UPDATE Weekly

On May 31st, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) announced that 14 long term and post-acute care members across North Carolina were recognized with a 2018 Bronze – Commitment to Quality Award by AHCA/NCAL for their dedication to quality care. The AHCA/NCAL National Quality Award Program honors providers throughout the country that have demonstrated their commitment to delivering quality care for seniors and persons with disabilities.

The National Quality Award Program, implemented by AHCA/NCAL in 1996, is centered on the core values and criteria of the Baldrige Performance Excellence Program, which is the foundation of the metric-based AHCA/NCAL Quality Initiative. The National Quality Award program assists providers of long term and post-acute care services in achieving the application of continuous quality improvement.

The program has three levels: Bronze, Silver, and Gold. Providers begin the quality improvement journey at the Bronze level, where they develop an organizational profile with essential performance elements such as vision and mission statements and an assessment of customers’ expectations. Bronze applicants must also demonstrate their ability to implement a performance improvement system. Trained Examiners review each Bronze application to determine if the center has met the demands of the criteria. Recipients of the Bronze – Commitment to Quality Award may now move forward in developing approaches and achieving performance levels that meet the criteria required for the Silver – Achievement in Quality Award.

The awards will be presented during AHCA/NCAL’s 69th Annual Convention and Exposition in San Diego, California, October 7-10, 2018.

Capital Nursing and Rehabilitation Center – Raleigh
Crystal Bluffs Rehabilitation and Health Care Center – Morehead City
Graham Healthcare and Rehabilitation – Robbinsville
Lenoir HealthCare Center – Lenoir
Liberty Commons of Alamance County – Burlington
Pender Memorial Hospital Skilled Nursing – Burgaw
Penn Nursing Center – Reidsville
Piedmont Crossing – Thomasville
Pisgah Manor Health Care Center – Candler
The Laurels of Forest Glenn – Garner
Trinity Grove – Wilmington
Universal Health Care of Fletcher – Fletcher
Universal Health Care of Oxford – Oxford
Wellington Rehabilitation and Healthcare – Knightdale

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The Situational Leadership workshop is an interactive and dynamic developmental session where attendees will discuss how best to apply the effective principles and approaches of The Situational Leadership Model popularized by renowned leadership and management experts Ken Blanchard and Paul Hersey.

Our high demand and ever-changing work environment requires that leadership interactions with staff be as effective and efficient as possible. Additionally, the diverse experiences, skills, and needs of our employees must impact, more than ever, how we manage, lead and inspire our workforce. The Situational Leadership Model suggests that there is no “one size fits all” approach to leadership.

The four different styles of situational leadership to be discussed are:

1. Delegating
2. Coaching
3. Directing
4. Supporting

This workshop will be held Thursday, June 14th at the Northeast Regional Library, Wilmington, 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. He 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. A few quotes from attendees from Mark’s session in March:

“Mark was great and very knowledgeable! I learned so much from him!”
“This was one of the best speakers I have heard!”
“Excellent! Kudos to NCHCFA for inviting Mark back!”

For the complete brochure and registration information, click here.

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NCHCFA Chair Jim Martin led a group of NCHCFA members this week to represent North Carolina’s Skilled Nursing Facilities during AHCA/NCAL’s Congressional Briefing in Washington, D.C. The annual Congressional Briefing is an opportunity to discuss the latest in long-term and post-acute care policy, and to take action with our Members of Congress and their staff to advocate for our members and the residents they serve. Over 450 providers from across the country took part in the event.

During the event, Chair Martin and other NCHCFA representatives met with members of the North Carolina congressional delegation. They discussed the SNF quality improvements NCHCFA members have led, as well as the significant challenges facing our profession, including negative reimbursement trends, the need for regulatory relief, and the workforce crisis.

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The Centers for Medicare & Medicaid Services’ (CMS) federal Requirements of Participation (RoP) contain many significant changes in the area of nursing home pharmacy services. There are many key highlights related to medications, pharmacy services, and medication regimen review. Back by popular demand, Todd King, Pharm. D., CGP, will continue the overview of pharmacy-related Phase 2 requirements and associated guidance required in 2017 and 2019. Attendees will learn how to manage the requirements and important pharmacy-related changes to Appendix PP. This presentation will be a sequel of the session offered in January during the 2018 Annual Convention & Expo! Don’t miss this informative program on Friday, August 10th during 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. Registration will open next week.

Todd King, Pharm.D., CGP, serves as Director of Clinical Services for Omnicare-A CVS Health Company and has worked in the long term care profession for 25 years. He is currently responsible for overseeing the clinical services for the Southeast and Northeast. This includes managing the consultant pharmacist and clinical managers for the regions, implementing clinical programs, managing facility formulary and providing education to customers and staff. He received his Doctor of Pharmacy Degree from Campbell University School of Pharmacy in 1990 and completed a Residency in Geriatrics and long term care in Durham, NC. Todd is a Certified Geriatric Pharmacist. Todd is currently active in a variety of local and national organizations.

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

The next Webinar in the series is scheduled for June 21st, from 12 noon-1:00 pm. Webinar details are below:

Title: Targeted Probe and Educate (TPE) Medical Review
Presenter: Rhonda Craig, RC Consulting

The objectives of this Webinar include:

A) Definition and mechanics of the review
B) How error rates are calculated
C) What happens when a provider fails to improve the error rate
D) Common errors/denial issues
E) How to prepare

Click here to register.

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Time is running out to nominate a long term or post-acute care colleague or volunteer for our national recognition programs. The application deadline for all awards has been extended to Friday, June 15th.

Visit AHCA Awards Program Website Here

• Volunteer of Year – 3 categories: Group, Adult and Young Adult
• ID/DD Hero of the Year
• Not for Profit Program of the Year
• Not for Profit Trustee Award

Recipients receive a free trip to San Diego for the 69th AHCA/NCAL Annual Convention and Expo! Give them the national spotlight! This is the ultimate way to thank and honor a valuable team member for quality caregiving.

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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. AHCA/NCAL has a diverse slate of keynote speakers who will share personal stories of challenge and success that will inspire and motivate you.

Choose from more than 70 sessions with topics to support all professional roles in long term and post-acute care! By attending education sessions from Sunday through Wednesday, attendees can earn up to 16 administrator CEs (separate ticketed sessions can increase CEs). Hear from speakers with advanced degrees, advanced experience, and a passion to further the profession. AHCA’s faculty is ready to share their considerable expertise with you.

Register Today. The early bird registration deadline is July 20th, don’t miss it!

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The June issue of the Medicaid Bulletin is now available. The current issue contains articles on provider re-credentialing, upcoming NCTracks provider trainings, changes in the Pre-Admission Screening and Resident Review (PASRR) Program, and others you may find valuable. You may view the June 2018 issue by clicking here.

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Over the past several weeks in UDPATE, NCHCFA has been discussing the Fair Rental Value (FRV) Modernization Survey. The deadline for submission of these surveys is only 9 days away, June 15th.

FRV has been in place for ten years and pays a more provider specific rate than the system it replaced. FRV rates are updated annually based on national construction data and provider submitted information. Our hope is to develop a modernized FRV system that more accurately reflects the true capital costs of operating a nursing facility, as well as providing more incentive to modernize existing buildings.

In order to develop a more provider specific rate, we must collect data on square footage from each facility. Completion of this survey is extremely important because providers missing square footage data in the rate model will be assigned the minimum default value.

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.

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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This reprocessing notice applies to Medicare Part B Crossover Professional and Outpatient claims that were processed and paid in NCTracks from January 1, 2017, to March 31, 2017.

Medicare experienced a claims processing issue with claims submitted on January 2, 2017, to January 5, 2017, causing incorrect reimbursement. Medicare corrected this reimbursement by implementing an adjustment that was completed by March 21, 2017. However, when Medicare automatically crossed the adjusted claims over to Medicaid, the NCTracks system denied them in error. The system error causing the denial of these claims was resolved on July 24, 2017.

NCTracks will void affected original claims. PROVIDERS MUST submit a new day claim to receive reimbursement. (New day claims must include adjusted claim information received from Medicare.)

Applicable claims will be voided in the July 10, 2018 checkwrite. Providers should submit new day claims within 30 days or less of the July 10, 2018 checkwrite date to avoid potential penalties and interest on outstanding balances.

Voided claims will be displayed in a separate section of the paper Remittance Advice (RA) with the unique Explanation of Benefits (EOB) 10244 -VOID CLAIM TO ALLOW PROVIDER TO RESUBMIT THE CLAIM DUE TO ERRONEOUS DENIAL OF MEDICARE CROSSOVER ADJUSTMENT. The 835 electronic transactions will include the voided claims along with other claims submitted for the checkwrite. Please note that there is no separate 835.

Reprocessing does not guarantee payment of the claims. Affected claims will be voided. While some edits may be bypassed as part of the claim reprocessing, changes made to the system since the claims were originally adjudicated may apply to the reprocessed claims. Therefore, the reprocessed claims could deny.

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AHCA contracted with a law firm to develop a toolkit to support members creating a compliance and ethics program by November 28, 2019, for Phase 3 of the Requirements of Participation.

Members must log into ahcancalED to access the resource. This toolkit is a concise summary of the requirements with helpful, practical tips for implementation. It also pulls in best practices from a variety of sources to support providers in building or improving their program. Creating an effective program requires advanced planning to have in-place the appropriate staff, training, and policies and procedures. While waiting for interpretative guidelines to provide additional clarity, the information in this toolkit will help providers plan for Phase 3 implementation. Please e-mail educate@ahca.org for questions pertaining to accessing this resource.

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Metro Atlanta-based Second Wind Dreams received a $1.5 million grant from the Center for Medicare and Medicaid Services to expand its Virtual Dementia Tour in nursing homes throughout North Carolina. The nonprofit’s Virtual Dementia Tour (VDT) is meant to build sensitivity and awareness for caregivers of those with dementia and improve the quality of life for those with dementia. The tour is a simulation that allows people to experience sensory impairments, vision loss, imbalance and confusion those with dementia often experience. The funds will be used to provide this experience in 200 nursing homes in North Carolina beginning March 2018. Applications are first-come, first-served.

Eligible Nursing Homes will receive:

• VDT conducted by a Second Wind Dreams certified trainer
• Designation as a “Dementia-Sensitive Environment”
• Person-centered assessment of staff performance
• VDT conducted in the local community
• CEU credit for multiple domains
• Staff in-service training

ALL AT NO COST TO YOUR NURSING HOME!

All certified, skilled nursing homes are welcome to apply to participate in the CMP Funds project.

Contact Ebony Blanding, Grants Coordinator, at grants@secondwind.org for more information or by calling (470) 242-0170.

To download the flyer and application, click here.

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VBP for Nursing Homes
This Webinar is scheduled for:
June 26, 2018
1:00 PM – 2:00 PM

Starting in October of this year, all SNFs will have their Medicare payments adjusted based upon how many residents have been admitted to the hospital. SNFs with low readmission rates can receive bonus payments and SNFs with higher readmission rates will have their Medicare payments cut. Join Alliant to learn more about this program to avoid a possible pay decrease this Fall.

Register Here
Phone: (800) 747-5150
Access: 2323667#

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Quality Measure Overview

• Reports the percentage of low-risk residents who lose control of their bowel or bladder in a 7-day look-back period.
• The resident will trigger this measure if the most recent Minimum Data Set (MDS) H0300/H0400 is coded as frequently or always incontinent.

Exclusions:

• Target assessment is admission, Medicare Prospective Payment System 5-day assessment, or readmission/return assessment.
• The resident has high-risk conditions such as severe cognitive impairment or total dependence on bed mobility, transfers, and locomotion.
• The resident does not qualify as high risk (see above) and both of the following two conditions are true: C0500 and C0700/C1000 coded as [99], [^], or [-].
• The resident does not qualify as high risk and any of the following three conditions are true: G0110A1, G0110B1, G0110E1 coded as [-].
• The resident is comatose or comatose status is missing.
• The resident has an indwelling catheter or status is missing.
• The resident has an ostomy or status is missing.
• The resident is not in the numerator and H300 or H400 is coded as [-].

MDS Coding Requirements

In the MDS:

• Include a look-back period of seven days.
• Select H0300 (urinary continence) if the resident is always continent, occasionally incontinent, frequently incontinent, always incontinent, not rated due to an indwelling catheter, condom, or urinary ostomy, or has had no urine output for entire seven days.
• Select H0400 (bowel continence) if the resident is always continent, occasionally incontinent, frequently incontinent, always incontinent, not rated due to ostomy or has had no bowel movement for entire seven days.

Ask These Questions:

• Was the MDS coded per Resident Assessment Instrument (RAI) requirements?
• Is the staff member’s coding documentation accurate?
• Are underlying conditions reviewed and treated for potential causative factors for incontinence (e.g., diabetes, kidney dysfunction, hypertension, medication adverse side effects, etc.)?
• Was the resident evaluated for elimination patterns for at least three days and were toilet programs developed to address individualized patterns?
• Was the resident re-evaluated for elimination patterns whenever there was a change in cognition, physical ability, or urinary tract function?
• Is continence managed through a check-and-change program if the resident is not appropriate for a toilet program?
• Is there documentation to support the:
  • Implementation of an individualized, resident-specific toilet program based on an assessment of the resident’s unique voiding pattern?
  • Communication of the individualized program to staff members and resident through a care plan, flow records, and a written report?
  • Resident’s response to the program and subsequent evaluations?

To download the Tip Sheet, click here.

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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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4 simple ways to become a more effective leader through mindfulness.

Smart Brief Article

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Hippopotomonstrosesquippedaliophobia is the fear of long words.

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