Happy Thanksgiving from your staff at KHCA/KCAL!

A Thanksgiving Poem
Author: Unknown

'Twas the night of Thanksgiving,
But I just couldn't sleep
I tried counting backwards,
I tried counting sheep.

The leftovers beckoned -
The dark meat and white
But I fought the temptation
With all of my might.

Tossing and turning
With anticipation
The thought of a snack
Became infatuation.

So, I raced to the kitchen,
Flung open the door
And gazed at the fridge,
Full of goodies galore.

I gobbled up turkey
And buttered potatoes,
Pickles and carrots,
Beans and tomatoes.

I felt myself swelling
So plump and so round,
'Til all of a sudden,
I rose off the ground.

I crashed through the ceiling,
Floating into the sky
With a mouthful of pudding
And a handful of pie.

But, I managed to yell
As I soared past the trees.. . .
Happy eating to all -
Pass the cranberries, please.

May your stuffing be tasty,
May your turkey be plump.
May your potatoes 'n gravy
Have nary a lump,

May your yams be delicious
May your pies take the prize,
May your Thanksgiving dinner
Stay off of your thighs.

Have a blessed Thanksgiving!!

The December 6 & 7, 2011 QIS trainings in Topeka have been postponed until the spring of 2012. A notification will be sent when the rescheduled dates are determined.These valuable trainings are a must for individuals new to the QIS survey process and for staff who are ready to look beyond the survey process and learn how to use data for improving quality care.

We are passing along some information that was distributed to us from CMS.  The information was released to the entire Midwest consortium…not just Kansas.   Even though the information is really nothing new from what we’ve said in the past regarding the 2012 edition, we just wanted to share with you what is still being disseminated.

Life Safety Code

CMS is aware that the National Fire Protection Association (NFPA) has recently released the 2012 Edition of the Life Safety Code (LSC), which includes changes to the health care chapters.  Some of these changes are related to kitchens, fire places, and furniture in corridors.  CMS has not adopted the 2012 Edition of the LSC, nor has it amended the Code of Federal Regulations to incorporate these new requirements into the 2000 Edition of the LSC.  CMS currently enforces the 2000 Edition of the LSC, which was not affected by the new LSC requirements. 

In summary, the recent release of the LSC, 2012 Edition, has not changed the requirements for health care facilities participating in the Medicare and Medicaid programs that require compliance with the LSC, 2000 Edition

Two-thirds of all RNs in the United States have no geriatric training. We’ve teamed with a nationally accredited provider of continuing nursing education so that you can provide advanced gerontological training to your key RN staff. Gero-Prep is a proven on-line learning program that prepares your RN staff or consultant to pass the Certification Exam in Gerontological Nursing by the American Nurses Credentialing Center (ANCC). It delivers triple-win benefits: for your nurses, for your residents and families, and for facility owners and administrators.It also fits the quality and workforce initiatives of our association.

Click HERE for the Gero-Prep brochure, and HERE to register for the Gero-Prep program. The cost to KHCA/Kcal members is $490 prior to January 1, then goes up to $690. KHCA/Kcal’s Joan Hamel Scholarship funds are available to help pay for this program. For that application, click HERE.

Need more information? Contact us at KHCA/kcal.

On Monday evening, the Congressional the Congressional super committee tasked to recommend $1.2 trillion in deficit reduction announced that it failed to come to bipartisan agreement. This announcement was made after months of apparent struggle by the 12-person committee to agree on where to trim funds over the next ten years. Read the statement from CEO and President Mark Parkinson.
 

Join AHCA/NCAL for its fourth annual symposium on quality performance in long term care.  The AHCA/NCAL Quality Symposium: Inspiring Excellence in Long Term Care conference, will take place February 23-24, 2012 at the Westin Galleria hotel in Houston, TX.

Register Online

The Registration Deadline is January 31, 2012

Earn up to 10 CEUs
Earn additional 4 CEUS by attending the Pre-Symposium Workshop

Returning for its fourth year, the symposium continues to offer comprehensive programming to quality practitioners at all levels. We have developed session designations that aid in measuring and assessing where you are in implementing quality improvement. These include:

•    Transition Sessions – for those professionals new to the quality journey

•    Commitment Sessions – for those professionals who have examined their organizations and begun the process of implementing policies and practices to advance their quality goals.

•    Advanced Sessions – for professionals who have achieved performance excellence and are looking for ways to sustain their accomplishments.

This conference is designed to be highly interactive with idea sharing and networking opportunities built upon the tenets of Continuous Quality Improvement, and features 14 individual sessions, two general sessions featuring keynote speakers and two networking lunch sessions -- comprise this intensive, two-day conference. Learning tracks have been developed from the framework of the Malcolm Baldrige National Quality Award program.
 
Earn four additional CEUs by attending one of two pre-symposium sessions*  on February 22.

Housing Reservations
You can complete your online registration, make housing reservations and get education information, plus download your conference brochure on this exciting event by visiting the AHCA/NCAL Quality Symposium website.
 
*Pre-symposium sessions are a separate ticketed event.

AHCA is hosted a much-needed webinar on the topic Mental Health Needs in Skilled Nursing Facilities

Below is a description for an upcoming webinar titled: Telemedicine for Mental Health Need in Skilled Nursing  Facilities. If you have any question please contact me via email.

Date: December 20, 2011
Time: 2:30 – 3:30p.m. (EST) 1 hour in duration
Speakers: Sylvia Rowe, VP of Nursing Informatics with Ethica Health.
                   Kemp Perry, Medical Director for Ethica Health

Webinar Description below; 

A Report on two years of experience using telemedicine to improve access and balance resources for Mental Services and Psychiatry in a five facility pilot in Georgia linking Skilled Nursing Facilities, Psychiatric clinicians, and an Emergency Room.  The Report will include clinical and Financial outcomes and logistics considerations.  The report will also outline the adjusted measurement and analytical tools that will be implemented in the upcoming expansion of the project.

Registration Link - http://webinars.ahcancal.org/session.php?id=7860

Learning Objectives:

• Understand logistical, clinical and compliance issues for telepsychiatry
• Review quality of care, access to care and patient feedback
• Discuss regulatory issues, compliance and reimbursement for services provided by telemedicine

A Survey and Certification Memo affecting Long Term Care Facilities has been released.
12-04: Alert:  Smoking Safety in Long Term Care Facilities (11/10/11)

This memo reviews current interpretive guidelines for F323, re-emphasizing adequate supervision of all residents. Facilities must include assessment of smoking areas and provision of emergency equipment in the designated smoking areas.  Facilities should also document the means by which individual residents are assessed as safe to smoke without supervision.  Oxygen use and smoking are known hazards.  Click here for this memo.

Revalidation:  This is a reminder that Section 6401 (d) of the Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. This revalidation effort applies to those providers and suppliers that were enrolled prior to March 25, 2011. Newly enrolled providers and suppliers that submitted their enrollment applications to CMS on or after March 25, 2011, are not impacted.   MACs are sending out notices on a regular basis through March 23, 2013 to begin the revalidation process for each provider and supplier. Providers and suppliers must wait to submit the revalidation only after being asked by their MAC to do so.  Note that 42 CFR 424.515(d) provides CMS the authority to conduct these off-cycle revalidations.  The two MLN Matters Articles attached, SE1126 and MM7350, provide details.

• Screening Category:  Consistent with 42 CFR §424.518, newly-enrolling and existing providers and suppliers, beginning on March 25, 2011, have been placed into one of three levels of categorical screening: limited, moderate, or high. The risk levels denote the level of the contractor’s screening of the provider when it initially enrolls in Medicare, adds a new practice location, or revalidates its enrollment information.   As AHCA argued in comments to the proposed rule, SNFs have been placed  in the  lowest category, that of limited risk.  The attachment R371 modifying the manual provides detailed information. 

AHCA Medicare 855A Enrollment 855 Project:  In February of 2011, AHCA staff surveyed membership regarding problems associated with the 855 forms and process. We provided CMS with a set of recommendations for improvement.  Upon receipt of the recommendations, CMS asked to meet with us.  The meeting went very well and we hoped for progress.  Two providers were immediately placed on CMS Enrollment Task Forces.  They reported positive CMS activity, especially with regard to PECOS issues.

On October 28, 2011, AHCA staff  we had a conference call with the CMS enrollment team.  The CMS team  believes that it is  making process regarding both PECOS issues and the 855 process itself.

The CMS staff has asked AHCA to meet with them in January for a review of all of their recommendations and CMS work since we submitted the recommendations.

In the interim, if providers run up against intractable 855 problems, please let us know.  We will report problems immediately to CMS and do our best to help facilitate correction.

On Fri Nov 17, the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS) announced that it would not initiate enforcement with respect to any HIPAA covered entity that is not in compliance on January 1, 2012 with the ASC X12 Version 5010 (Version 5010), NCPDP Telecom D.0 (NCPDP D.0) and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards until March 31, 2012. Notwithstanding OESS’ discretionary application of its enforcement authority, the compliance date for use of these new standards remains January 1, 2012 (small health plans have until January 1, 2013 to comply with NCPDP 3.0).

Medicare FFS will soon issue direction to the Medicare Administrative Contractors (MACs) on how these transactions are to be processed on January 2, 2012.  Further guidance related to Medicare Fee-for-Service will be available via listserv messages and the CMS website.

Links to information on Version 5010, NCPDP D.0, and NCPDP 3.0 are available at www.CMS.gov/Versions5010andD0.

CMS had proposed for January 1, 2011 implementation of a  rule which would have required a  physician’s or qualified non physician practitioner’s signature on all requisitions for clinical diagnostic laboratory tests paid for on the basis of the Clinical Laboratory Fee Schedule (CLFS).  AHCA fought the proposal “tooth and nail.”    CMS had first delayed the implementation and then had indicated that it would eliminate the requirement but needed to do so in a final rule.  The final rule has arrived!
 
Today CMS released its final rule making Revisions to Payment Policies Under the Physician Fee Schedule CY 2012 (CMS has officially retracted its signature on clinical lab test requisition policy.  Here’s the bottom line: (from page 737):
 
Comment: All commenters supported CMS's proposal to retract the policy  requiring a physician's or NPP's signature on a requisition for clinical diagnostic
laboratory tests paid under the CLFS, which was finalized in the CY 2011 PFS final rule  with comment period. All commenters also supported the proposal to reinstate the prior  policy that the signature of the physician or NPP is not required on a requisition for a clinical diagnostic laboratory test paid under the CLFS for Medicare purposes. 
 
Response: We thank the commenters for their support and, as discussed below,  are finalizing our proposal without modification.
 
After consideration of the public comments received, we are finalizing our proposal to retract the policy that was finalized in the CY 2011 PFS final rule with comment period, which required a physician's or NPP's signature on a requisition for clinical diagnostic laboratory tests paid under the CLFS (75 FR 73483) and to reinstate our prior policy that the signature of the physician or NPP is not required on a requisition for a clinical diagnostic laboratory test paid under the CLFS for Medicare purposes.

 The Centers for Medicare and Medicaid Services 2012 MDS National Conference is a 2-day conference that will be held twice. One on March 6-7, 2012 and repeated on March 8-9, 2012, at the Hyatt Regency St. Louis at the Arch in St. Louis, MO. The conference registration will begin November 14, 2011 and close on December 30, 2011. Please visit the CMS MDS 3.0 Training Conference Information page:  for additional information.

The next Skilled Nursing Facility (SNF)/Long Term Care (LTC) Open Door Forum is scheduled for Thursday, December 1, 2011 from 2pm-3pmET. If you wish to participate, dial 1-800-837-1935 Conference ID 93952052. This call will be Conference Call Only. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums.

 As many of you have heard, there are a number of electronic billing issues affecting the processing of SNF PPS Part A claims.  AHCA has been actively working with CMS to address and resolve these issues as expeditiously as possible and to minimize the impact on providers.  CMS is in the process of resolving the HIPPS code issue.  The fix is scheduled to be implemented on December 5th. 
 
There is also an issue that is holding up claims with revenue code = 0022 and HIPPS code AAAxx.  Through AHCA, state affiliate, and member activities, CMS should no longer be holding up all claims with revenue codes = 0022 as some FIs/MACs seem to have interpreted the initial CMS hold.  Rather only claims with a HIPPS code of AAAxx are affected. CMS notes that if providers are billing a claim where the first part of the stay is covered and the last part of the month are no pay billing days (not benefits exhaust claims), they could split out the no pay billing days and be paid for the first part of that month.  Directions to that affect are in the CMS claims processing manual, chapter 6, section 40.8.   

This issue of Vaccinate Adults presents an array of materials that healthcare professionals can rely on to vaccinate adults against influenza. Readers will also find new and updated resources for vaccine storage and handling, as well as for Td/Tdap vaccination.

• Download the entire issue (16-page PDF)

This publication is free but you will need to subscribe in order to view the file.