UPDATE Weekly

NCHCFA would like to thank all facilities that submitted nominations for the 2018 NCHCFA Annual Awards. We had a great response to help recognize front-line staff for their contributions. Nominations will be judged today by the Education and Programs Committee. As soon as all winners have been notified, the 2018 Annual Award Winners will be listed in UPDATE.

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The second issue of Grassroots, the quarterly newsletter for the North Carolina Health Care Facilities Association Political Action Committee (NCHCFA/PAC) is now available. Grassroots will keep members updated on activities related to the NCHCFA/PAC and our advocacy efforts. Grassroots will be published in January, April, July, and October. To view Grassroots Issue #2, click here.

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Today, the Centers for Medicare & Medicaid Services (CMS) released Payroll-Based Journal (PBJ) data to the public through files posted here. These files contain preliminary data submitted by providers for the first and second quarters of calendar year 2017. CMS will continue to publicly post data for subsequent quarters. Any provider that did not submit data prior to the submission deadlines or submitted data that failed to pass quality checks is not included in the public use file (PUF). These providers are flagged on Nursing Home Compare (NHC).

Initial calculations by the American Health Care Association (AHCA) of the data posted today shows the following hours per resident day for the various staffing categories. CMS has indicated they will generate a new set of measures and use a new risk adjustment methodology for the PBJ data. AHCA will continue release information as they learn more. At present, it is not clear how CMS will translate this data into the Five-Star Rating or any other calculations. AHCA will continue to advocate for the meaningful and appropriate use of this data.

The table below represents PBJ data from second quarter 2017. You can compare your second quarter 2017 results to the national median, 25th and 75th percentiles listed in this table. This will tell you, without risk adjustment, if your staffing levels are higher or lower than half of other SNFs (compare to median) or to at least 75% of other SNFs or 25% or other SNFs (the 25th and 75th percentile rates, respectively).

AHCA will continue to advocate on behalf of our members to improve this system and provide updates on PBJ as they become available. In the meantime, members are encouraged to submit their PBJ data frequently and check its accuracy via the available CASPER reports. The next PBJ reporting deadline is November 14, 2017 for the reporting period July 1 – September 30.

Members should pay attention to making sure all discharges have an MDS discharge assessment completed. Not completing an MDS discharge assessment will make your daily census look higher than actual, which will cause your staffing hours per day, to appear lower than they actually are.

Lastly, members are encouraged to join the CMS Open Door Forum scheduled for Thursday, November 2, 2017 at 2:00 PM ET where CMS will provide an update on PBJ. To participate by phone dial (800) 837-1935 and reference Conference ID 61375771. More information about the call can be found here.

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Make plans today to attend the NCHCFA Annual Convention and Expo January 28 – 31, 2018. The meeting will be held at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center, Greensboro, NC. Don’t miss the opportunity to hear Mark Gogal. Mr. Gogal is an enthusiastic, energetic, and passionate leader and presenter who truly enjoys developing others to reach their fullest potential both professionally and personally. He has facilitated four Empowerment Leadership workshops for NCHCFA that have all sold-out!

Mark is 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. Mark has worked in a variety of industries in the public and private sectors including healthcare. Don’t miss the opportunity to hear this informative program on Tuesday, January 30th at 9:00 AM.

To make your overnight reservation, call the Sheraton at (800) 242-6556 and identify that you are with “NC Health Care Facilities Association 2018 Convention” to receive the group discounted rate. Brochures outlining specific program details will be available in November.

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The Intent to Apply process for the 2018 AHCA/NCAL National Quality Award application cycle is now open.

The deadline to submit an Intent to Apply payment is Thursday, November 9th at 8:00 PM EST. The Intent to Apply is not mandatory to apply for the Quality Award, but members who submit an Intent to Apply benefit by saving money on their overall application fee and receive weekly tips on submitting a successful application.

Please note the following:

• All applicants should read the application packet in full before submitting an Intent to Apply payment.
• If your center last received a Bronze or Silver Quality Award in 2015 and has not submitted an application meeting minimum requirements since then, this is your last year to submit an application at the next level. If you do not submit an application this year, you will be considered a past recipient and will need to resubmit at the Bronze level if your center chooses to participate again in the program. For more information, please review the recertification policy here.
• The National Quality Award Website has numerous resources for applicants. Please make sure to visit AHCA’s Website at http://ahcancal.org/qualityaward to learn about the latest updates to the program.

If you would like to review your center’s award history or have any questions, please feel free to contact AHCA at qualityaward@ahca.org.

Key Upcoming 2018 Quality Award Program Dates

November 7, 2017: NCHCFA Silver Quality Award Workshop
November 30, 2017: NCHCFA Bronze Quality Award Workshop
November 9, 2017: Intent to Apply deadline
December 7, 2017: Bronze, Silver and Gold applications accepted online
February 1, 2018: Bronze, Silver and Gold final application deadlines
All deadlines are at 8:00 PM EST.

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The North Carolina Health Care Facilities Association will present a full-day session on the following important topics with Cindy Deporter, MSSW, State Survey Agency Director, Division of Health Service Regulations (DHSR).

• New Interpretative Guidelines
• The second phase of the Requirements of Participation (RoP) to be implemented by November 28, 2017
• CMS’ intent to implement, as well as an overview of, the New Survey Process which is scheduled for implementation on November 28, 2017

**Please note that Ms. Deporter presented a shorter session on the above content at our recent Summer Symposium. This will be a more comprehensive, full day session.

We will conclude this session with a one hour presentation by Polly Welsh, Executive Vice President of the NC Health Care Facilities Association, that will focus on staff interface with the new RoP and the Survey Process. Click here to register on-line. Click here to download and print the brochure and registration form.

November 9th, 2017 – Hilton Greenville, Greenville, NC

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Judy Wilhide Brandt will be presenting an encore presentation on the following topics in Durham, NC on November 16th, 2017. If you could not attend the previous sold-out seminar on September 26th, don’t miss out on this one. Click here to download and print the brochure and registration form. Click here to register on-line.

• Review SNF Quality Reporting Program (QRP), Section GG Coding
• Discuss the purpose of Post-Acute QRP and the role of SNF-QRP
• Understand which MDS items are used for MDS based QRP measures and how to avoid a 2% APU reduction
• List the current QRP claims and MDS based measures with overview of how they are calculated
• Discuss the new MDS items for QRP and new QRP measures to begin collection October 2018 as finalized in the FY18 SNF Final Rule
• Discuss implications of accurate coding for Section GG, to include assessment periods, timing and value in health information exchange for transitions
• Review 5 star quality measures and accurate coding
• Discuss administrative oversight of the MDS department to ensure compliance with accurate coding and transmission for all QMs that are MDS based
• Understand how MDS coding affects risk adjustment for claims based measures
• Review Requirements and Interpretative Guidelines for baseline care planning
• Discuss authentic ways to engage the physician and CNAs in care planning as required by Phase 2 ROP

About the Presenter

Judy Wilhide Brandt is one of the nation’s leading experts on skilled nursing facility (SNF) clinical Medicare compliance, Five Star Rating System, Quality Measures and the MDS/RAI process. Judy brings over thirty-five years of combined experience to the long term care profession, with over twenty years in positions of increasing responsibility in nursing facilities as a nurse manager, executive, and consultant. She is the principle for Wilhide Consulting, Inc. and serves as an advisor, auditor, and trainer for multiple providers from stand-alone communities to multi-state chains across the country.

PLEASE NOTE:
This is the same session that was presented on September 26th in Greensboro.

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If your facility has achieved the AHCA Bronze Award for its commitment to quality, it may be time to apply for the Silver Award. In this two-day workshop, you will walk through the application process and apply the criteria to your organization. At the end of the workshop, participants will have the framework for the Silver AHCA/NCAL Quality Award application.

Learning Objectives

• Translate your Bronze application into a Silver Organizational Profile
• Understand the structure and demands of the Silver Quality Award criteria
• Learn how examiners will use key evaluation tools to score your application and how you write to meet the demands of these tools
• Develop an outline to address the basic demands of the Silver criteria and key systems to either describe or develop your application
• Discover effective strategies to avoid the four most common application mistakes

This workshop will be presented November 7th – 8th at the Association office in Raleigh, NC. Click here for more information and to download and print the brochure with registration form.

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The AHCA Quality Award program has three progressive step levels. This seminar will cover the first level, Bronze – Commitment to Quality. Bronze Award applicants begin their quality journey by developing an organizational profile including vision and mission statements, an awareness of their environment and customers’ expectations, and a demonstration of their ability to improve a process.

This session includes a full day of training and consultation on how to complete the AHCA/NCAL Bronze Quality Award Application This training will decipher the criteria, answer questions, clarify concepts, and guide participants through the process of writing an organizational quality award application. Using interactive technology, participants will leave the workshop with their applications complete or with few areas to fill in.

Objectives:

• Gain knowledge on the AHCA/NCAL Bronze National Quality Award Application Process
• Understand the technical requirements of the application process and recertification policy of the Awards Program
• Review and learn the Bronze Quality Award Criteria
• Develop the framework of a Quality Award Application

It is never too early to begin thinking about and planning your quality award application. This is an opportunity for you and your team to begin your quality journey by working together through the writing process. Get your application ready early and have plenty of time to fine tune it before the deadline.

For the complete brochure and registration information, click here.

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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.

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 Quality Innovation Network-Quality Improvement Organization (QIN-QIO) 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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This 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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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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Isolated nurses and the crisis of LTC identity

McKnight’s Article

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Though a common in horror movies and Halloween decorations, a full moon on Halloween is very rare. The next full moon on Halloween will not occur until 2020. The most recent was back in 2001.

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