KHCA/KCAL is committed to providing our members with important updates. Below is a list of the most recent information. Please visit our website for a list of complete updates. www.khca.org/covid-19-resources
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From The Reimbursement Policy Team: CMS Issues FY 2023 SNF Proposed Payment Rule
Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2023 update. Highlights include:
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The proposed rule provides for a net market basket increase for SNFs of 3.9 percent beginning October 1, 2022, but for a proposed parity adjustment of 4.6 percent.
- The 3.9 percent market basket update reflects an unadjusted market basket increase of 2.8 percent increased by 1.5 percent forecast error adjustment, as well as a reduction of 0.4 percentage points, in accordance with the multifactor productivity adjustment required by Section 3401(b) of the Affordable Care Act.
- However, due to the proposed parity adjustment, CMS estimates that the net market basket update would decrease Medicare SNF payments by approximately $320 million in FY 2023.
- While CMS questions the need for a second delay, it solicits comments on a possible delay or phase of the proposed parity adjustment.
AHCA/NCAL has developed a summary of the payment rule and the greatest impacts on members.
Additionally, the Association will host a member-only webinar on Thursday, April 14 at 3 PM Central. AHCA/NCAL President and CEO Mark Parkinson will provide an overview of the proposed rule and brief the membership on submitting comments to CMS. The webinar will be recorded, and all registrants will receive an email when the recording is ready. If you have questions or need assistance registering, please email educate@ahca.org.
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ATTENTION Assisted Living, Residential Health Care and Home Plus HCBS Providers
Bonus payments to HCBS direct-care workers (From Hawver’s Capitol Report)
If your center was enrolled as an HCBS provider and billed for services between July 1, 2020 and June 30, 2021 you should apply. If there is money left in the grant, KDADS may include more recent providers. If you have a mix of HCBS and private pay (assume you would) You will need to determine what percent of time is spent with the HCBS folks. So if an employee works 20 hours in a week or less with HCBS, you would apply for “part-time” for that employee. If that employee works more than 20 hours with HCBS clients, you may apply for full-time benefit for that employee.
Bonuses totaling $51 million will be distributed to Medicaid Home and Community-Based Services (HCBS) providers starting in June, Gov. Laura Kelly announced today.
The bonuses will benefit about 24,000 direct support workers in the state.
“Our direct-care workers have worked tirelessly to provide exceptional care to vulnerable Kansans during the pandemic and beyond,” Kelly said. “We recognize the hard work direct-care workers do, and we’ll build on this opportunity as an incentive to recruit and retain qualified staff.”
Provider agencies will receive a payment amount based on their number of current direct-care workers and immediate supervisors. All funds go directly to direct service workers and their immediate supervisors. Additionally, as an incentive to bring more direct support workers to the field, agencies will receive $1,500 dollars per new staff for a recruitment bonus.
The bonus payments are available through the American Rescue Plan Act signed into law in March 2021 to provide enhanced federal funding for Medicaid HCBS through a one-year 10% increase to the state’s Federal Medical Assistance Percentages.
The Kansas Department for Aging and Disability Services and the Kansas Department of Health and Environment will administer funding distribution.
A goal is to help Kansas with disabilities and behavioral health challenges to receive care in their homes and communities.
How to Apply (From the KDADS HCBS Workforce Team)
We have had a full week with the Workforce Incentive program and would like to provide you with some updates to the program.
Firstly, there are several updates to the KDADS Website that are available. We have posted an updated FAQ sheet and have added an FAQ sheet for FMS providers. We have also added two completed example application packets, one for day and residential support providers and another for FMS providers. As always, the items can be found at https://kdads.ks.gov/funding-opportunities
Secondly, we have received several questions about the necessity of the Unique Entity ID (UEI) assigned by SAM and have provided the following additional information. More guidance can be found in the FAQ online:
- Friendly reminder to please register with SAM in order to receive funding.
- Under the American Rescue Plan Act, Interim Final Rule, all eligible payees are required to have an active registration with the System of Award Management (SAM or SAM.gov) (https://www.sam.gov). You may provide a DUNS number if you are in the process of obtaining SAM.gov registration during the time of submission. However, it will be required in order to receive your payment.
- Why is System for Award Management (SAM or SAM.gov) registration required for this program?
- The US Department of the Treasury’s Final Rule to implement the American Rescue Plan Act (ARPA) expressly provides that the Uniform Guidance applies to programs funded by ARPA such as Workforce Incentive Program:
- “Payments from the Fiscal Recovery Funds as a general matter will be subject to the provisions of the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR part 200) (the Uniform Guidance).”
- 2 CFR parts 25.100 and 25.105 of the Uniform Guidance, in turn, establish that the System for Award Management (SAM) is the repository for standard information about applicants and recipients and provides that such part applies to “grants, cooperative agreements, loans, and other types of federal financial assistance.”
- Further, paragraph C.4 of the U.S. Department of the Treasury’s Compliance and Reporting Guidelines [SLFRF Compliance and Reporting Guidance Update 2.1 final (treasury.gov)] provides that, “in administering a program…[KDADS] will need to maintain procedures for obtaining information evidencing a given beneficiary, subrecipient, or contractor’s eligibility including a valid SAM.gov registration.”
- You might be wondering how long will it take to complete the SAM registration process? It should take about an hour to register through SAM.gov once you have all paperwork in order. A SAM.gov registration will take on average 7-10 days to process but may take longer given your unique business’ situation and the General Services Administration (GSA) processing time.
- Can I check on the status of my SAM.gov registration? Yes. From the SAM.gov home page, click on “Check Registration Status” and follow the instructions. The SAM.gov system will also email you regarding your status throughout the registration validation process.
- How much does it cost to acquire a SAM.gov registration? SAM.gov registration is free. If you receive any solicitation or navigate to any website requesting a fee to register for SAM.gov, be cautious. These services are not affiliated with this program or SAM.gov. It is free to register, and free assistance is available.
Please continue to refer to the website as we will be updating FAQs frequently. If you cannot find an answer to your questions online, please do not hesitate to email us at KDADS.workforce@ks.gov
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KHCA/KCAL President/CEO Update from 4/11/22
Click here if you missed Monday's President/CEO Update.
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SSA Declines to Survey for F888 Compliance - Vaccine Mandate
As you may already be aware, KDADS has declined to survey Kansas facilities for compliance with F888- vaccine mandate. We learned from CMS Monday afternoon that:
- The SSA (KDADS) has made providers aware that they will not survey for compliance for F888.
- CMS will use federal surveyors or contract surveyors to conduct a sample of onsite surveys to verify compliance with F888.
- All surveys will be conducted onsite; however, CMS may move toward other methods of conducting the survey in the future (they did not indicate what this would look like).
- Surveys may be in conjunction with state surveys (may have a federal surveyor present with state survey team) but will more than likely be a separate survey from the state.
- Facilities will receive a separate 2567 if survey is done separate.
- CMS will be coordinating with states on the timing of surveys to ensure they are not jeopardizing participation by surveying during non-optimal times (while awaiting revisits, etc.).
- Federal surveys will be starting this week and apply to all Medicare and Medicaid providers subject to the COVID-19 staff vaccination requirement.
- Federal surveyors will be presenting the administrator with a letter upon entry indicating that they are there to conduct the survey.
If there are any questions with the process or concerns related to the federal surveys for compliance with F888 they have indicated that providers should contact their regional location. Also, please don’t hesitate to reach out to khca@khca.org with questions.
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Zoom Session for CMS COVID-19 Waivers - Fire Safety and Life Safety
From the Office of the State Fire Marshal
In an effort to further explain the COVID-19 1135 changes by CMS we will have a zoom session on Thursday, April 28, at 10 a.m.
John Sprague is inviting you to a scheduled Zoom meeting.
Topic: CMS 1135 waiver update
Time: Apr 28, 2022 10:00 AM Central Time (US and Canada)
Join Zoom Meeting
Meeting ID: 990 4426 1771
Passcode: FE3SSn
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Known KMAP Portal Issue Notice
From the desk of Trescia Power:
It has come to KDADS' attention that there is a glitch in the new portal that is affecting Nursing Facilities. The known issue is with the admit date for nursing facilities and those issues can be tracked on the Claims Resolution Guide. My understanding is there is a fix coming early this week for the admit date issue. There are training guides as well as demos on the Public KMAP site and bulletins explaining the changes to the KMAP portal.
We strongly suggest sharing this information with your billing department or 3rd party biller and have them check out the Public KMAP site for updates and training guides.
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Members Only Nurse Advisory Call – Friday, April 15 2022 at 10:00 AM
Please join KHCA’s Nurse Advisory Committee President, Teresa Coover on this month’s Members Only NAC Call to discuss notice of the waivers ending. How is everyone handling the transition? How the TNA going away might affect our communities staffing. Does anyone have TNAs that flat out don’t want to take the full 90 hour course?
Microsoft Teams Meeting
Join on your computer or mobile app
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Members Only Facility Standards Call – Friday, April 15, 2022 at 11:00 AM
Join Linda Farrar - KHCA Consultant and Polly Berkley - VP of Operations and Education as they discuss the latest SNF survey findings.
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Vote Now! AHCA Documentary Honored as Telly Award Finalist
Please visit the Telly Awards webpage and vote for the documentary by rating it five stars. Please note that you will need to register your email address and create a password. Once you have rated the film, you will also need to confirm your vote via an email sent from the program.
Voting ends Friday, April 22, so please vote today. Feel free to share this information with staff, residents, families, and anyone else who may also be able to vote.
Moving to this stage of the Telly Awards is a big honor. This program showcases the best work created within television and across video. Receiving over 12,000 entries from all 50 states and five continents, Telly Award winners represent work from some of the most respected advertising agencies, television stations, production companies, and publishers from around the world.
Produced in 2021, AHCA’s documentary provides an inside look at how the COVID-19 pandemic impacted nursing home residents, staff, and families – and honors those heroes who continued to serve through the most challenging times.
Please reach out with any questions, and thank you. We appreciate your support!
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Next Steps for Facilities Using 1135 Waivers including Nurse Aid Training and Certification
Thursday, April 7th, CMS announced 30 and 60 day phase down period for certain LTC facilities Section 1135 blanket waivers.
Of note, the 3-Day Stay and Spell of Illness waivers are not impacted by yesterday’s announcement. Those waivers remain in place nationwide for all communities, hospitals and SNFs. At this point we do not have any indication of CMS intent to phase down these two waivers.
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From the Office of the State Fire Marshal
The Office of the State Fire Marshal weighs in on COVID-19 Emergency Declaration Blanket Waivers for Specific Providers.
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Clinical Update from KHCA Consultant Linda Farrar
I am going to do a “repeat” in case some of you missed the previous discussion about requirements for respiratory care. F695 is a very “popular” deficiency to be written these days. Let’s start with the recommendations from AMDA and other groups of practitioners. As a guide to physicians and practitioners, an article was written and updated on February 28.2022 with review for accuracy through March, 2022 by Mark Yurkofsky, MD and Joseph Ouslander, MD (the developer of the INTERACT project). READ MORE
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Speaking face-to-face with your Members of Congress is the most effective way to advocate for the kind of quality care you want to provide in your centers.
AHCA/NCAL’s Congressional Briefing offers you that invaluable opportunity. Come to Washington, D.C. this June, and ask for what you need and want. You’ll get an update on the latest happenings in long term and post-acute care, make an effective and immediate plan of action with your colleagues, and then meet with your Representatives and their staff on Capitol Hill. It’s a priceless chance to use your voice, and one that you can’t afford to pass up. Click here for more details.
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Call for Presentations
An essential service to our association is offering high quality training and education to our members. We invite you to join us in our commitment to delivering timely, relevant, and engaging information as we prepare for our 2022 Nurse Leadership Conference (June) and Annual Convention (September).
We are looking for topics that fit skilled nursing, assisted living, home plus and residential health care communities.
Click here to learn more on our needs and how you can submit a proposal.
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8 Week Webinar Series: MDS Mastermind Insights for MDS Coding and Reimbursement Accuracy
Weekly webinars starting on May 4 and ending on June 22 from
1:30 - 2:30 PM
Members $352
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Improving Resident Relationships in Long-Term Care (IRRL)
The IRRL program is a federally funded, evidence-based intervention developed by Cornell University to prevent resident-to-resident aggression (RRA) in long-term care settings. This program educates staff on how to recognize and mitigate RRA. It empowers staff to help create a safer community for residents and reduce stressful events in the workplace.
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Webinar: Restorative Nursing Series: Bowel Bladder, Dining, Communication & Cognition (Part 2)
4/14/22 from 1:00PM - 2:15PM
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Webinar: The Proficient Infection Preventionist Series: Competency in Infectious Diseases Common in Post-Acute Care Settings
4/19/22 from 1:30PM - 2:30PM
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Webinar: Restorative Nursing Series: ROM, Bed Mobility, Transfers, Ambulation, Dressing & Grooming, Amputation & Prosthetic Care (Part 3)
4/21/22 from 1:00PM - 2:15PM
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2022 Spring Joint Provider Surveyor Training
4/27/22 from 9:00 - 4:30 (Topeka)
4/28/22 from 9:00 - 4:30 (Wichita/Virtual)
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8 Week Webinar Series: MDS Mastermind Insights for MDS Coding and Reimbursement Accuracy
5/4/22 through 6/22/22 from 1:30PM - 2:30PM
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The AHCA/NCAL Quality Summit is Back! Registration Now Open!
Quality Summit will be held in Kissimmee, FL, May 16-18.
This year’s AHCA/NCAL Quality Summit delivers three days of education programs and awesome networking opportunities with like-minded, quality professionals in long term and post-acute care. The Quality Summit offers 30 sessions topics focused on leadership, recruitment and retention, infection prevention and PDPM.
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Kansas Health Care Association and the Kansas Center for Assisted Living
1100 SW Gage Blvd. | PO Box 4770 | Topeka, KS 66604
PH: 785-267-6003 FAX: 785-267-0833
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