The Centers for Medicare & Medicaid Services (CMS) issued its Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule for FY 2012 on July 29, 2011. The rule will cut payments to SNFs by $3.87 billion or about 11.1% in FY 2012, which AHCA estimates to be about $60 - $65 per patient day. The cut reflects a $600 million net increase from the Medicare market basket update and a $4.47 billion reduction due to the recalibration of the SNF PPS RUG-III to RUG-IV parity adjustment that CMS says is needed to make the change in RUG systems budget neutral for the Medicare program in FY 2011. In addition, CMS’ final rule outlines modifications to group therapy and to Change of Therapy (COT) and End of Therapy (EOT) Other Medicare Required Assessments (OMRAs), among numerous other changes to the SNF PPS.

Please find attached an overview of the CMS FY 2012 SNF PPS final rule.  The overview highlights key components of the final rule and range from financial and regulatory matters to clinical and quality issues.  The overview is also available for download under the Medicare Updates section of the Medicare page under the Facility Operations section of the AHCA web site.

To assist AHCA members in examining and evaluating the impact of the CMS FY 2012 SNF PPS final rule, AHCA has prepared a Medicare rate calculator (rate simulation model). Using information on the distribution of Medicare Part A days by RUG category, the calculator will allow you to simulate and understand the impact of SNF PPS payment policy changes for FY 2010, FY 2011, and FY 2012 on a facility. The Medicare rate calculator can be found under the Medicare section of  the Research and Data Funding page on the AHCA website.
The final SNF PPS wage indexes for FY 2012 are also available on the AHCA website. The wage index file is available for download under the Recent Medicare Regulations section of the Medicare page under the Facility Operations section of the AHCA web site.

1. Registration Now Open for the Skilled Nursing Facility Prospective Payment System Fiscal Year 2012 Policy Changes Relating to the Minimum Data Set Version 3.0 National Provider Call

Join the call
Tuesday, August 23 from 12:30-2:00 pm CT.
The Centers for Medicare & Medicaid Services (CMS) will host a National Provider Call on "Skilled Nursing Facility (SNF) Prospective Payment System (PPS) FY2012 Policy Changes Relating to the Minimum Data Set (MDS) 3.0." Subject matter experts will discuss new MDS 3.0 policies that will be implemented on October 1, 2011. A question and answer session will follow the presentations.

Agenda:
Allocation of group therapy
Student supervision
Changes to the MDS Assessment Schedule
End of Therapy (EOT) Other Medicare Required Assessment (OMRA) clarifications End Of Therapy with Resumption (EOT-R) Change of Therapy (COT) OMRA Transition timeline for new policies

Target Audience: 
SNF providers, Resident Assessment Instrument (RAI) coordinators, physical therapists, occupational therapists, and speech language pathologists.  

Registration:
In order to receive the call-in information, you must register for the call.  Registration will close at 1:30 pm on Monday, August 22 or when available space has been filled. No exceptions will be made. Please register early.  For more details, including instructions on registering for the call, please visit http://www.eventsvc.com/palmettogba/082311.

 
2. BKD, LLP will be hosting a FREE webinar on the potential effects of the SNF PPS Final Rule on August 24, from 2-3:30 pm. Lori Brunholtz and Suzy Harvey will be the speakers. To register go to https://www2.gotomeeting.com/register/310684986  

3. SIGNIFICANT SKILLED NURSING FACILITY (SNF) FISCAL YEAR (FY) 2012 POLICY CHANGES RELATING TO THE MINIMUM DATA SET (MDS) VERSION 3.0 TELECONFERENCE - SEPTEMBER 15, 2011

Join WPS Medicare on September 15, 2011, from 1:00 pm - 2:30 pm CT, for a teleconference on Significant SNF FY12 Policy Changes Relating to the MDS Version 3.0
http://www.wpsmedicare.com/j5macparta/training/training_programs/teleconference/2011-snf-policy.shtml

TRANSITION FOR IMPLEMENTATION OF FY 2012 SNF PPS POLICIES
Printed Information
http://www.cms.gov/SNFPPS/Downloads/fy12transpolicymemo.pdf

4. Register for webinar on Changes Related to MDS Completion and SNF Medicare Billing
Join AHCA for a webinar entitled Changes Related to MDS Completion and SNF Medicare Billing, on September 7, 2 – 3:30 PM ET. Darlene Thompson and Tami Johnson will review the changes made by CMS’s final rule related to MDS completion and SNF Medicare Billing.  The webinar will cover the basics of scheduling Medicare MDSs including changes to scheduled and unscheduled assessments and take an in-depth look at the impact of the changes to the End of Therapy OMRA requirements along with the two new OMRAs: End of Therapy-Resumption and Change of Therapy. 
These two new OMRAs and changes in the group therapy calculation will impact the way rehab delivers care, increase the center’s communication with rehab, and impact the number and frequency of MDSs completed by the center. Register today!  http://webinars.ahcancal.org/session.php?id=7226

Two Survey and Certification Memos have been released since the last note:
11-30: Reporting Reasonable Suspicion of a Crime in a Long-Term Care Facility (LTC):  Section 1150B of the Social Security Act (Released 6/17/11; Revised 8/12/11)

This memo was revised to include the Questions and Answers document, which is pages 13 to 18 of the revised document. The last page of the revised memo is
also new. The revised memo is attached.

KHCA has created a poster for you to hang in your home that meets the requirements of the Elder Justice Act. These posters are free to KHCA members and may be picked up at the KHCA/kcal office.

11-35:  Mandate of Section 6121 of the Affordable Care Act for Nurse Aide Training in Nursing Homes (8/12/11)

Section 6121 of the Affordable Care Act mandates the inclusion of training for nurse aides working in nursing homes on abuse prevention and care of persons with Dementia. Interpretive Guidelines have been revised for the Inservice Training Tag (F497). We are developing a regulation to mandate these topics and training materials that nursing homes may use to train staff. 

Requirement for all Medicare Providers to Begin to Revalidate Enrollment

All providers and suppliers who enrolled in the Medicare program prior to Friday, March 25, 2011, will be required to revalidate their enrollment under new risk screening criteria required by the Affordable Care Act (section 6401a).  (Providers/suppliers who enrolled on or after Friday, March 25, 2011 have already been subject to this screening, and need not revalidate at this time.)

In the continued effort to reduce fraud, waste, and abuse, CMS implemented new screening criteria to the Medicare provider/supplier enrollment process beginning in March 2011.  Newly-enrolling and revalidating providers and suppliers are placed in one of three screening categories – limited, moderate, or high – each representing the level of risk to the Medicare program for the particular category of provider/supplier, and determining the degree of screening to be performed by the Medicare Administrative Contractor (MAC) processing the enrollment application.

Between now and March 2013, MACs will be sending notices to individual providers/suppliers; please begin the revalidation process as soon as you hear from your MAC.  Upon receipt of the revalidation request, providers and suppliers have 60 days from the date of the letter to submit complete enrollment forms.  Failure to submit the enrollment forms as requested may result in the deactivation of your Medicare billing privileges.  The easiest and quickest way to revalidate your enrollment information is by using Internet-based PECOS (Provider Enrollment, Chain, and Ownership System), at https://pecos.CMS.hhs.gov.

Section 6401a of the Affordable Care Act requires institutional providers and suppliers to pay an application fee when enrolling or revalidating (“institutional provider” includes any provider or supplier that submits a paper Medicare enrollment application using the CMS-855A; CMS-855B, not including physician and non-physician practitioner organizations; CMS-855S; or associated Internet-based PECOS enrollment applications); these fees may be paid via www.Pay.gov.

In order to reduce the burden on the provider, CMS is working to develop innovative technologies and streamlined enrollment processes – including Internet-based PECOS.  Updates will continue to be shared with the provider community as these efforts progress.

For more information about provider revalidation, review the Medicare Learning Network’s Special Edition Article #SE1126, titled “Further Details on the Revalidation of Provider Enrollment Information.”

Note that failure to submit the enrollment forms as requested may result in the deactivation of Medicare billing privileges.

In order to better serve you, our members, KHCA/kcal is asking that you complete a very short survey to update our records for several key staff members in your building. By providing us with this information, we will be better able to communicate with the right person in your home with the right information. Please complete this survey by September 1, 2011. Click here to start the survey.

Windsor Place in Coffeyville, KS will host an Eden Associate Training October 19-21, 2011 at the Windsor Event Center in Coffeyville, KS. This three day training will provide you and your team the trainingi and understanding necessary to create a human habitate by bringing the principles of the Eden Alternative to your home. Click here for more information and registration details.

Governor Sam Brownback and the Kansas Department on Aging will host a reception for all Kansas centenarians September 15, 2011 at 10 am.
“I am thrilled to meet and hear the stories of our Kansas centenarians, especially this year, as we celebrate our state’s sesquicentennial anniversary,” said Governor Brownback.
The reception will be held at the Kansas State Fair, in conjunction with Governor’s Day. 

“I look forward to meeting more Kansas centenarians and celebrating their lives,” said Secretary on Aging, Shawn Sullivan.

If you are interested in more information, or would like to RSVP for a centenarian please call Sara Arif at 785-296-6154.

Greetings! My name is Terry Maple and I’m excited that Governor Brownback has appointed
me Acting State Fire Marshal. I truly feel it is an honor to work within an organization that
has such an important mission as that held by the Office of the State Fire Marshal.
I’d like to start by thanking each of you for your efforts and support of fire prevention in our state
and within our communities. Your support and assistance is critical to the success of the dedicated
professionals that make up the Office of the State Fire Marshal. When combined, our efforts provide
the education and prevention methods to help keep Kansans safe from the potential impact of
fire and explosion hazards.

click here for more from the Fire Prevention Newsletter.

This national health observance presents a great opportunity to educate seniors and other people with Medicare on the importance of disease control and prevention through immunization.  Vaccine-preventable disease levels are at or near record lows, yet many adults remain under-immunized, missing opportunities to protect themselves against diseases such as hepatitis B, seasonal influenza, and pneumococcal disease.
 
What Can You Do?
CMS asks healthcare providers who provide care to seniors and others with Medicare to join us during National Immunization Awareness Month to help protect your Medicare patients from vaccine-preventable diseases.  This can be done by ensuring their immunizations are up-to-date, educating them on risk factors, and encouraging their use of appropriate Medicare-covered immunizations. 
(Note that if you provide the Medicare Annual Wellness Visit to your eligible Medicare patients, please ensure that a written screening schedule for immunizations is reflected on their personalized preventive service plan.)
 
Medicare Part B Immunization Benefits:
Medicare provides coverage for seasonal influenza, pneumococcal, and hepatitis B vaccines and their administration for qualified beneficiaries as preventive immunizations.  Providers who accept the Medicare-approved payment amount for the following services are paid under Medicare Part B:

  Seasonal Influenza Immunization – Medicare provides payment for the seasonal influenza vaccine and its administration for all people with Medicare, once per influenza season.  Medicare may cover additional influenza vaccinations, if medically necessary. 

You may visit the Centers for Disease Control and Prevention (CDC) website for the latest 2011-2012 seasonal flu recommendations and alerts.

  Pneumococcal Immunization – Medicare provides payment for the pneumococcal vaccine and its administration for all beneficiaries, generally once in a lifetime.  Medicare may cover additional vaccinations based on risk.

  Hepatitis B Immunization – Medicare provides payment for the hepatitis B vaccine and its administration for beneficiaries at medium to high risk of contracting hepatitis B.