RURAL SWING BED MANAGEMENT (RSBM) TRAINING PROGRAM

Transcription

1 RURAL SWING BED MANAGEMENT (RSBM) The Georgia State Office of Rural Health and HOMETOWN HEALTH Present: The Need for Rural Swing Bed Training One of the challenges that rural hospitals face today is a shrinking inpatient census. In fact the average daily census in rural hospitals across the country is under four. Under the Medicare program, rural hospitals with 100 or fewer licensed routine care beds are eligible to participate in the swing bed program, meaning that a bed can be used for either an acute care patient or a post-acute patient who has been discharged from a medically necessary three-day minimum acute stay and requires skilled nursing care. Swing bed hospitals include both critical access hospitals (CAHs) and those paid under the Prospective Payment System (PPS). While financial considerations are different for each setting, the need for post-acute services is increasing as CMS restructures to episodic payment and quality outcomes. While providing more resources at the local level, swing beds can strengthen relationships with tertiary facilities. In both settings swing beds can improve occupancy and productivity in addition to increasing facility revenue. However, swing bed programs will do more harm than good if hospital leadership do not understand very specific skilled nursing regulations. Working Together to Improve Compliance and Efficiency As the first comprehensive swing bed education and training program for Georgia hospitals, this grant program will comprehensively address the rural swing bed issues and provide the necessary tools for compliance and quality. The ability to utilize swing beds for CAHS not only reduces the Medicare costs per patient bed day in these facilities, but increases revenues and margins that can help support population health, wellness, and other services. Care can be provided closer to home, with less disruption in services and continuity of care improves. Rehospitalizations can decrease with more ready access to physicians and needed ancillary services for a population that is more typically elderly and has multiple chronic conditions. This education and training program for Georgia hospitals provides rural hospitals with the basics for compliance and assists in building a strong peer network. The goal of the RSBM Training Program is to assist rural Perspective Payment System (PPS) and Critical Access Hospitals (CAHs) with expert training and guidance for their staff to: understand Swing Bed Conditions of Participation (CoP), improve the quality of their swing bed programs, optimize the patient outcome, and increase utilization and revenue for post-acute care services.

2 - Rural Swing Bed Management (RSBM) Program Overview The - RSBM training program will provide comprehensive training and consultative services rural hospital swing bed programs. The grant will provide two tracks of training and consultative services, including one CAH Swing Bed Track and one Rural PPS Hospital Swing Bed Track. Key components of the training sessions will include topics such as: Basics of Swing Bed services, Overview of CoP, Key Policies and Procedures, Medicare qualifying stay, beneficiary benefits and notices, Skilled nursing and therapy medical necessity documentation, Interdisciplinary team, Role of the physician, Billing and utilization review activities, Measuring outcomes and value to drive program marketing, Overview and Purpose of the MDS (PPS), and RUG IV Characteristics by Category (PPS) Hospital Pre-Assessment Upon registration, a Pre-Assessment is provided electronically to complete and help the team to assess each hospital s current level of compliance and efficiency related to their swing bed program. These will be followed by an individual hospital call with a RSBM Expert to discuss specific needs for the program. Best Practice Training Webinars A Kickoff webinar will launch two tracks of interactive training webinars: six for CAHs, and six for PPS Hospitals. Led by the team at HomeTown Health and swing bed consultants, the interactive training webinars will provide specific training for various members of the Hospital team, including Administration, Nursing, Therapy, Ancillary Services, Coding and Billing. Topics will range from Medicare requirements to medical necessity documentation specificity to preparation for changes in healthcare leading all hospital services toward better understanding of episodic care and quality standards. Employing interactive tools, the webinars will allow for the hospitals to provide instant feedback, creating a swing bed community of practice for the sharing of best practices. Critical Access Hospitals and PPS Hospitals each face unique challenges in compliance and efficiency related to swing bed programs. By working together through exclusive Participant Dashboards, resources, and live polls during training, the RSBM Training Program will create a collaborative Georgia Swing Bed Community of Practice. Through collaboration and sharing of best practices, hospitals will enjoy the benefit of learning what works, or has not worked, in the pursuit of a successful swing bed program from their hospital peers. Live RSBM Workshops & Breakout Sessions A live 2-day workshop with other participating hospitals will provide live, collaborating, hands-on training with experts. Participation in the grant provides registration for one hospital attendee, with the option to send additional members if desired. In addition, three Breakout Training Sessions will be provided at existing HomeTown Health Spring and Fall Conferences allowing for one attendee per hospital to participate in the half-day sessions. (Additional members can participate for a fee if desired.) Each Workshop and conference breakout session meeting will focus on a theme for a particular group of stakeholders in the hospital s swing bed program, including Focus on Administration, Focus on the Basics, Focus on Financials, and Focus on the Future. Individual Hospital Consultations Hospitals will also receive a telephone consultations during the program period to discuss specific needs and initiatives at the hospital. Each month, hospitals will receive aid and feedback in the monitoring of their hospital s compliance and efficiency benchmarking data in order to improve compliance with skilled nursing standards and in establishing viable census expectations. In addition, the live Boot Camp and Conferences will provide each hospital with the opportunity to schedule one-on- one consultation time and compliance/efficiency reviews with the RSBM team of experts. Help Desk Support from the RSBM Team of Experts A selected team of trainers and consultants will serve as support during the project period as needed.

3 The RSBM Program Team of Experts Kerry Dunning, MHA, MSH, CPAR, RAC-CT Ms. Dunning has almost 20 years in health care consulting and nearly 30 years in the industry. She specializes in the post-acute market working with hospital based skilled nursing and swing bed programs, critical access hospitals, freestanding skilled facilities, inpatient/outpatient rehab programs, inner city teaching hospitals and rural health care systems. Ms. Dunning worked for Horizon Rehabilitation and ServiceMaster Rehabilitation in varied roles including Vice President of Development, Sr. Vice President and Chief Operating Officer. Prior to that, she was employed by HCA and HealthTrust hospitals as a marketing manager, business development manager and services development manager. In addition to serving as an Adjunct Instructor in the College of Health at the University of North Florida, Ms. Dunning regularly leads workshops and webinars regarding Medicare, skilled nursing (including MDS), swing bed programming, and reimbursement cycle improvement. She also works on international health care projects and research, and serves on the Editorial Board for Rehab Management Magazine. Lisa Carhuff, Director of Hospital Services, Georgia State Office of Rural Health Ms. Carhuff is the Director, Hospital Services for the Georgia State Office of Rural Health. She has worked in the health care industry for the past twenty (20) years serving in quality improvement and patient safety leadership roles across the healthcare continuum. She is a native southerner from Mississippi with a passion to serve rural communities. Ms. Carhuff received her Bachelor of Science in Nursing from the University of Mississippi Medical Center and her Master of Science Degree in Nursing focused on case management for rural populations from the University of Alabama. She is a member of the national Rural Quality Advisory Council. Kristy Thomson, COO - HomeTown Health Kristy Thomson joined the HomeTown Health team in 2006 and served for 9 years as the Director of Education where she has directed the education services offered to HomeTown s hospital members and their affiliated clinics and physician practices. In this role, Kristy was responsible for course curriculum, content, technical set up and instructors, as well as directing live and online education services offered to HomeTown s network of 60+ rural hospitals and their affiliated clinics and physician practices along with 60 supporting business partners. She was also was responsible for compliance with the IACET/ANSI continuing education and training standards along with other accreditation standards and assisted in preparation, review and administration of state and federal grants. In 2015, Kristy moved into the Chief Operating Officer position for HomeTown Health where she is responsible for both the HomeTown Health operations and the education programs of HomeTown Health University. After graduating from Stephens County High School in Toccoa, Georgia, Kristy earned her degrees which are a B.S. from Clemson University and an M.S. from the University of Georgia, both in math and sciences. Prior to joining HomeTown, she worked as Special Projects Manager for the Town of Jupiter in Jupiter, Florida. She currently lives in Clarkesville, Georgia with her husband, John Lee, and her two sons, Jack and Luke. Among other community and industry related arenas, she currently serves as IACET Awards Committee Member and Georgia Medicaid RAC Provider Relations Committee Member. Swing beds not only provide a necessary revenue source for rural hospitals, post-acute services are necessary for increasing care continuums with tertiary hospitals as well as for quality care focused on elderly and frail patients. - Kerry Dunning, MHA, MSH, CPAR, RAC_CT

4 The RSBM Training Program Schedule Date Track One: Critical Access Hospitals Track Two: PPS Hospitals Aug 25, CAH: 11am -Noon The Georgia State Office of Rural Health and HOMETOWN HEALTH Present: Training Program Kickoff Webinar: CAH To include remarks from Lisa Carhuff, Swing Bed Overview, participation requirements, Services Provided, Dashboard basics, Program Resources and Pre-Assessment Survey introduction. Training Program Kickoff Webinar: PPS To include remarks from Lisa Carhuff, Swing Bed Overview, participation requirements, Services Provided, Dashboard basics, Program Resources and Pre-Assessment Survey introduction. PPS: 1:00pm- 2:00 pm Sep 22, Oct 27, Completion of Hospital Pre-Assessment / Individual Hospital Calls for Pre-Assessment by September 1 CAH Training Webinar #1: Medicare To include SWB- Medicare Intent, CoP, Regulations, Medicare Documents, Medical Necessity, and Dashboard Addition Select Technical Site Visits (2 PPS Hospitals) Live RSBM Breakout Session & Hospital Consults - HTH Fall Conference, Callaway Gardens Focus on Administration: Program Overview & Support Including: Policies and Procedures, Admissions, Appropriate Patients, Physician Oversight Intended Audience: Hospital and Nursing Home Administration, CEOs, CNOs, COOs, NHAs Nov 17, Select Technical Site Visits (2 CAH Hospitals) PPS Training Webinar #1: Medicare To include SWB- Medicare Intent, CoP, Regulations, Medicare Documents, Medical Necessity, and Dashboard Addition Dec 22, CAH Training Webinar #2: Working with Your Administration (For Program Director, Interdisciplinary Team): To include policies and procedures, Admissions, Appropriate Patients, Physician Oversight, & Dashboard Addition Jan 26, Feb (TBD) Mar (TBD) PPS Training Webinar #2: Working with Your Administration (For Program Director, Interdisciplinary Team): To include policies and procedures, Admissions, Appropriate Patients, Physician Oversight, & Dashboard Additions Hospitals Select from February or March Meeting; Live RSBM Training Meeting & Hospital Consults (Location #1: TBD/S.GA) Focus on the Basics: Including: Swing Bed Basics, Medicare Intent, MDS and RAI Manual, RUGs/CAH Reimbursement, Medical Necessity Documentation, Case Studies/Small Groups, Identified Issues Review Intended Audience: Facility Program Leads/Director (RNAC, MDS Coordinators, Swing Bed Directors) and IDT - CAH Track/PPS Track Live RSBM Training Meeting & Hospital Consults (Location #2: TBD/N.GA) (same as above)

5 The RSBM Training Program Schedule Date Track One: Critical Access Hospitals Track Two: PPS Hospitals Apr 27, CAH Training Webinar #3: Skilled Therapy To include Skilled Therapy Overview, Therapy Documentation, Nursing Documentation, Physician Documentation, Dashboard Addition April, 25-28, May 25, Jun 22, Live RSBM Breakout Session & Hospital Consults - HTH Spring Conference, Savannah Focus on Financials: Intended Audience: Program Director + Business Office Directors, Billers, Coding Coding Review, Billing Review, Dashboard/Benchmarks CAH Training Webinar #4: Ancillary Services To include Ancillary Services Overview (Lab, Radiology, RT), Dashboard Addition PPS Training Webinar #3: Skilled Therapy To include Skilled Therapy Overview, Therapy Documentation, Nursing Documentation, Physician Documentation, Dashboard Addition Jul 27, Aug 24, Sept 28, Oct, Oct 18-20, CAH Training Webinar #5: Moving Forward Topics to include Issue resolution, Dashboard Reviews, Setting Goals, and Post-Assessment Overview Post-Program Assessment Completion/ Individual Hospital Calls PPS Training Webinar #4: Ancillary Services To include Ancillary Services Overview (Lab, Radiology, RT), Dashboard Addition PPS Training Webinar #5: Moving Forward Topics to include Issue resolution, Dashboard Reviews, Setting Goals, and Post-Assessment Overview Live RSBM Breakout Session & Hospital Consults - HTH Fall Conference, Callaway Gardens Focus on the Future: To include Upcoming CMS Change training and Future Needs Intended Audience: Facility Program Leads/Director (RNAC, MDS Coordinators, Swing Bed Directors) - CAH Track/PPS Track