New CMS SNF Quality Program

CMS has announced they are moving forward with a program called Quality Assurance and Performance Improvement (QAPI), and will be notifying 4200 randomly selected nursing homes across the country of their selection as a participant. 
Facilities are advised to check their Quality Improvement & Evaluation System (QIES) mailbox [where MDS data is submitted] to determine if they have been selected to participate.

CMS Issues Survey Guidance Regarding Single Dose/Single Use Medications

Nursing Homes, Hospice and Home Health providers should read this linked CMS Survey Guidance (S & C:12-35-ALL) related to the repackaging of single dose medications for the prevention of healthcare-associated infections.

The Healthcare facilities that do not adhere to USP <797> standards but reuse SDVs for multiple patients must be cited for deficiencies under the applicable infection control standards for each type of provider/supplier. On the other hand, healthcare facilities that utilize appropriately stored medications, derived from repackaged SDVs and prepared in accordance with USP <797> must not be cited solely on the basis of this practice.

SNF Bad Debt Reimbursements Cut

CMS has just issued rules codifying the reductions Congress made last February to the SNF bad debt payments.  These reductions helped pay for the therapy cap extension, extension of the payroll tax reduction and extension of unemployment payments.  The reduction in bad debt reimbursement is projected to yield savings to the program of $10.9 billion over 10 years. 

• Payment of allowable bad debt to SNFs and swing bed hospitals for cost reporting periods beginning during fiscal year 2013 or a subsequent fiscal year would be reduced by 35 percent for coinsurance amounts for services furnished to a beneficiary who is not a dual eligible;
• Payment of allowable bad debt to SNFs and swing bed hospitals for coinsurance for services furnished to a beneficiary who is a dual eligible individual would be:
• For cost reporting periods beginning during fiscal year 2013, reduced by 12 percent;
• For cost reporting periods beginning during fiscal year 2014, reduced by 24 percent; and 
• For cost reporting periods beginning during fiscal year 2015, reduced by 35 percent.

Mitigating Risks Using Patient Lifts

The FDA has compiled a list a best practices to help mitigate risks associated with use of patient lifts.

LeadingAge: Editorial: New Jersey Must Plot New Future for Adult Day Care

New Jersey stopped issuing Adult Day Services licenses in 2008 after the New Jersey Department of Health and Human Services found evidence of numerous providers scamming Medicaid. On April 16, the state of New Jersey issued a decision stating that the moratorium will be in place until at least Nov. 1.

Peter Notarstefano, LeadingAge's director of Home and Community-Based Services, said that it is important that the state of New Jersey prosecuted Medicaid fraud, much of which came from for-profit adult day providers. "Unethical practices hurt our elders, persons with disabilities, and caregivers, as well as the innovative adult day providers that are abiding by the law," Notarstefano said.

Roberto Muniz, president and CEO of the Francis E. Parker Memorial Home, a LeadingAge member in New Jersey, said that while the moratorium wasn't a surprise, the demand in New Jersey for home and community-based long-term care services is growing and adult day care is a cost-effective option."We are grateful that the state identified the unethical sources of fraud in adult day health services and put corrective actions in place," Muniz writes. "Now, it’s time for state officials to lift the moratorium on new adult day centers, so that more high quality adult day programs can become available."

Oxygen Concentrators: Class I Recall - Risk of Fire, Loss of Supplemental Oxygen

Nidek Medical Products Mark 5 Nuvo, Nuvo 8, and Nuvo Lite Oxygen Concentrators: Class I Recall - Risk of Fire, Loss of Supplemental Oxygen

Safety Alerts for Human Medical Products Nidek Medical Products Mark 5 Nuvo, Nuvo 8, and Nuvo Lite Oxygen Concentrators: Class I Recall - Risk of Fire, Loss of Supplemental Oxygen

Senior Services & Technology: Workshop Scheduled in SeaTac

Save the Date of February 29th, Marriott Hotel, SeaTac for an informative Technology Workshop presented by Aging Services of Washington. 

Details will be forthcoming.

For information, contact Pat Sylvia.

5th Annual Nursing Summit: Special Guest Teepa Snow

Don't miss it...

Mark your calendar for February 16th, Cedarbrook Lodge, SeaTac.  An excellent day of learning is planned.  Targeted for boarding home and nursing home administrators, managers and nursing staff.

Contact Pat Sylvia, Aging Services of Washington, for information.  Registration materials will be posted soon.

Analysis of Governor's Budget Released 11-21-2011

Aging Services of Washington provides this analysis of the Governor's proposed 2012 Supplemental Operating Budget and its impacts on senior care and services:

You can find it here.  Contact Paul Montgomery pmontgomery@agingwa.org for information and assistance.

Email Your Electeds: Advocate Now for Nursing Homes! Session Begins Nov. 28

Nursing Home Advocacy: Send your elected officials the Aging Services of Washington sample message via Contact Congress.  It's easy.

Contact Julie Martin or Paul Montgomery for assistance.

Public Comment Being Accepted on Proposed Criteria for Potentially Inappropriate Medication Use in NHs

Corresponding with CMS' new focus on inappropriate use of medications for nursing home residents, we encourage your Medical Directors and DNS' to review the proposal linked here.

By way of introduction, the updated Criteria address three primary areas:

1. Potentially Inappropriate Medication Use in Older Persons
2. Potentially Inappropriate Medication Use in Older Persons Due To Drug - Disease or  Syndrome Interaction
3. Potentially Inappropriate Medication Use in Older Persons - Drugs to Be Used With Caution

To comment, or for assistance, please contact Bonnie Blachly, Aging Services of Washington.

CMS Not to Enforce Certain HIPAA Requirements...

On November 17, 2011 CMS 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 CMS' 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)

For assistance, contact Paul Montgomery, Aging Services of Washington.

CMS to Focus on Reducing Inappropriate Use of Antipsychotics in Nursing Homes

CMS is calling for improvement in how antipsychotics are used in the treatment of nursing home residents with dementia.  Bonnie Blachly, Clinical Director, Aging Services of Washington, is analyzing this initiative and its impacts on our nursing home members. Please contact her for assistance or additional information.

Citing the Food and Drug Administration (FDA) black-box warning and the fact that these medications have been linked to adverse outcomes in nursing home populations, CMS Administrator Dr. Berwick asked stakeholders, including LeadingAge, to provide CMS with proposals for reducing the prevalence of these medications in the nursing home setting. 

DSHS Secretary's Message on the Governor's Budget Proposal

This message was released on behalf of Susan N. Dreyfus on November 21, 2011

The governor met her constitutional responsibility by presenting a 2012 Supplemental Budget balanced by offering an additional $2 billion in spending reductions in order to remain within existing revenue. But because she finds many of those reductions to be unconscionable, Governor Gregoire proposed several options for generating the additional revenue to prevent the most damaging reductions.

Evidence-Based Cognitive Rehabilitation and Memory Enhancement Training

We are proud to support this March 26 & 27th, 2012 program presented by Dr. Rob Winningham, Professor, Western Oregon University. 

Details will be forthcoming. Mark your calendars now. For information, please contact Pat Sylvia.

QIS Suspends CMS Implementation In Some States

 
CMS has notified some states that the 'future implementation of the QIS process has been suspended until further notice due to budget cutbacks at CMS'.  LeadingAge has been further informed that "There is a temporary delay, because of some technological and training issues that have been identified by some states and regions.  We are working through them, and anticipate moving ahead with full implementation as soon as we are confident that the issues have been adequately resolved..." 

DSHS is confirming that these issues are unlikely to impact our state because QIS is already in operation, and it is unclear the intersection of budget cuts and technical glitches.

We will continue to monitor this situation and keep you posted on any forthcoming information that might impact our state.
 

DSHS & Governor Proposed Budget Reduction Options (updated 10-27-11)

Last week, Governor Gregoire outlined her 2012 Supplemental Budget proposal.  In the analysis attached, we have compared the state agencies' proposals (released earlier) with the Governor's recommendations. http://agingwa.org/wp-content/uploads/DSHS-and-Governor-Budget_-Supplemental-2012-_as-of-10.27.111.pdf

Our analysis includes Medicaid coverage of services provided by boarding homes, adult family homes, adult day programs and psychiatric hospitals, health care insurance proposals for state-paid in-home caregivers (Individual Providers ~ IPs) as well as suggested cuts to specific rate add-ons for nursing homes and boarding homes.

Please contact pmontgomery@agingwa.org with specific questions or for additional assistance.

NH Administrator rule amendments proposed

State law, as amended with the passage of SB 5708 in 2011, requires the Board of Nursing Home Administrators (Dept. of Health) to adopt rules which would allow a nursing home administrator, when the nursing home has converted some of its licensed nursing facility bed capacity for use as assisted living or enhanced assisted living services (Medicaid contracts), to ALSO serve as a boarding home administrator for those beds.

New Skilled Nursing Facility (SNF) Health Insurance Prospective Payment System (HIPPS) Codes

CMS recently developed a new Change of Therapy (COT) Other Medicare Required Assessment (OMRA) for the SNF PPS and developed a mechanism to allow providers to report a Resumption of Therapy on an End of Therapy (EOT) OMRA. In addition, several new Assessment Indicators (AIs) were created to identify that a COT OMRA was completed.

Also, to distinguish between cases where an EOT OMRA is performed with the resumption items completed and cases where an EOT OMRA is completed without the resumption items completed.  The new AIs were introduced in Chapter 6, Section 6.4, of the new Minimum Data Set (MDS) manual located at http://www.CMS.gov/NursingHomeQualityInits/downloads/MDS30RAIManual.zip

Nursing Homes Making a Difference...

... in reducing hospital readmissions. A recent article from Healthy Skin magazine titled “Hospital Readmissions: Facts, Challenges and Real-Life Solutions” provides information on the factors that lead to readmissions, provides real life examples of how LTC facilities are making a difference in reducing hospital readmissions, and contains solutions, tips and tools for the reader.The article also offers 1 hour of CE credit for nurses.

This is a great article for Administrators, Directors of Nursing, Operations, Clinical Services and staff educators within a community.

Read the article here: http://agingwa.org/aging-services-today/improving-transitions