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October 4, 2019

Top Stories

MCOPs Clarify Hospice Contracting Status
Erin Begin

Four the of Five MyCare Ohio Plans have issued clarification to OHCA regarding their status of network availability for Hospice providers. As a reminder, hospice providers who are out of network with MyCare Ohio plans effective October 17th may not be able to accept out of network referrals. While some of the plans are not currently requiring network status for room and board billing, we encourage our members to apply for contracts with all open networks to prevent service interruption should the policy change in the future. We are still awaiting a response from Buckeye Health Plan, and will provide an updated OHCA Hospice Room and Board Billing Guideline once received. A summary of network availability and requirements can be found below:

MyCare Ohio Plan

Network Status for Hospice Providers

Contracting Required 10/17

Prior Authorization Required- In Network

Prior Authorization Required Out of Network

Single Case Agreement Required Out of Network

Aetna Better Health of Ohio

No Network

No

Yes

Yes

No

Buckeye Health Plan

 

 

Yes

Yes

 

Caresource MyCare Ohio

OPEN

Yes

Yes

Yes

Yes

Molina Health Plan

OPEN

No

No

No

No

UnitedHealthcare Community Plan Connected for MyCare Ohio

OPEN

No

No

No*

Yes*


Hospice News

Hospice Period Date Reporting Issue in CWF
Erin Begin

Palmetto GBA has found that some hospice period dates are not calculating correctly on the Common Working File (CWF). For example, period three and later should be no more than 60 days from the start through termination dates. They have found third or later periods have more than 60 days calculated in the period. This issue has been escalated to the CWF maintainer for research and resolution. No provider action is required at this time and Palmetto GBA will provide an update as soon as available.

Hospice Provider Preview Reports: Review Your Data by October 11
Erin Begin

From MLNconnects Newsletter
Hospice providers should be aware that two reports are available in your Certification and Survey Provider Enhanced Reports (CASPER) non-validation reports folder:

• Hospice provider preview report: Review Hospice Item Set (HIS) quality measure results from the first quarter of 2018 to the fourth quarter of 2018

• Hospice Consumer Assessment of Healthcare Providers and Systems (CAHPS®) provider preview report: Review facility-level CAHPS survey results from the first quarter of 2017 to the fourth quarter of 2018

If you believe the denominator or other HIS quality metric is inaccurate or if there are errors in the results from the CAHPS survey data, please request a CMS review no later than October 11th:

HIS Preview Reports and Requests for CMS Review webpage

CAHPS Preview Reports and Requests for CMS Review webpage

Instructions can also be found here:

Hospice Provider Preview Report

Hospice CAHPS Provider Preview Report

Additionally, CAHPS Hospice Survey has updated the following Survey Materials: Updates to the Case-Mix Adjustment (CMA) Methods document, CAHPS Hospice Survey state score document, and CAHPS Hospice Survey national percentiles document.


Other News & Education

OHCA Certified Executive for Home Care and Hospice (CEHCH) - Last Chance to Register!
Erin Begin
In today’s highly competitive world of home and community-based services, professional executives need a way to distinguish themselves. The Certified Executive for Home Care and Hospice (CEHCH) credential brings you a recognized certification designed specifically for HCBS executives. Completing the Certified Executive course gives you the necessary training and tools to succeed on the National Association of Long Term Care Administrator Boards Home and Community Based Services examination. Becoming a Certified Executive for Home Care and Hospice will empower you to excel in the profession you love and will enhance your distinction within Ohio’s home and community-based services marketplace. The CEHCH program will be held in Columbus, Ohio on October 8th and 9th and November 12th and 13th. For more information, please visit our EFOHCA website.

2019 Photo Contest Open for Voting
Steve Mould
The 2019 OHCA Photo Contest "Capturing Life and Caregiving Through Photography" is now open for voting! To vote for your favorite photos, please go to the OHCA Facebook page and the Photo Contest album. Please be sure to "Like" the OHCA Facebook page, and then click the "Like" button and add your comments on your favorite photos. Be sure to "Share" the contest on your own Facebook page! The photos with the most "Likes" will be selected as this year's winners. Voting is open until 8:00 p.m. on Monday, October 14. Winners will be announced on Tuesday October 15.

DNR Orders Require Physician’s Signature
Mandy Smith

OHCA has heard that the September 1st update to Ohio’s Do Not Resuscitate (DNR) form and rules may not be completely effective due to legislative issues. The ODH rule allows for a Physician Assistant or Nurse Practitioner to complete a DNR order, but the statute governing Ohio’s Emergency Medical Services does not support this fully. EMTs may refuse to follow these orders if they do not comply. Until this is resolved physician’s should sign all DNR orders. OHCA is offering a webinar ‘What’s New with DNR?’ on October 22, 2019. See details at EFOHCA.org.

Nurse Licensure Renewal
Mandy Smith

The Ohio Board of Nursing reports that the end of renewal is October 31st. The individual’s (who do not renew by that time) license will lapse on November 1, 2019, and they cannot work as a nurse as long as their license has lapsed. They must then apply to reinstate their license which takes additional time to process. OHCA recommends that all providers check to ensure that their nursing staff has successfully renewed their license and that they continue to have a license in good standing.

Ohio Patient Safety Institute 2020 Best Practice Award
Mandy Smith
The Ohio Patient Safety Institute invites long term care, home health care, hospitals, health systems, physicians and outpatient facilities to submit a nomination for the annual Dr. Frank Dono Best Practice Award by Dec. 31. The best practice award is presented annually to an individual or organization that has designed and implemented the most innovative, evidence-based patient safety practice in Ohio. Award submissions must include a project summary, description of the performance improvement process, an explanation of the data analytics used (measurable goals, use of benchmarks, etc.), verifiable results and sustainability, and a report of the lessons learned. All applications must be submitted online by Dec. 31. An awards committee will review all applications to select the finalists and ultimate recipient which will be announced in March. The award will be presented at the OHA Annual Meeting in June. Questions should be addressed to Rosalie Weakland, 614-221-7614.

Don't Miss the OHCA Human Resources Conference November 6!
Kathy Chapman
This one-day program is packed with human resources essentials, and is one of the most anticipated sessions by the provider HR community. The 2019 event features 6 hours of SHRM-CP and SHRM-SCP professional development credits (PDCs), and for NHA, CEHCH and nursing. Programming will include:

  • Finders Keepers: Recruitment & Retention
  • Human Resources 'Hot Topics'
  • Employee Benefits Programs: Innovations and Inspiration
  • Legal and Regulatory Human Resource Update:
    • FMLA
    • ADA
    • Board of Nursing Investigations
    • Other Issues

For details and registration please go to www.efohca.org.

Don't Miss the Workforce E Series: Culture Driven Recruitment and Retention
Kathy Chapman
Are you struggling to get and keep the best people? Are you spending tens of thousands of dollars to fill open positions? Are you craving education to stop the bleed and do things differently? OHCA has contracted with the Drive team to compile the best advice and quick wins they have uncovered into a step-by-step program: The E Series: Culture Driven Recruitment and Retention. Beginning October 9 with "Energized Employees: Thank Goodness It's Monday!," The E series consists of five high-energy, information-packed, 90-minute webinars and two inspiring in-person sessions over the course of seven months. This time frame allows organizations enough time to create sustainable change, not just bandages that don't stick! The program is designed for anyone who hires or is involved in the hiring process, including leaders, department directors, and managers. The program will provide deliverables you can use immediately:

  • Checklist for ensuing sustainability of recruitment/retention changes.
  • Coaching documents and guidelines
  • Ten must dos for orientation
  • Orientation assessment and tips
  • Guideline for creating magical moments
  • Interview guidelines and process flow
  • Sample interview questions
  • Sample job postings
  • Audit form for website and online presence of the organization
  • Focus group questions and tips
  • A worksheet for determining the cost of recruitment/retention

A tip sheet on turnover from Drive is available here. For program details and registration please click here.


Association News/Services

New Associate Members Support OHCA
Cindy Lee
We are pleased to welcome the following new Associate Members. If you are in need of any of these services or products please contact these vendors and thank them for their support of the long-term care community in Ohio. We have over 300 vendor members that provide the goods and services you need daily. If you are looking for a specific product or service you can contact Cindy Lee at clee@ohca.org for a list of members specializing in that area or you can look up an associate membership business partner or type of service using our vendor locator. https://www.ohca.org/pages/vendor_locator.aspx

Guardian Connection -- Legal Services -- Mordechai Lichtenstein

HELP Paradigm -- Emergency Preparedness Solutions -- Steven Foss

ICS -- Nurse Call, Fire Alarm, Security -- Curtis Davis

Heroes Needed!
Nominate your Hero of Long-Term care today! The OHCA Heroes of Long-Term Care program honors individual long-term care employees for their service to residents, the company, and to their community. Heroes are nominated from long-term care employees across the state. The program is also intended to provide good news opportunities for use in local and statewide markets. Program details and copies of the Heroes of Long-Term Care nomination form are available at Heroes of Long-Term Care.

Free Job Posting Available to Members
Steve Mould
Members may post openings in the "Job Opportunities" section of the OHCA website for 30 days at no cost. To post an opening, go to the Long Term Care Careers page at www.ohca.org log in and post the job through your account. You will need to be logged into the site with your user name and password before you attempt to post a position. For additional information contact Stephen L. Mould, APR (smould@ohca.org), 614/540-1325.


Hospice Bites
OHCA's Hospice Bites is distributed electronically each week (except for holidays and special occasions). Member representatives who would like to be added to or deleted from the distribution list should send an email to Debbie Jamieson (djamieson@ohca.org), including the individual's name, company, and email address. Individuals will be added to the email listing for all of OHCA's Hospice-related electronic bulletins and publications.