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Transitions in Care Webinar Series May 11th - Webinar on "The Foundation" - to download the slides from this webinar, click HERE. May 18th - Webinar on "INTERACT" - to download the slides from this webinar, click HERE. (will be uploaded on May 18th) May 25th - Webinar on "How to conduct a Quality Admission" - to download the slides from this webinar, click HERE. (will be uploaded on May 25th) June 1st - Webinar on "Management of top 3 Conditions" - to download the slides from this webinar, click HERE. (will be uploaded on June 1st)
The Goal The Georgia Health Care Association is encouraging nominations for the 2016 Georgia LTC Leadership Excellence Awards. We honor the accomplishments of individuals who have made strides in helping Georgians receive better long term health care at the 2016 Summer Convention at the Ritz Carlton Amelia. Who Qualifies If you know someone who is making a difference and helping Georgia residents receive better long term health care, please tell us their story! We are looking for administrators, corporate staff, long term care managers, CEOs, nurses, or any nursing home staff member, volunteer, etc. to honor them with one of our three Leadership Excellence Awards. Nominations are due by Friday, May 20, 2016. ALL sections of the form must be completed to be considered. For questions, please contact Mendee Rock, firstname.lastname@example.org or 678-289-6555. The Process Nomination forms must be completed and submitted by Friday, May 20, 2016 to be considered. ALL sections of the form must be completed for consideration by the selection committee. All nominations will be reviewed by a selection committee comprised of long term care leaders. The selection committee will determine the recipient(s). The Awards The recipient(s) will be announced to the long term care community at the GHCA Summer Convention at the Ritz Carlton in Amelia Island. GHCA will publish a [...]
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! PEPPER is an educational tool that summarizes provider-specific data statistics for Medicare services that may be at risk for improper payments. Providers can use the data to support internal auditing and monitoring activities. Please click HERE for more information on report access.
National Pressure Ulcer Advisory Panel (NPUAP) Announces a Change in Terminology from Pressure Ulcer to Pressure Injury and Updates the Stages of Pressure Injury
On April 13th, the NPUAP announced the term “pressure injury” replaces “pressure ulcer” in the National Pressure Ulcer Advisory Panel Pressure Injury Staging System. In addition to the change in terminology, Arabic numbers are now used in the names of the stages instead of Roman numerals. Other changes were agreed upon at a recent meeting of over 400 professionals per a consensus format. Additional information regarding the aforementioned changes can be found here.
The Department of Justice (DOJ) recently announced the establishment of 10 regional Elder Justice Task Forces, which bring together federal, state and local prosecutors, law enforcement and agencies that provide services to the elderly to coordinate and enhance efforts to identify and pursue nursing centers that provide substandard care to residents. Participants in the regional task forces will include the state Medicaid Fraud Control Units, US Attorneys’ offices, HHS, state Adult Protective Services agencies, Long Term Care Ombudsman programs, and various other law enforcement agencies. The DOJ indicates the task forces will focus on protecting nursing center residents from serious abuse, neglect, and other harmful care resulting in “grossly substandard care,” by prosecuting individuals and companies involved in such care. These task forces will play an integral role in DOJ’s future investigation and enforcement activities against nursing centers.
The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), enacted on October 6, 2014, requires the implementation of a quality reporting program for SNFs beginning with FY 2018. SNFs that do not submit required quality data to CMS under the SNF Quality Reporting Program (QRP) will be subject to a 2.0 percentage point reduction to their annual updates. The IMPACT Act requires the continued specification of quality measures for the SNF QRP, as well as resource use and other measures. In order to satisfy the requirements of the IMPACT Act, CMS is proposing one new assessment-based quality measure, and three claims-based measures for inclusion in the SNF QRP. These measures align with the measures proposed for inclusion in the Long Term Care Hospitals (LTCH) QRP and the Inpatient Rehabilitation (IRF) QRP. Assessment-based measure for the FY 2020 payment determination and subsequent years: 1. Drug Regimen Review Conducted with Follow-Up for Identified Issues. Claims-based measures for the FY 2018 payment determination and subsequent years: 1. Discharge to Community – Post Acute Care (PAC) SNF QRP; 2. Medicare Spending Per Beneficiary (MSPB) – PAC SNF QRP; and 3. Potentially Preventable 30 Day Post-Discharge Readmission Measure for SNFs
The Skilled Nursing Facility Value Based Purchasing Program (SNF VBP), which was part of the Protecting Access to Medicare Act of 2014 (PAMA), established a 2 percent withhold to SNF Part A payments that can be partially earned back based on a SNF’s rehospitalization score. The rehospitalization score is the better of either an achievement score (i.e. the rehospitalization rate) or improvement score (i.e. the change in rehospitalization rate over time). The PAMA requires that the lower 40 percent of ranked SNFs will receive less than the top 60 percent of ranked SNFs. The rehospitalization score and withhold will be publicly reported. In last year’s rule, CMS specified the measure to be used – SNF Rehospitalization Measure (SNF RM). This is a claims-based risk adjusted measure that is an all-cause 30 day rehospitalization measures. The PAMA SNF VBP requires CMS to transition to a potentially preventable measure. Also in last year’s rule, CMS asked for input on all aspects of operationalizing the SNF VBP program. The Agency did not finalize any aspects of the program in the final rule except for specifying SNF RM. This rule proposes to specify the SNF 30-Day Potentially Preventable Readmission Measure, (SNFPPR), as the all-cause, all-condition risk-adjusted potentially preventable hospital readmission measure to meet the requirements of section 1888(g)(2) of [...]
On April 21st, the Centers for Medicare and Medicaid Services (CMS) issued the FY 2017 Skilled Nursing Center Prospective Payment System Proposed Rule. The AHCA conducted and archived a webinar on the proposed rule for member reference and have also provided a summary of the rule. The CMS hosted an open door forum on Thursday, April 27th related to the proposed rule and discussion items from the forum can be accessed here. Below are some highlights from the proposed rule specific to the VBP & QPR programs.
The six new measures the Centers for Medicare and Medicaid Services (CMS) announced would be posted to Nursing Home Compare—four short-stay and two long-stay— were posted on April 27th. The short-stay measures include: discharge back to the community; emergency room use; rehospitalizations; and, improvement in function. The new long-stay measures are decline in mobility and the use of hypnotics/anxiolytics. Five of these measures will begin to impact centers’ five star rating beginning in July (hypnotic/anxiolytic measure will not be used in five star rating at this time). On April 21st, Five-Star Preview Reports were made available through the CMS QIES System. Instructions on how to access these reports can be found here. Technical specifications defining methodology for impact to five star rating have not been released.