Your KHCA/kcal office will close at noon on December 23, 2011 and reopen December 27, 2011. Have a very Merry Christmas from your staff at KHCA/kcal.

Get ready for some first-rate education and legislator conversation at the annual KHCA/Kcal Winter Conference at the Ramada Inn Downtown in Topeka on Jan. 24-25, 2012. This year's conference focuses on Quality and Collaboration.

This year, our members will have individual appointments to meet with their legislators at the capitol rather than going over as a group (you will receive an email with specifics on this). Transportation will be provided via shuttle bus from the hotel.

We will have a new twist on our Legislative Reception Tuesday evening. It will be at the beautiful Kansas State Historical Society/Kansas Museum of History. Dinner will be included as well as music and a host bar. There will again be shuttle buses available between the hotel and the museum, which is just west of 6th and Wanamaker on the northwest side of Topeka.

Since there is so much attention being given to preventing unnecessary re-hospitalizations these days, we'll learn about QAPI, Care Transitions and Interact II in a general session. Our former Kansas Governor and now President/CEO of the American Health Care Association, Mark Parkinson, will join us, along with our KDOA Secretary Shawn Sullivan, at the Leadership Breakfast on Wed., Jan. 25.

Our valued vendor partners will join us on Wednesday in the atrium of the hotel with displays and information on the newest products and technologies. Lunch includes an excellent presentation by Ted McDonald, an attorney from Kansas City, on Risk Management that will get your attention and keep it!

We’ll end the conference on Wed. afternoon with the inspiring “Lighting Your Candle and Fanning Its Flame” by an old friend of KHCA/Kcal, Ron Willis.

Click HERE for the conference brochure and registration information.

As KDOA moves forward with work groups and task forces seeking to improve the practices we employ while care for our elders, KHCA/kcal will continue to offer our members feedback and a chance to provide input to the workgroups. Below is a request for information from our member Terry Pearce, RN - Americare who is one of our representatives on the KDOA Quality Assurance workgroup. Please click here to request additional information or to respond to this request.

From the desk of Terry Pearce, RN:
I was invited to be on a work task force with KDOA.  The intent of the task work force is to prepare for the implementation of the Quality Assurance and Performance Implementation in nursing homes.  CMS has contracted with the University of Minnesota and its subcontracting partner, Stratis Health (Minnesota's Quality Improvement Organization) to conduct a demonstration program that will develop and pilot test materials that can be used for the national QAPI rollout, most likely sometime in 2014.

The task work force reviewed the outline of what CMS expects and then started reviewing some QA/best practices the group used in their various homes. 

I would like your input on what are some of your best practices to assist in maintaining compliance with the Federal tags listed below.  I need this information no later than December 30th at 5:00pm.  This not something that is going away and we, as a state, would like to be ahead of the game with the QAPI process.  Your input is vital.  I have also included some information regarding what CMS has sent out, the 5 Elements of a successful QAPI program and tips for Senior Leadership in preparing for QAPI. Thank you all for your assistance. Terry

F224 Abuse, Neglect & Explotation
F279 Develope Care Plan
F280 Revise Care Plan
F323 Accidents
F253 Environment, Safe & Clean
F309 Care & Service
          Pain Management
          Bowel Management
          Diabetes Management
          Non-Pressure Skin Issues
F312  ADL Assistance
F314 Pressure Ulcers
F315 Urinary Incontinence
          Catheter
          Toileting Schedules
F329 Unnecessary Medications
F325 Nutritional Status - Weight Loss
F327 Hydration
F371 Sanitary Conditions - Diatary
F441 Infection Control
F428 Drug Regimen Review

As the quarter end/year end nears we wanted to review the accounting and reimbursement treatment you should apply to these payments.  This guidance relates specifically to the long-term care provider assessment program.  If you are paying a provider assessment as part of the Hospital program and would like specific guidance on accounting and reimbursement for that program let us know.

If you have other accountants or cost report preparers besides BKD please discuss this guidance with them and evaluate its propriety for your organization.  Also consider whether these amounts are immaterial to your financial statements in determining when you record the quarter end amounts.

Accounting – the provider assessment paid is an administrative expense.  The payment periods are based on calendar quarters – the payment related to the October 1 to December 31 time frame should be recorded as a payable as of 12-31 even though the State will not bill you until January, 2012.  This process should be continued at no less than each quarter’s end or on a monthly basis throughout the term of the provider assessment program.

The corresponding amount that’s receivable from the State should also be recorded separately and not netted against the payable.  The computation is fairly simple – Medicaid days(LTC Unit only)/Total days (LTC Unit only) for the quarter of 10-1 to 12-31 (use the information from the form the State requires you to complete and send in each quarter).  The credit should be recorded as a negative contractual adjustment.  This process should be continued at no less than each quarter’s end or on a monthly basis throughout the term of the provider assessment program.

Cost report – Medicare – for those of you who file Medicare cost reports Paul Hula of WPS advises that the amount of the rebate (the Medicaid days (LTC Unit only)/total days percentage(LTC Unit only) that’s been recorded should be offset against the provider assessment paid.  This net amount of provider assessment is reported in the Administrative and General cost center in the Medicare cost report.  Please make sure to identify the provider assessments paid, including the account they are in if it’s not a separate account for your cost report preparer.  Likewise also identify the amount of the negative contractual adjustments that are related to the rebates of the Medicaid share of the assessment.  This would not include the rebate of the 10% withholding related to the January to June 2010 time frame or the amounts received in February/March, 2011 that related to the rate adjustments due to rebasing.

Cost report – Medicaid – for those that only file a Medicaid cost report Dave Halferty of KDOA has indicated that none of the assessment is to be reported as an expense and likewise none of the reimbursement/rebates are to be offset against any costs.  Please identify these amounts for your cost report preparer so they can be addressed appropriately.

Should anyone have questions about the accounting or reimbursement of these items please let us know.

John M. Harris, CPA
Partner | BKD, LLP
1551 N. Waterfront Parkway, Suite 300
Wichita, Kansas 67206
316.265.2811

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.

AHCA submitted comments to CMS on a provision that appeared in a proposed rule to change the conditions of participation for hospitals.  The provision requested comments on whether CMS should adopt the 2012 edition of the Life Safety Code (LSC), which would apply to hospitals and other health care providers.  AHCA strongly encourages CMS to adopt the 2012 edition of the LSC. 

AHCA was instrumental in having the 2012 LSC include provisions that will enable providers to have more home-like environments and be in compliance with the LSC.  Two examples of such changes are: (1) kitchens serving no more than 30 residents will be permitted to be open to the corridor and other spaces, and either residential or commercial stoves or cooktops may be used provided certain criteria are met; (2) gas or electric fireplaces will be allowed to be used in smoke compartments that contain sleeping rooms, with some restrictions (such as controls must be locked and a sealed glass front must be provided).

AHCA/NCAL is encouraging member facilities to participate in the National Quality Award program.  Section 6102(c) of the Affordable Care Act requires that all nursing homes develop Quality Assurance and Performance Improvement (QAPI) programs and must have a written QAPI plan in place, which will likely be implemented in late 2012 or early 2013. The program standards established for QAPI are directly aligned with the Quality Award criteria. Therefore, Quality Award participants will be better prepared to comply with CMS’s QAPI program requirements.  In addition, facilities who achieve the Silver and Gold award are much more likely to have fewer survey deficiencies (including deficiency free surveys), better quality measures (such as lower use of off-label antipsychotics) and higher satisfaction scores. Pursuing an award will help our members achieve excellence in quality on metrics we are all being measured on by CMS and others.
 
We are only weeks away from the Intent to Apply deadline for the National Quality Award program. All 2012 Quality Award applicants must submit an Intent to Apply by January 12, 2012 at 8 p.m. EST in order to apply for the award. A majority of our members have never applied and we are encouraging you to start this process by applying for the Bronze, Silver or Gold this year. The effort is worthwhile.  Please help us get more of our members working towards Gold recognition. 

Want to get ahead of Black Box Warning deficiencies? Look into LICA MedMan
Why LICA MedMan?
Better Care. Better Compliance.
LICAMedMan is a software tool that helps long term care facilities to create required medication documents.  LICAMedMan was created to facilitate optimal health care medication management for the long term care consumer (resident/patient).

Simply enter basic patient and doctor information, click on required patient medications, and have fully formed documents ready for printing in seconds!

Want more information? Just click GO -  

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• No payment information necessary to sign up for the 30 day trial.
• Click here to watch a 1 minute demonstration on YouTube.

Subscribe to our free 30 day trial, and be locked in at the lower price!
Starting January 1st, 2012, the annual subscription will be $950 for unlimited use of our easy Individualized Medication Care Plan Generator.  Lock in at the $500 annual price by subscribing to the free 30 day trial before the 1st of January.  If you don't want it after the 30 days, no problem....no obligation to subscribe.