UPDATE Weekly

Register today to attend the NCHCFA Annual Convention and Expo February 26 – March 1, 2017 at the Sheraton Greensboro Hotel at Four Seasons/Joseph S. Koury Convention Center in Greensboro, NC! Call the Sheraton at (800) 242-6556 to make your room reservation. Identify that you are with “NC Health Care Facilities Association 2017 Convention” to receive the group discounted rate. Don’t miss the opportunity to earn up to 17.0 hours of educational credit for North Carolina Nursing Home Administrators, as well as up to 16.0 hours of Nursing CE credit! The advanced registration deadline is Friday, February 10th. To obtain an additional brochure visit the Member Center of the Association’s Web site at http://www.NursingHomesNC.com.

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The NC Health Care Facilities Association presents “Updated Regulations.” The Centers for Medicare & Medicaid Services (CMS) issued a final rule to make major changes to improve the care and safety of the nearly 1.5 million residents in the more than 15,000 long term care facilities that participate in the Medicare and Medicaid programs. The policies in this final rule are targeted at reducing unnecessary hospital readmissions and infections, improving the quality of care, and strengthening safety measures for residents in these facilities. This program will kick off the lengthy implementation of these rules, beginning with Phase One and the new survey process. Much remains unknown as we anxiously await interpretive guidelines and many needed clarifications.

This session will be presented by Cindy DePorter, MSSW. Ms. DePorter was appointed as Interim Assistant Section Chief of the Acute Home Care Section in July of 2013, overseeing approximately 2000 home care agencies, 269 certified home health care agencies, and 200 Hospice Agencies in North Carolina. She is also Branch Manager of Quality Evaluative Systems at DHSR. This section is responsible for Informal Dispute Resolution (IDR), Independent Informal Dispute Resolution (IIDR), Enhancement Coalition, Enhancement Grants, Civil Money Penalties (CMP), and the Quality Improvement Committee. Ms. Deporter also directs Quality Indicator Surveys (QIS), and leads Electronic Plans of Correction (ePOC) that are being implemented by CMS. In this session, Ms. DePorter will:

• Provide an overview of the revised survey process.
• Discuss timelines for implementation of the revised survey process.
• Discuss the Phase 1 implementation of the federal long term care requirements.

Please note that this will be a five-hour comprehensive session devoted to both the new requirements and survey process. Ms. DePorter will return to our convention in late February for a quick review of the implementation and any available updates or commentary on implementation progress from CMS.

This seminar will be offered in Charlotte on February 2nd and again in Raleigh on February 15th. The price is $205.00. Click here to download a brochure/registration form. Click here to register on-line!

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The Centers for Medicare & Medicaid Services (CMS) has released MLN Matters Number SE1626. This article informs providers of the policies surrounding the use of the 3-day stay waiver available for use under the Comprehensive Joint Replacement (CJR) model.

The CJR model waives certain existing payment system requirements to provide additional flexibilities to hospitals participating in CJR, as well as other providers that furnish services to beneficiaries in CJR episodes. The purpose of such flexibilities is to increase Lower Extremity Joint Replacement (LEJR) episode quality and decrease episode spending or provider and supplier internal costs, or both, and to provide better, more coordinated care for beneficiaries and improved financial efficiencies for Medicare, providers, and beneficiaries. In order to provide more comprehensive care across the post-acute spectrum and support the ability of participant hospitals to coordinate the care of beneficiaries, CMS will conditionally waive the 3-day stay requirement for covered SNF services for beneficiaries in CJR episodes in performance years 2 through 5 of the CJR model (i.e. on or after January 1, 2017).

For additional information on waiving the 3-day stay, click on the link above.

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The North Carolina Health Care Facilities Association would like to thank our 2017 Gold Convention Hosts for supporting the upcoming Annual Convention & Expo. Be sure to visit Blue Ridge Pharmacy at booths 425 & 524, Medipack Pharmacy at booths 315 & 414, Neil Medical at booths 301, 303, 400 & 402, NH Med Services at booths 415 & 514 and Southern Pharmacy at booths 501 & 503 on Tuesday, February 28th during EXPO 2017 – Mardi Gras – Laissez Les Bon Temps Rouler.

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“Your Top-Line” is a new report for each skilled nursing facility. The American Health Care Association (AHCA) has used the data they have in LTC Trend Tracker to create a unique five-page report for each of the 15,000 facilities in the country. This report is produced quarterly and reports all your Five-Star data, how you stack up to your peers, where you have opportunities to gain a star, where you are at risk to lose one and provides links to useful tools.

You could pay thousands of dollars each quarter for a report like this, but as an AHCA member, it is yours for free. You can learn more about how to access Your Top-Line here.

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As they like to say in New Orleans, “Who Dat?” It’s Chair Phillip Hill and the NCHCFA Board of Directors “Krewe” inviting you to St. Peter Street in New Orleans for a night of fun at “Pat O’ Brien’s” on Monday, February 27th at 8:00 pm. Come be the belle of the ball! Get into the spirit of Carnival with your colleagues at the Sheraton’s Club 5th Season. There will be plenty of masks, beads, food and fun!

It is Lundi Gras, are you ready for a good time? The band Liquid Pleasure is back by popular demand! Get ready to hear great music, dance and watch three straight hours of mesmerizing choreography. For more than two decades, Liquid Pleasure has been bringing audiences to their feet. The Liquid Pleasure Super Show includes its six amazing original band members, three additional female vocalists, and an entire horn section. The band will play all the greatest tunes.

Come dressed in your regal attire. A photographer will be on hand and the best dressed male and female will be crowned the King and Queen of Mardi Gras. Great prizes will be awarded so start working on your creative costume. Heavy hors d’oeuvres will be served. Register today, we are going to have a ball!

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As of July 1, 2016, electronic submission of staffing data through the Payroll-Based Journal (PBJ) is mandatory for all long term care facilities. You have up to 45 days after the end of the quarter to submit data for Federal Fiscal Quarter 1 (October 1, 2016-December 31, 2016.) The final submission file for this quarter is due on February 14, 2017. Providers are encouraged to submit early to avoid system delays. Please note that an updated policy manual and FAQ are now posted on the PBJ Web site.

For questions related to software or technical requirements, please e-mail NursingHomePBJTechIssues@cms.hhs.gov. For questions related to PBJ policies, please e-mail NHstaffing@cms.hhs.gov.

PBJ Web site link: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html

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The Centers for Medicare & Medicaid Services (CMS) has released updates to the PBJ Policy Manual and the PBJ Policy Manual FAQ. The documents, updated in December 2016, highlight changes in red text. The updated PBJ Policy Manual (V2.2) can be read by clicking here. The new FAQs answered in the PBJ Policy Manual can be read by clicking here.

To stay up to date on changes to PBJ submission guidelines, visit the “What’s New” section at the bottom of CMS’ Staffing Data Submission PBJ Web page.

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In early December, the Centers for Medicare & Medicaid Services (CMS) released the quarterly National Correct Coding Initiative (NCCI) edits tables that apply to Medicare Part B and some state Medicaid agency claims for the period of January 1 through March 31, 2017. NCCI edits look combinations of procedure codes submitted on claims, and denies payment for codes that should not be billed together on the same day. Some codes listed in the edits can be billed together in certain situations, but only if an appropriate modifier (e.g. -59) is appended to the procedure code that would ordinarily be denied by the edit.

However, there appeared to be errors in the edits that will apply to the new physical therapy (PT) and occupational therapy (OT) evaluation code combinations 97162/97165, 97163/97165, and 97165/97164. In the posted NCCI edits tables, these PT and OT code combinations could never be billed on the same day, even with an appropriate modifier. This appeared to be inconsistent with CMS policy that has always permitted PT and OT evaluations on the same day, if medically necessary, and the American Health Care Association (AHCA) submitted a request to CMS to review the published CCI edits tables, and provide corrections as appropriate. In a follow-up communication with CMS, AHCA also cited concerns that the incorrect edits could potentially have a negative downstream impact on the outpatient therapy claims-based functional reporting requirement if not corrected by January 1, 2017.

CMS responded favorably regarding the concerns raised by AHCA. Specifically, CMS has issued a technical direction letter (TDL) to the Medicare Administrative Contractors (MACs) to utilize a workaround from January 1 through March 31, 2017 to bypass the incorrect procedure-to-procedure (PTP) edits for the Current Procedural Terminology (CPT) PT and OT evaluation code combinations 97162/97165, 97163/97165, and 97165/97164, until they can be correctly updated in the April 1, 2017 version of the NCCI edits tables. CMS also provided instructions to the state Medicaid agencies that apply NCCI edits to outpatient therapy CPT codes.

After reviewing the letters, AHCA believes that these actions by CMS should adequately address the concerns raised, and providers should use the appropriate new PT and OT evaluation codes as defined without fear of improper NCCI edit denials. Outpatient therapy providers should not receive NCCI edit denials for these three code combinations beginning January 1, as long as the appropriate modifier (e.g. 59) is appended to the claim.

Please inform Sam Clark at samc@nchcfa.org if you receive any such denials, and we will notify CMS so they may resolve the issue ASAP.

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Join this call to learn more about discharge planning and reducing unplanned hospital readmissions using INTERACT Tools. Hosted by SPACE (Southern Partners Action Collaborative for Excellence) in partnership with NCHCFA.

Date: January 31, 2017
Time: 1:00 pm – 2:00 pm
Join the event at https://qualitynet.webex.com

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The book presents specific care strategies for all stages of dementia and emphasizes relatively simple interventions that nurses can incorporate into their care plans to prevent problems or address them before they escalate. The guide distinguishes between dementia and conditions that mimic dementia, discusses issues related to specific care settings, presents person-centered strategies for families and care partners, and covers the assessment and management of pain, safety concerns, communication strategies, and ethical and legal issues. It additionally provides numerous resources that nurses can offer to caregivers. Fast Facts for Dementia Care will serve as a daily companion for all clinical nurses who work with older patients in any setting, including the emergency room, medical-surgical unit, medical office, and community mental health settings.

Key Features:

• Easy to use and carry in all patient settings
• Provides communication techniques for different stages of dementia
• Describes numerous interventions for addressing issues such as pain, safety, behaviors, and ADLs
• Includes the “Fast Facts in a Nutshell” feature for quick reference
• Illustrates content with case vignettes

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

Product #8293
AHCA MEMBERS $30.00

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If you were unable to attend one of our sessions on the introduction to the new regulations, the notebook used in the training is now available for purchase (Polly Welsh’s powerpoint presentation). E-mail Donna Snyder to order a notebook for your facility at donnas@nchcfa.org. The cost is $25.00 plus tax and shipping.

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Bridging the gap: Millennials in LTC

http://www.mcknights.com/guest-columns/bridging-the-gap-millennials-in-ltc/article/627849

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Anthony Daniels is the only actor to appear in all the Star Wars films. He portrayed C-3PO.

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