UPDATE Weekly

Register today to attend the Fifth Annual NCHCFA Summer Symposium August 9-11, 2016 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://NursingHomesNC.com & click on Fifth Annual Summer Symposium Registration! Administrators and registered nurses will be able to earn up to 11.5 hours of continuing education. Early registration ends July 22, 2016!

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Do not miss Trending Regulatory News on Thursday, August 11 at 9:00 AM. Join Cindy Deporter, MSSW, State Agency Director, Division of Health Service Regulation (DHSR), for the latest regulatory hot topics. Ms. Deporter will review numerous topics including the Centers for Medicare & Medicaid (CMS) changes to the Five Star Rating System, Emerging Infection Control Issues in congregate living, Updated LTC regulations, and other revisions to the State Operations Manual (SOM) and much more. The content of this presentation will continue to change until August. Please submit any additional topics that you would like to have Ms. Deporter address to allisonb@nchcfa.org.

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In June, the Centers for Medicare & Medicaid Services (CMS) released S&C Letter: 16-29-LSC on Adoption of the 2012 edition of the National Fire Protection Association (NFPA) 101 – Life Safety Code (LSC) and 2012 edition of the NFPA 99 – Health Care Facilities Code (HCFC).

The memorandum states that:

• CMS has adopted by regulation the 2012 LSC and the 2012 HCFC. The regulation effective date is July 5, 2016.
• CMS will begin surveying for compliance with the 2012 LSC and HCFC on November 1, 2016.
• CMS will offer an online transitional training course for existing LSC surveyors to provide an update on the new requirements. The course will be available on September 2, 2016 via the CMS Surveyor Training Web site.
• CMS will update the ASPEN program (i.e., the information system which tracks surveys) and CMS Fire Safety Forms (2786) prior to the November 1, 2016 survey start date.

To read the memo, click here. Click on the following links for additional information on these items:

• NFPA 101: Life Safety Code
• NFPA 99: Health Care Facilities Code

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On the July 14 Open Door Forum call, the Centers for Medicare & Medicaid Services (CMS) reported that starting on July 27 at 10:00AM ET the Quality Measure (QM) component of the Five-Star Rating System will reflect five of the six new QMs that are currently featured on Nursing Home Compare (NHC). You will recall, the agency announced in March that this change was going to happen in July. For a summary of that presentation and a list of the six new measures, click here.

CMS also announced that it has posted an updated Technical User’s Guide on its Web site here. On the second page of the guide, there is a short list of the overall changes you can expect. Below are the key changes outlined in the guide:

• The five new QMs will be phased in between July 2016 and January 2017.
• In July 2016, they will have 50 percent of the weight of the current measures.
• In January 2017, they will have the same weight as the current measures.
• The methodological changes that will be introduced in July include:

o Using four quarters of data rather than three for determining QM ratings.
o Reducing the minimum denominator for all measures (short-stay, long-stay, and claims-based) to 20 summed across four quarters.
o Revising the imputation methodology for QMs with low denominators meeting specific criteria. A facility’s own available data will be used and the state average will be used to reach the minimum denominator.
o Using national cut points for assigning points for the ADL QM rather than state-specific thresholds.

NCHCFA recommends members review the guide for more details.

In addition, the agency is making changes to the CASPER provider preview report. The revised report will incorporate the new measures, display updated star ratings, and include a new column that shows the points assigned to each QM for a better understanding of the quality rating. All skilled nursing care centers will have access to their preview reports through the QIES System by the end of this week.

At this time, NCHCFA does not know how the new QMs may impact your star rating. For example, the number of stars that may be lost or gained.

On Thursday, July 28 at 3 PM ET, AHCA will host an all-member webinar to walk through these changes and answer questions. Please register here.

In the meantime, members should continue to take steps to prepare for these upcoming changes. Resources, including the updated Technical User’s Guide, are available on the members-only Five-Star ahcancalED Web site here. The AHCA Quality Initiative Web site here, along with blog posts here and here, provide additional tips and information.

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The following message is a request from the American Health Care Association (AHCA) and the Aon LTC Benchmark Team.

With the support of the American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL), Aon is again soliciting your help to assemble the facility-specific data necessary to conduct the annual Aon Study on General Liability (GL)/Professional Liability (PL) Costs in the Long Term Care (LTC) profession.

Last year they were able to split liability costs for Cook County, Illinois from the rest of Illinois. They hope to build on that model in Pennsylvania and Florida.

The purpose of the Aon study is to:

• Identify the overall trends in the cost of GL/PL claims for long term care;
• Identify state specific trends in the cost of GL/PL claims for long term care;
• Identify trends in frequency and severity overall and on a state by state basis, including detail on Cook County, Illinois; Philadelphia, Pennsylvania; and Miami-Dade County, Florida.
• Explore the impact of Alternative Dispute Resolution (ADR) on GL/PL claims; and
• Examine differences in claims costs segregated by payer type.

Over the years, many AHCA/NCAL members have participated in this effort. They are requesting your help again. There is no cost to participate and you will receive an advance free electronic copy of the report as soon as it is available in mid-November 2016. Your participation is essential to ensure that the Aon analysis is representative of the profession, and that the states where you operate are profiled. Note: Aon holds all data in confidence and no individual participant is identifiable in the study.

Please see the following data call files for additional information on how you can participate.

e following data call files for additional information on how you can participate.
• Participant Survey
• Benchmark Data Call Excel File
• Benchmark Data Call Presentation

The deadline for participation in the Aon Study is Tuesday, August 16, 2016.

If you have any questions, please contact Dianna De La Lame with the American Health Care Association at ddmare@ahca.org or (202) 898-2830.

Thank you for your participation,

The LTC Benchmark Team

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On July 13, OSHA announced that it would delay the effective date of one portion of the final rule, “Improve Tracking of Workplace Injuries and Illnesses” also known as the Electronic Recordkeeping rule. Specifically, OSHA has delayed enforcement of the anti-retaliation provision, 1904.35(b)(1)(iv), from August 10, 2016 until November 1, 2016. Section 1904.35(b)(1)(iv), states, “[employers] must not discharge or in any manner discriminate against any employee for reporting a work-related injury or illness.”

According to the agency’s news release, the delayed effective date will allow OSHA “to conduct additional outreach and provide educational materials and guidance for employers.” Employers are still required to inform employees that they have a right to report work-related injuries and illnesses and inform employees that employers are prohibited from discriminating against employees from reporting such injuries and illnesses by August 10, 2016. This can be accomplished by posting the OSHA Job Safety & Health – It’s the Law poster dated April 2015 or later (available at no cost on the OSHA Web site).

The above information is from the Jackson Lewis OSHA Law Blog and distributed by AHCA.

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The North Carolina Health Care Facilities Association would like to thank our 2016 Summer Symposium Corporate Sponsors for supporting the upcoming Fifth Annual Summer Symposium in Myrtle Beach, SC! We appreciate your support: Blue Ridge Pharmacy, Healthcare Services Group, Liberty Healthcare Group, Medipack Pharmacy, NH Med Services, QMX Mobile Health & Southern Pharmacy Services.

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This is part of a series featuring one element of the Building Prevention Into Every Day Practice: Framework for Successful Clinical Outcomes.

Success in achieving positive resident/patient outcomes is even more critical now than ever before. The link between quality and payment in long term and post-acute care is growing stronger, as evidenced by the SNF Value Based Purchasing Program (VBP), Improving Post-Acute Care Transformation (IMPACT) Act, SNF Quality Reporting Program (QRP) and more. In addition, regulatory activity is intensifying through focused surveys on adverse events, dementia care and MDS. The Five-Star Rating system and Nursing Home Compare have been revised and will add items in the future as it broadens public reporting and transparency. Most importantly, consumers expect and deserve high quality care.

The entire framework outlines key elements from both an organizational and clinical nature that are critical to successful clinical and organizational outcomes. Positively, these elements reflect common denominators that cross multiple care situations. Therefore, instead of being yet another initiative or single focused project to achieve just one outcome, it is a way of acting, thinking and being that will benefit multiple areas across an organization. Each element is addressed in detail throughout the framework.

This week features the element of Clinical Foundation: Timely Provision of Necessary Care

Key Takeaways: Timely Provision of Necessary Care

 Timely availability of resources is essential for the staff and practitioners to be able to deliver timely and effective care.
 Our centers can improve the timeliness of care by scrutinizing existing systems and processes to make them more efficient.
 Commit to a culture of safety

Probing Questions for Team Reflection and Discussion:

1. Do we have the right resources available at the right time? How do we know?
2. How do we prevent unnecessary delays from occurring?
3. How do we know what is necessary and/or desired care for each individual?
4. How do our staff that are not involved in direct care help the staff providing care in every way possible to be more efficient and effective?

Visit the AHCA Clinical Practice Web site to learn more about the element of “Clinical Foundation: Timely Provision of Necessary Care” and answers to these key questions:

What does this mean? Why is this important? What are some examples? What is my part (as an individual employee, manager or practitioner)? What can my organization do?

Start somewhere, pick one element and work through it with your team.

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Alliant Quality wants to encourage SNFs to keep signing up for the National Collaborative – or SPACE. Alliant recommends having as much time as possible to get started on Quality Assurance Performance Improvement (QAPI) improvement work and improving facility quality measures in a systems approach to improve their five star and composite scores.

Alliant Quality is the Medicare Quality Innovation Network (QIN)-Quality Improvement Organization (QIO) for North Carolina. Under contract with the Centers for Medicare & Medicaid Services (CMS), Alliant Quality invites your nursing home to participate in a collaborative designed to ensure that every nursing home resident receives the highest quality of care.

The Collaborative offers an exciting opportunity to learn from high performing nursing homes regarding their processes as they pertain to consistent/permanent staff assignment, teamwork and communications, leadership, regulatory compliance, clinical models, and quality of life indicators. The Collaborative aligns national nursing home quality initiatives and partnerships such as the Advancing Excellence in America’s Nursing Homes Campaign, The Partnership to Improve Dementia Care, and QAPI. Targeted focus areas will include increasing mobility, decreasing unnecessary use of antipsychotics in residents with dementia, decreasing potentially avoidable hospitalizations and decreasing healthcare acquired infections and conditions.

When ready to register, click here for the Participation Agreement and fax or e-mail it back to Lisa Klemis, contact information is on the Participation Agreement. For more details, e-mail Jennifer Brock at Jennifer.Brock@area-F.hcqis.org or call (678) 527-3417.

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Thinking about how to reduce C. diff infections? Please join the Southern Partners Action Collaborative for Excellence (SPACE) Webinar: Introduction to NHSN C. Diff Collaborative!

Date: July 21, 2016
Time: 3:00 pm

This initiative will support nursing home submission of data into the CDC’s National Healthcare Safety Network (NHSN) data bank which will provide for analysis and creation of a national baseline for C. Difficile infections in nursing homes. NHSN provides LTC centers with a customized system to track infections in a streamlined and systematic way.

Join to learn more in this introductory session about how you can begin to identify and track your progress toward stopping C. Diff infections.

Registration info is here, https://qualitynet.webex.com.

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The early bird registration deadline is this Friday, July 22nd! Register now and get the maximum savings on your registration package. Find out about all the AHCA/NCAL Convention & Expo registration packages and choose the one that best meets your needs. Join your colleagues in Nashville at the long term and post-acute care event of the year. There will be great speakers, incredible educational opportunities, and priceless networking all in an unbeatable location!

The 2016 AHCA/NCAL Convention & Expo is designed to help you find new solutions to your latest challenges. Excellent speakers on a variety of key topics will help you gain fresh ideas for meeting your Quality Initiative goals and find new strategies for success. Education tracks include:

• Staff Stability
• Risk Management
• Quality
• Leadership
• Dementia Care
• Improving Post-Acute Care
• The Customer Experience

Get all the details, and make your plans now! Registration fees increase after July 22nd, so don’t wait! Register today!

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High-quality clinical care comes from high-quality education. Prove the value of your staff development program with help from author and staff development expert Adrianne E. Avillion, DEd, RN, in this new groundbreaking book. Dr. Avillion offers clear guidance to help you put your program’s worth into quantifiable terms and align staff development with your organization’s goals. Educators of all levels will be able to evaluate the effect of training on retention, staff competency, and patient outcomes.

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

Product # 8333
AHCA Members (on-line price) $99.00

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This brochure outlines what physical restraints are, when they should be used, rules and regulations concerning restraints, and making decisions about using them. To order, e-mail your request to Donna Snyder at donnas@nchcfa.org.

• 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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Change your tone, change their tune – Positive feedback inspires better employee performance

http://www.ltlmagazine.com/article/change-your-tone-change-their-tune

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Closing your eyes can help you remember things. A study of 178 people found that when they closed their eyes while trying to recall details from a movie they just saw, they were able to answer 23% more questions correctly.

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