UPDATE Weekly

In the past week, the Centers for Medicare & Medicaid Services (CMS) finalized major changes to the mandatory post-acute bundling programs. You may recall that these large-scale demonstrations were created by the Center for Medicare and Medicaid Innovation (CMMI) under the Obama Administration and required bundling in large parts of the country. The demonstrations also placed hospitals in control of the bundles.

The final rule is available online at
https://www.federalregister.gov/documents/2017/12/01/2017-25979/medicare-program-cancellation-of-advancing-care-coordination-through-episode-payment-and-cardiac. There are several parts of the final rule that are especially pertinent.

This final rule cancels the most recent mandatory bundling program. This is the program that would have added two cardiac episodes to mandatory bundling and gave hospitals the bundle. CMS had previously delayed this program until January 1, 2018 and has now eliminated it.

The final rule also makes major changes to the initial mandatory bundle, the Comprehensive Care for Joint Replacement (CJR). Specifically, the rule reduces the number of Metropolitan Statistical Areas (MSAs) included in the demonstration from 67 to 34. Low-volume and rural hospitals also will not be required to participate. For the 33 MSAs that are eliminated, bundling can continue but only on a voluntary basis. A complete list of the MSAs that are included is online at https://innovation.cms.gov/initiatives/cjr.

CMS states that it expects to roll out additional opportunities for providers to participate in voluntary initiatives instead of mandatory bundled payment models.

In addition to the final rule, CMS issued an interim final rule with a comment period establishing and seeking comment on a policy to provide flexibility in determining episode costs for providers located in areas impacted by extreme and uncontrollable circumstances, such as the hurricanes that occurred earlier this year.

As you may recall, the American Health Care Association (AHCA) advocated for these changes immediately after the election. AHCA has been very clear that it is not opposed to bundling, but the AHCA Board has taken a position against mandatory bundling – particularly when nursing facilities have no ability to hold the bundle. The mandatory nature of these bundling programs had previously been called into question by former Health and Human Services Secretary (HHS) Tom Price. The final rule signals that, even with Secretary Price’s departure, HHS and CMS are committed to developing and implementing only bundling demonstrations that are voluntary in nature.

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The updated List of Excluded Individuals and Entities (LEIE) database file, which reflects all OIG exclusions and reinstatement actions up to, and including, those taken in November 2017 has been posted. The updated files are posted on OIG’s Web site at https://oig.hhs.gov/exclusions/exclusions_list.asp. Healthcare providers have an “affirmative duty” to check to ensure that excluded individuals are not working in their facilities or face significant fines.

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Register today to attend the NCHCFA Annual Convention and Expo January 28 – 31, 2018 at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center in Greensboro, NC! Call the Sheraton at (800) 242-6556 to make your room reservation. Identify that you are with “NC Health Care Facilities Association 2018 Convention” to receive the group discounted rate. Don’t miss the opportunity to earn up to 16.5 hours of educational credit for North Carolina Nursing Home Administrators, as well as up to 15.5 hours of Nursing CE credit! The advanced registration deadline is Friday, January 12th. Click here to register.

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Let the games begin. Wear your favorite jersey from your alma mater or come dressed in your high school homecoming attire. Make plans today to attend the Chairman’s Tailgate Party & Homecoming Extravaganza on Monday evening, January 29th. Join Chairman Phillip Hill and the Board of Directors for a night of fun because it’s official, nobody’s riding the pine!

Calling all ballers! Shoot some hoops, brave Thunder Mountain on a snowboard, or show off your skills with a game of air hockey, ping pong, or pool. For the golfers in the group, see who has the longest drive on the golf simulator. Then start your engines on the remote control racetrack or challenge your colleagues on the Daytona USA Racing Simulators. Don’t forget to try the NASCAR Pit-Stop Challenge before the night is over. Prizes will be awarded for the fastest time.

Have you got talent? Get ready for great live music and Chairman Hill’s open mic night. NCHCFA alumni Todd Roper, Administrator, Conover Nursing & Rehab Center, will play piano and perform all the greatest tunes from your favorite decade. Attendees can sign-up for karaoke throughout the evening and be a part of the show. When the DJ calls a timeout, be sure to take a line dance lesson or play a game of Dance Revolution so you will be ready for the Homecoming Dance. At halftime, the NCHCFA Homecoming King and Queen will be crowned.

Great prizes will be awarded throughout the night and a photographer will be on hand for the NCHCFA yearbook. Don’t miss this night of fun! Heavy hors d’oeuvres will be served.

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Be prepared to register on January 15, 2018 for:

Infection Control in Long Term Care Facilities
March 26-28, 2018
William and Ida Friday Center, Chapel Hill, NC

Link to SPICE registration policy: http://spice.unc.edu/wp-content/uploads/2017/11/New-Registration-Policy-112717-3.pdf

Link to obtain a Course Quote: https://spice.unc.edu/course-quote

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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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The new emergency preparedness requirements from the Centers for Medicare & Medicaid Services (CMS) become effective November 16. To help prepare skilled nursing facilities participating in Medicare and Medicaid to meet these new requirements, the American Health Care Association (AHCA) is pleased to offer a new Emergency & Disaster Preparedness Kit prepared by IlluminAge Communication Partners.

The new kit includes three main components:

• Online Emergency Document Storage and Portal. This service makes it easy and fast to organize, store, and have online/offline emergency access to “must have” documents, such as emergency contact lists, evacuation and resident relocation plans, emergency staffing plans, valve shut-off instructions, etc.
• Step-by-Step Video. A 26-minute video that provides an excellent overview of CMS’ new emergency preparedness requirements, including their background and context, the timeline for compliance, and the elements every emergency planning effort must include.
• Emergency Preparedness Checklist. A 28-page companion that will give your emergency prep coordinator an easy-to-follow, 15-step framework to help shape and guide an effective compliance program.

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

AHCA MEMBERS $179.00

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NCHCFA has partnered with nationally recognized speaker, Cara Silletto and her company Crescendo Strategies, to offer you a new online course. Are you having trouble retaining young workers? Do you find it hard to understand Millennials? If you missed our Full Day Workforce Summit, this 90-minute, self-paced online course shows leaders a Millennial speaker’s first-hand stories about the real generational issues on the T.A.B.L.E. (technology, authority, balance, loyalty, entitlement). Course participants will learn critical insights about all of today’s workers in order to bridge the widening generational gaps and reduce unnecessary employee turnover.

How companies use this online course:

• Consistent training across multiple locations
• Catch-up session for those who missed it live
• New supervisor and manager orientation
• Prep for strategic planning or leadership retreats
• Deep-dive diversity training beyond the basics
• Continuing education credits (1.5 NAB-approved credits)

NCHCFA is pleased to offer member discounts! Click here for more information and promotional codes. Click here to start the course (Remember to enter your promo code).

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A Heart to Serve

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The cigarette lighter was invented before the match.

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