UPDATE Weekly

Recently, nursing homes received their Medicaid rate letters detailing their rates effective July 1, 2014. Unfortunately, the Medicaid case-mix index (CMI) on the letter (and used to calculate the rates) did not match the Medicaid CMI on the Myers and Stauffer resident roster. This has been corrected. Revised rate letters will be sent to all providers and the revised rates have been posted on the Medicaid Fee Schedule Web page.

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Register today to attend the third annual NCHCFA Summer Symposium August 5-7, 2014 at the Embassy Suites Resort at Kingston Plantation, Myrtle Beach, SC for the most up to date information affecting long term care. You can register and pay on-line. Visit http://www.NursingHomesNC.com & click on Third Annual Summer Symposium Registration! Administrators and registered nurses will be able to earn up to 12.0 hours of continuing education.

The North Carolina Health Care Facilities Association would like to thank 2014 Summer Symposium Hosts for supporting this year’s event!

Call the Embassy Suites Resort at (800) 876-0010 to reserve your overnight room. Use group code “NHF” to identify yourself as a NC Health Care Facilities Association Convention attendee! To make your reservation on-line, visit http://tinyurl.com/2014symposiumreserve. If you have any difficulty making a reservation, please call the Association office at (919) 782-3827!

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Don’t miss Regulation and Quality: Where We Are and Where We Are Going on Tuesday, August 5th! Cindy Deporter, Division of Health Service Regulation Acting Assistant Section Chief Acute and Home Care & Manager Quality Evaluative Systems NH Licensure and Certification, Division of Health Service Regulation (DHSR), will report on new Hospice Services: interpretive guidance to surveyors of long term care (LTC) facilities related to the provision of hospice services in a nursing home. In addition, NCHCFA staff Polly Welsh and Eric Kivisto will review the latest regulatory data affecting skilled nursing facilities. You cannot afford to miss this informative program!

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Register today for the North Carolina Health Care Facilities Association’s “TRANSFORMING DECISION MAKING AT LIFE’S END: FROM FEARFUL TO FULFILLING.” Since the N.C. General Assembly modified North Carolina law governing advance directives and end of life choices in 2006, the state’s long-term care providers have wrestled with these revised laws, and with the policies and ethics behind them. This program will provide an overview of the ethical and legal backdrop to North Carolina’s end of life laws; a review of the legal and regulatory standards governing residents’ rights and providers’ responsibilities related to end of life health care choices; and tips on how to have discussions about end of life choices with residents and families. The program will include an exploration of common challenges faced by long-term care providers in understanding and implementing residents’ end of life choices; dealing with related family dynamics; regulatory expectations of the Division of Health Service Regulation and CMS; and practical tips for best outcomes for end of life issues.

We have assembled some of the most knowledgeable speakers from which to learn rules and laws, gain awareness from research, evidence and human experience, and to hear about your most frequent and complex interactions while providing care. NCHCFA is proud to offer this educational opportunity in our continuing commitment to compassionately, and knowledgeably navigate, one of the most meaningful and challenging transitions of life. Visit our Web site http://www.NursingHomesNC.com to register on-line OR download and print the registration form to fax!

This seminar is scheduled for July 15, 2014 at the following location:

Embassy Suites Greensboro
204 Centreport Drive
Greensboro, NC 27409

Call the Embassy Suites at (336) 668-4535 to make your overnight room reservations! Use code NCHCFA to get our special group rate if still available!

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Throughout June, the LTSS Medicaid Reform staff conducted a series of Strengths, Weaknesses, Opportunities and Threats (“SWOT”) Analysis Sessions with DMA provider networks and other community stakeholders. The concept of whole person care concept is at the center of the Department’s Medicaid Reform initiative and the insight gained through the SWOT sessions has been tremendously helpful.

DMA will be hosting a Webinar next Monday, July 14 from 3pm to 4pm to provide a summarized synthesis of the insight gained through these SWOT sessions, and we invite any interested stakeholder to participate.

To register for the Webinar session, please follow this link:
https://attendee.gototraining.com/r/91581981651188225
After registering you will receive a confirmation e-mail containing detailed information about joining the Webinar.

Materials will be posted on the Medicaid Reform Web site at http://www.ncdhhs.gov/medicaidreform.

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Effective July 1st, Medicare Advantage plans must submit HIPPS/RUGs codes on all of their SNF claims to CMS, regardless of whether or not provider payment is based on RUGs. The American Health Care Association (AHCA) has prepared a brief 2-page overview/FAQs outlining this issue. Click here to access this overview.

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NCTracks will be offering several training opportunities in the month of July. Two of these trainings will be:

Monday, July 21 – 9:30 a.m. to 12:00 p.m. – Prior Approval Institutional
This is Prior Approval submission training for Institutional providers. This course shows authorized users how to electronically submit and inquire about prior approvals for different kinds of medical services.

Monday, July 21 – 1:00 p.m. to 4:00 p.m. – Submitting an Institutional Claim
This course will focus on how to submit an Institutional claim. At the end of training, providers will be able to enter an Institutional claim, save a draft claim, use the Claims Draft Search tool, submit a claim, and view the results of a claim submission.

Providers can register for the courses in SkillPort, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access SkillPort. Open the folder labeled Provider Computer-Based Training (CBT) and Instructor Led Training (ILT). The courses can be found in the sub-folder labeled ILTs: On-site. (Refer to the Provider Training page of the public Provider Portal for specific instructions on how to use SkillPort.)

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The Division of Medicaid Assistance publishes the Medicaid Bulletin each month. The current issue, with information on claim adjustments and PCS rate changes, other recent issues and Special Bulletins can be found at http://www.ncdhhs.gov/DMA/bulletin/index.htm.

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In an effort to provide consistency in provider refund requests, a new form has been developed and posted to the NCTracks Web site. Providers are encouraged to use this new form when submitting refunds to NCTracks.

Refunds may be due to NCTracks for a variety of reasons, including billing errors, overpayments, and claims reprocessing resulting in an accounts receivable, among others. In some cases, providers may need to submit a claim adjustment to enable the claim information in the system to be updated accurately.

When a claim adjustment is submitted to NCTracks, the system will recoup the funds as needed. However, if the provider’s paid claims in that checkwrite cycle are not sufficient to cover the recoupment, an account receivable will be created. Rather than waiting on an automated recoupment of the accounts receivable, which will not begin for 30 days, providers may choose to submit a refund check to NCTracks. If not paid within 30 days, providers will incur penalties and interest.

When submitting a refund, there are several key considerations to keep in mind:
1. Refunds are specific to a payer. Payers supported by NCTracks include Medicaid, Health Choice (NCHC), DMH, and DPH. If you have refunds for multiple payers, please submit separate forms and separate checks for each payer. If a single check is received for multiple payers, it will be returned to the provider. It is also important that the form and check be mailed to the correct address. Note the address for each Payer listed on the Provider Refund Form.
2. Refunds are specific to an NPI. If you have refunds for multiple NPIs, please submit separate forms and separate checks for each NPI. If a single check is received for multiple NPIs, it will be returned to the provider.
3. Please complete all fields on the form, according to the instructions. Incomplete forms will delay processing.
4. If the refund is claim(s) specific, for Medicaid and NCHC services, the provider is to adjust the claim(s) and submit the adjustment(s) to NCTracks following the billing guidelines for adjustment claims.

The new NCTracks Provider Refund Form, along with Instructions for completing the form, can be found in the Provider Forms section of the Provider Policies, Manuals, and Guidelines page of the NCTracks Provider Portal.

If you have any questions about the provider refund request process, please contact the NCTracks Call Center at (800) 688-6696.

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The 65th Annual AHCA/NCAL Convention & Expo registration is OPEN! This year’s convention will offer you the opportunity to deepen your professional knowledge, network with colleagues from across the country, spend time in the Expo Hall discovering new business solutions, and even rock out a little.

NCAL Day is the best way for you to begin your convention experience. With a slate of educational programming devoted to assisted living providers as well as excellent speakers, and opportunities to network with your peers, you will not want to miss this innovative event. (Please note: NCAL Day is a separate ticketed event.)

This is the must-attend event for long term and post-acute care professionals. Early bird registration for this year’s AHCA/NCAL Convention & Expo continues through July 18. Register today for the maximum savings.

For information or to register, visit http://www.AHCAconvention.org.

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The American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) released the names of the 77 long term and post-acute care centers that have earned a 2014 Silver – Achievement in Quality Award. The award is one of three distinct awards possible through the AHCA/NCAL National Quality Award Program, which honors select centers across the nation that serve as models of excellence in providing high-quality long-term care.

“These recipients have demonstrated strong approaches that will lead them to improved performance,” said Ed McMahon, Ph.D., Chair of the AHCA/NCAL National Quality Award Board of Overseers. “I congratulate all of them for being on this quality improvement path.”

Implemented by AHCA/NCAL in 1996, the National Quality Award Program is centered on the core values and criteria of the Baldrige Performance Excellence Program. The program assists providers of long term and post-acute care services in achieving their performance excellence goals.

The program has three levels: Bronze, Silver, and Gold. As a recipient of the Silver – Achievement in Quality Award, these centers and their staff have demonstrated systematic advancements in quality, plans for continual improvement, and sustainable organizational goals. Recipients of the Silver Award may now move forward in developing approaches and achieving performance levels that meet the criteria required for the Gold – Excellence in Quality Award, which requires them to address the Baldrige Health Care Criteria for Performance Excellence. A full list of the recipients is available on the AHCA/NCAL Web site.

The North Carolina Silver award winners are:
Cherry Point Bay Nursing and Rehab Center- Havelock, NC
Macon Valley Nursing and Rehab Center – Franklin, NC
Southwood Nursing and Rehab – Clinton, NC

The North Carolina Bronze award winners (announced in May) are:
Cross Creek Health Care – Swan Quarter, NC
Harnett Woods Nursing and Rehab Center – Dunn, NC
Roanoke Landing Nursing and Rehab – Plymouth, NC
Franklin Oaks Nursing and Rehab – Louisburg, NC
Harmony Hall Nursing and Rehab – Kinston, NC
Avante at Reidsville – Reidsville, NC
Tarboro Nursing Center – Tarboro, NC
Roanoke River Nursing and Rehab – Williamston, NC
Avante at Wilkesboro, Wilkesboro, NC
Northampton Nursing and Rehab Center – Jackson, NC
Bethany Woods Nursing and Rehab Center – Albemarle, NC
Ayden Court Nursing and Rehab Center – Ayden, NC
PruittHealth at Sealevel – Sealevel, NC
Emerald Ridge Rehab and Care Center – Asheville, NC
Enfield Oaks Nursing and Rehab Center – Enfield, NC

AHCA/NCAL announced the recipients of the Bronze – Commitment to Quality Award on May 30th. The names of the coveted Gold- Excellence in Quality Award will be released in August. The recipient centers will be honored during the AHCA/NCAL’s 65th Annual Convention and Exposition, October 5-8, 2014, in Washington, D.C. CONGRATULATIONS TO ALL OF OUR AWARD WINNERS!

The National Quality Award Program is sponsored by AHCA/NCAL Associate Business Members My InnerView, by National Research Corporation and PointRight.

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You don’t won’t to miss this! Save the date for NCDONA’s 3rd Quarterly Meeting on July 18, 2014! Featuring Dr. James Horst- “Understanding Psuedobulbar Affect.” This meeting is sponsored by Avanir Pharmaceuticals. Then spend the night and enjoy SPA day on Saturday, July 19th! Enjoy Healing Touch, Reflexology, neck and shoulder massage, manicures, pedicures, Thirty-One, Mary Kay facials and more! Treat yourself!

Holiday Inn-Biltmore East
1450 Tunnel Road
Asheville, NC 28805

Schedule
9:30 AM – Meet and Greet
10:00 AM – Education Session
Lunch (provided)
Business meeting will be held after lunch!

Book online at http://www.biltmorehotels.com or call 1-888-298-5611 or 1-800-HOLIDAY.

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This book provides the theory, principles, methods, and tools for the nurse manager or leader of a long term care facility. It contains more than 150 guidelines, flow sheets, communication, assessment, and feedback procedures that can be implemented with little or no modification by directors of nursing in every type of long term care facility.

To order, visit http://www.AHCApublications.org or call (800) 321-0343.

Product #6746
AHCA MEMBERS $84.95

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Important information for residents and families This brochure outlines what physical restraints are, when they should be used, rules and regulations concerning restraints, and making decisions about using them. Contact Jan Williams at janw@nchcfa.org to order brochures for your facility.

• NCHCFA Member: $30.00 per 100 brochures plus tax and shipping
• Non-Members: $60.00 per 100 brochures plus tax and shipping

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Nurse Firing Highlights Hazards of Social Media in Hospitals –

https://gma.yahoo.com/nurse-firing-highlights-hazards-social-media-hospitals-095759346–abc-news-topstories.html

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87,477 Boy Scouts earned the First Aid merit badge in 2013, more than any other merit badge. Since 1911, it has been earned by more than 6.9 million scouts.

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