OPPOSE $18 Billion in Medicare Cuts!! Action Needed Today.

Ask Your Members of Congress to Oppose SNF Payment Cuts Today!

Ask Your Senator to Send a Letter to Secretary Sebelius and Your U.S. Representative to Sign on to the Berkley-Capito-Pomeroy Dear Colleague Letter

Ask your Members of Congress to OPPOSE the $18 billion in SNF Medicare cuts recently proposed by the Centers for Medicare and Medicaid Services (CMS). There are only 5 days left until the June 22nd deadline. Therefore, you must ask your Senators and U.S. Representatives to communicate this message to Health and Human Services Secretary Kathleen Sebelius. Please do two things: 1) Ask your Senators to send individual letters to Secretary Sebelius. In your letters to the Senate, we have included a web address to a sample letter your Senators can use to send to Secretary Sebelius. (Click the Take Action! tab above to send a letter to your Senators) 2) Ask your Representative to sign on to the Berkley-Capito-Pomeroy "Dear Colleague" letter by clicking here and entering your zip code. WHY WE OPPOSE THE PROPOSED SNF CUTS We oppose the approximately $18 billion in cuts to Medicare reimbursement for skilled nursing care proposed by CMS in its recently issued Fiscal Year 2010 Notice of Proposed Rule Making. CMS seeks these funds to make up for its own projection error related to the 2006 implementation of revisions to the SNF patient classification system (RUG-III.) AHCA/NCAL is gravely concerned that this ill-timed administrative tactic will slash Medicare funding for skilled nursing facility (SNF) care by $1.05 billion in FY 2010 alone, rising to $7.23 billion over five years, and totaling $18 billion over ten years. Implementation of this Bush-era Medicare regulation will eliminate at least 30,000 good health care jobs, undermine economic stimulus initiatives, and derail badly-needed delivery system reforms already helping beneficiaries and taxpayers. Further, these cuts will cause a $2.5 billion reduction in business activity, and force the loss of $1.1 billion in labor income nationwide. Therefore, we urge the Administration and Congress to avoid adopting short-term, budget-driven policies that are inconsistent with the goal of improving post-acute care coordination and payment efficiency. Dennis Moore (D-KS)  The only Kansas Congress person signed on to the letter. To see how the economic impact of these cuts will affect your state CLICK HERE For more information, CLICK HERE to view the AHCA issue brief To view a copy of the Dear Colleague letter, CLICK HERE To view a copy of the sample Senate letter to Kathleen Sebelius, CLICK HERE

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  New Regs and Reimbursement

Just to update everyone.  The KDOA Regulation Revisions have all been posted on KDOA's website.  If you have any questions please do not hesitate to contact the association office for assistance.  You might notice that the Regulation Interpretation Manual is no longer on the website.  We have been asked to review the Interpretive Guidelines and offer suggestions on what needs to remain and what has been folded into regulations.  The KHCA Resident Satisfaction Committee will begin the process next week of review.

Dave Halferty informed the association the FY 2010 Rates and Reimbursement Methodolgy will be posted in the June 25th Kansas Register.  I did ask for clarification about the Culture Change Instrument Survey.  He said the homes will have to fill it out and submit it to Amanda Barta at KDOA, Amanda.Barta@aging.ks.gov for credit in the incentive program.  We will post the new rates on www.khca.org as soon as they are published.

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  Risk Analysis Portal Information

Thank you to all of you who attended the webinar last week about the Risk Analysis portal being provided by TEAMTSI and Healthcare Solution.  We have put together some questions and answers for providers.  If did not attend the webinar and would like more information, please contact Chris Cardinal at ccardinal@khca.org or Cindy Luxem at  cluxem@khca.org.  This is a fabulous tool so we hope you are using it. 

Click here for Questions and Answers about use of the portal.

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  Reserve Day Edits

Dave Halferty, KDOA, recently informed the association, that Reserve Day Edits are currently being reviewed by EDS.  KDOA would not give us a list of providers or the amount that EDS will recoup.  It is our understanding that you will receive a letter and the money will be adjusted with the June 22nd payments.   If you have any questions about this, do not hesitate to give Dave Halferty a call at 785-296-8620, or email him at dave.halferty@aging.ks.gov

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  KDOA announces New Regional Director

Greg Reser recently announced, Janice VanGotten, RN, has been appointed to the position of Regional Manager in the Southeast District Office, Chanute.  She will take over leadership of the district office on June 15, following the retirement of Mary Saporito.

Janice has been a Health Facility Surveyor since 1995 and the district's Quality Improvement Coordinator since February, 2008.   In addition, she has 30 years experience as an LPN and RN, including 14 years as an assistant DON in a nursing facility.

This level of experience, in addition to Janice's commitment to the mission of nursing facility survey and certification, provides LCE with a very qualified individual to manage the survey process in the SE district.

Janice can be reached in the Chanute office at 1500 West 7th, Chanute, Kansas  66720 and 620-432-5115.

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  H1N1 Virus, Emergency Prepare Training and Clarcon products

Last week the World Health Organization declared the H1N1 Virus a pandemic, which means moving from PHase 5 to Phase 6.  This shift from Phase 5 to Phase 6 means that the pandemic is spreading wider geographically, not that it is any more severe.  As the H1N1 virus continues to be a public health concern, please remember to visit the www.khca.org for the latest information, including links.

Emergency Preparedness for Long Term Care. Train the Trainer. 

It is not to late to sign up for a Free one-day Public Health Emergency Management training coming to Kansas next week.  Go to www.khca.org to sign up.  Trainings will be held in Garden City, Salina, Wichita and Lawrence.

Clarcon Products

CMS is advising health care providers and consumers not to use skin products made by Clarcon Biological Chemistry Laboratory. Clarcon is voluntarily recalling some skin sanitizers and skin protectants marketed under several different brand names because FDA analyses of several samples of Clarcon products revealed high levels of various bacteria, including some associated with unsanitary conditions. Click herefor examples of products that should be discarded. Health care professionals and consumers may report serious adverse events or product quality problems to the FDA's MedWatch Adverse Event either online; by regular mail (use postage-paid FDA form 3500); fax: 800-FDA-0178; or phone: 800-FDA-1088. 

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  Veterans' Affairs Update from American Health Care Assoc.

We recently received an update from AHCA regarding facilities with VA contracts.  The update is included below in its entirety.

AHCA has learned that some nursing facilities (NFs) with veterans affairs (VA) contracts are receiving information technology (IT) security addenda to their contracts which require compliance with the VA Acquisition Regulation (VAAR) clause 852.273-75.  AHCA is advocating to VA that NFs NOT be subject to the requirements in this clause, which include compliance with the Federal Information Security Management Act (FISMA).  We have been told that an announcement from VA about this is imminent.  If your VAMC is requesting that you sign this addenda, we recommend telling them that the issue is being vetted by Central office VA.

AHCA is also hearing from members that few VA Medical Centers (VAMCs) are willing to use the new VA/NF agreement that AHCA negotiated with VA and announced late last year.  VA’s General Counsel now states that unless a VAMC is preauthorized to use an agreement, it must use a contract to place veterans in civilian NFs.  Even if the VAMC does use the new agreement, the new 10 VA RUGs system in the agreement will not be used; VA’s current 8 RUGs system will be used until, and if, the agreement is required nationwide as administering two different reimbursement systems is infeasible for VA.

AHCA has been told that a proposed rule about the new agreement has been drafted and will be released for public comment this summer.  AHCA will notify members when this rule is released and will submit comments to VA.

For more information, contact Melissa Temkin at AHCA, mtemkin@ahca.org  or call Cindy Luxem.

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  S & C letter-09-20-Related to Liability Notices and Beneficiary Appeal Rights

This memorandum reviews a skilled nursing facility obligation to issue Medicare beneficiary liability notices, a Medicare benefiary's rights related to standard claim and expedited appeals; and the surveyor's responsibility to determine compliance.  Please review the letter.  This issue was brought up during the QIS trainings this week and it is important to review the notice.  We have posted this on the members website under Quality.

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  Register for the AHCA/NCAL 60th Annual Convention & Expo.

Long-term care providers, including staff of independently owned, national and regional multis, plus assisted living/housing with services communities, can earn up to 15 CEUs by attending more than 70 diverse education sessions covering 13 tracks at this year’s AHCA/NCAL Annual Convention.  Attendees can boost their CEU value to 19 by including the Not for Profit Board Training*, or 21 CEUs by attending NCAL Day*.

You can view education sessions now by using the Session Search interface found on the Education page of the AHCA/NCAL Convention webpage:  www.ahcaconvention.org or www.ncalconvention.org.  Browse sessions by Track, Day, Speaker, and Key Content.  All sessions are designed to provide you with up-to-date, results-oriented information translating to professional and operational value!

Register Online by July 15, 2009 and save with the early bird special.  To find out more information about the AHCA/NCAL 60th Annual Convention and Expo, visit www.ahcaconvention.org or www.ncalconvention.org.

To stretch your convention travel dollars further:

·         Make sure you book your hotel room within the AHCA/NCAL room block where we have already negotiated discounted rates for our attendees.

·         Choose from two airports – Midway and O’Hare; both locations serve discounted airlines.

*Separate ticketed events.  Additional fees required.

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  Important Scam Alert Notice from CMS!

CMS asks that you share this important information with all of your association members and State and local chapters. 

Scam Alert

CMS has become aware of a scam where perpetrators are sending faxes to physician offices posing as the Medicare carrier or Medicare Administrative Contractor (MAC).  The fax instructs physician staff to respond to a questionnaire to provide an account information update within 48 hours in order to prevent a gap in Medicare payments.  The fax may have  the CMS logo and/or the contractor logo to enhance the appearance of authenticity.
 
Medicare FFS providers, including physicians, non-physician practitioners, should be wary of this type of request.  If you receive a request for information in the manner described above, please check with your contractor before submitting any information.  Medicare providers should only send information to a Medicare contractor using the address found in the download section of the  CMS.gov website found at http://www.cms.hhs.gov/MLNGenInfo/ or http://www.cms.hhs.gov/MedicareProviderSupEnroll .

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  CATS . . . A New Version of RAPS for MDS 3.0

With the anticipated October 1, 2010 implementation of the 3.0 Minimum Data Set (MDS) for nursing facilities, the Centers for Medicare and Medicaid Services (CMS) will end the required use of the Resident Assessment Protocols (RAPs).  However, as we have previously reported in Action, the basic premise of the RAPs will live on in a new incarnation called Care Area Triggers (CATs).

Utilizing CATs, providers will still need to conduct additional in-depth assessment and analysis of triggered MDS items to determine whether or not the identified care areas should be part of the development of a care plan.  However, CATs will permit providers to have a choice of options for documenting the process utilized.
Why the change?  CMS decided that widespread access to the Internet no longer required the use of RAPs as a required framework for further assessment.  “If you Google, you will find at least 12,000 references to clinical practice guidelines for any particular issue that might be triggered out of the MDS assessment process,” said CMS officials.  So providers will “be free to choose and use whatever clinical practice guideline or other authoritative source material they wish to use to complete that in-depth assessment process.”

Here is how the CAT process will work:

1. A care area (e.g., pressure ulcers) triggers from a resident’s MDS 3.0.
2. The provider can use any clinical practice guideline to conduct a further in-depth assessment of the Care Area Trigger (CAT).  The RAPs will remain one option for conducting that further assessment.  The new RAI User’s Manual is supposed to include updated RAP outlines that providers can choose to use.
3. The provider will be required to complete a CAT summary.  Documentation requirements should stay the same as they currently are for the RAP summaries.  The CAT summary should point to why that particular guideline, tool, or instrument was utilized and what was the result of that further assessment, that is:  Did you decide to care plan, or did you not decide to care plan?

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  LTC Trend Tracker

AHCA's LTC Trend Tracker™, is a new, free, web-based benchmarking and analysis tool for AHCA member nursing facilities to analyze your performance, and compare it against your peers. LTC Trend Tracker™ is designed to assist facilities in identifying target issues you may have in your operations and to provide resources that may enhance performance. For more information, check out www.LTCTrendTracker.com, or click here to contact LTC Trend Tracker™ or Cindy Luxem.

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