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Volume 23 Issue 17 - April 14, 2016

RIPPED FROM THE HEADLINES— LEAD STORY
Managed Care Will Hit SNFs Relying On Part A Payments, Experts Say
By Elizabeth Leis Newman

Skilled nursing providers should be prepared for managed care to drill down on Medicare Part A residents, creating the potential for major financial problems, a long-term care expert warned.

Managed care experts “don't see what value we add to the equation — you need to prove it,” said Jill M. Krueger, the president and CEO of Symbria in Warrenville, IL, during a session at the LeadingAge Illinois annual meeting. “The pendulum is going to swing and they'll drill down on Medicare rates. Then you'll show the data and it will swing back, but there will be a 3-year period where you need money in your piggy banks as money from Part A moves to managed care.”

In states where there is more managed care, the length of stay is as low as 14 days, said Krueger, speaking at a session titled “Contracting with ACOs and Other Multi-Provider Arrangements” with attorney and McKnight's Ask the Legal Expert columnist John Durso.

In addition to a loss of census around a short length of stay, more patients are bypassing skilled nursing for home health, and SNFs can be excluded from narrow networks in ACOs.

Providers — especially in the nonprofit sector — should recognize the importance of relationship building.
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LeadingAge Florida Presents - Why Everyone Should Care About Managed Care Workshop: Educational Series
Join us for an important workshop to help aging services providers understand the potential impacts of these changes, to deliver the latest critical information about the plans and the nuances of their processes, and to help prepare for what may well be the next major shift in the aging services environment.

JUST THE FACTS— EXPERT OPINIONS!
April Is Florida Volunteer Month
By Volunteer Florida CEO Chester W. Spellman

Every day in Florida, volunteers serve at schools, senior centers, state parks, and non-profits. They mentor and tutor vulnerable students, restore Florida’s precious natural resources, provide meals to homebound individuals, and work with those with unique abilities. They make our communities safer, stronger, and healthier.

Volunteer Florida is proud to recognize April as Florida Volunteer Month. Together with state and local leaders across the Sunshine State, we stand together and say “thank you” to the millions of Floridians who serve their neighbors.

We also celebrate Florida Volunteer Month by promoting volunteerism across the state. While we encourage service all year long, Florida Volunteer Month is a great time to get started if you’re not already volunteering!

FROM THE DESK OF THE PRESIDENT
As I travel around the state meeting with our members, I hear numerous stories about the incredible work you are doing in your communities and for your residents. On Tuesday, John Hehn of Florida Presbyterian Homes took a stand on behalf of his community, LeadingAge Florida, and those doing innovative and quality work in long-term care by pushing back against a local newspaper article that painted an unfair picture of care in Polk County. LeadingAge Florida is pushing back as well, as we have previously with the Miami Herald. John’s letter is a great example of advocacy at the local level, where it is almost always most powerful. Click here to read John’s Letter to the Editor.

While on the road this week, I attended our first workshop on ‘Why Everyone Should Care About Managed Care.’ LeadingAge Florida has developed an important set of workshops to be held across the state to help members understand the increasing sophistication of managed care plans, the new incentives they are responding to, and how those responses affect our members. I hope you’ll join us for this important workshop, Why Everyone Should Care About Managed Care, when it’s in your area. Here are the next locations and dates:
     Westminster Winter Park on June 7th
     Pompano Beach at John Knox Village on September 28th
     Orange Park at Moosehaven on November 30th

Lastly, my thanks to Rob Goldstein and Menorah Manor for hosting our managed care workshop this week, and to Harry Hobson at Plymouth Harbor and Joel Anderson at Village on the Isle for hosting me as I continue to traverse the state to visit members in their communities.
                                                 
 COMING ATTRACTIONS
April
21 - Healthy Executive Transitions: When Succession Planning Isn't Enough Workshop:
In a time of unprecedented CEO & C-Suite retirements, succession planning and executive searches are often the reactive processes leaving boards and candidates feeling frustrated and compromised. How can we conduct sound leadership development and organizational planning to improve the odds of successful and mutually gratifying transition experience? Tim Ficker, Managing Director of MHS Consulting, along with Rich Scanlon, Managing Director of Ziegler, will propose an integrative approach to leadership planning and executive transition, facilitating a discussion of best practices and less-than-best practices.

May
12 - Preceptor Refresher Webinar

19 - Finance and Strategic Positioning Workshop at Inn on the Pond, Clearwater
A block of rooms have been reserved at the Hilton Clearwater Beach. The special room rate will be available until April 18, 2016, or until the group block is sold-out, whichever come first.

19 - Nurse Rules and Regulations Mandatory 2 Hour In-Service: This webinar will cover the laws and rules that govern the practice of Nursing in Florida.

26 - Working WITH, not AGAINST Elders with Dementia Using Jujutsu Webinar
June
7 - Educational Series (1 Meeting, 3 Locations) Why Everyone Should Care About Managed Care

14 - Preceptor Training, Location: Vicar's Landing, Ponte Vedra Beach

22 - Risk Management in Long-Term Care Webinar

July
25-27- 53rd Annual Convention & Exposition: Join us for motivational and educational sessions that explore how you can Be the Difference in the lives of the seniors you serve. 

Registration is OPEN for the 53rd Annual LeadingAge Florida Convention & Exposition!


August
23 – Preceptor Refresher Webinar

30 – ICD-10 Refresher Webinar

September
8 – Nursing Home Survey Trends, with Connie Cheren & Kim Smoak, Location: TBA in Orlando area

28 - Educational Series (1 Meeting, 3 Locations) Why Everyone Should Care About Managed Care

November
30 - Educational Series (1 Meeting, 3 Locations) Why Everyone Should Care About Managed Care
THE LEADINGLINK LIMELIGHT
Special Thank You to Marlee Nickerson From Lakeview Terrace
Marlee Nickerson, daughter of Holly Nickerson (LVT employee) chose getting iPods for each bed in the Memory Care unit as her Gold Award project with Girl Scouts. “The Gold Award is the highest award recognized by Girl Scouts; I chose the Music and Memory program as my project because I have had close family affected by the disease. After watching the movie "Alive Inside," I saw how music affects the impaired memory of the elders. Through support from friends and family, I was able to donate seven Apple iPod Shuffles to the Music and Memory program. With continuous support from the Lakeview Terrace staff, volunteers, and residents I was able to complete my award after numerous months. A special thank you to Mrs. Susan, for not only pushing me to grow as an individual but for being my mentor through this project.” Marlee Nickerson - Girl Scout Troop 4715
REGULATORS!
Quality Assurance
What exactly does Quality Assurance mean? At the end of the day Quality Assurance is the act of ensuring the product we produce in the long-term care industry is good patient care and good resident care. Quality Assurance is really a combination of auditing, tracking, rounding, and measuring your outcomes.

Reach out to our Clinical & Compliance Specialist, Connie Cheren, RN, MSW by phone at (678) 778-0561 or via  ccheren@LeadingAgeFlorida.org.  Connie is available to our members as a value-added service, paid for by LeadingAge Florida, to help answer questions before, during and after surveys OR anytime throughout the year! She can help nursing home and assisted living members improve regulatory compliance and clinical outcomes and to offer suggestions about survey results and corrective plans of action.
FACES OF AGING 
Three Delray Beach Senior Living Communities Compete In Weight Loss Challenge
Three Delray Beach senior living communities joined forces to shed the pounds this year in a friendly biggest loser competition. Sixty-five residents, from Abbey Delray, Abbey Delray South and Harbour’s Edge, participated in the fitness program, proving that you’re never too old to take on a new challenge. Mike Schmidt, 
Abbey Delray South fitness director, launched the weight loss challenge last year as a new way to help seniors get fit at the community. After great reviews, and more than 150 total pounds lost, Abbey Delray and Harbour’s Edge decided they wanted a piece of the weight loss challenge. The participants even took on team names: The Castaweighs, Slim Jims and Skinny Hips. After 10 weeks of exercising, learning healthy eating and cutting the calories, the teams lost over 300 pounds. Experience proved beneficial for the Abbey Delray South team, as they took the crown as the biggest losers.
NEWS FROM AROUND THE SUNSHINE STATE
18th Annual Ziegler LeadingAge National Senior Living CFO Workshop
This week, nearly 200 Chief Financial Officers (CFOs) and industry finance professionals gathered for the 18th year to attend the Ziegler LeadingAge National Senior Living CFO Workshop. Ziegler staff, LeadingAge staff, and roughly 20 CFOs formed a Steering Committee to develop a robust educational and networking agenda specifically designed for not-for-profit senior living professionals. The speakers represent industry specialists in areas such as policy, compliance, accounting, actuary science and healthcare reform, as well as providers who are innovating, growing and willing to share their best practices.
Don’t miss the LeadingAge Florida and Ziegler Finance & Strategic Planning Workshop May 19, 2016, at Inn on the Pond in Clearwater.

Priceline.com Co-Founder & Former CEO Jeff Hoffman Announced as LeadingAge Florida’s 53rd Annual Convention & Exposition Keynote Speaker
His legendary, inquisitive mind and willingness to go outside of his comfort zone pads an internationally renowned resume as an entrepreneur and motivator! Jeff is the Co-founder and Former CEO of global juggernaut Priceline.com – he built it into the $65B company it is today. As a master problem solver Jeff has spent the last three-and-a-half years mentoring entrepreneurs around the globe. A millionaire before the age of 30, Hoffman developed a philosophy saying it is important to create a mentality in the workplace of “I get to go to work” versus “I have to go to work.” In his keynote, Jeff will tell his stories of hard work, perseverance and vision coupled with the value of wonder and play. You won’t want to miss this author, philanthropist and serial entrepreneur who is changing the world one start-up at a time!

Registration is OPEN for the 53rd Annual LeadingAge Florida Convention & Exposition!
Submit Nominations For Quality Senior Living Awards
The 2016 Quality Senior Living Awards Program (QSLA), sponsored by Florida Power & Light, is accepting nominations through Wednesday, May 11, 2016. This statewide awards program annually recognizes the efforts of individuals and organizations that positively impact the quality of life of seniors. The four awards categories include: Public Service Award, Service to Seniors by an Organization Award, Senior Vision Media Award, & Dr. Carter Osterbind Outstanding FCOA Member Award.

CMS S&C Letter: ACA Mandate - State Consumer-Oriented Websites
Following is the link to the Centers for Medicare and Medicaid Services (CMS) Survey and Certification Letter, Affordable Care Act Section 6103: Guidance for State Consumer Oriented Websites- Update to Survey and Certification Letter 11-41-NHs [3/25/16]. This Letter updates the Survey & Certification Letter of 9/30/11, providing guidance to States on implementing section 6103 of the Affordable Care Act. All new language is redlined.  CMS provides links to CO, FL, and MN as examples.
Scott Poised To Act On Health Bills
By Jim Saunders

In a final flurry of activity from the legislative session, Gov. Rick Scott this week will take action on heavily debated health, education and tax bills. Scott faces deadlines to act this week on 25 bills, including 22 of them on Thursday, April 14, 2016.

Statement From Assistant Secretary For Aging Kathy Greenlee Welcoming Passage Of The Older Americans Act Reauthorization
On behalf of older adults and those of us hoping to grow old, I am extremely grateful that the reauthorization of the Older Americans Act has been successfully passed by both the House and Senate," stated Kathy Greenlee, Assistant Secretary for Aging.
Patient Look Up Webinar
Register for the Patient Look-Up (PLU) Webinar on April 20, 2016, at 10:00 AM. The Florida Health Information Exchange’s PLU service allows participating health care organizations and affiliated users to query the medical records of other participating health care entities for individual patient data. Join the webinar to learn how varied types of providers, from large health systems to small provider practices, can get connected.


News Bytes
In this edition of News Bytes you will find information on:
• Electronic Health Record (EHR) Incentive Program Applications, Updated Resources, Medicare Payment Adjustments, and Security Risk Assessments
• Funding opportunities for Long-Term and Post-Acute Care Providers to get involved in the Florida Health Information Exchange’s (Florida HIE’s) Patient Look-Up (PLU) service.

FHFC Rule Development Workshop
The Florida Housing Finance Corporation will hold a workshop to discuss proposed revisions to the following rules:
• 67-21 F.A.C. – Non-Competitive Affordable Multifamily Rental Housing Programs (Multifamily Mortgage Revenue Bonds / Housing Credits)
• 67-48 F.A.C. – Competitive Affordable Multifamily Rental Housing Programs (SAIL / HOME / Housing Credits / Elderly Housing Community Loan)
• 67-60 F.A.C. – Multifamily Competitive Solicitation Funding Process
The workshop will be held on April 19 at 2 p.m. at Florida Housing’s Tallahassee offices, and will also be accessible by telephone. To view the draft rules, workshop notice, and call-in instructions, click here.

'Scarier Than We Initially Thought': CDC Sounds Warning On Zika Virus
By Gregory Kate

Public health officials used their strongest language to date in warning about a Zika outbreak in the United States, as the Obama administration lobbied Congress for $1.9 billion to combat the mosquito-borne virus. "Most of what we've learned is not reassuring," said Dr. Anne Schuchat, the principal deputy director of the Centers for Disease Control and Prevention. "Everything we look at with this virus seems to be a bit scarier than we initially thought." As summer approaches, officials are warning that mosquito eradication efforts, lab tests and vaccine research may not be able to catch up. There are 346 cases of Zika confirmed in the continental United States — all in people who had recently traveled to Zika-prone countries, according to the most recent CDC report.

Notice of Public Hearing: Recordkeeping & Documentation Requirements:
The Agency for Health Care Administration has scheduled a public hearing for Rule 59G-1.054, Florida Administrative Code, Recordkeeping and Documentation Requirements.  The public hearing is scheduled for April 27, 2016 from 11:00 a.m. to 12:00 p.m. ET at the: Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Tallahassee, FL 32308. There will not be a phone call-in number available. Official notice of the hearing was published in Volume 42, Number 70 of the Florida Administrative Register (FAR) on April 11, 2016. A copy of the notice may be found on the FAR Web site.


Florida Housing Posts Income & Rent Limits
Florida Housing has posted its combined 2016 income limit and rent limit schedule by County on the Property Owners and Managers webpage.
 - 2016 combined income and rent limits for multifamily programs (except HOME and SHIP)
 - 2016 SHIP combined income and rent limits

HUD has not yet announced when 2016 income limits and rent limits will be released for the HOME program. When Florida Housing becomes aware that HUD has released its 2016 HOME income limit and rent limits, the HUD schedules will be posted on the Florida Housing web site and notification will be sent via the Asset Management listserv.

DOEA Notice Of Proposed Rule
The Florida Department of Elder Affairs has noticed the latest revisions to the Proposed Rules for Chapter 58A-5 relating to Assisted Living Facilities. The changes in this version reflect only those changes made after the last rule workshop.
If requested, a public hearing will be held on May 9th from 9:30 am to 11:30 am at DOEA in Tallahassee.
Not All Below Average
By John M. Hehn

"Polk's nursing homes below average in quality and care" is a misleading headline [March 31, A1]. There may be some below average but there are also some that are doing innovative, quality work. The governor's panel on excellence in long-term care awards a gold seal that recognizes nursing homes that demonstrate excellence in long-term care over a sustained period, promote stability of the industry and facilitate the physical, social and emotional well-being of nursing home residents. Florida Presbyterian Homes was one of the first six communities in the state to receive this prestigious award in 2001 and has received it continuously since 2006.
FloridaHealthFinder.gov Webinar
Sign up for a one hour webinar demonstration of the many resources available to providers on FloridaHealthFinder.gov. Please register for FloridaHealthFinder.gov Webinar on Friday, April 15, 2016 at 2:00 p.m. ET. Providers utilize our website to compare health outcome, pricing and performance measures; facility licensure information and inspection reports; view the Nursing Home Watch List and Gold Seal Facilities; and search our Medicaid Health Plan Report Card to compare health plan quality scores. Our new Assisted Living Facility Tool compares ALF performance measures. Use the Patient Data Query tool to generate trending reports on facility performance and charges with minimal clicks.
Notice Regarding Medicaid Provider On-site Activities
The purpose of this alert is to provide notice to Medicaid providers that employees from the Agency for Health Care Administration (AHCA) are authorized to have access to a Medicaid provider’s place of business and their Medicaid-related records, without prior notice. For more information about this authority, please see Section 409.907(3)(e), Florida Statutes, which requires providers to permit access to all Medicaid-related information. Employees from several organizational units within AHCA may present themselves at your offices, seeking the opportunity to conduct an on-site review. AHCA employees all carry an AHCA-issued identification badge that states their name, and the organizational office. This alert is specific to the authority granted to AHCA, which is typically invoked by the Office of the Inspector General (OIG), Bureau of Medicaid Program Integrity (MPI), under s. 409.913, Florida Statutes.

Act Now! Advertise 
In The LeadingAge Florida 2016 Membership Directory

Sign Up Now! Advertise in the 2016 Membership Directory. The directory will be distributed statewide to LeadingAge Florida members and hospital discharge planning departments. LeadingAge Florida works with E&M Consulting, as the official publisher of our 2016 Membership Directory. E&M Consulting provides advertising services to build your company’s image and link your brand with buyers in Florida aging services.

For more information, contact Mike Lindsay at (800) 572-0011. If you have questions, call Julie Copeland at (850) 702-0317.

2016 LeadingAge Awards
The LeadingAge Annual Awards honor individuals and organizations that embody excellence in not-for-profit aging-services leadership, are committed to quality, are models of care and service innovation, and are making outstanding contributions. Entry deadline is April 30, 2016.  In award categories open to LeadingAge members, only member aging-services organizations are eligible for consideration. Current members of the national LeadingAge Board of Directors and the Nominations and Awards Committee are not eligible for awards that recognize individuals.  To access the entry form, you will need to log in to your My.LeadingAge account. Your login will also enable sections of the application to be saved as they are completed.
VALUE FIRST
Saludos de Bobby Bernal… Hello From The Road With Value First!

I want to thank all of you that participated in the Nursing Home Survey Trends Workshop, especially our host community - The Mayflower. I had an opportunity to speak with a number of you regarding Value First opportunities in identifying savings and the many cost reports we undertake. Again, special thanks to The Mayflower for hosting the workshop and specifically Steve Kramer, Anne Cameron, and the rest of the staff at the Mayflower.

And I want to thank Wendy Ford and Yunior Hernandez of Oak Leaf Landings for their time in meeting with me on Friday after the workshop.

Let’s not forget we still have a few weeks remaining for the Special Group Buy with Sherwin Williams!


Specials From Our Value First Partners
Sherwin Williams:  Please see the new group-buy flier from Sherwin Williams for the months of March and April. To access special pricing you will need to have a L.O.P. on file. Please contact me if you need assistance.

Direct Supply: Trust Direct Supply to keep your large projects running smoothly. Please see the Capitol Projects Program by Direct Supply.


Value First's portfolio consists of over 400 vendors. To enroll, simply sign the Participation Agreement. This Participation Agreement is not a contract and does not bind you to buy anything. No minimum purchase is required. For more information, please contact Robert Bernal at (850) 671-3700 to start saving money now! To view a complete list of Value First vendors please CLICK HERE.

See you on the road
Bobby
PICTURE PAGES

Nursing Home Survey Trends Workshop
Connie Cheren speaks to a full room at The Mayflower in Winter Park during LeadingAge Florida's Nursing Home Survey Trends Workshop.

HE SAID: SHE SAID

As to methods there may be a million then some, but principles are few.
 
The man who grasps principles can successfully select his own methods.  The man who tries methods, ignoring principles, is sure to have trouble.  - Ralph Waldo Emerson
BE THE DIFFERENCE
There is something for everyone at the 53rd Annual LeadingAge Florida Convention & Exposition Convention.

Choose the perfect room in one of five locations at the luxurious Boca Raton Resort & Club and Boca Beach Club. Every room presents timeless sophistication, style and design. Enjoy views of the water and marina at the Yacht Club. Savor being near the pool at the Tower or the Pool Oasis located at Boca Beach Club. Enjoy peaceful accommodations in the centrally located Cloister or in the Bungalows at the edge of the historic resort golf course.



Registration is OPEN for the 53rd Annual LeadingAge Florida Convention & Exposition!


Silent Auction Donations – LeadingAge Florida will host a Silent Auction at the Annual Convention, and is requesting donations. Some ideas for donated items include: jewelry, books, gift certificates, theme baskets, sport memorabilia or make a cash donation and leave the shopping to us! Click here for more information on the donations.  LeadingAge Florida is a nonprofit educational charitable organization under Section 501(c)(3) of the Internal Revenue Code; therefore, your Silent Auction donation is fully tax-deductible.

Program Advertisements Available- Plan your involvement at the 53rd Annual LeadingAge Florida Annual Convention and Expo. Be sure to get the prime real estate in the Program. Click here for additional information or contact Julie Copeland at (850)702-0317.

2016 Exposition Registration- Our Expo provides opportunities for your products and services at our Annual Convention — excellent and cost effective ways to obtain new leads and reconnect with current clients. The Exposition will be held on Tuesday, July 26, 2016, for five hours. Refer to the Prospectus for Exposition logistics. To register online, please click here. For additional assistance, contact Julie Copeland at (850) 702-0317.

BY THE NUMBERS
As Retirement Nears, Boomers Have More Fears - 55 percent of boomers said they’ve saved for retirement, down from 58 percent last year and below the three-in-four in prior years.

Source: NextAvenue

   FILING CABINET

Jeff Hoffman Announced as LeadingAge Florida’s 53rd Annual Convention & Exposition Keynote Speaker: Global entreprenuer, Jeff Hoffman developed a philosophy saying it is important to create a mentality in the workplace of “I get to go to work” versus “I have to go to work.” In his keynote, Jeff will tell his stories of hard work, perseverance and vision coupled with the value of wonder and play. You won’t want to miss this author, philanthropist and serial entrepreneur who is changing the world one start-up at a time!

Early Bird Discount Ends April 15: Join your colleagues at Healthy Executive Transistions: When Succession Planning Isn't Enough Workshop on April 21, 2016, at Plymouth Harbor in Sarasota. 

Call for Nominations - At-Large Trustee Position: This notice is a request to encourage you to submit a nomination, or self-nomination, to run for a LeadingAge Florida Board of Trustees position.

Call for Nominations - Central Region Chair Position: This notice is a request to encourage you to submit a nomination, or self-nomination, to run for a LeadingAge Florida Board of Trustees position. The following position is open for candidates for a one-year term: Central Region Chair

Call for Nominations - Region Vice Chair Positions:
This notice is a request to encourage you to submit a nomination, or self-nomination, to run for a LeadingAge Florida Vice Chair position. The following positions are open for candidates: Southeast Region: Vice Chair, Membership; Southwest Region: Vice Chair, Advocacy & Vice Chair, Membership

Upcoming Events: We have more education workshops and webinars available throughout the year offering a variety of topics to fit the needs of your staff. Please return to our website often to see an updated list of events.


QUICK HITS— IN OTHER NEWS…
Mandatory Bundling: Are You Ready?
There were rumors of a delay to the start of the Centers for Medicare and Medicaid Services (CMS) Comprehensive Care for Joint Replacement (CJR) model and even a bill proposed by Georgia Reps Tom Price (R-GA) and David Scott (D-GA) to delay implementation to January 1, 2018. However, as of today, it moves forward as planned. Hospitals in 67 selected geographic areas are now the mandatory risk-bearing entity for lower extremity joint (hips and knees) replacements under the CMS Comprehensive Care for Joint Replacement (CJR) model. These hospitals are facing both upside and downside risk through annual reconciliations of target prices to actual expenditures over the five-year life of the model. Bundled joint replacement episodes include the hospitalization itself and all related Medicare Part A and Part B expenditures for 90 days post-discharge, including readmissions and post-acute care. For lower extremity joint replacements, both elective surgery and unplanned fractures are included in the risk-adjusted payment bundle. This is important because there can be different clinical trajectories between elective and unplanned joint replacements.
National Partnership to Improve Dementia Care & QAPI Call
Thursday, April 28 from 1:30 - 3:00 PM. This call focuses on infection control, highlighting Antibiotic Stewardship and community-wide efforts, including a presentation from a nursing home administrator. Common concerns related to the clash between individualized, person-centered care and the medical model of controlling infections will also be addressed. This is critical for residents with dementia, who often struggle to complete complex tasks and may have issues with continence. Additionally, CMS subject matter experts will share information about the upcoming Infection Control Pilot Project, as well as updates on the progress of the National Partnership to Improve Dementia Care in Nursing Homes and Quality Assurance and Performance Improvement (QAPI). A question and answer session will follow the presentations. Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the Continuing Education Credit Information webpage to learn more.
CMS Launches New Effort To Improve Care For Nursing Facility Residents
The Centers for Medicare & Medicaid Services (CMS) today announced it will test whether a new payment model for nursing facilities and practitioners will further reduce avoidable hospitalizations, lower combined Medicare and Medicaid spending, and improve the quality of care received by nursing facility residents. This next phase of the Initiative to Reduce Avoidable Hospitalizations among Nursing Facility Residents seeks to reduce avoidable hospitalizations among beneficiaries eligible for Medicare and/or Medicaid by providing new payments to practitioners for engagement in multidisciplinary care planning activities. In addition, the participating skilled nursing facilities will receive payment to provide additional treatment for common medical conditions that often lead to avoidable hospitalizations.  Through this model, CMS would facilitate practitioner engagement when a nursing facility resident needs higher-intensity interventions due to an acute change in condition. Medicare currently pays physicians less for a comprehensive assessment at a skilled nursing facility than for the same assessment at a hospital. 

Guidance From CMS On New Construction - Compliance With HCBS Settings Rule
The Centers for Medicare & Medicaid Services (CMS) released additional Frequently Asked Questions on implementation activities associated with the home and community-based services final regulation. Specifically, guidance is provided on how CMS will review requests to build new settings in categories that are presumed to be institutional in nature. The guidance also identifies the components of person-centered planning regulatory requirements that are in effect now and those that are part of the home and community-based settings transition period in effect through March 2019. This information is part of our ongoing effort to assist states in meeting regulatory requirements for residential and non-residential home and community-based settings.

Tennesse First State To Receive Approval Of Its HCBS Settings Rule Transition Plan
The final regulations for Home and Community-Based Services (HCBS) published January 26, 2014, require states operating section 1915(c) HCBS waivers or a section 1915(i) HCBS state plan benefit programs ( in effect on or before March 17, 2014) to submit a statewide transition plan (STP). The STPs provide CMS with details of how states determine their compliance with the regulation’s requirements for home and community-based settings at 42 CFR 441.301(c)(4)(5) and 441.710(a)(1)(2), and describe to CMS how, for settings that don’t yet meet the requirements, they will bring their HCBS systems into compliance with the new requirements. On April 13, 2016, CMS granted Tennessee final approval of their STP. Final approval was granted because the state completed both its systemic assessment and its site-specific assessment, included the outcomes of both assessments in the STP, outlined remediation strategies to rectify issues that both assessments uncovered, and laid out its heightened scrutiny, ongoing monitoring and relocation processes. Tennessee will need to provide quarterly written updates, and participate in quarterly phone discussions with the CMS team to review the state’s progress in implementing the STP. In addition, the state must work collaboratively with CMS to identify any areas that may need strengthening with respect to the state’s remediation, relocation, and heightened scrutiny processes as they implement each of the key elements of their state transition plan.
VIDEO: Provider Enrollment Revalidation- Cycle 2 MLN Connects® Call 03/01/16
During this Provider Enrollment Revalidation- Cycle 2 MLN Connects National Provider Call, CMS experts discuss the timing, improvements, and updates for the second round of Medicare enrollment revalidations required by the Affordable Care Act and 42 CFR §424.515.

VIDEO: Life Plan Community: A Paradigm Shift
Live panel and presentation with early adopters of Life Plan Community share research and insights as well as best practices of adoption of a new category name for CCRC.

Copyright 2016 — Publication of LeadingAge Florida
Chairman: Josh Ashby
President/CEO: Steve Bahmer
Managing Editor: Greg Ungru

Copyright Information: Copies of the articles and other information in this publication may be noncommercially reproduced for the purpose of educational or scientific advancement. Otherwise, no part of this publication may be reproduced or utilized in any form or by any means, mechanical or electronic, including photocopying, microfilm and recording, or by any information storage and retrieval system, without the written permission of the editor.

The information provided via this newsletter is is provided “as is” without representations or warranties, express or implied. LeadingAge Florida makes no representations or warranties in relation to the legal information on this website.