term care every day.

Together, we have been a big part of this success. You have done so much over the past months to make sure our voice is heard. This year, more than 115,000 people have contacted their member of Congress through our grassroots outreach system, asking them to preserve Medicaid funding for America’s seniors. Amazingly, 23,000 of those contacts came in the last 30 days alone.

This is spectacular. You have joined together to speak on behalf of and protect those who rely on Medicaid to access the quality care they need. You came through loud and clear and have truly made an impact. Thank you for your tremendous efforts and for everything you do.

Next Steps

Although the past day has been good, we can’t breathe easy quite yet. The risk to Medicaid has dropped, but things continue to change very quickly. We must continue to be vigilant and active. There are still other vehicles in which Medicaid reform could be addressed.

Possibly as early as later this week or early next, Senator McConnell has indicated he will bring the House version of the health care bill to the Senate floor with the intent to amend it as the 2015 ACA repeal bill. Already, three Republican senators – Collins, Shelley Moore Capito (West Virginia), and Lisa Murkowski (Alaska) – have all said they would oppose any vote to proceed with an immediate repeal of the law, threatening its passage. Again, the risk to Medicaid is low, but it still exists.

What You Can Do

It is important to continue our outreach on Capitol Hill and educate House and Senate Republicans. You can register for the AHCA/NCAL online grassroots Care Advocacy resource to easily locate and contact your member of Congress. Use the state-specific talking points developed by the Association to explain the devastating impacts significant Medicaid cuts would have on our profession and those for whom we care.

We will keep you apprised of new developments as things continue to change. I am truly in awe of your commitment and passion. It is a pleasure to work with each of you and see what we can accomplish together. Thank you, again, for your unwavering support and efforts every single day” – Mark Parkinson, President and CEO.

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Register today to attend the sixth annual NCHCFA Summer Symposium August 9-11, 2017 at the Embassy Suites Resort at Kingston Plantation, Myrtle Beach, SC for the most up to date information affecting long term care. You can register and pay on-line. Visit http://NursingHomesNC.com and click on Sixth Annual Summer Symposium Registration! Administrators and registered nurses will be able to earn up to 11.5 hours of continuing education. Early registration ends this Friday, July 21st!

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The North Carolina Health Care Facilities Association would like to thank our 2017 Summer Symposium Corporate Sponsors for supporting the upcoming sixth annual Summer Symposium in Myrtle Beach, SC: Equinox Ventures Group, Healthcare Services Group, and QMX Mobile Health. We appreciate your support!

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NCHCFA has exceeded its block of rooms at the Embassy Suites Resort for the Annual Summer Symposium. NCHCFA is working with the hotel to secure a few additional rooms for our event. Please call Allison Dew at the Association office at (919) 782-3827 as soon as possible if you need an overnight reservation. NCHCFA will do our best to accommodate all attendees for the event within the hotel properties!

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Do not miss the NCHCFA Day at the Beach – Volleyball & Corn Hole Tournament on Thursday, August 10th. Join your colleagues on the beach for an afternoon of fun! Represent your district in the NCHCFA Volleyball Tournament. Challenge the NCHCFA staff and Board of Directors in the quest for the Chairman’s Cup. If you are not set on volleyball, get a team together for the Corn Hole Tournament. Sponsors will provide snacks, beverages, and prizes.

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Please plan to join your friends and colleagues in beautiful Southern Pines, North Carolina, on September 14th and 15th for the NCHCFA 6th Annual Autumn Classic. The event will be held at the world famous Pine Needles Lodge and Resort. Built in 1928, the Donald Ross course at Pine Needles has been host to three U.S. Women’s Open tournaments in 1996, 2001 and again in 2007.

You do not have to play golf to participate. In addition to the “Cabana Club” Package, we are pleased to announce we are offering a new “Recharge Club” Package at this year’s event. Come enjoy lunch and spend the afternoon relaxing at The Spa at Pinehurst. This 31,000 square foot facility is a Forbes Four-Star Spa that offers a wide variety of treatments and services. This package includes access to all areas at the spa, which features a heated, three lane saline lap pool, eucalyptus steam rooms, a spacious fitness center, and much more. Transportation will be provided to and from the Village at Pinehurst.

The Autumn Classic is hosted by the NCHCFA to benefit our political action committee (PAC). Click here to review the information about the scheduled events and to register. We hope you will join us in Southern Pines in September.

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If you still haven’t registered for the AHCA/NCAL 68th Annual Convention & Expo, do it today! Register before July 21st for maximum savings! The Convention & Expo is the winning deal – four days of top-notch education, national speakers, networking, special events, and an Expo Hall packed with all the best products and services for long-term care and post-acute care professionals. When registering, make sure to get your tickets for the Gala Dinner & Show with Huey Lewis and the News. It will be a night you won’t forget!

Early bird registration and savings continue through July 21.

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The book presents specific care strategies for all stages of dementia and emphasizes relatively simple interventions that nurses can incorporate into their care plans to prevent problems or address them before they escalate. The guide distinguishes between dementia and conditions that mimic dementia, discusses issues related to specific care settings, presents person-centered strategies for families and care partners, and covers the assessment and management of pain, safety concerns, communication strategies, and ethical and legal issues. It additionally provides numerous resources that nurses can offer to caregivers. Fast Facts for Dementia Care will serve as a daily companion for all clinical nurses who work with older patients in any setting, including the emergency room, medical-surgical unit, medical office, and community mental health settings.

Key Features:

• Easy to use and carry in all patient settings
• Provides communication techniques for different stages of dementia
• Describes numerous interventions for addressing issues such as pain, safety, behaviors, and ADLs
• Includes the “Fast Facts in a Nutshell” feature for quick reference
• Illustrates content with case vignettes

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

Product #8293
AHCA MEMBERS $30.00

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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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Essential analytics for thriving in LTC

http://www.mcknights.com/blogs/essential-analytics-for-thriving-in-ltc/article/668722

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Honey does not spoil. You could feasibly eat 3,000 year old honey.

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