National Nursing Home Week

“Love is Ageless” is this year’s theme for National Nursing Home Week, May 11-17, 2008. The theme encourages facilities to recognize those whose compassion, acts of kindness and love of life inspire and exemplify a caring community of residents, families, friends, staff, consultants and volunteers.

The Planning Guide for the event, produced by the American Health Care Association (AHCA), includes activity ideas to help facilities celebrate and demonstrate the quality of care provided in nursing facilities. Activities are designed to give ample opportunity for all who are involved in a facility to foster and maintain a loving environment; a place where our elders and persons with disabilities can trust and be happy with all residents and those who care for them. AHCA member facilities will receive a Planning Guide in March. A web site (www.nnhw.org) is being developed which will include a downloadable copy of the planning guide as well as templates, sample press releases and more.

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  Fire Marshal Updates

"Five Minutes to Fire Safety"

Kenya Patzer with the Kansas State Fire Marshals Office will be updating providers on Life Safety Code issues.  She will produce a one-page PDF document, available via email and on the State Fire Marshals website at http://www.accesskansas.org/firemarshal/FirePrevention/preventionhome

To sign up via email please contact Kenya at 785-296-3802. The first topic will explore various online resources. Future topics will explore individual K-Tags, tips on maintaining documentation, ideas for fire drills and equipment checks, and other topics pertinent to fire safety.

The hope is that "Five Minutes to Fire Safety" will provide facilities with a bit more information and the occasional reminder for fire safety requirements.

Life Safety Code Revisits

A reminder from Brenda Mc Norton, Chief of Fire Prevention, as of January 25, 2008 the Fire Marshals office will no longer be conducting revisits at the healthcare facility unless a facility is cited for a deficiency with a S/S greater than an “F”.  
  
They advise facilities at their exit interview to do the following:
 
* Mail and/or fax their POC to KSFM within 10 days from date of survey, along with all waiver requests.
* Remind the facility they have 30 days to correct the deficiencies, unless they submit a waiver request.
* Submit photos and/or invoices to KSFM office as soon as the work is complete for ALL DEFICIENCIES CITED (except those tags that have waiver requests).
* The K-tag number is required to be clearly marked on each photo and/or invoice submitted.
* Enforcement inspector will review photos and/or invoices and will advice facility if documentation is acceptable or not in order to clear all deficiencies.
 
Please contact Brenda at 785-296-3401 with any questions. 

Helpful Hints When Documenting Your Fire Scenario On Your Fire Drill Record
 
Your documentation should include:
 
Where the fire is?
Who located the fire?
Did the employee/person acted as stated in your policy and procedures?
What type of fire it was it?   (i.e. electrical, grease, paper, material etc.)
Document those that were present?  (staff)
Which person called the “Code Red” upon finding the fire?
Did they used an extinguisher or evacuated a hall?
Where did they evacuation too?   (i.e., behind fire doors, or outside)
What amount of time did it take to secure effected area?
What resident might have been a part of the fire scenario?
Documentation any changes required during the drill procedure.
 
If you have any questions please ask your inspector or email me at mcnortob@ksfm.state.ks.us 
 
Recall Alert!

Alert! A potential fire hazard involving wall heating unit electrical plugs.  The plugs are under a voluntary recall by the manufacturer “McQuay.”  The information below is from a nursing home fire report January 2008.  A similar event occurred at another nursing home in November 2007:   

Fire incident at the electrical plug for the PTAC unit.  Staff member removed occupant(s) and pull the fire alarm. Staff used a fire extinguisher on the PTAC unit and plug.
Fire was contained to the plug unit of the PTAC unit.  The plug was designed with the GFI built into the plug.

The PTAC unit was a McQuay brand and the plug had the letters TRC on the front and the Model # was 37190 and had listed on the back-"Made in China".

The plug had melted down to a point where the electrical plug points and wiring were all that remained. The staff member saw a bright flash of light and smoke that alerted her to the problem.

The Maintenance Director looked at other PTAC units and found two more electrical plugs that were showing overheating problems and brown heat spots adjacent and around the electrical plug blades and on top of one of the plug units.  They cut these off those units.

Damage held to the PTAC unit and a small wall area above the right side of the unit that was smoke stained. 

More info:
PTAC-Personal Temperature Air Control or Conditioner.
Plug shows Canadian Certified but we could not find any U.L. number on the plug.
Plug did state made in China.

The additional plugs and the plug that melted did show signs of electrical pitting on the hot lead blade of the plug.
The system is a 220-V system.

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  Life Safety Code Issue
--provided by the Iowa Health Care Association

Comments below provided by the Iowa Health Care Association.

Just recently a new issue popped up regarding life safety.  The State Fire Marshall cited one of our member facilities under K51 (citing NFPA 72) when the strobe lights did not continue after the fire alarm was silenced but not yet reset.  The local Fire Inspector told our member that this was a result of a federal look behind and was required by the Region 7 office.  This same member said he called his alarm company and they told him they are getting a lot of calls on this issue.  This would cost facilities a couple thousand dollars to change.

We immediately contacted Tom Jaeger – AHCA’s National Life Safety expert to obtain an opinion.  Tom Jaeger’s opinion is contrary to the Iowa Fire Marshall and Region 7’s direction.  Tom’s professional opinion is that NFPA 72 actually requires just the opposite, that is the visible signal must be silenced when the audible signal is silenced.   He further stated the notification signal is the alarm signal in the building that notifies occupants that the fire alarm signal has been activated; the notification signal is addressed in Section 1-5.4.8 of the 1999 NFPA 72 and contains no requirement that the visual signal must activate when the audible signal is silenced in accordance with Section 1-5.4.8.    Tom states that a facility would actually be violating the ADA if the visual alarm notification appliances were required to continue to operate when the audible notification appliances are silenced.  Please see Section 4.4.3.7.2 “when an alarm signal deactivation means is actuated both the audible and visible notification appliances shall be simultaneously deactivated.”  Tom points out that the 2007 edition goes on to state in Section A4.4.3.7 that it is the intent of the NFPA 72 that when one is turned off both have to be turned off or you would be in violation of the ADA. 

We wanted to give you all a heads up on this issue to let your membership know about this potential deficiency and to make sure to challenge any such deficiencies cited.  I am attaching a copy of NFPA 72 Tom sent us. 

NFPA 72    (information from Tom Jaeger)

JAEGER & ASSOCIATES, LLC
11902 Holly Spring Drive
Great Falls, Virginia 22066           
T (703)-433-5880
F (703)-433-5888
C (703)-674-6379
Tjaeger1@aol.com

Extract from 1999 NFPA 72

 
1-5.4.8 Alarm Signal Deactivation.
A means for turning off activated alarm notification appliances shall be permitted only where it is key-operated, located within a locked cabinet, or arranged to provide equivalent protection against unauthorized use. Such means shall be permitted only if a visible zone alarm indication or the equivalent has been provided as specified in 1-5.7.1, and subsequent actuation of initiating devices on other initiating device circuits or subsequent actuation of addressable initiating devices on signaling line circuits cause the notification appliances to reactivate. A means that is left in the “off” position when there is no alarm shall operate an audible trouble signal until the means is restored to normal. If automatically turning off the alarm notification appliances is permitted by the authority having jurisdiction, the alarm shall not be turned off in less than 5 minutes.
Exception No. 1:  If otherwise permitted by the authority having jurisdiction, the 5-minute requirement shall not apply.
Exception No. 2:  If permitted by the authority having jurisdiction, subsequent actuation of another addressable initiating device of the same type in the same room or space shall not be required to cause the notification appliance(s) to reactivate.

1-5.7 Zoning and Annunciation.
1-5.7.1 Visible Zone Alarm Indication.
If required, the location of an operated initiating device shall be visibly indicated by building, floor, fire zone, or other approved subdivision by annunciation, printout, or other approved means. The visible indication shall not be canceled by the operation of an audible alarm silencing means.

Extracts from 2007 NFPA 72
 
4.4.3.7* Alarm Signal Annunciation

4.4.3.7.2 When an alarm signal deactivation means is actuated both audible and visible notification appliances SHALL(emphasize added) be simultaneously deactivated.

A4.4.3.7 It is the intent that both visual and audible appliances are shut off when the signal silence feature is activated on the fire alarm control panel.
Per the ADA, it is important not to provide conflicting signals for the hearing impaired.

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  CMS Clarifies Use of Interpretive Guidelines

Surveyors Must Cite All Deficiencies Based On a Violation Of Statutory and/or Regulatory Requirements

The Centers for Medicare & Medicaid Services (CMS) has been asked to clarify the use of the Interpretive Guidance to Surveyors for Long Term Care Facilities in reviewing for compliance with the regulatory requirements for nursing homes.  Surveyors must cite all deficiencies based on a violation of statutory and/or regulatory requirements.

In providing new interpretive guidance, CMS is careful not to prescribe new requirements. Instead, the focus is on relaying to surveyors information consistent with the regulations and accepted standards of care. There are portions of the interpretive guidelines that specify such things as permissive duties or tools that facilities may be using to care for residents. Permissive duties are not requirements, and the lack of use of any particular tool does not, by itself, constitute sufficient grounds for the citation of a deficiency. 

An example of a permissive duty is found in the guidance for 42 C.F.R. § 483.25(c) Pressure Sores. One section of this Guidance refers to repositioning as a common and effective intervention for individuals with a pressure sore or who are at risk of developing one. The Guidance provides, “The care plan for a resident at risk of friction or shearing during repositioning may require the use of lifting devices for repositioning.” This sentence indicates a permissive action by the facility but does not create a requirement that facilities use lift devices in order to prevent pressure sores, as the facility may have other interventions in place to avoid shearing and friction. The lack of use, by itself, does not create a deficient practice for a facility. Words like “should” or “may” create permissive standards, vs. words like “shall” and “must” that indicate requirements.

Surveyors should refer to SOM Section 2712 Use of Survey Protocols in the Survey Process and Principle #5 in the Principles of Documentation for clarification in using information found in the interpretive guidelines. Both sources make it clear that surveyors must base all cited deficiencies on a violation of statutory and/or regulatory requirements, rather than sections of the interpretive guidelines. The deficiency citation must be written to explain how the entity fails to comply with the regulatory requirements, not how the facility fails to comply with the guidelines for the interpretation of those requirements.

State Operations Manual, § 2712 reads, in part, “Included in the survey protocols are interpretive guidelines that serve to interpret and clarify the CoPs, conditions for coverage, and requirements of participation for specific types of entities. The interpretive guidelines contain authoritative interpretations and clarification of statutory and regulatory requirements and are to be used to make determinations about a provider’s compliance with requirements. These interpretative guidelines define or explain the relevant statutes and regulations and do not impose requirements that are not otherwise set forth in statute or regulation.

Principles of Documentation, Principle #5 reads, in part, “The deficiency citation demonstrates how the entity fails to comply with the regulatory requirements, not how it fails to comply with the guidelines for the interpretation of those requirements. These Guidelines were designed to assist surveyors to develop a better understanding of the requirements, to apply these requirements in a consistent manner across entities, and to suggest pathways for inquiry.

Although surveyors must use the information in Guidelines, they must be cautious in their use. Guidelines do not replace or supersede the law or regulation, and therefore, may not be used as the basis for a citation.

CMS Guidance--Use of Interpretive Guidance by Surveyors of Long Term Care Facilities--Read document

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  QIS
QIS Draft evaluation study

AHCA received a draft copy of the final QIS evaluation study.  CMS has not yet released this study although we understand that it will be released later this month.  The study was conducted by Abt Associates, Inc.  The study is attached as well as a brief summary of the evaluation findings.  The summary document also contains a review of the last chapter in the report, which was written by Dr. Andrew Kramer, one of the primary designers of the QIS process.

Evaluation of the Quality Indicator Survey (QIS)
Summary of the Final Draft Report

 Note:  The information in this document is taken either directly from or is paraphrased from “Evaluation of the Quality Indictor Survey (QIS): Final Report,” Abt Associates Inc., December 2007. Chapter 8 of this report is written by Andrew M. Kramer, M.D., the Head of the Division of Health Care Policy and Research at the University of Colorado at Denver and Health Sciences Center. While not part of the Abt evaluation, Dr. Kramer was invited to contribute this chapter, which reflects his experiences with the QIS.

This is a summary of the draft evaluation and does not reflect any opinion that the American Health Care Association has regarding the Quality Indicator Survey.  Click here to read.
________________________________________________________________________

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  CMS updates

The NPI is here.  The NPI is now.  Are you using it?
 
Important National Plan and Provider Enumeration System (NPPES) Information for
Organization Providers
When organization health care providers apply for NPIs, it is important that
they enter their correct legal business name and Employer Identification Number
(EIN). 
NPPES will be establishing a verification process with the Internal Revenue
Service (IRS) to verify the legal business name and the associated EIN submitted
on the NPPES applications and updates. Providers will be notified as CMS
develops and implements this process.  In the meantime, CMS encourages providers
to be proactive and verify that this information is correct in order to avoid
any potential issues in the future.
 
Important Information for Medicare Providers
 
Importance of “Complete” Medicare Provider/Supplier Enrollment Applications
Correcting your 855 enrollment form can be critical to assuring your claims are
processed.  We are urging providers to avoid delays in 855 processing that are
caused by missing or incomplete information.
 
CMS has instructed its Medicare Fee-For-Service (FFS) contractors to process
complete Medicare provider/supplier enrollment applications that contain all
supporting documentation, including the electronic funds transfer authorization
agreement (CMS-588) and licensing information, within prescribed processing
timeframes.  Incomplete or incorrect application information will result in an
extension of these processing times for as long as it takes to obtain the
correct information from the provider. This wastes precious time, especially for
those seeking to rectify NPI/legacy conflicts and poses unnecessary work for
both the contractor and the provider.

For an enrollment application to be considered complete:
  All applicable sections of the CMS-855 and fields, including check boxes,
  within a section must be filled-out at the time of filing,
  The application must contain an original signature (blue ink is preferred) and
  date of signature (blue ink is preferred), and
  The application must be accompanied by all supporting documentation listed in
  section 17 of the enrollment application.

Make Sure you Understand the Key Dates: New MLN Matters Article Now Available
The latest NPI-related MLN Matters Article is now available and illustrates
information, in chart form, regarding the difference between the March 1st and
May 23rd FFS Medicare NPI implementation dates.  Visit
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0802.pdf to view this
article.
 
REMINDER for FFS Medicare Physicians, Non-Physician Practitioners & Other
Suppliers
Effective March 1, 2008, all 837P and CMS-1500 claims must have an NPI or
NPI/legacy pair in the required primary provider fields.  Failure to include an
NPI will cause the claim to reject.
Visit the CMS NPI web page at
http://www.cms.hhs.gov/NationalProvIdentStand/02_WhatsNew.asp for more details.
 
TEST NPI-only NOW: If you have been submitting claims with both an NPI and a
Medicare legacy number and those claims have been paid, you need to test your
ability to get paid using only your NPI by submitting one or two claims today
with just the NPI (i.e., no Medicare legacy number).  If the Medicare NPI
Crosswalk cannot match your NPI to your Medicare legacy number, the claim with
an NPI-only will reject. You can and should do this test now!  If the claim is
processed and you are paid, continue to increase the volume of claims sent with
only your NPI.  If the claims rejects, go into your NPPES record and validate
that the information you are sending on the claim is the same information in
NPPES.  If it is different, make the updates in NPPES and resend a small batch
of claims 3-4 days later.  If your claims are still rejecting, you may need to
update your Medicare enrollment information to correct this problem.  Call your
Medicare carrier, FI, or A/B MAC enrollment staff or the National Supplier
Clearinghouse for advice right away. Have a copy of your NPPES record available.
 The enrollment telephone numbers are likely to be quite busy, so don't wait. 
 
 
Need More Information?
Not sure what an NPI is and how you can get it, share it and use it?  As always,
more information and education on the NPI can be found through the CMS NPI page
www.cms.hhs.gov/NationalProvIdentStand on the CMS website.  Providers can apply
for an NPI online at https://nppes.cms.hhs.gov or can call the NPI enumerator to
request a paper application at 1-800-465-3203.  Having trouble viewing any of
the URLs in this message?  If so, try to cut and paste any URL in this message
into your web browser to view the intended information. 
 
Note: All current and past CMS NPI communications are available by clicking "CMS
Communications" in the left column of the www.cms.hhs.gov/NationalProvIdentStand
 CMS webpage.

 *  * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
New from the Medicare Learning Network!
 
New MLN Quarterly Journal Ad—Guided Pathways -- This quarter’s journal ad
features a new product, Guided Pathways.  Guided Pathways has been developed as
an educational tool for fee-for-service (FFS) health care staff who are
relatively unfamiliar with the Medicare Program, as well as for those
professionals looking for easy access to the many resources on the CMS website. 
Using a “road trip” motif, the pathways lead users through nine broad sections
of information covering the Medicare Program, with links to further pertinent
information.  The pathways also provide links to other government resources
pertaining to Medicare FFS items.
 
Each calendar quarter, the Medicare Learning Network creates a journal
advertisement based on an initiative or new product of particular importance
during that time frame.  National, state and local associations are encouraged
to use this journal ad in their publications and/or newsletters and websites, as
appropriate.
 
The files for this quarter’s ad, as well as future ads, can be found at
www.cms.hhs.gov/MLNGenInfo on the CMS Website.  Once on the page, click on
Quarterly MLN Journal Ad (zip file) in the Downloads Section
 
#   #   #   #   #   #
 
The following products are now available in downloadable format from the Centers
for Medicare & Medicaid Services Medicare Learning Network:
 
  The revised Medicare Physician Fee Schedule Fact Sheet (January 2008), which
  provides general information about the Medicare Physician Fee Schedule, can be
  accessed at
  http://www.cms.hhs.gov/MLNProducts/downloads/MedcrePhysFeeSchedfctsht.pdf .
 
  The revised Skilled Nursing Facility (SNF) Spell of Illness Quick Reference
  Chart (January 2008), which provides Medicare claims processing information
  related to SNF spells of illness, can be accessed at
  http://www.cms.hhs.gov/MLNProducts/downloads/SNFSpellIllnesschrt.pdf .
 
  The Hospital Outpatient Prospective Payment System Fact Sheet (revised January
  2008), which provides general information about the Hospital Outpatient
  Prospective Payment System, ambulatory payment classifications, and how
  payment rates are set, is now available in downloadable format from the
  Centers for Medicare & Medicaid Services Medicare Learning Network at
  http://www.cms.hhs.gov/MLNProducts/downloads/HospitalOutpaysysfctsht.pdf .  
 
 *  * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
DMEPOS Accreditation Quality Standards
 
The Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
Accreditation Quality Standards have been posted for a 30-day public comment
period only on the underlined/highlighted portions of the document.  Comments
must be received electronically or by mail no later than 5:00 P.M. E.S.T., on
Tuesday, March 18, 2008.  The guidelines on how to submit your comments are
located on the following web page:
http://www.cms.hhs.gov/MedicareProviderSupEnroll/03_DeemedAccreditationOrganizations.asp.
 
 *  * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Flu Shot Reminder
 
It’s Not Too Late to Give and Get the Flu Shot!
In the U.S., the peak of flu season typically occurs anywhere from late December
through March; however, flu season can last as late as May. Each office visit
presents an opportunity for you to talk with your patients about the importance
of getting an annual flu shot and a one time pneumococcal vaccination.  Protect
yourself, your patients, and your family and friends by getting and giving the
flu shot. Don’t Get the Flu. Don’t Give the Flu. Get Vaccinated!
 
Remember - Influenza and pneumococcal vaccinations and their administration are
covered Part B benefits.  Note that influenza and pneumococcal vaccines are NOT
Part D covered drugs.  You and your staff can learn more about Medicare’s
coverage of adult immunizations and related provider education resources, by
reviewing Special Edition MLN Matters article SE0748 
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0748.pdf on the CMS
website.”
 
 

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  Kansas Department on Aging
Aging Updates

Rebasing

Before submitting a request for rebase of assets please remember:

1.  Dollar thresholds:  $25K for facilities with 50 or less beds and $50K for facilities with 51 or more beds.
2.  Include a current depreciation schedule.
3.  Include invoices for all assets and loan document with amortization schedule for interest.
4.  Include assets purchased for the Nursing Facility only, do not include assets for Apartments, Assisted Living or other non-NF facilities.
5.  The Real and Personal Property Fee is limited as determined by KDOA prior to each new State Fiscal Year.
6.  Assets must have been acquired no longer than 24 months prior to KDOA receipt of rebase request.
7.  Allowed to include request for construction in progress with sufficient documentation.
8.  Reference KDOA regulation 30-10-25. 
9.  Vehicle rebasing is limited by 30-10-23a.

CARE

When accepting a resident as an “emergency admission” the in-house trained CARE assessor needs to fax:
  1- the emergency  memo -
  2-completed sections Columns 1 and 2 of the CARE assessment
to local Area Agency on Aging CARE Coordinator on the NEXT    WORKING DAY.
 
The AAA CARE Coordinator will then assign a trained assessor to come
out and do the CARE assessment within 5 working days.

If the resident needs Medicaid as a payor source the DATE OF PAYMENT for nursing facility care for the resident will BEGIN with the DATE on the CARE assessment. 

When we are asked to authorize functional eligibility for Medicaid payment and we find a CARE has never been done, payment will begin-if the resident functionally qualifies - from the date the CARE is completed forward. 

AAA CARE coordinator’s have 5 working days from the time they
receive a request  for a CARE assessment to assign and it be done..   It is possible for them to be in compliance and you to wait up to 10 days for the CARE to be done.
Example: call made 4:30pm on Friday;  Monday is a holiday; the 5 day count BEGINS on Tuesday, Wednesday, Thursday, Friday - the next Monday is the last day … you have cared for a resident for 10 days during which you will be unable to receive Medicaid payment. 

PLEASE - call the NEXT working day, in the morning! The CARE
Coordinators will know when you made contact; if the Nursing Facility calls for the assessment timely KDOA can authorize payment accordingly.
A wait of several days before initiating the call for the CARE assessment does often result in the facility losing payment days. 
Medicaid can not issue payment for a resident without PASRR compliance.
    

Mental Health Transfers

Please be advised that there is a workshop, sponsored by Sunflower Health Network Inc., about mental health transfers.  You can get more information about the seminar from Heather Fuller at hfuller@srhc.com 

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  Part A Provider Information

Dear Kansas Part A Provider,

On September 5, 2007, the Centers for Medicare & Medicaid Services (CMS) announced Wisconsin Physicians Service (WPS) is the Medicare Administrative Contractor (MAC) for Iowa, Kansas, Missouri and Nebraska. 

The award is part of a Congressional requirement to replace all current Medicare Part A and B contracts with new contract entities called Medicare Administrative Contractors, or MACs.  As a MAC, WPS will serve as a single point-of-contact entity, processing Medicare Part A and Part B claims from hospitals and other institutional providers, physicians, and other practitioners within this four-state region.  The new single contract replaces the existing six contracts. 

With the award of the J5 MAC, WPS is excited to begin administering your claims beginning March 1, 2008.  We have developed the following information to help answer any questions that you may have regarding this implementation. 

Customer Service Phone Numbers
Beginning March 1, 2008, you should begin to use the following customer service phone numbers:

Direct Data Entry/ Remote Line (password reset) (866)518-3251
Direct Data Entry (questions)    (866)518-3295
Claims Correction      (866)518-3253
Medicare Secondary Payer (Credit Balance)  (866)518-3254
Medicare Secondary Payer (Claims)   (866)518-3284
Provider Customer Service (Inquiry)   (866)518-3285
Customer Service Voice Response Unit (VRU) (866)518-3291
Teletypewriter (TTY)     (866)518-3293
Electronic Data Interchange (EDI)   (866)503-9670
Appeals      (866)518-3298
Audit and Reimbursement    (866)734-9444 
Finance       (866)734-1522

Provider Customer Service Hours of Operation
The Provider Customer Service area hours of operation are 8:00 a.m. to 5:00 p.m. Central Standard Time, Monday through Friday.  Our Provider Customer Service will assist with questions regarding Medicare billing, coverage of specific items or services, or general Medicare enrollment questions.

Mailing Addresses
The following mailing addresses should be used when correspondence is being sent to WPS:

Provider Audit (including checks associated     WPS Medicare Part A
with the submission of cost reports):      P.O. Box 8310
Provider Enrollment:       Omaha, NE 68108-0310

EDI Correspondence:       WPS Insurance
         EDI Department
         1717 W Broadway
         Madison, WI  53713

Administrative Checks to include PS&R, and   WPS Medicare Part A
Part A workshops:       P.O. Box 8310
         Omaha, NE 68108-0310

All other checks:       WPS Medicare Part A
         P.O. Box 8810
         Marion, IL 62959-0900
       
All other correspondence:      WPS Medicare Part A
         P.O. Box 7576
         Madison, WI 53707-7576

855 Enrollment Forms
You do not need to fill out an 855 Enrollment Form.  This information will be provided to us prior to implementation.

Electronic Data Interchange (EDI) Enrollment
If you are currently enrolled to submit EDI transactions to Medicare you will not have to re-sign an EDI Enrollment Form for implementation.  Blue Cross and Blue Shield of Kansas will provide us with your existing Enrollment Form at the time of implementation. 

Providers that will submit EDI claims directly to WPS will need to complete a self-registration process on our WPS Trading Partner System (WTPS) to prepare for transaction testing and production claim submission.  WTPS is located at: http://corp-ws.wpsic.com/apps/wtps-web/unauth/wtps.do.  If your office submits EDI claims through a clearinghouse, your clearinghouse will need to register on our WTPS application. 

After you complete registration on WTPS, we will send you the appropriate submitter ID and password information to connect to our WPS Bulletin Board System (BBS) through asynchronous telecommunications, along with our BBS user guide.  If you use a clearinghouse, we will coordinate this information through your clearinghouse. 

Providers without Internet access may register by contacting us at 1-866-503-9670.

For further information regarding EDI changes, please check our website at: http://www.wpsic.com/edi/med_macj5.shtml

PC-ACE Pro32
We offer free billing software for providers to submit electronic claims and will continue to use this software in the future.  The software is PC-ACE Pro32 and is available on our Website at http://www.wpsmedicare.com/part_a/business/pcacepro32.shtml. 

If you currently use PC-ACE software to submit your claims, you may continue to use your current PC-ACE version to send claims to WPS after implementation.  You will need to establish connectivity with the WPS Bulletin Board System (BBS).  For more information, please contact the Electronic Data Interchange area at 1-866-503-9670.  

Electronic Fund Transfer (EFT) Remittance Advices
WPS Medicare will execute new EFT agreements with all new Kansas providers.  Letters have been sent out regarding these agreements.  For more information, please contact the Medicare Part A Finance area at (866)734-1522.

J5 MAC Local Coverage Determinations (LCDs)
On December 15, 2007, consolidated LCDs were posted to our Website for the 45 day notice period.  These J5 MAC LCDs will be posted as Final LCDs and will become effective on February 1, 2008.  You should begin to use these Final LCDs beginning March 1, 2008.

Cost Reports
For submission of any correspondence related to cost report issues (i.e. submission of cost reports, cost report checks, supporting documentation, rate review requests, etc.) mailed on or after Thursday, February 28, 2008, please submit these to the following address:

WPS Medicare Part A
P.O. Box 8310
Omaha, NE 68108-0310

To utilize an overnight delivery service to submit cost report correspondence, please send to the following address:

WPS Medicare Part A
3333 Farnam Street
Omaha, NE 68131

1099 Forms
You will receive two 1099 forms for 2008.  One will come from Blue Cross and Blue Shield of Kansas and the other will come from WPS.

Cutover Information

Cutoff date for the submission of EMC and paper bills, redetermination requests,  audits, etc. to the outgoing contractor
02/28/08

Electronic claims  must be received by 2:00PM

Last day the outgoing contractor will make bill/claim payment
02/28/08

Last day the outgoing contractor will have telephone, lobby and contact station service for providers and beneficiaries
02/28/08

Last date for cost reports and cost report appeals
02/28/08
System Dark Day-EDI and payment systems will not be available.  No Provider Customer Service calls will be taken.
02/29/08
The first day the MAC will accept paper claims
02/29/08
The first day the MAC will accept EMC claims
03/01/08
The date when the MAC will begin the bill/claim payment cycle
03/03/08

Additional information regarding your March 1, 2008 implementation can be found on our Website at www.wpsmedicare.com by accessing the J5 MAC link, accepting the license agreement, and clicking on the Select this link for J5 Implementation Information from the J5 MAC Home Page.

Again, we are looking forward to begin administering your claims and working with you in the future.

WPS Medicare

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  Kansas Center for Assisted Living News
2008 Board elected

2008 KCAL Board

Chairperson--Bev Blassingame
Rolling Hills Assisted Living, Topeka

Vice-Chair--Joleen Klausman
Lexington Park Assisted Living, Topeka

Secretary/Treasurer--Rachel Storm
Cedar Lake Village, Olathe

District 1--Joe Perkin
Midwest Health Management

District 2--Shelley Gromer
Guest Homes Estates, Pittsburg

District 3--Ken Hartle
Linnwood Place, Valley Falls

District 4--Brenda O'Gorman
Eaglecrest Retirement, Salina

District 5--Elaine McDaniels
Cherry Creek Village Retirement, Wichita

District 6--Steve Dawson
Carriage House, Greensburg

At-Large- Susan Korthanke
The Gran Villas, Hiawatha

Thanks for all of you willing to serve.

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  NCAL Guiding Principles

The National Center for Assisted Living approved the following three documents  January meeting.  The first document is NCAL’s general guiding principles for assisted living.  This is an updated version of guiding principles document that NCAL first released in 2000.  The other two documents are new and contain NCAL’s guiding principles on quality and consumer disclosure. 

NCAL’s Board and committees spent a considerable amount of time developing these guiding principles.  The principles establish a strong philosophical foundation for the myriad policy and operational issues facing the assisted living profession today and in the future.  We hope to use the documents in our state advocacy efforts and share these documents with others.

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  Assisted Living Medication Management Issues

A recent symposium by the Center for Excellence in Assisted Living (CEAL) was held in Washington DC.  The February NCAL Focus article is quoted, " Medication use among residents of assisted living facilities has reached critical mass..."

Medication management rules and regulations are currently under review with the Kansas Department on Aging.

A study was released by Susan Reinhard, MSN, director of the Washington DC based AARP Public Policy Institute, revealed more than 77 percent of the residents needed assistance with medications.

Click here to read Reinhard study.

The biggest concern the KCAL board has expressed to the Department on Aging is keeping in mind the resident needs in mind, having as much autonomy as possible.  We have great dialogue going with aging and hope to continue.  If you have any suggestions, please contact your KHCA/KCAL staff.

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  Gary Ingenthron Retiring!!

Gary Ingenthron will be retiring from the Kansas Department on Aging in April.  After 41 years of service, he plans to spend time with a new grandchild and doing what he loves.  Gary will be greatly missed.

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  Long Term Care Pre-Conference Details
Exceptional Nurse Leader Workshop

Radiating Excellence a training workshop done in cooperation with the American Health Care Association, focusing on the assessment of the specific leadership roles and competencies essential to nurse leaders working in skilled nursing, assisted living and residential homes is coming to the Long Term Care Nurse Pre-Conference Day.

You will gain top quality training from a superior training team.  The workshop will establish "universal requirements" for leadership and will guide senior nurse leaders to identify what it takes to be a strong leader.

You will benefit from things such as:

Comprehensive understanding of nursing leadership in long term care

Objective validation and recognition of leadership performance

Increased confidence and job satisfaction

Enhanced relationships with staff, residents and families

Tools to guide targeted leadership development

Be watching your mail for the details.  The Radiating Excellence workshop will be during the pre-conference day of the Long Term Care Nurse Conference.  If you would like more information, contact Linda MowBray.
lmowbray@khca.org.

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Jobs and Board positions

KHCA will soon have a Career Center available on our website.  You will be able to post job openings and also post resumes!

Kansas Health Care Association has been asked to submit names for the Speech-Language Pathology and Audiology Advisory Board.  The positions to be filled include:  one licensed speech-language pathologist, one licensed audiologist, one licensed physician and one member of the general public.  The deadline for nominations is Friday, February 29, 2008.  Please let Cindy Luxem know if you are interested or would like to nominate someone.

Director of Nursing  Great opportunity for a successful Director of Nursing to lead a flourishing 100-bed Skilled Nursing Facility in Salina, KS.  Very competitive salary and benefit package.  Looking for someone who knows long term care systems and regulations.  This key position requires a positive, professional to lead all aspects of the nursing department.  The D.O.N. will design, implement, and evaluate patient care programs and requires exceptional knowledge of the Minimum Data Set process.

To apply for this position please send your resume to mbosley@slccrc.com.

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