DCH: Suspension of Providers Who Have Not Revalidated Their Enrollment Effective November 1

Effective November 1, 2016, the Georgia Department of Community Health, Division of Medicaid will suspend those providers who were sent revalidation letters from Hewlett-Packard Enterprise (HPE) between June 1, 2016, and September 1, 2016, and have not submitted a revalidation application. As noted in the revalidation letter, DCH allowed providers a period of 60 days to revalidate. Those providers who have not revalidated their enrollment within the 60-day time period will be suspended from the Georgia Medicaid program. Click here to view the full notice from DCH.

October 25th, 2016|News, Newsfront, Reimbursement Corner|

NCAL Advocates on Concerns over HCBS Final Rule Implementation

As reported on AHCA/NCAL’s Long Term Care Leader blog: Last week the National Center for Assisted Living sent a letter to the Centers for Medicare and Medicaid Services (CMS) about concerns on the implementation of the home and community-based services (HCBS) waiver final rule. The rule, published in January 2014, presumes that certain settings are institutional and thus ineligible to provide Medicaid HCBS unless they overcome the presumption during a heightened scrutiny review from CMS. These settings include those in a publicly or privately owned facility that provides inpatient treatment, those located in a building on the grounds of or immediately adjacent to a public institution, or those that have the effect of isolating individuals receiving HCBS from the broader community. NCAL noted concern that the rule could ultimately exclude many AL communities from the Medicaid program. These exclusions would reduce access to this type of home and community-based setting and therefore significantly increase Medicaid expenditures because AL residents would be left with no options other than costlier intuitional settings. NCAL requested more guidance from CMS, specifically on: (1) operationalizing PCC for people with dementia; (2) criteria for AL communities to overcome a heightened scrutiny review for home and community-based settings that are co-located with or adjacent to an institutional setting; (3) CMS’ process for [...]

October 20th, 2016|News, Newsfront|

 NCAL Announces Addition of Assisted Living Measures in LTC Trend Tracker at Convention

As reported by AHCA/NCAL: At the AHCA/NCAL National Convention, the National Center for Assisted Living (NCAL) announced an expanded national effort to demonstrate the profession’s commitment to quality care through data. NCAL added four new assisted living measures to its online data collection tool LTC Trend Tracker: hospital admissions, hospital readmissions, the off-label use of antipsychotic medications, and occupancy rates. “We know our assisted living communities are providing high quality care, but in today’s health care environment, we need to be able to demonstrate it,” said NCAL Executive Director Scott Tittle. “NCAL is proud to grow our assisted living footprint in LTC Trend Tracker to help providers better understand how they’re doing, share that with other health care partners and consumers, and hopefully, get recognized for their amazing work.” The four additional measures bring the total to six for assisted living providers in LTC Trend Tracker. Reports currently exist regarding staffing (calculating turnover and retention) and customer satisfaction. Today’s announcement now gives NCAL member organizations the ability to track their progress on all of the NCAL Quality Initiative goals within one tool. “What sets LTC Trend Tracker apart from other data collection platforms is that our measures are clearly defined, so that everyone is comparing apples to apples,” said NCAL Senior Director of Workforce & [...]

October 20th, 2016|Assisted Living, News, Newsfront|

AHCA/NCAL Elects New Board of Governors, Directors at Annual Convention in Nashville

As reported by AHCA/NCAL: This week, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) elected AHCA’s Board of Governors and NCAL’s Board of Directors for the 2016-2017 term. Tom Coble of Oklahoma was elected for a second term as AHCA Chair, and Christian (Chris) Mason of Oregon was re-elected as NCAL Chair. New to the AHCA Board of Governors were Not-For-Profit Representative Gary Kelso (Utah), Affiliated State Health Care Association Executives (ASHCAE) Representative Dirk Anjewierden (Utah), and At-Large Board Representative Janet Snipes (Colorado). New members to the NCAL Board of Directors include ASHCAE Vice President Veronica Sharpe (Washington, D.C.) and At-Large Representative Gail Sheridan (Minnesota). “We are proud to welcome this distinguished group of leaders to our respective Boards,” said AHCA/NCAL President and CEO Mark Parkinson. “We face many challenges and opportunities in the coming year, and I believe that we can continue to deliver solutions for quality care under Tom and Chris’ leadership.” Coble is CEO of Elmbrook Management Company in Oklahoma. He has been a board member of the Oklahoma Association of Healthcare Providers since 2000 and began serving on AHCA’s Board of Governors in 2011 in various roles. Coble spent over 15 years working in the oil and gas industry prior to entering the long term care profession [...]

October 20th, 2016|News, Newsfront|

American Health Care Association Files Court Challenge to Arbitration Rule

CMS Exceeds Statutory Authority by Banning Pre-Dispute Arbitration Agreements in Updated Requirements of Participation As reported by AHCA/NCAL: On Monday, the American Health Care Association (AHCA) filed a lawsuit against the Department of Health and Human Services challenging the legality of a provision of a recently released regulation. The Requirements of Participation final rule, issued by the Centers for Medicare and Medicaid Services (CMS) on September 29, will prohibit skilled and nursing care facilities from entering into pre-dispute arbitration agreements with residents at their centers, no matter how fair or beneficial those agreements may be to residents. By filing the suit, the named plaintiffs are seeking to enforce rights under federal law, including the Federal Arbitration Act (FAA), to enter into arbitration agreements. The FAA mandates that arbitration agreements can only be changed by Congress. Congress has repeatedly rejected attempts to regulate or prohibit the use of arbitration agreements between nursing care centers and their residents. “We are taking this step to stop what is a clear overreach by CMS. Federal law plainly prohibits CMS from issuing this arbitration regulation,” said Mark Parkinson, AHCA President and CEO. “The merits of allowing individuals in our centers and their families this legal remedy are clear: study after study shows that arbitration is fair and speeds judgments in [...]

October 20th, 2016|News, Newsfront|

Update Following Hurricane Matthew

Last week, Gov. Nathan Deal declared a state of emergency ahead of Hurricane Matthew. Thirty counties were included in the state of emergency and Gov. Deal ordered a mandatory evacuation for six of those counties. GHCA staff worked throughout the storm to ensure that members were prepared and safe. The State of Georgia activated the State Operations Center ahead of the storm and GHCA Emergency Preparedness Coordinator Alexandra Benoit was onsite to assist with the Emergency Support Function 8 (ESF 8). GHCA staff assisted the State Operations Center by calling centers in the six evacuating coastal counties to help coordinate their evacuation plans. Alexandra was on hand at the ESF 8 Transportation Desk to help manage evacuation transportation requests made through the Georgia Emergency Management and Homeland Security Agency (GEMHSA) LTCF Evacuation Transportation Board. Over 2,000 residents and caregivers were safely evacuated during Hurricane Matthew. Following the storm, Alexandra worked with GEMHSA and the Department of Public Health to assist in transportation efforts to return residents and staff back to their respective centers after the affected counties were cleared for reentry. As of October 13, 2016, all evacuated residents and caregivers have returned to their buildings with the exception of one facility that is in the process of repairing damage. GHCA’s Emergency Preparedness Council Coordinators were extremely [...]

October 14th, 2016|Emergency Preparedness, News, Newsfront|

October 13 DCH Board Meeting Recap

On October 13, the Department of Community Health (DCH) held its monthly Board meeting. There was no Commissioner report, as Commissioner Reese was not in attendance. After committee reports, the Board gave final approval to two public notices: Community Behavioral Health Rehabilitation Services State Plan Amendment to add new services for children, youth, and families and expand services New Options Waiver (NOW) Program Amendment to add new rates and services There was no new business for the Board.

October 13th, 2016|News, Newsfront, Reimbursement Corner|

CMS urges providers: Give feedback on functional outcome quality measures for SNFs

As reported on McKnight’s Long Term Care News: The Centers for Medicare & Medicaid Services is seeking providers' comments on recently drafted functional outcomes quality measures for skilled nursing facilities. The proposed measures, published in a report by CMS contractor RTI International late last month, focus on residents' self-care and mobility activities. The measures cover: Change in self-care score between admission and discharge for skilled nursing residents Change in mobility score between admission and discharge for skilled nursing residents Percentage of skilled nursing residents who meet or exceed an expected discharge self-care score Percentage of skilled nursing residents who  meet or exceed an expected discharge mobility score The measures are calculated based on assessment items from the Continuity Assessment Record and Evaluation Item Set, according to CMS. The public comment period on the draft measures began Friday and will remain open until October 28. Comments can be submitted at

October 13th, 2016|News, Newsfront, Quality Corner|

CMS Proposed Rule Would Expand MFCU Authority 

As reported on AHCA/NCAL’s Long Term Care Leader blog: The US Department of Health of Human Services, Office of Inspector General (OIG) and Centers for Medicare and Medicaid Services (CMS), have released a proposed rule that “would update the Medicaid fraud program, which has undergone only 2 amendments since its establishment in 1978.” In the last four decades, “growth of the Medicaid Fraud Control Units (MFCU) program…as well as changes in MFCU practice, healthcare, and the workplace have led to the need for many amendments to the regulation,” according to the agencies. The proposed rule also would incorporate statutory changes affecting MFCUs, as well s policy and practice changes that have occurred since the regulation was initially issues in 1978. These changes include a codification of OIG’s delegated authority, MFCU authority, functions and responsibilities, disallowances, and issues related to organization, prosecutorial authority, staffing, recertification and the MFCUs relationship with the state Medicaid agencies. AHCA/NCAL will submit formal comments on the November 21, 2016, the due date.

October 13th, 2016|News, Newsfront, Reimbursement Corner|

DOL Overtime Webinar for Small Businesses with SBA Advocacy

As reported by AHCA/NCAL: As you know, the Department of Labor (DOL) earlier this year issued a final rule updating the overtime regulations of the Fair Labor Standards Act (FLSA). The new regulations revise the overtime exemptions for executive, administrative, and professional employees, commonly known as the "white collar" exemptions. Provisions of this final rule are effective on December 1, 2016. On Monday, October 17, 2016, 11 a.m. EDT - 12 p.m. EDT, the DOL's Wage & Hour Division - in partnership with the Small Business Administration's Office of Advocacy - is hosting a webinar to highlight resources and guidance available for employers and answer compliance assistance questions. The session will include the opportunity to submit questions during the presentation's Q&A segment, but attendees are encouraged to submit questions in advance to Click here to register for the webinar.

October 13th, 2016|News, Newsfront, Reimbursement Corner|