The Q4FY15 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2015 is now available! Free-standing SNFs: Download PEPPER through the PEPPER Resources Portal. The SNF's Chief Executive Officer, President, Administrator or Compliance Officer should: Review the Secure PEPPER Access Guide. Review the instructions and obtain the information required to authenticate access. Note: A new validation code will be required. A patient control number or medical record number from a claim for a traditional Medicare FFS beneficiary with a “from” or “through” date in September 1-30, 2015 will be required. Visit the PEPPER Resources Portal. Complete all the fields. Download the PEPPER. Hospital-based SNFs: PEPPER was uploaded to the AutoRoute_inbox of QualityNet account administrators and those with user accounts with the PEPPER recipient roles. The PEPPER file will be available for download in QualityNet for 60 days from the date it was uploaded. View instructions for downloading your PEPPER.
On April 19th, Hope Hickman gave a brief public comment supporting the 3% growth allowance applied to the current Medicaid cost report (2012) costs. There were no other oral comments submitted.
On Monday, April 18th, Tony Marshall, Doug Burr, and Hope Hickman met with the following DCH officials – Elizabeth Brady, CFO; Marcey Alter, Assistant Chief, Medicaid; John Upchurch, Reimbursement Director; and Darryl Threat, Reimbursement Manager to discuss reimbursement policy and payment. One topic covered was mass adjustments and what providers are confronted with when edits have changed since the claims were originally adjudicated. This is especially tedious since the reinstatement of the PASRR edits in April of 2015. DCH agreed to give special attention to this issue during any future mass adjustments. GHCA consented to hosting additional PASRR trainings. Another discussion topic centered on the implementation of the inflationary increases passed in the 2016 Legislative Session. DCH shared that once the governor has signed the budget bill and the DCH Board has approved the SNF rate and ventilator increases, the state plan amendment (SPA) with the very minimal changes noted above will be submitted to CMS. As usual, CMS has 90 days to rule on the SPA. Should they do that, it will be at least August before the rate increase can be implemented. Tony asked if DCH would think about putting the rate increase into effect on July 1st since the SPA changes are so minimal.
The CMS also issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) for FY 2017 update on April 21st. We will continue to review and provide additional information and education in the near future. Key highlights include: The proposed rule provides for a net market basket increase for SNFs of 2.1 percent beginning October 1, 2016. The 2.1 percent market basket update reflects a full market basket increase of 2.6 percent reduced by 0.5 percentage points, in accordance with the multi-factor productivity adjustment required by Section 3401(b) of the Affordable Care Act (ACA). No forecast error was incurred. The market basket 2.1 percent for FY 2017 for the SNF PPS is based on the IHS Global Insight, Inc. (IGI) first quarter 2016 forecast with historical data through fourth quarter 2015. This figure could change when CMS issues the final rule based on more recent IGI data. CMS estimates that the net market basket update would increase Medicare SNF payments by approximately $800 million in FY 2017. As noted above, a forecast error correction was not needed. Since the difference between the estimated and actual amount of change in the market basket index was below the 0.5 percentage point threshold in FY 2015, the payment rates for FY 2017 are not impacted by [...]
With election day approaching, we continue to ask all members to invite your local senators and representatives into your facilities for tours and visits. Educating your local elected officials on issues is both the most effective and sincere form of advocacy there is. We especially ask your assistance in engaging those members who have primary elections in May. Please see the presentation above for information on who is facing opposition in the upcoming elections. Pictured below (left to right): GHCA President Tony Marshall, Georgia House Speaker David Ralston and the Cook Family enjoy a visit at McRae Manor during the Speaker’s recent South Georgia Tour. Pictured below: State Representative Jimmy Pruett addresses residents and staff during a recent visit to McRae Manor in McRae, Ga. FOR ALL INFORMATION ON GEORGIA VOTING (EARLY VOTING LOCATIONS, APPLICATIONS FOR ABSENTEE BALLOTS, PRECINCT INFORMATION), PLEASE CLICK HERE
Join Georgia Health Care Association’s (GHCA) Public Relations Committee and Georgia’s long term and post-acute care facilities in celebrating National Nursing Home Week - “It’s a Small World with a Big Heart.” As all long term care professionals know, nursing homes rely on the daily activities that are planned and provided in fulfilling each resident’s life with purpose. And what better way to show these precious residents that they do matter, and have purpose, than to have a week FULL of FUN activities and celebrations? This week is dedicated not only to the hard-working individuals that devote numerous hours caring and serving in our nursing homes, but also to the residents who continue to have an indomitable spirit for life. There are so many good things happening in nursing homes that we want to showcase them with a little competition… Here’s how to play – Capture photos of all the activities/events being held at your facility during National Nursing Home Week which is from May 8-14, 2016. Make the hard decision of picking one (1) photo that showcases all the fun residents and staff had during the week. Submit the chosen photo, a brief caption of the photo, and what facility you are from to email@example.com by MAY 16, 2016, at 5PM. (Be sure you [...]
I have learned through the years that the strength of any organization is derived from the active participation of its members. Certainly that is the case for the Georgia Health Care Association. April allowed several opportunities for participation highlighted by an informative Owner/Operator Committee meeting, chaired by Brad Bilbo, where we heard from DCH Commissioner, Clyde L. Reese III, Esq. and AHCA’s Senior Director, Member Relations, Christy Sharp. We also welcomed many of you to Stockbridge for April’s calendar of education including several Activity Directors for the Activity Directors’ State Approved 36-Hour Training Course. And the month ended with our semi-annual tour of the State as we held our first six Council Education Days. Here are some of the opportunities for participation in May. (Please see the full event calendar at the end of this newsletter for additional events and details for registration.) 2016 SOURCE Spring Conference (May 3rd) 2016 GHCA/GCAL Spring Education Day – Northwest (May 5th) 2016 GHCA/GCAL Spring Education Day – Metro Atlanta (May 6th) National Nursing Home Week (May 8th – 14th) GHCA Board and Committee Day (May 17th) Ms. Georgia Nursing Home Pageant (May 21st) Georgia Health Care Education & Research Foundation Annual Golf Tournament (May 26th) And finally, I want to encourage you to register for the 2016 GHCA/GCAL [...]
The Georgia Department of Public Health (DPH) and the Georgia Hospital Association (GHA) will hold an Infection Prevention Educational Program for Long Term Care Facilities May 3-4, 2016 at the Georgia Hospital Association (GHA) Education Center, 1675 Terrell Mill Road, Marietta GA 30067, 770-249-4500. There is no registration fee for participants from Long Term Care Facilities in Georgia. Hotel Accommodations for attendees over 50 miles away GHA will reimburse attendees whose place of employment is over 50 miles from the meeting location for up to two nights hotel stay. Participants should submit a copy of their receipt with the GHA Expense Report. Mileage reimbursement should be submitted to your place of employment. For participants needing hotel accommodations, the GHA has a preferred client rate at the Doubletree by Hilton Atlanta - Marietta, of $104.00 per night single occupancy. This hotel is conveniently located to the GHA Education Center at 2055 South Park Place, Atlanta, GA 30339. The hotel has a free shuttle to the GHA Education Center. If you chose to stay at another hotel, it must not exceed the GSA per diem for Atlanta, which is currently $138, inclusive, per night. GHA cannot reimburse hotel rooms that are over the GSA per diem rate. Registration Information You can register online at the link below [...]
The Wanderers Information Sheet provides information in case a resident wanders away or becomes lost. Keep a copy of this sheet handy to give to law enforcement. All searches begin with an investigative component. During this time you will be asked dozens of questions to aid law enforcement and search teams determine where and how to look for a missing person. This information is critical to the success of the search. Completion of this form, before an incident, allows the searching to start sooner and aids in collecting more accurate information. Click here to access the Wanderers Information Sheet.
In order to complete the Life Safety portion of your CMS survey, the documentation provided in the link below is required to be reviewed before the Compliance Officer completes the survey of your facility. Click here for complete list.