UPDATE Weekly

House and Senate negotiators moved closer to agreement on the two issues left to resolve before the 2014-15 budget is adopted, public school teacher salaries and Medicaid. It is believed the remaining differences will be settled by next week. One major issue yet to be resolved is whether the budget will include cuts to Medicaid providers. Your calls, letters and emails to members of the General Assembly have been very helpful in our efforts to avoid rate cuts.

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Today the Senate proposed sweeping changes to the state’s Medicaid program. “A new Department of Medicaid Benefits would be created using provider-led and non-provider-led capitated health plans to take on all risks, other than enrollment numbers and enrollment mix.” The Department of Medicaid Benefits would be governed by a seven member board, appointed and confirmed by September 2014. By 2016 Medicaid would be managed by provider-led or privately owned managed care companies (MCOs or ACOs). By 2018 all Medicaid services will be capitated and risk based. This proposal is a major departure from the Medicaid reform plans put forward by Governor McCrory and the NC House. The Senate plan would delegate virtually all responsibility for North Carolina’s Medicaid program to managed care companies. This is a very ambitious and controversial proposal that will not likely pass in its present form. It does, however, signal the strong support of many state lawmakers to move North Carolina into private risk based managed care.

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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. Early registration ends Friday, July 18th!

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

Do not miss Long Term Care Legal Landscape on Wednesday, August 6th. Join attorneys Ken Burgess and Elizabeth Johnson for the most pertinent legal matters affecting long term care. Ken will provide an update on numerous topics including; new use of directed Plans of Correction (POC), Immediate Jeopardies (IJ’s), noncompliance issues, 30-day discharge payments, and more. In addition, Ken and Elizabeth will discuss Health Insurance Portability and Accountability Act (HIPAA) surveys. The Centers for Medicare & Medicaid Services (CMS) has recently begun focusing on privacy and security violations under HIPAA and other state and federal laws during surveys, and issuing burdensome directed plans of correction in response to alleged violations. This session will examine CMS’s recent activity on this issue, outline the risks for all long term care providers and offer some practical preventive measures you can take to minimize your risk of exposure under federal privacy and security laws, and during CMS surveys. You cannot afford to miss this informative program!

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It is time once again for the NCHCFA “Fabulous 50” awards! This time-honored event provides the opportunity to acknowledge front line, unlicensed personnel who have demonstrated outstanding achievements in the long term care profession. The Fabulous 50 awards program honors individuals who are the backbone in our facilities because of the support they provide to our residents. A panel of judges from the Education and Programs Committee will select ten nominees from each district. Each of the award recipients will be honored at a dinner and awards presentation in their district. The deadline to receive completed nominations is Tuesday, September 2nd. Please encourage your facility to participate in this special award program.

District I – October 16, 2014, Grand Bohemian Hotel, Asheville
District II – October 21, 2014, Hilton Charlotte University Place, Charlotte
District III – October 23, 2014, Grandover Resort, Greensboro
District IV – October 28, 2014, Mad Boar Restaurant, Wallace
District V – October 30, 2014, Renaissance North Hills Hotel, Raleigh

To fill out nomination forms online, visit the Member Center of the Association Website at http://www.NursingHomesNC.com. Click on “News & Updates”, select “2015 Fabulous 50 Nomination Packet” and choose “Survey Monkey”. If you have any questions about the Fabulous 50 awards, call the Association office at (919) 782-3827. Pictures for nominations submitted online may be e-mailed to karenl@nchcfa.org or mailed to the Association office.

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The US Department of Health and Human Services, Office of Medicare Hearings and Appeals (OMHA) has just announced a new pilot, Settlement Conference Facilitation, which it hopes will alleviate some of the significant backlog of Medicare Part B claims being appealed to the Administrative Law Judge (ALJ) level. Settlement Conference Facilitation is an alternate dispute resolution process, designed to bring providers and CMS together to negotiate and settle some Medicare Part B disputes (e.g., only those appeals of Medicare Part B Qualified Independent Contractor (QIC) disputes) with the help of a settlement conference facilitator. The facilitator will be an employee of the Office of Medicare Hearings and Appeals (OMHA), who will use mediation principles to help the parties come to a “mutually agreeable resolution.” The facilitator will not make official determinations on the merits of the claims; but instead will help all the parties “see the relative strengths and weaknesses of their positions.” If a resolution can be reached, a settlement document will be drafted to reflect the agreement, and the document will be signed by all the parties. As part of the agreement, any provider requests for an ALJ hearing for the claims covered by the settlement will be dismissed.

To obtain more information and learn about eligibility and the process to request Settlement Conference Facilitation go to the HHS/OMHA Web site at http://www.hhs.gov/omha/settlement_conference_facilitation_pilot.html. For complete information, please read the entire Settlement Conference Facilitation Pilot Fact Sheet and the process flowchart linked to the HHS/OMHA Web site.

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The “Medicare Overpayment Collection Process” Fact Sheet (ICN 006379) was revised and is now available in downloadable format. This fact sheet is designed to provide information on the collection of Medicare provider and supplier overpayments. It includes the definition of an overpayment, an overview of the overpayment collection process, timeframes for the debt collection process for provider overpayments, and additional resources.

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The early bird registration for the 65th Annual AHCA/NCAL Convention & Expo ends this Friday, July 18th! If you haven’t registered for this year’s event, don’t wait any longer. Register before the deadline ends and get the maximum discounts available.

Join AHCA/NCAL and thousands of long term can post-acute care professionals in the nation’s Capital. This year’s event will be held at the Gaylord Resort & Convention Center, across the banks of the Potomac River at National Harbor. Don’t miss this amazing opportunity to learn, network, hear from national keynote speakers, and explore one of the largest healthcare Expos while discovering the rich history of Washington, D.C.

Click here to register now!

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The “Updated LEIE” database file reflects all OIG exclusion and reinstatement actions up to, and including, those taken in June 2014. This new, “Updated LEIE” (List of Excluded Individuals and Entities), is a complete database file containing all exclusions currently in effect. Individuals and entities that have been reinstated to the federal health care programs are not included in this file.

All the updated files are posted at https://oig.hhs.gov/exclusions/exclusions_list.asp.

OIG now only archives monthly supplement files for the previous 12 months. Older material is no longer available on the website or via phone call to Exclusions staff, although the “Downloadable LEIE” gives users the latest information on excluded individuals or entities.

Two instructional videos explaining how to use the online database and the downloadable files are available below:

• http://oig.hhs.gov/exclusions/online.asp
• http://oig.hhs.gov/exclusions/download.asp

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How can you measure the effectiveness of quality improvement efforts? Read this book and find out! Chapters cover preparing to collect data, data collection, understanding variation, run and control charts, control chart case studies, developing improvement strategies, and using patient surveys for CQI. An appendix shows five ways to calculate control limits.

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

Product #6912
AHCA MEMBERS $58.00

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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, contact Jan Williams at janw@nchcfa.org. The price is $35.00 (tax and shipping included).

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This Scent Can Help Heal Wounds, Study Says

http://time.com/2969963/sandalwood-scent-heal-wounds/

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Asphalt pavement is America’s most recycled and reused material. It is recycled and reused at a rate of over 99%.

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