Healthcare Legislation Moving Across the Gold Dome

Our associates at Frogue Clark Public Affairs have provided the following update on healthcare legislation moving across the Gold Dome: CALENDAR Day 21-24 Tuesday, February 21 – Friday, February 24 Day 25-27 Monday, February 27 – Wednesday, March 1 Day 28 Friday, March 3 Day 29 Monday, March 6 Day 30-31 Thursday, March 9 – Friday, March 10 Day 32-35 Monday, March 13 – Thursday, March 16 Day 36 Monday, March 20 Day 37 Wednesday, March 22 Day 38 Friday, March 24 Day 39 Tuesday, March 28 Day 40 Thursday, March 30   Governor Nathan Deal signed SB 70 in to law on Tuesday. Sponsored by Sen. Butch Miller (R-Gainesville), this piece of legislation renews the Hospital Provider Payment Program/Hospital Medicaid Financing Program and extends the program until June 30, 2020. The original law had a sunset date of June 30, 2017. On Wednesday, he signed HB 43, the $24.3 billion dollar Amended FY2017 Budget that included much needed funding for nursing home surveyors at DCH. SB 41 – Authored by Sen. Renee Unterman (R-Buford), this piece of legislation would provide for the licensure of durable medical equipment suppliers. The following persons and entities shall be exempt from the requirements (unless any such person or entity has a separate company that is in the business [...]

February 17th, 2017|Gold Dome, Legislative, News, Newsfront|

Satisfaction Survey Outcomes

NRC (My Innerview) has provided GHCA with aggregate reports by council area for the 2016 satisfaction surveys for resident, family and employee.  This year’s survey reflected behavioral based questions and a different response scale.  However, “legacy” global satisfaction survey questions were included as well to provide consistency for the quality incentive program criteria. The survey also included AHCA’s Core Q questions related to overall satisfaction with care and overall recommendation.  Georgia continues to perform very well and residents, families and employees reflect a high level of satisfaction.  Response rates decreased slightly, in part due to a higher number of surveys being issued. Georgia exceeded national averages for overall rating (0-10 scale) on resident, family and employee satisfaction surveys!  This is outstanding and reflects your dedication to quality care and service for Georgia’s deserving seniors.  However, there is no room for complacency in the long term and post-acute care profession.  GHCA and NRC urge you to comprehensively review your outcomes and develop a plan of action based upon your areas of greatest opportunity.  Communication of results to those involved in the survey process is also important.  Satisfaction and response rates are more likely to improve if participants feel their participation in the survey really has an impact. The Healthcare Facility Regulation Division (HFRD) reports an increase [...]

February 17th, 2017|News, Newsfront, Quality Corner|

Regulatory Alert: Updates from HFRD

GHCA appreciates the ongoing collaboration with Healthcare Facility Regulation Division (HFRD) to promote the highest quality of care possible for Georgia’s seniors.  These efforts are ongoing and we will provide updates as we have clear, objective guidance or information to share. We appreciate Chief Melanie Simon, Deputy Chief Norma Jean Morgan and LTC Director Amanda Miranda attending the House of Delegates meeting in January. The presentation and opportunity for questions was very helpful. Chief Simon’s presentation can be found here and includes very helpful information related to the increase in complaint survey activity as well as tips for addressing care and service issues that may lead to citations at a harm level.  We encourage you to review this information with key staff and consider an internal review of processes and systems relative to these high risk areas.  Also, please find current contact information for key staff at HFRD and regional alignment here. The new requirements of participation that were released on October 4 with an effective date of November 28 for Phase 1 requirements, has led to questions related to when the LTC Ombudsman should be notified of a transfer or discharge (§483.15 (3) (i).  There has been widespread interpretation that the requirement is to notify the ombudsman of all transfers and discharges.  However, Chief Simon [...]

February 17th, 2017|News, Newsfront, Quality & Regulatory|

AHCA: Medicaid at Risk – We Need Your Help

See below message from AHCA President & CEO Mark Parkinson: The future of our Medicaid funding faces its greatest threat in my six-plus years at AHCA/NCAL. Congress is considering reforms that would further challenge our ability to provide care to our poorest residents. These proposals could dramatically reduce funding to the states, and some even eliminate provider assessments and other important funding mechanisms. The good news is that we are on top of it, and I am convinced that if we work together and respond in a huge way, we will win. We need you to be part of our response. This memo will explain the challenge we are facing, outline our response, and discuss several steps you can take to help ensure our success. Why Medicaid is at Risk Republicans have wanted to reform the Medicaid program for the last 10 years. This is not a criticism; they are responding to a financial reality. Republican leadership, led by Speaker Ryan, believes that spending for Medicaid has increased dramatically and that its growth is not sustainable. The Speaker and others have argued that even though the short-term pain of reforming Medicaid could be considerable, it is necessary to ensure the long-term survival of the program. Despite the Speaker's focus on Medicaid, his efforts have stalled [...]

February 17th, 2017|News, Newsfront|

CMS Acts Upon Executive Order to Review Rules – EPM Bundling Rule Timeline Delayed

See below message from AHCA/NCAL President & CEO Mark Parkinson: Yesterday, the Centers for Medicare and Medicaid Services (CMS) delayed the effective date for the second mandatory hospital bundling program issued on January 3, 2017. We had asked for the delay. In a letter to the Trump Transition Team, AHCA/NCAL included a request that the incoming administration carefully scrutinize the Episode Payment Models (EPM) final rule for possible significant changes or to completely rescind the rule. You may recall that this is the second mandatory bundling rule. AHCA is not opposed to bundles, but we are opposed to mandatory bundles, particularly when hospitals hold the bundle as required in this rule. EPM Background The rule implemented three new mandatory EPMs: coronary artery bypass graft (CABG); acute myocardial infarction (AMI); and surgical hip/femur fracture treatment (SHFFT). The two cardiac episodes will be tested in 98 Metropolitan Statistical Areas (MSAs) across the country, while the SHFFT episode will be tested in the 67 MSAs currently participating in the Comprehensive Care for Joint Replacement (CJR) demonstration. Under the program, hospitals will be held accountable for total Medicare Parts A and B spending, as well as performance on certain quality measures, during 90-day episodes of AMI, CABG and SHFFT episodes, depending on where the hospital is located. Hospitals may [...]

February 17th, 2017|News, Newsfront|

NNHW “The Spirit of America” May 14-20, 2017

Every skilled nursing care center embodies a unique and vibrant spirit and community for residents, volunteers and staff alike. Acts of kindness, generosity and compassion from proud veterans, immigrants, and hardworking people of different faiths fill the walls of each center. During National Nursing Home Week (NNHW), May 14- 20, 2017, skilled nursing care centers will unite under the theme, “The Spirit of America.” This theme underscores the bond between staff, volunteers and residents that capture the American spirit. To celebrate, GHCA’s Public Relations Committee will again host the NNHW Social Media Photo Contest. Help us showcase the wonderful things your center is doing to enrich the lives of those entrusted in your care by participating. See contest guidelines below. GHCA Social Media Photo Contest Guidelines Capture photos of the activities/events being held at your facility during National Nursing Home Week May 14-20, 2017. Pick one (1) photo that you feel best showcases the fun your center’s residents and staff had during the week. GHCA will only accept one photo per facility. Submit the chosen photo, a brief caption for the photo, and your center’s name to by 5:00 p.m. on Monday, May 22, 2017. Be sure you have permission from all individuals in the photo to share on social media. Photos will be [...]

February 15th, 2017|News|

An Update from the AHCA Chair – February 2017

See below update from AHCA Chair Tom Coble: Dear Colleagues: It's hard to believe it is already February! We jumped right into 2017 with its many opportunities and challenges. We had a very successful 2016, and with your continued efforts and perseverance, we will continue to offer solutions, improve lives and deliver quality care. The AHCA Board of Governors recently held its first meeting of the year, and I hope you will find the summary below helpful. Association & Washington Updates Financials AHCA/NCAL remained financially strong in 2016. I am pleased to report that we wrapped up the year significantly better than budget on operating expenses and revenues, and net assets remain strong. We had a tremendous year with many contributions to this success, including record-breaking attendance at the Annual Convention and Expo and a diligent staff that continues to serve as good stewards of our membership's dues. Everyone played an important part - and for that, thank you. AHCA/NCAL President and CEO Mark Parkinson reported that association membership continues to be strong. AHCA now represents two-thirds of nursing homes in the country. It is also exciting to share that we continue to see a significant increase in not for profit and assisted living growth. 2017 Strategic Plan and Priorities The first 100 days of the [...]

February 10th, 2017|News, Newsfront|

More Than a Third of Georgia’s Freestanding Nursing Centers Have Negative Margins

Summary of Key Findings Eljay, LLC, a consulting firm specializing in development and modification of Medicaid payment systems for nursing facilities was engaged by GHCA to determine the financial margins of Medicaid nursing facilities in Georgia utilizing nursing facility revenues and expenses as reported on the 2015 Medicaid cost reports. Only freestanding nursing facilities were included in the analysis in that cost reports for most hospital-based facilities do not segregate nursing facility revenues and expenses from those of the hospital. The scope of the project went well beyond a simple computation of margins based upon net income from nursing facility services divided by total nursing facility revenue as reported on the cost reports. It included extensive review and adjustments, as described below. To present the most conservative analysis, costs incurred that could possibly be viewed as artificially inflated as the result of transactions with parties related to the owners of the nursing home were recognized only to the extent allowed by the Georgia Medicaid program, including costs for management fees, related party arrangements and owners’ compensation. In total, almost $48 million of costs were excluded in computing nursing facility margins.   Key Findings The combined margin for the 293 nursing facilities in the database was $71.6 million, representing a margin percentage of 3.3% on reported revenue [...]

February 10th, 2017|News, Newsfront|

Skilled Nursing Facility 30-Day All Cause Readmission Measure (SNFRM)

As reported by CMS: In the Fiscal Year (FY) 2016 SNF Prospective Payment System (PPS) final rule, CMS adopted the SNFRM as the first measure for the Skilled Nursing Facility Value Based Purchasing (SNF VBP) Program. The measure is defined as the risk-standardized rate of all-cause, unplanned hospital readmissions of Medicare beneficiaries within 30 days of discharge from their prior hospitalization. Hospital readmissions are identified through Medicare hospital claims (not SNF claims) so no readmission data is collected from SNFs and there are no additional reporting requirements for the measure. Readmissions to a hospital within the 30-day window are counted regardless of whether the beneficiary is readmitted directly from the SNF for after discharge from the SNF as long as the beneficiary was admitted to the SNF within 1 day of discharge from a hospital stay. The measure excludes planned readmissions because they do not indicate poor quality of care.  The measure is risk-adjusted based on patient demographics, principal diagnosis from the prior hospitalization, comorbidities, and other health status variables that affect probability of readmission. In calculating the readmission measure, unplanned readmissions are identified using a modified version of the CMS planned readmissions algorithm. Other exclusions include patients who were hospitalized for medical treatment of cancer, do not have Medicare Part A coverage for the [...]

February 9th, 2017|News, Newsfront, Reimbursement Corner|

SOURCE Day Held at GHCA Headquarters February 2

Yesterday, SOURCE Steering and Leadership Committees met at the Fred A. Watson Training Center at GHCA headquarters in Stockbridge. We were excited to have many SOURCE providers in attendance. The group was joined by Brian Dowd and Lorrie Stewart from DCH, who shared updates and information about cost of care reports, expanding Medicaid eligibility for potential SOURCE clients, conflict-free case management, and the 2016 SOURCE Quality Incentive. The Quality Committee reported that, along with the Hospice Association, a subcommittee has planned training to education the case managers of both organizations on best practices around caring for their hospice clients. Tony Marshall, GHCA President and CEO, shared information regarding the potential for Medicaid block grants as well as news that GHCA is advocating for a 3% monthly case management fee increase for SOURCE agencies. SOURCE President, Dorothy Davis, announced that Hope Hickman, GHCA liaison for SOURCE members, plans to retire at the end of March. She expressed appreciation for Hope’s dedication to the SOURCE group and wished her well.

February 3rd, 2017|News, Newsfront, Reimbursement Corner|