Nursing Home Incentive Program

Several points of clarification about the new incentives for FY 2010.  The Completion of the Kansas Culture Change survey can  be completed at any time during a month and the $.15 would appear on the next month reimbursement rate.  Of course this is contingent on a home not being disqualified for the incentive program because of survey deficiencies.  See document below if you have not found the survey tool.

http://www.nursingoutcomes.org/documents/KCCILeaderVersion_000.pdf
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  CMS Releases Guidance F-441, 5 for 1 tag!!!

CMS recently issued F-441 guidance, which essentially consolidates five infection control F-Tags into one.  The initial transmittal from CMS originally had an effetive and implementation date of July 17, 2009, because their was not advance notice to providers, CMS has revised the guidance with an effective date of September 30, 2009.  Click here to read the transmittal.

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  Save The Date: 2009 Annual Meeting and Trade Show

2009 Annual Convention and Trade Show- October 13 &14, 2009.  Save the date for the 2009 Annual Meeting and Trade Show, "Trekking Towards Quality", to be held on Tuesday and Wednesday, October 13 and 14th, 2009 at the Hyatt Regency and Century II In Wichita.  Please join us as we pay tribute to our workers and elders.   Registraton materials will be available in August.  Therre is already over 60 vendors signed up for the trade show.

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  Cindy Rush's letter to the Editor on Saving Medicare

Cindy Rush, direct care staffer at Plaza West In Topeka had her letter to the editor published.  Cindy is becoming a regular in her advocacy in Washington, DC.  She is an outstanding advocate for all direct care staff in Kansas adult care homes.  Click here to read her letter which was published last week in the Topeka Capital-Journal.  Thank you Cindy on behalf of over 24,000 long term care employees in the state of Kansas and the 20,000 elders you take care of each and every day.

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  HINI Update

Today, CDC reports 43,771 confirmed and probable cases of novel H1N1 pandemic influenza and 302 deaths in the U.S.  This is the last day that CDC is providing individual confirmed and probable cases of novel H1N1 influenza. Individual case counts represent a significant underestimate of overall disease burden and spread. CDC will report the total number of hospitalizations and deaths each week, and continue to use its traditional surveillance systems to track the progress of the novel H1N1 flu outbreak.

Twenty states are reporting widespread or regional influenza activity. According to the CDC, it is likely that localized outbreaks will continue to occur over the summer and that there will be novel H1N1 virus, illness and death during the upcoming flu season in the fall and winter. CDC anticipates that novel H1N1 viruses will co-circulate with regular seasonal influenza viruses over the influenza season.

N95 Respirators

As we’ve reported previously, CDC interim guidance recommends N95 respirators for the routine care of patients with confirmed or suspected H1N1 influenza virus infection, but there is a possibility that the recommendation will change. Yesterday, the CDC Healthcare Infection Control Practices Advisory Committee (HICPAC) Influenza A (H1N1) Virus Infection Control
Working Group unanimously approved Updated Isolation Precaution Recommendations for Care of Patients with Confirmed or Suspected Novel Influenza A (H1N1) Virus in Healthcare Setting.  HICPAC is a federal advisory committee made up of outside infection control experts who provide guidance to the CDC and the Department of Health and Human Services on health care infection control.

 HICPAC’s proposed recommendations include the recommendation that for the routine care of patients with confirmed or suspected influenza 2009 A (H1N1) virus infection, health care personnel should wear a surgical or procedure mask.  For selected procedures that are more likely to generate small particle aerosols, health care personnel should wear a fit-tested N95 respirator.  The recommendation goes to the CDC for a final determination.  Until such time, the interim guidance that requires N95s remains in effect.

According to Occupational Safety & Health Reporter, labor representatives on the HICPAC working group resigned prior to the completion of its work.  The unions had been advocating for the continued recommendation to require N95 respirators for health care workers in the routine care of H1N1 patients. The Institute of Medicine has agreed to convene a panel in August to provide its recommendations to CDC on protecting health care workers from H1N1influenza A, according to the newsletter.   

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  Two Opportunities for RAC Training-Recovery Audit Contractor Outreach

The Centers for Medicare & Medicaid Services’ Region VII invites you to participate in our upcoming Provider and Partner Call on August 6, 2009 from 1:00 pm to 3:00 pm Central Time. 

The topic will be the Recovery Audit Contractor (RAC) Program.  Section 302 of the Tax Relief and Health Care Act of 2006 makes the RAC Program permanent and requires the Secretary to expand the program to all 50 states by no later than 2010.  The national RAC program is the outgrowth of a successful demonstration program that used RACs to identify Medicare overpayments and underpayments to health care providers and suppliers in California , Florida , New York , Massachusetts , South Carolina and Arizona .

The demonstration resulted in over $900 million in overpayments being returned to the Medicare Trust Fund between 2005 and 2008 and nearly $38 million in underpayments returned to health care providers.  Expansion of the RAC program to Region D which includes Iowa, Missouri, Kansas, and Nebraska is scheduled for  August 1, 2009.  Health care providers that might be impacted by this program include hospitals, physician practices, nursing homes, home health agencies, durable medical equipment suppliers, and any other provider or supplier that bills Medicare Parts A and B.
During the call a CMS subject matter expert will provide an in-depth presentation on the subject and will be available to answer your questions.  Space for this call is limited.  If you would like to participate on this call, please register by sending an email to Kansas_City_CMS@cms.hhs.gov  containing the following information:

      Your Name
      Organization
      State
      Contact Information
      Estimated number of people who will be on your line

The toll-free call-in number and presentation materials will be sent shortly before the call.  In the meantime, if you have questions or need additional information, please contact Jacqui Stanard, of my staff, at 816-426-6405. 

Please share this invitation with your colleagues, association members, and networks.   We appreciate your assistance in promoting this call and welcome any ideas on how CMS can best serve our Region VII healthcare community.  We look forward to our call on August 6th. 

The Second Training opportunity is

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  Medicaid Integrity Program (MIP)

The Centers for Medicare & Medicaid Services (CMS) will held a Special Open Door Forum (ODF) to discuss the Medicaid Integrity Program (MIP) provider audit program. This primary audience for this Special ODF is provider groups.
Section 1936 of the Social Security Act requires CMS to enter into contracts to perform four key Medicaid program integrity activities:
1. Review of provider actions to determine whether fraud, waste, or abuse occurred or may have occurred;
2. Audit provider claims;
3. Identify overpayments; and
4. Educate State or local employees involved in Medicaid administration, providers, managed care entities, beneficiaries and others with respect to payment integrity and quality of care.

CMS has awarded umbrella contracts with several contractors to perform these functions. These firms are known as the Medicaid Integrity Contractors (MICs). There are three types of MICs: Review MICs, Audit MICs, and Education MICs. The Review MICs use advanced data mining and analysis techniques to identify provider targets for the Audit MICs to pursue. The Audit MICs conduct audits of these Medicaid providers and identify overpayments. The Education MICs provide education to Medicaid providers and others with respect to Medicaid payment integrity and quality of care issues.

During this ODF, CMS staff will discuss the:

The MIP audit process;
•
Audit timelines;
•
Web site information;
•
Future meetings/calls.

An audio recording and transcript of this Special Open Door Forum will be posted to the Special Open Door Forum website: http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning July 24, 2009.

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  Talking to your Legislators!

We appreciate everything you all do in sending emails and hosting meetings with your legislators and Congress folks to discuss the magnitude of the Medicare cuts. The new Community Cares Coalition, CoCares, is designed to create a broad-based coalition of providers with businesses in their communities who will be adversely affected if the proposed cuts in SNF funding become a reality.  CoCares provides an avenue for these companies to communicate directly with legislators in Washington urging opposition to these (and other) misguided policy proposals.  It has the potential to greatly expand our grassroots network; it uses the same electronic communications system in use by AHCA/NCAL’s Legislative  Action Alert system (CapWiz). 

In addition to enrolling their individual facilities in the coalition, the CEOs will be encouraged to push this initiative out to their many vendors/suppliers and others in their communities to enlist their support.  Obviously, we are encouraging your state association to join – along with your many business contacts. 

http://mycocares.org/

We are in the process of developing talking points and issue papers to have when your legislators decide to stop by for a visit. 

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  Advancing Excellence

http://www.nhqualitycampaign.org/star_index.aspx?controls=nhtechAssist--Click Here...

A Free Resource and Bridge to Excellence

The Advancing Excellence In America's Nursing Homes website offers ideas about how a nursing home can implement organization-wide culture change and best-practice protocols. A free resource, Implementing Change in Long Term Care, contains suggestions about preparing your organization for change, assisting your staff with gaining a sense of ownership over the changes and sustaining the changes over time. The resource makes interesting assumptions about nursing home staff that is refreshing to read such as “Nursing home staffs are committed, intelligent and hardworking; they are supportive of efforts that improve care quality, quality of life for residents, and quality of the work environment.” Just click on the title above to read the manual.

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