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CMS Posts Medicare Program Integrity Manual Updates -
Changes Affect SNF Enrollment, CHOWs, and Reenrollment Beginning January 2023
CMS posted a display copy of updates to the calendar year (CY) Final Rule for the 2023 Medicare Physician Fee Schedule (PFS), other Medicare Part B policies, and Medicare and Medicaid provider enrollment policies. Many of these updates impact skilled nursing providers.
Most notably – effective January 6, 2023 – SNFs that are initially enrolling or undergoing a change in ownership (CHOW) fall within the “high” screening category under 42 CFR § 424.518. SNF revalidations are processed at the “moderate” screening level. These changes include the addition of site visits for all SNF providers and fingerprint-based criminal background checks for 5 percent or greater direct and indirect owners at specific times.
The Federal Register version of the Final Rule will be posted on November 18.
AHCA/NCAL has developed a detailed summary of the changes impacting SNF provider enrollment, revalidation, CHOW, and reenrollment. Note: A member log-in is required to view the summary.
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DEADLINE TODAY!
National Quality Award Intent to Apply Submissions Due by 7pm CT
Final chance! Today is the deadline to submit your Intent to Apply for the 2023 National Quality Award Program.
Get expert tips, save money, and continue your quality journey by submitting your ITA by 7pm CT tonight!
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TOMORROW! CARE/PASRR Office Hours with KDADS Staff
The CARE and PASSAR process continue to cause slowdowns and headaches for Medicaid and other payer sources when individuals are admitted to LTC. Join the new KDADS CARE team for a monthly office hours session for the latest updates on the CARE and PASSAR process, how to avoid pitfalls and frequently asked questions. Dedicated time will be set aside for you to ask your questions about the process. Please note questions should not be about specific individual or divulge HIPPA protected information. The next open office hours will be held on Wednesday, November 16th at 11:00 am and will continue the third Wednesday of every month at 11:00 am.
Microsoft Teams Meeting
Join on your computer, mobile app or room device
Meeting ID: 277 737 122 417
Passcode: wz6r2z
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Despite the federal government’s likely decision to keep the public health emergency (PHE) in place past January, the nursing home industry continues to prepare for operations without the safety net of certain waivers. READ MORE
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SNFs Must Stop Underutilizing DNSs In Order To Thrive In Value-Based Care
In an opinion piece for Provider Magazine (11/1, 151K), Alexis Roam, a curriculum development specialist for the American Association of Post-Acute Care Nursing (AAPACN), said "the director of nursing services (DNS) plays a pivotal role in the success of a skilled nursing facility (SNF)." Roam wrote, "The health care system is transforming to value-based care, and this means SNFs must be innovative in the methods used to consistently produce quality of care and life outcomes as efficiently as possible." Roam said the underutilization of DNSs "does not position a SNF to thrive in value-based care, because the DNS needs to be at the heart of managing clinical care and services so that the facility can produce the best outcomes in nursing care." Roam concluded, "Underutilization of the DNS is not new, but SNFs that want to thrive in value-based care must change this practice."
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Members Only Nurse Advisory Call – Friday, November 18, 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 concerns and issues you may be having, hot topics, and the latest happenings.
Microsoft Teams Meeting
Join on your computer, mobile app or room device
Meeting ID: 283 466 140 174
Passcode: UfqCAi
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State lawmakers consider cutting CNA training hours, hiking Medicaid pay to address staffing woes
Raising state Medicaid pay rates and financial support for nursing homes and greater accountability for supplemental staffing agencies are getting a hard look from the Kansas legislature and provider advocacy organizations.
They met during a bipartisan committee hearing last week to address skilled nursing staffing shortages, a major culprit causing strife and facility shutdowns in Kansas and many other states.
The hearing specifically dealt with a domino felled by staffing shortages, use of agency staff. Last year, nursing homes nationwide saw an 83% increase in their median contract labor use compared to 2020, according to a report issued i n October by accounting firm CliftonLarsonAllen. READ MORE
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White House to extend PHE designation through April, reports say
The federal government will extend the COVID-19 public health emergency declaration until at least April, according to published reports.
The development would be roundly applauded by long-term care operators, and other healthcare providers.
American Health Care Association / National Center for Assisted Living President and CEO Mark Parkinson said in August that the sector sorely needed extensions until at least April to create a bigger window to lobby state legislatures to enrich their Medicaid pay rates. READ MORE
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AHCA/NCAL Executive Discusses Importance Of Adopting Population Health Approaches For LTC Providers
In an opinion piece for Provider Magazine (11/1, 151K), AHCA/NCAL Senior Vice President for Reimbursement and Market Strategy Mike Cheek said CMS "and states are heavily focused on moving from fee-for-service and payment by volume to value-based care and PHM [population health management] models, thereby also driving health plans, health systems, and physicians groups down this path." Cheek wrote, "Being able to understand and adopt population health approaches is critical if long term care providers want to move upstream in the health care reimbursement food chain." Cheek said "a key step is understanding the PHM options and potential paths to engagement. AHCA/NCAL’s Population Health Summit will be held on December 7-8, 2022, at the Gaylord National Harbor in Maryland and offers long term care providers further exploration, solutions, and opportunities in PHM."
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November Reflections & Survey Findings
We will not have a Facility Standards call this Friday, but the latest Reflections and Survey Findings can be found below.
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Clinical Update from KHCA Consultant Linda Farrar
Advance Directives is a very important but sensitive subject the facility is required to address. AND it has to be addressed immediately at the time of admission. The best scenario is that the resident comes to the facility with an Advance Directive already developed and organized and the resident and family are all aware and “on board”. So how often does that actually happen? Not often enough for sure. READ MORE
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𝗩𝗶𝗿𝘁𝘂𝗮𝗹 𝗥𝗲𝘀𝗶𝗱𝗲𝗻𝘁 𝗔𝘀𝘀𝗲𝘀𝘀𝗺𝗲𝗻𝘁 𝗖𝗼𝗼𝗿𝗱𝗶𝗻𝗮𝘁𝗼𝗿—𝗖𝗲𝗿𝘁𝗶𝗳𝗶𝗲𝗱 (𝗥𝗔𝗖-𝗖𝗧®) 𝗖𝗲𝗿𝘁𝗶𝗳𝗶𝗰𝗮𝘁𝗶𝗼𝗻 𝗪𝗼𝗿𝗸𝘀𝗵𝗼𝗽 - 𝗗𝗲𝗰𝗲𝗺𝗯𝗲𝗿 𝟮𝟬𝟮𝟮
Increase your knowledge of clinical assessment and care planning, completion of the MDS, the regulations surrounding the RAI/MDS process, and managing the PDPM by attending an AAPACN Resident Assessment Coordinator—Certified (RAC-CT) certification workshop. Having the RAC-CT credential behind your name shows that you are a knowledgeable and capable MDS professional.
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Webinar: Survey Success! Avoiding Top Citations. Post Survey Activities: Developing Effective Plan of Correction & IDR
12/6/2022 1:30PM-2:30PM
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Webinar: The Proficient Infection Preventionist Series: Astute Survey Preparedness & Application of Infection Control Regulatory Requirements
12/20/2022 1:30PM-2:30PM
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Looking for options for required Staff In-Service?
KHCA’s online learning platform is BACK! We’ve loaded the in-services for SNF and for AL first. Many more education sessions to come.
Questions about education can be directed to Polly Berkley VP of Operations and Education.
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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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