Weekly Roundup Reporting the state and national long term care news

Transcription

1 @ Weekly Roundup Reporting the state and national long term care news Please disseminate the relevant information contained in this week s edition of the Weekly Roundup to the appropriate department. Administration Nursing Dietary Activities Social Services Rehabilitation Housekeeping Maintenance Laundry Page 1 of 9 NATIONAL NEWS Friday, October 1, 2010 CMS Posts New 802 and 672 The Centers for Medicare and Medicaid Services (CMS) has issued a new CMS 802 (Roster Sample Matrix) and a new CMS 672 (Resident Census and Conditions). It is our understanding that these forms are effective TODAY and are to be used during the survey process. Attached is a copy of the forms and their instructions for completion. MDS 3.0 Section Q Resource Information The new MDS 3.0, Section Q will contain a specific assessment and require care planning for any resident wishing to return home or to the community. A number of resources have been developed by CMS and are aimed to provide more information for consumers, providers, surveyors and local contact personnel (community placement specialists.) The latest Section Q survey and local contact agency, Questions and Answers document is attached. Additionally, you should reference: A brochure that allows adding Medicaid Agencies, Money Follows the Person programs, Ombudsman, etc. contact information. Residents and family members can call MEDICARE to order a free copy. Please visit if you are a provider who wishes to order the brochure. Providers are asked to set up an account to order. Once the account is approved providers will be able to log on and place orders. By October 1, 2010, CMS will have the following website available, The website provides the most up to date point of contact list and Section Q, Questions and Answers document, best practice tools and links to CMS Section Q training, brochure and video resources. Money Follows the Person videos can be found at A 10-minute video of two recently transitioned nursing home residents provides perspectives on returning to home after being admitted to a nursing home. The MDS 3.0 website containing coding training slides, instructor guides, training aides, MDS 3.0 RAI Manual updates and linkages to CMS internal and external websites can be

2 found at OfPage. ANHA representatives met with Medicaid yesterday afternoon regarding Section Q. There is NOT a list of Local Contact Agencies (LCA) available as of yet. We continue to meet with them on a regular basis and will provide information as it becomes available. If a facility has identified an individual who indicates that they wish to talk with someone regarding the desire to return to the community and the facility has determined that they could be transitioned, then the contact information is as follows until further notice: Alabama Medicaid Agency Robin Arrington lca@medicaid.alabama.gov Phone: At our Annual Convention last week, members of the ANHA Section Q Task Force distributed a document that we encourage facilities to use in documenting their efforts in regards to Section Q. The document is enclosed for your use. This document has been reviewed by Medicaid, DHCF and other interested parties. To date, no one has indicated a problem with our facilities using this document. A copy of this form is attached for your use. Transition from MDS 2.0 to MDS 3.0 Many providers are asking questions to gain a better understanding about how best to handle the transition from MDS 2.0 to MDS 3.0. CMS points providers to the information from the SNF PPS transition RUG-III to RUG-IV covered on the August audio-conference. The audioconference power point slides and spreadsheet are posted at Scroll down the page to find download information. According to CMS, the audio-conference transcript will be available soon. The Centers for Medicare and Medicaid Services (CMS) written information pertaining to MDS 2.0 to MDS 3.0 transition, released September 2010 is attached for your review. PointRight, a long term care consultation firm, has developed a training program for RUG IV Assessments with Transition Options. To obtain information about the training and to view the training slides, please visit CMS Changes SFF Program for Nursing Facilities The Centers for Medicare and Medicaid Services (CMS) released a Survey and Certification (S&C) letter dated September 17, 2010 to state survey agencies announcing significant changes to the Special Focus Facility (SFF) Nursing Home program. It is believed that the changes are a result of previous congressional hearings and a recent Office of Inspector General (OIG) report critical of the current SFF program. S&C NH institutes the following important changes to the SFF program (a copy is attached for your review): Page 2 of 9

3 Number of SFF Slots Previously the number of SFF facilities was based on the number of nursing facilities in each State. Alabama currently has 2 facilities on the SFF list. The new formula is based on the number of beds in each state, with a 10% increase in identified SFF s nationally. Despite these changes, this new formula will keep Alabama with 2 identified SFF facilities. Number of Eligible Facilities Previously CMS identified 15 eligible facilities in each state. The new formula is based on 5 candidates for each available SFF slot, plus additional candidates if currently selected SFF s are on the eligible list. This means instead of 15 candidates, Alabama will now have 10 candidates for ADPH to select from when a new facility must be selected as an SFF. Timeline to select new SFF When a SFF graduates from the SFF program (2 consecutive 6- month surveys with no findings issued with a Scope/Severity above an E and no intervening complaint surveys with findings issued above an E ), ADPH has a maximum of 21 days to select a new SFF from the list of eligible facilities. Selection of new SFF CMS also clarified that when selecting a new SFF facility, the state agency may choose any from the eligible list; the selection does not need to be based on any rank order of the eligible candidates. Progressive Enforcement Remedies CMS has clarified that it expects enforcement remedies of increasing severity for SFFs. Examples of remedies include: civil money penalties, denial of payment for new admissions, directed plans of correction, and directed in-service training. The S&C highlights the need for the state agencies to proceed to termination of the SFF s participation in the Medicare and Medicaid programs if the facility cannot graduate from the SFF program within 4 surveys without significant triaging between the state agency and regional office. This is a fundamental departure from previous practice. SFF Formula On a positive note, CMS has chosen to have the SFF formula used to rank facilities within each state to match the CMS 5-Star formula used to determine star rankings for survey outcomes. This consistency will help providers better understand where they stand within the state and their risk of being selected as a SFF. In CMS words, The methodology for selecting replacement facilities for the SFF program has been harmonized with the methodology of the health inspection domain of the Five-Star Quality Rating System. What does this mean to nursing facility providers in Alabama? 1. It means less facilities in Alabama will be eligible to be selected as an SFF when an SFF graduates from the SFF program or is terminated from the Medicare and Medicaid programs. 2. It means that if your facility has one of the state s 10 worst SFF scores, your facility could be selected to be a SFF, regardless of your ranking in the It means that if you are chosen as a SFF, it is imperative that you quickly graduate from the program. Failing to quickly have surveys with no findings above a S/S of an E will result in significant and increasing enforcement, including termination of your provider agreement. We do not expect to see facilities able to be on the SFF list for months as a result of the S&C letter, which previously did occur... SFF s will need to improve or they will be out! Page 3 of 9

4 The changes regarding the number of SFFs in each state and eligible slots are effective October 1, All other changes issued in the S&C become effective as soon as the State Agency is ready, but no later than 60 days from the date of this memo, which is November 16, CMS Posts Updates **Updated September 23, Availability of 2010 MCPSS Results: CMS has completed the administration of the 2010 MCPSS. The results are in! Ratings reflect the percentage of provider satisfaction as distributed on the new, fully labeled, 5-point scale. A random sample of over 33,000 providers was selected to participate in this year's survey. Providers were asked to rate their satisfaction with services provided by the Fee-for-Service (FFS) contractors. Of all providers who responded, more than 69 percent stated they were satisfied or very satisfied with their contractor's overall performance. Approximately 13 percent stated they were dissatisfied or very dissatisfied with their contractor's overall performance. To view more MCPSS results, visit the CMS website at scroll down to the "Downloads" section of the page and click on the link corresponding to the 2010 MCPSS Public Report. If you have general questions about the MCPSS please send them to MCPSS@cms.hhs.gov. **Additional Update September 23, MDS 3.0 Training Materials Important Notice MDS 3.0 RAI Manual Chapter 3, Section O, Page O-17 Errata Document: A formatting issue was identified on page O-17 of Section O of the latest published version of the MDS 3.0 RAI Manual (MDS_3.0_Chapter_3_-_Section_O_V1.04_Sept_2010.pdf) which may have resulted in miscoding of item O0400 on the MDS 3.0. Please download the PDF file below labeled "MDS 3.0 Chapter 3 Section O Page O-17 Errata Document September 2010.pdf" and insert the new page O-17 in your MDS 3.0 RAI Manual. Now Available - YouTube Training Videos for MDS 3.0: VIVE Video for Interviewing Vulnerable Elders Gold Standard Nurses Presentation from the April National Train the Trainer Conference in Baltimore RAI Manual Chapter 3 Sections A, B, C, D, G, K, Q, and P Please click on the appropriate YouTube Link under "Related Links Outside of CMS" on the CMS Nursing Home Quality Initiatives website ( Additional postings will be added as they are completed. You can also visit the "CMS YouTube Channel" at MDS 3.0 Technical Information: The "RUG-IV Medicare SNF PPS CMIs pdf" document in the RUG-IV package has been found to have labeling errors in the "Hierarchical Classification" column for 4 groups (CD2, CD1, CB2, and CB1). The CMI values are correct and are associated with the correct group. This document has been replaced by a new version ("RUG-IV Medicare SNF PPS CMIs V2.pdf") with the labeling errors corrected. A RUG-III Errata document has been posted. In three documents in the RUG-III Version 5.20 grouper package on the "MDS 2.0 Software and Specifications" page, the incorrect ADL ranges were given for groups RAB and RAB for the 34-group model. These are only documentation errors and all codes (SAS, C++, or DLL) are correct. Page 4 of 9

5 CDC Updates Guidance on Influenza Prevention and Infection Control in Healthcare Settings On September 20, the Centers for Disease Control and Prevention (CDC) released new guidance ( that supersedes its previous Interim Guidance on Infection Control Measures that were issued to control the 2009 H1N Influenza in healthcare settings. CDC explains that current circumstances and new information including reports that face mask use reduce the risk of influenza infection justify an update of the recommendations. Among other precautions, the guidance says health care professionals should don a facemask when entering the room of a patient with suspected or confirmed influenza and wear an N95 respirator when performing aerosol generation procedures on patients. The updated guidance emphasizes a comprehensive, multifaceted influenza prevention strategy that includes vaccine, respiratory hygiene, management of ill health care workers, adherence to infection control precautions for all patient-care activities and aerosol-generating procedures, and implementing environmental and engineering controls. The guidance states that annual vaccination is the most important measure to prevent seasonal influenza infection. NFPA Codes and Standards Link for AHCA Members Earlier this year, National Fire Protection Association (NFPA) arranged for all American Health Care Association (AHCA) members to be able to directly link to all the relevant NFPA codes and standards for nursing homes. This availability does not require NFPA membership and was done at the request of our Life Safety Consultant, Tom Jaeger. NFPA s willingness to do this was because these codes and standards are relatively old and generally unavailable, except electronically. Here is the link: Standards/Code%20development%20process/&cookie_test=1&cookie%5Ftest=1 Advancing Excellence Statement on the MDS/Quality Measure Transition Editor s note: The following is a statement from Advancing Excellence on the transition from MDS 2.0 to MDS 3.0. On October 1, 2010, nursing homes throughout the country will begin to use the MDS 3.0 assessment instrument. The Advancing Excellence Campaign is excited about the new MDS 3.0 and believes it will result in better quality of care and life to our nation's residents. However, as a result of the transition from MDS 2.0 to MDS 3.0, there will be a period of time when the Quality Measure (QM) reports that the Campaign has used to monitor performance for use of restraints, prevalence of high-risk pressure ulcers and symptoms of pain and the Quality Indicators that nursing homes use for internal QI/QA will not be available. The last set of QMs, based on MDS 2.0 data for the quarter ending September , will be posted in January CMS has developed 17 new quality measures that are based on MDS 3.0.These measures were submitted to the National Quality Forum (NQF) Page 5 of 9

6 ( early in 2010 and the final endorsement status should be announced by the NQF around December Therefore, the new QM data will not be available on Nursing Home Compare, or on the Campaign website until April In order to help nursing homes stay on track with their quality improvement efforts during this interim period, the Advancing Excellence Campaign has updated a series of tools so that a nursing home can continue to monitor its performance for pressure ulcers, restraints, and pain. Go to the Resources Section of the website to access the tools. In addition, over the next few months, we will provide nursing homes with tips to help integrate these tools into the nursing home s quality improvement process. The Campaign is also using this transition period as a time to encourage nursing homes to focus on the organizational goals - decreased staff turnover, increased use of consistent assignment, measurement of resident/family and staff satisfaction, and increased attention to advance care planning. Tools for these goals are also available in the Resources Section of the website. So that nursing homes can really show the progress they are making, the Campaign is urging homes to enter their data and use the website to help them monitor progress. To make it easier, there are videos on the website that show how to enter the data and use the Staff Turnover and Consistent Assignment tools. Page 6 of 9 ANHA NEWS Register Now for the ANHA 2010 Activity/Social Services Annual Convention Join ANHA as we present the ANHA 2010 Activity/Social Services Annual Convention on October 20-22, 2010, at The Wynfrey Hotel in Birmingham. This year s convention is packed with great educational offerings for ALL nursing home staff. Continuing education will be offered for activity professionals, social workers, nursing home administrators and nurses. During the convention, we will hold the Annual Activity/Social Services Auxiliary General Business Session, and officers will be elected for The Wynfrey Hotel is the host hotel for this event, and reservations can be made by calling the hotel at (800) or (205) The following rates have been negotiated with The Wynfrey Hotel for our 2010 Activity/Social Services Annual Convention Attendees: $140 per Standard/Double Room $170 per Double Concierge Level Based on space availability, these rates will be offered one day before and following the meeting dates. To ensure availability of reservation space, all participants are encouraged to make their overnight reservations by OCTOBER 5. After this date, rooms from our block which are not reserved will be released for general sales to the public and availability cannot be guaranteed. Please see the attached brochure and registration form for more information. My InnerView Reports Online by October 15 My InnerView will publish individual facility reports by the end of the business day on October 15, Access to the reports is granted by the Super User of your organization. If you have been assigned access, the reports will be available at

7 ANHA s account manager at My InnerView, Christa McCarten, can be reached at (715) or cmccarten@myinnerview.com. You may also contact John Matson at the Association Office at (334) or jmatson@anha.org Membership Assignments on ANHA Committees It s that time of year for ANHA members to indicate their committee preferences. Your participation on one or more of ANHA s committees will allow you the opportunity to be a viable voice in association decisions. Please review the attached committee memo and form and express your desire for yourself and/or key members of your staff to work with a particular (or several) committees. As you will see on the attached form, we ask that you indicate your preferences on a scale from 1 to 3 (1 being your first choice and 3 your third choice). Please note that those committees marked with an asterisk meet on an as-needed basis. Feel free to copy this form if you have more staff interested in serving than there are spaces available. So that we will have time to prepare for the coming year, we ask that you complete and mail, fax or the form to the Association office by Friday, October 8, If you have any questions, or if you have items relating to the committee which you wish to discuss, please contact Nancy Thomas at the Association office at (334) or nthomas@anha.org. Medicaid Cost Reports The Alabama Nursing Home Association will once again collect cost reports for analysis by our independent reimbursement consultant, Dave Bishop. As in the past, our reimbursement consultant will provide you a detailed analysis of your costs compared to the costs of other facilities of a similar size. We cannot stress enough the importance of sending in your cost report. In order to negotiate with Medicaid on various issues, we need to have accurate information concerning the profession. This information has proved very beneficial in the past. Please send a copy of your 2010 Medicaid Cost Report to: Alabama Nursing Home Association 4156 Carmichael Road Montgomery, Alabama, ATTN: Katrina Magdon FACILITY NEWS Andalusia Manor Holds a Luau Andalusia Manor recently hosted a luau for residents and their family members. The facility dining room was transformed into a tropical paradise complete with palm trees and flamingos. The evening was topped off with some hula hoop games. Pictured from left to right are Sandra Owens and Syble Tompkins. Page 7 of 9

8 Altoona Health & Rehab Hosts Antique Car Show and Fun Day Altoona Health & Rehab recently held an afternoon of fun and games that included an antique car show. Residents said the old cars brought back many memories. After the car show, residents participated in a pie throwing contest where they tried to cream the staff members. Page 8 of 9 STATE NEWS New Address for the OBRA PASRR Office Until further notice, please use this address for correspondence for the OBRA PASRR Office: OBRA@mh.alabama.gov Alabama Board of Nursing Posts Data Each year, the chief nurse of all types of Alabama facilities submits an Annual Report of Standardized Procedures or procedures beyond basic education being performed in their facility/agency/company in accordance with ABN Administrative Code Rule 610-X-6-.12(6). The report for 2010 has been compiled to reflect the most frequent procedures beyond basic nursing education performed in each facility type throughout the state. Now that five (5) years of data has been collected in the same or similar format, trends can be identified. The 2010 report including the background information and data summary are available on the CNO page and at the following link: %20&%20Data%20for%202010%20Annual%20Report%20of%20Standardized%20Procedures. doc If you have questions, please contact Carolyn Morgan, Practice Consultant, at cmorgan@abn.state.al.us. CALENDAR OF EVENTS Date Event Location Time October 6 th ANHA Region V Meeting Golden Ranch BBQ 12:00 p.m. RSVP: Eldridge Stewart Selma (334) or estewart@frontiernet.net Speakers: ADPH Division of Healthcare Facilities New SouthernLINC phones will be distributed bring your old phone

9 October 7 th ANHA Region VII Meeting Felix s Fish Camp 12:00 p.m. RSVP: Gail McInnish Mobile (251) or gail.mcinnish@infirmaryhealth.com Speakers: ADPH Division of Healthcare Facilities October 19 th ANHA LSC and Physical Plant ANHA Offices 10:00 a.m. Committee Meeting Montgomery October 20 th ANHA ACT/SS Convention The Wynfrey Hotel -22 nd Birmingham October 27 th My InnerView Webinar on Webinar 10:00 a.m. Satisfaction Survey Results October 28 th My InnerView Webinar on Webinar 2:00 p.m. Satisfaction Survey Results Alabama Nursing Home Association 4156 Carmichael Road Montgomery, AL PH: (334) FAX: (334) WEB SITES: Alabama Nursing Home Association AL Board of Examiners of Nursing Home Administrators AL Dept. of Public Health CMS Page 9 of 9