UPDATE Weekly

Last Friday, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year 2019 and Pre-Rule on Possible New Payment System.

This proposed rule includes several changes to the SNF system of Medicare Part A payments.

• 2.4% market basket increase effective October 1, 2018. This results in an estimated total increase in payments to SNFs of $850 million.
• An update in the wage index will have an impact on the rate changes that providers actually see. In some areas of North Carolina, the proposed wage index increased more than 3%, while other areas saw a decrease of almost 5%.
• In 2017, CMS proposed a new payment methodology called Resident Classification System Version 1 (RCS-1). One of the biggest changes under RCS-1 was the four direct care components based on patient characteristics rather than therapy minutes in determining the payment rate. In addition, under RCS-1, there would have been only two mandatory MDA assessments, the 5 day and a discharge assessment. Based on considerable stakeholder feedback, RCS-1 has been revised and renamed the Patient-Driven Payment Model (PDPM). While PDPM addresses the same goals as RCS-1 and follows a similar structure, there are five case mix adjusted payment components and the timing in the reduction of component payment payments.

The American Health Care Association (AHCA) has created a summary document with a highlights section and preliminary overview of the payment updates, the SNF value-based purchasing (VBP) program proposed new components, the IMPACT Act quality reporting additions, and an overview of the payment reform discussion. AHCA members may view this document by clicking here.

On Monday, April 30th, AHCA also hosted a Webinar on the proposed payment rule. For those who were unable to participate, you can view a recording of the Webinar through ahcancalED with your AHCA member log-in (required). Please e-mail educate@ahca.org with any questions about or issues accessing the recording.

As mentioned during the session, you can view CMS’ SNF Patient Driven Payment Model resources and tools, including the grouper tool, here.

The proposed rule can be viewed at https://www.federalregister.gov/d/2018-09015. Comments will be accepted on this rule until June 26, 2018. The CMS fact sheet is available here.

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North Carolina nursing facilities have been receiving payments for their capital costs through a Fair Rental Value (FRV) system since 2007. As designed, FRV provides rate recognition to providers who invest in new buildings or make improvements to their current buildings. After being in place for ten years, it is believed that improvements can be made to the FRV system to better reflect today’s nursing facility operations.

The North Carolina Health Care Facilities Association (NCHCFA) is working collaboratively with the North Carolina Division of Medical Assistance (NC DMA) to gather data related to FRV in order to modernize the current FRV system.

To develop an alternative methodology for FRV, we must collect data on square footage from each facility. Completion of this survey is extremely important because the data you provide may be used in future Medicaid rate setting for your facility. Earlier this week, an email regarding this survey was sent to each of our member facilities and corporate offices.

This survey can be completed in two different ways.

1. Survey Monkey – This option is designed for the entry of data one facility at a time.
2. Excel Spreadsheet – The Excel spreadsheet is designed to ease the data entry for multiple facilities. If desired, it can also be used to submit information for a single facility. Once completed, the file should be e-mailed to samc@nchcfa.org.

Regardless of which submission method you choose to utilize, it is recommended that you take the following steps:

— Download and print the PDF version of this on-line survey and use it as a worksheet.
— Review the FAQs at the end of the PDF survey.
— With a completed worksheet in hand, you will be able to complete the on-line survey in one sitting or the Excel file.

The deadline for data submission is Friday, June 15, 2018. If possible, we would appreciate receiving as many surveys as possible before the deadline. June 15th was set as the deadline in order to allow additional time for providers needing to prepare their December 31st year end cost reports.

Useful links:
PDF Copy of the Survey Worksheet
FRV Survey Link
FRV Excel Spreadsheet

If you have any questions on this process, please contact Sam Clark at samc@nchcfa.org or by phone at (919) 782-3827.

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Make plans today to join your colleagues for the seventh annual NCHCFA Summer Symposium. The three-day event will be August 8-10, 2018 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 “HCF” to identify yourself as a NC Health Care Facilities Association Convention attendee! To make your reservation on-line, visit https://tinyurl.com/ncsummersymposium2018.

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The North Carolina Health Care Facilities Association will be presenting this workshop to our members for the fifth time! This workshop was offered across the state of NC in 2017 with great success and outstanding reviews. If you missed it last year, sign up today!

Servant leadership is a set of behaviors and practices that turn the traditional “power leadership” model upside down; instead of the people working to serve the leader, the leader exists to serve the people. When leaders shift their mindset and serve first, they unlock purpose and ingenuity in those around them, resulting in higher performance and engaged, fulfilled employees. As servant leaders, your purpose is to inspire and equip those you influence.

The goal of this workshop is to provide attendees with information and tools that are relevant, transformative, memorable, and actionable. You will learn and practice execution of the most critical skills needed for leading by serving first. You will come out of this course feeling energized and have a number of tools and skills you can start to apply immediately to empower your teams.

This workshop will be Thursday, May 24th in Greensboro, NC. It will be facilitated by Mark Gogal, 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. Mark is an enthusiastic and passionate leader and presenter that has a multi-faceted background in developing and implementing core HR policies/practices to meet the changing business, legal, and labor compliance environment. He has worked in a variety of industries in the public and private sectors including healthcare. Mark truly enjoys developing others to reach their fullest potential both professionally and personally.

For the complete brochure and registration information, click here.

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NCHCFA Districts have scheduled their spring meetings. District meetings allow participants to interact with peers in a comfortable atmosphere, promoting valuable and productive conversation. Each space will be limited to 50 individuals. There will be a small registration cost of $35.00 to help with the speaker fee. Lunch will be provided.

This program 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.

The agenda will include the following topics/presentations:

Agenda

10:00 AM – 10:30 AM
Alliant Quality (QIN-QIO) –Alliant Quality will present an update on NC’s facilities’ quality measures.

10:30 AM – 2:30 PM
All Clear Emergency Management Group, LLC – Will Moorhead, President and Owner of All Clear Emergency Management Group, LLC, will dive into the “how to” of the exercise requirement of the Centers for Medicaid and Medicare Services emergency preparedness rule. Learn how to design, conduct, and evaluate an exercise in a nursing home environment. The session will briefly review the CMS requirements, provide practical tips for efficiently completing a useful risk assessment, and examine the contents of a CMS compliant and practically applicable emergency plan. This review of the CMS requirements will demonstrate how exercise design is more easily accomplished when utilizing the best practices for risk assessment and emergency planning. Participants will be guided through information and steps that can be utilized for exercise design within their facility.

District II
May 8th
Wilkes Senior Village
204 Old Brick Yard Road
North Wilkesboro, NC 28659
Click here for District II registration form

District III
May 22nd
Clapp’s Mountain Top Living Apartments
450 Mountain Top Drive
Asheboro, NC 27203
Click here for District III registration form

District IV
May 9th
Bradley Creek Health Center at Carolina Bay
630 Carolina Bay Drive
Wilmington, NC 28403
Click here for District IV registration form

District V
May 23rd
Cypress Glen Retirement Community
100 Hickory Street
Greenville, NC 27858
Click here for District V registration form

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NCHCFA has a new benefit of membership in 2018—a monthly Lunch and Learn Webinar Series. NCHCFA will offer a one-hour Webinar on a timely and relevant topic to its members for no additional charge. There will be no CEUs offered for these Webinars.

The next Webinar in the series is scheduled for May 17th, from 12 noon-1:00 PM. Mark your calendar today! Webinar details are below:

Title: Therapy, Therapy, Therapy – Things Every SNF Needs to Know

Presenter: Iain Stauffer, Poyner Spruill, LLP, Rhonda Craig, RC Consulting

Therapy continues to be one of the most profitable services SNFs offer, as evidenced by the growth of short-term rehab units across the country. Nothing is more maddening than to develop a busy rehab program, only to have Medicare and/or Medicaid agency contractors recoup large sums of money for allegedly inappropriate or unnecessary therapy services. This Webinar will examine the common sources of problems that lead to issues with therapy services and claims for repayment, including documentation; coordination with outside therapy vendors; management of therapy staff and related issues. Providers need to know both before providing services, and after receipt of a repayment demand, how to manage the provision of therapy services and how to respond to claims for records and repayment/recoupment.

Click here to register!

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The American Health Care Association (AHCA) National Skilled Nursing Care Week (NSNCW) is May 13-19, 2018! NSNCW, formerly known as National Nursing Home Week, provides an opportunity to recognize the role of skilled nursing care centers in caring for America’s seniors and individuals with disabilities. This year’s theme, “Celebrating Life’s Stories”, serves as a tribute to life’s most significant events, relationships and experiences that shape the unique perspectives of residents, families, staff, and volunteers in long term and post-acute care.

Are you ready to start “Celebrating Life’s Stories”? AHCA is excited to release the 2018 NSNCW Planning Guide and Product Catalog! Visit the NSNCW Website to download the guide and purchase 2018 products now http://bit.ly/2hFJAjr. Members are encouraged to place orders early for best product selection (color, size, and available quantities). NSNCW items are very popular and will sell out.

Don’t forget to “Like” the NSNCW Facebook page here for updates and to see what centers are planning during this special week, May 13-19, 2018, and be sure to use the hashtag, #NSNCW in any social media posts related to the observance.

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It’s time to register and make plans to join your colleagues from around the country in beautiful San Diego for the most valuable long term and post-acute care gathering of the year. You will be treated to fantastic education sessions designed to help you meet the challenges of today. Earn CEUs while learning from top-notch speakers, engaging in priceless discussions, and making connections with people you can call upon throughout the year.

Early bird registration discount ends July 20th! Click here to register now.

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The American Health Care Association (AHCA) is now accepting entries for the AHCA Awards Program. AHCA honors individuals who are committed to improving the quality of life for residents. The categories are as follows:

• ID/DD Hero of the Year
• Not for Profit Trustee of the Year
• Not for Profit Program of the Year
• Volunteer of the Year – Please note nomination revised as of 04/13/2018
  • Young Adult (Ages 13-19)
  • Adult
  • Group

Nominations packets are available on AHCA’s Website. In a change from previous years, Volunteer of the Year nominations may be submitted directly by centers in good standing with the state affiliate. All nominations are due by Friday June 8th at 11:59 PM.

Please spread the word and take the time to submit a nomination. This is a great opportunity to recognize those who go above and beyond on the national stage. Honorees will be recognized at AHCA/NCAL’s 69th Annual Convention and & Expo in San Diego.

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This newly updated and revised book presents ready-to-use materials for planning, implementing, and evaluating cultural competence strategies and programs. Learn to identify the needs of diverse constituents, evaluate outcomes, prevent multicultural-related workplace conflict, and much more. Includes tools to evaluate and assess cultural competence on a companion Website.

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

Product #8173
AHCA MEMBERS $80.00

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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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Finding Meaning and Happiness in Old Age

NY Times Article

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In England, the Speaker of the House is not allowed to speak.

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