UPDATE Weekly

The Intent to Apply (ITA) for the 2019 AHCA/NCAL National Quality Award application cycle is closing soon! The deadline to submit an ITA is November 8, 2018 at 8 p.m. Eastern Time. AHCA/NCAL encourages you to submit an ITA through the Quality Award Portal here before the deadline. More information about the AHCA/NCAL National Quality Award Program, the benefits of submitting an ITA and key dates are listed below and available at http://www.ahcancal.org/qualityaward.

We hope you will take the next step to continue your quality journey this coming year by submitting an ITA.

If you have any questions, please feel free to contact the AHCA/NCAL Quality Award team at qualityaward@ahca.org.

What is the AHCA/NCAL National Quality Award Program?

The National Quality Award Program recognizes long term and post-acute care organizations across the nation for quality and excellence. The program has three levels of awards: Bronze – Commitment to Quality, Silver – Achievement in Quality, and Gold – Excellence in Quality, each of which set progressively higher standards for performance. AHCA/NCAL data has found that Silver and Gold recipients perform better than the national average on key quality metrics, like the off-label use of antipsychotics, hospital readmissions and more. By moving through the three award levels, organizations improve the quality of the care and services they provide.

Why should I submit an Intent to Apply?

While not mandatory, applicants who submit an ITA will save money on their overall application fee and receive extra educational resources. No paperwork or application is needed to submit an ITA through the Quality Award Portal here. Please note:

• We encourage all applicants to review the application packet in full before submitting an ITA payment. Applications are available at http://www.ahcancal.org/qualityaward.
• The 2019 Quality Award Survey Eligibility, as of the September Nursing Home Compare release, for all award levels is now available on the Quality Award website.

Learn More About Serving as a National Quality Award Examiner

One of the best ways to understand the demands of the criteria is to serve as an Examiner. The Quality Award Program is looking for individuals interested in learning more about quality improvement and performance excellence to serve as Examiners. Benefits of volunteering with the program include in-person and online training on the Baldrige Performance Excellence Criteria, CEUs, opportunities for professional development, and networking with other industry professionals. Register for our webinar to learn more.

Key Upcoming 2019 Quality Award Program Dates

• November 8, 2018: Intent to Apply deadline
• November 29, 2018: Examiner application deadline
• January 31, 2019: Bronze, Silver and Gold final application deadline
• All deadlines are at 8 PM Eastern Time

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This is a reminder that effective August 1, 2018, the Division of Medical Assistance (DMA) and Division of Health Benefits (DHB) combined into one division called the NCDHHS Division of Health Benefits. Although the division has a new name, the programs, North Carolina Medicaid and NC Health Choice, remain the same, and are collectively referred to as “NC Medicaid” or simply “Medicaid.”

NCTracks and the Medicaid Website are updating content, templates and other information, but providers are encouraged to use both terms when using the search function on the Medicaid Website or in NCTracks.

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Over the past several years, the Centers for Medicare and Medicaid Services implemented and utilized a revised format for Allegations of Compliance (AOCs) and Plans of Correction (POCs) that focused on “processes” and procedures that both cased noncompliance and were designed to correct it, causing much confusion among providers. Earlier this year, CMS returned to the former delineation of AOC and POC elements and, as a result, how to obtain past noncompliance and either a one-day civil money penalty or reduce daily CMPs, where a CMP is the remedy chosen by CMS for a noncompliant event. This Webinar will include a review of an actual successful POC that avoided daily CMPs as an example, and will discuss recent trends at the State and Federal levels in citations of past noncompliance versus daily CMP imposition.

Title: Drafting Acceptable Allegations of Compliance and Plans of Correction
Presenter: Ken Burgess, Poyner Spruill, LLP

Click here to register!

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Cindy Deporter, MSSW, State Survey Agency Director, Division of Health Service Regulation, will be teaching a full day session (two locations) on the following topics:

• Upcoming changes/additions to the federal regulations for November of 2019
• Review of the changes to the state nursing home regulations
• Update on current CMS workgroups on area of transfer/discharge, Facility Reported Incidents
• Revisions to Immediate Jeopardy language

The sessions will be presented at the following two locations:

November 7th – Sheraton Imperial Hotel, Durham, NC
November 13th – Crowne Plaza Hotel, Asheville, NC

Click here to register online! Click here to download the brochure with registration form.

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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 at MAHEC in Asheville, NC. It will be facilitated by Mark Goal, 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.

For the brochure and registration information, click here!

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The TRECS Institute, with support from the Leonard Davis Institute of Health Economics (LDI) is pleased to announce the launch of a national, grass roots initiative designed to identify and address “No Brainers” within our long term care system.

A “No Brainer” is any current practice that negatively effects the quality of care provided to the residents in our nation’s long term care facilities and results in unnecessary and wasteful spending. These practices are driven by historical practice patterns, reimbursement and/or operational regulations and have two undeniable outcomes:

1) The practice is not in the best interest of residents
2) The practice results in wasted and unnecessary spending for our health care system

The goal of this initiative is to identify “No Brainers”, confirm the negative quality implications they present and to estimate the overall negative economic impact they have on our healthcare system.

To find out more about this initiative or submit what you believe to be a “No Brainer” specific to the long term care system, please visit the TRECS Institute’s Web site and follow the prompts for the “No Brainer” Initiative.

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NCHCFA has scheduled the AHCA/NCAL Bronze and Silver Quality Award Workshops. The AHCA/NCAL National Quality Award Program provides a pathway for providers of long term care services to journey towards performance excellence. The program is based on the core values and criteria of the Baldrige Performance Excellence Program. The Quality Award program has three progressive step levels.

The first level is Bronze, Commitment to Quality. Last year, 8 of out 10 facilities that attended the Bronze Quality Award workshop received the Bronze Quality Award! 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. This workshop is being offered in two locations:

November 15th – Silver Bluff Village, 100 Silver Bluff Drive, Canton, NC 28716
December 6th – NCHCFA, 5109 Bur Oak Circle, Raleigh, NC 27612

Click here to download the brochure and registration form for the Bronze Quality Award Workshop.

The second level is Silver, Achievement in Quality. A requirement of the program is to receive a Bronze – Commitment to Quality Award before applying at the Silver level. At this level applicants continue to learn and develop effective approaches that help improve performance and health care outcomes. In addition to the Organizational Profile, applicants provide a thorough assessment of their systematic approaches and the deployment of these approaches. At the end of this workshop, participants will have the framework for the Silver AHCA/NCAL Quality Award application.

November 28th – 29th – NCHCFA, 5109 Bur Oak Circle, Raleigh, NC 27612

Click here to download the brochure and registration form for the Silver Quality Award Workshop.

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This contains information about the inaugural release of the SNF QRP data on the Nursing Home Compare website that occurred on October 24, 2018.

Why is this information being released? – In accordance with Section 1899B(g)(1) of the Social Security Act, which requires CMS to provide for the public reporting of SNF provider performance on the quality measures, CMS is announcing the inaugural release of the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) quality data on Nursing Home (NH) Compare. The law requires certain post-acute care (PAC) providers, including SNFs, to report provider performance data on quality. The Improving Medicare Post-Acute Care Transformation (IMPACT) Act also requires CMS to publicly report quality measure data submitted by SNFs on certain quality measures specified in the Act.

Why is the SNF QRP data being posted on Nursing Home Compare? – Nursing Home Compare allows you to find and compare SNFs that are certified by Medicare and nursing facilities that are certified by Medicaid collectively referred to as nursing homes. This website contains quality of resident care and staffing information for more than 15,000 nursing homes around the country, and will now include SNF QRP quality data that can be used to help compare SNF providers by their performance on important indicators of quality, such as the percentage of a SNF’s residents that develop pressure ulcers, or how many residents fall and are injured as a result of the fall.

What can I learn from reviewing this data? – These data can demonstrate how a SNF’s performance on SNF QRP quality measures compares to that of other SNFs, as well as to the national average. These data can showcase a SNF’s ongoing commitment to quality, improving engagement and confidence among staff, residents, caregivers, families, and stakeholders.

What is the source of this publicly reported data? – The SNF QRP data used for calculating measures include claims data for some measures and for others the data are collected and submitted to CMS via the Minimum Data Set (MDS), which is a core set of screening, clinical, and functional status elements, including common definitions and coding categories, which form the foundation of a comprehensive assessment for all residents of nursing homes certified to participate in Medicare or Medicaid. SNFs must complete a MDS admission record and discharge record on each resident that enters that SNF for care. The SNF QRP measures are calculated based on the admission and discharge data submitted for each SNF resident.

What are the SNF QRP quality measures that have been added to Nursing Home Compare? – CMS has added the following five SNF QRP measures to Nursing Home Compare:

Assessment-based measures:

1. Percent of Residents or Patients in a SNF that develop new or worsened pressure ulcers (National Quality Forum #0678)
2. Percentage of residents or patients whose activities of daily living and thinking skills were assessed and related goals were included in their treatment plan (NQF #2631)
3. Percentage of SNF patients who experience one or more falls with major injury during their SNF stay (NQF #0674)

Claims-based measures:

1. Medicare Spending Per Beneficiary (MSPB) for patients in SNFs
2. Rate of successful return to home or community from an SNF

CMS has decided not to publish a 6th quality measure, Potentially Preventable 30-Day Post-Discharge Readmissions, at this time. Additional time would allow for more testing to determine if there are modifications that may be needed both to the measure and to the method for displaying the measure. This additional testing will ensure that the future publicly reported measure is thoroughly evaluated so that Compare users can depend upon an accurate picture of provider quality. While we conduct this additional testing, CMS will not post reportable data for this measure, including each SNF’s performance, as well as the national rate.

Summary of Findings – The following table lists the new SNF QRP measures that are included on Nursing Home Compare and displays the national average rate of performance on the measures.

Resources Available to Skilled Nursing Facilities

• Visit the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Webpage for more information on Hospice Compare.
• Visit the SNF QRP Measures and Technical Information Webpage for more information on submitting data to CMS.

Help Desks

• For questions related to the SNF Quality Reporting Program including:
• SNF Quality Reporting Program requirements
• General quality reporting requirements and reporting deadlines
• SNF Quality Reporting Program quality measures
• MDS 3.0 coding instructions for Part A PPS Discharge assessment and Section GG
• Data reported in the SNF QRP CASPER Review and Correct reports
• Data reported in the SNF QRP CASPER Quality Measure reports
• Email: SNFQualityQuestions@cms.hhs.gov

• For questions related to Public Reporting of quality data including:
• Questions related to SNF Provider Preview reports
• Requests for the CMS review of the data contained within the Provider Preview Report that a SNF may believe to be erroneous
• Questions related to SNF Public Reporting, including SNF QRP Public Reporting on Nursing Home Compare and/or SNF QRP data on data.medicare.gov
• Email: SNFQRPPRQuestions@cms.hhs.gov

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The AHCA education library is a living repository of tools and resources to help you navigate the Requirements of Participation. It contains an array of documents divided into three categories- Action Briefs, Tools, and Webinars.

• Action Briefs – provide highlights, specific information, tips and resources about a particular topic
• Tools – are an instrument designed to assist you in implementing the requirement
• Webinars – are an array of communications from AHCA to assist you in learning and mastering the new requirements

Click here to view the AHCA library and return often to see the newest materials available.

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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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Use meaningful words to explain clear, precise goals

Michael Hyatt Article

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A mantis shrimp can swing its claw so fast it boils the water around it and creates a flash of light.

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