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Vol. 22 Issue 21


Nursing: Path to Excellence Workshop A Success - This past week 62 members from our nursing homes attended the Nurse Leadership workshop and heard Kim Smoak, QIDP, MSH, Chief of Field Operations for the Agency for Health Care Administration discuss the top 10 Federal survey deficiencies, myths versus reality about the survey process as well as results of the MDS/Staffing focused surveys. Connie Cheren, RN, MSW LeadingAge Florida’s Clinical and Compliance Specialist, presented to the attendees ways to ensure compliance with each of the top ten deficiencies. This included rounding, tracking and auditing, and a series of logs and systems.

Some of the comments about the workshop are:
    “Both speakers were phenomenal with their knowledge of their information. I learned more from this one conference than at any other conference or training sessions.”

    “One of the best conferences LeadingAge Florida has every put on. Multiple takeaways. Excellent presentation.”
A new video published by LeadingAge Florida and featuring Connie Cheren called “How to Be the Best of the Best” was presented to each nursing home. The video features ways to know your residents are meaningfully engaged, tips on how to be smarter than a surveyor, staffing recommendations, and restorative care for all residents.

CMS Extends Comment Period on RoPs Rule - CMS is extending /reopening the comment period for the Requirements of Participation Proposed (RoPs) Rule. The new deadline is October 14 for input on Reform of Requirement for Long-Term Care Facilities.

CMS appreciates all the hard work and comments that have been submitted thus far. They will continue to work on this proposed rule and remain interested in receiving any additional comments. For more information and instructions on how to submit comments, please click here.

LeadingAge Comments on CMS Comprehensive Care for Joint Replacement Demonstration (Jill Sumner, LeadingAge) - After carefully reviewing the proposed rule on the creation of the Comprehensive Care for Joint Replacement and its potential impact on our members and those they serve, LeadingAge filed comments with the Centers for Medicare and Medicaid Services (CMS). Please click here to view the proposed rule. To view the comments filed by LeadingAge, please click here.

Our comments discussed the following issues:

  • Our support for the transition to a reimbursement system based on payment for value instead of payment for volume.
  • CMS ensuring that bundling does not incentivize providers to select only those patients who have the best chance of successful recoveries using the fewest, least expensive services. Risk adjustment factors must be applied reflecting both patient and provider characteristics.
  • Ensuring the 5-Star Nursing Home rating system is not used to determine which skilled nursing facilities would be best able to manage joint replacement patients. The 5-Star system contains only 1 measure, on pain management, that would apply to these patients, and it does not include measures of hospital readmissions or emergency room use -- both of which would be far more applicable.
  • Protecting Medicare beneficiaries' choice of post-acute providers under the final rule.
  • Ensuring that CMS allows more time for hospitals and post-acute care providers in the selected areas to prepare for bundling.

CMS will review and consider all public comments submitted on the proposed bundling demonstration before issuing a final rule.

About the Comprehensive Care for Joint Replacement Proposed Rule

The Centers for Medicare and Medicaid Services (CMS) announced the creation of the Comprehensive Care for Joint Replacement, a new demonstration that would make participation in bundled payment for lower extremity joint replacement (LEJR) mandatory in 75 geographic areas across the country.

Most hospitals in the demonstration region would be responsible for managing the care and costs across provider types for patients undergoing LEJR.

Hospitals participating in the Bundled Payment for Care Improvement demonstration Model 1 or Phase II of Model 2 or 4 for LEJR would be exempt.

What Joint Replacement Demonstration Means for LeadingAge Members

Under the demonstration, providers will be required to accept both upside and downside risk for patient outcomes through 90 days post discharge.

As a result, LeadingAge providers in demonstration regions could see significant changes in processes for transitions of care and pressure for shortened length of stay for patients receiving therapy related to LEJR.
However, the opportunity exits to seek out meaningful partnerships with hospitals required to participate in the demonstration.

The need for high quality, efficient post acute care providers will be marked.

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