News Bites October 21 2016

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October 21, 2016

Top Stories

AHCA Sues CMS Over Arbitration Ban
Pete Van Runkle
As expected, AHCA filed a lawsuit against the Centers for Medicare and Medicaid Services (CMS) for including in the final SNF survey regulations (Requirements of Participation) a rule that prohibits new, pre-dispute arbitration agreements entered into on or after November 28, 2016. AHCA argues that the Social Security Act does not give CMS the authority to enact such a rule, particularly when another federal act favors arbitration. AHCA seeks to strike down the rule and hopes to get a temporary ruling before November 28. Here is what AHCA had to say about it:

Today, the American Health Care Association (AHCA), along with the Mississippi Health Care Association (MHCA), and AHCA/MHCA members, Great Oaks Rehabilitation and Healthcare Center, Heritage House Nursing Center and Pavilion at Creekwood, filed a complaint for declaratory and injunctive relief (attached) in the US District Court for the Northern District of Mississippi, Oxford Division, against the US Department of Health and Human Services (HHS) Secretary, Sylvia Mathews Burwell, and the Centers for Medicare & Medicaid Services (CMS), Acting Administrator, Andrew Slavitt.
The complaint asserts that the arbitration regulation banning pre-dispute arbitration agreements in CMS’Reform of Requirements for Long-Term Care Facilities Final Rule, violates the Federal Arbitration Act (FAA) and exceeds HHS and CMS authority under the Medicare and Medicaid Acts. We are taking this step to stop what is a clear overreach by CMS. If we are successful in obtaining an injunction, and showing the Court that our members are immediately harmed by the ban, the current November 28, 2016, effective date will be stayed. If not, we still have the opportunity to be heard in court on the merits, and we have a strong legal case. A special thanks to our friends in MS and TX for standing in the gap with us to challenge this onerous and needless regulation. They have truly stepped up on behalf of the entire profession and its members.
The final decision from the court could be handed down anywhere from 3-6 months from the filing of the complaint. If you have any questions, please contact Dianne De La Mare at ddmare@ahca.org. Additionally, if you have any questions from the press, please refrain from commenting, and send those questions to Greg Crist at gcrist@ahca.org.

Robin Hillier Re-Elected AHCA Secretary/Treasurer
Pete Van Runkle
The AHCA Council of States has re-elected Ohio’s Robin Hillier as Secretary/Treasurer at the national organization’s annual convention in San Antonio. Ms. Hillier has been a member of the AHCA Board of Governors for six years, also serving on the Executive Committee and a variety of other advisory bodies. At the convention, the Council of States AHCA members elected Tom Coble of Oklahoma for a second term as AHCA chair, and Christian (Chris) Mason of Oregon was re-elected NCAL chair. Hillier is well known to OHCA members by virtue of her long service as a member of the Board of Directors as an officer and as Association President. She is also a frequent instructor and performs numerous other activities on behalf of OHCA. In addition to the officers, the AHCA Council of States elected other Board of Governors members, and the NCAL State Leaders elected officers and members of the assisted living organization’s governing board. Additional details areavailable here.

Reimbursement

Medicaid to Reintroduce Exception Reviews
Pete Van Runkle
Exception reviews of SNF RUG scores, authorized by Ohio law when the state originally switched to a RUG-based case-mix payment system, fell out of favor with the Department of Medicaid (ODM) a number of years ago because the resources devoted to recapturing dollars by lowering centers’ case-mix scores did not generate an adequate return on investment. With the change to RUG IV, however, ODM apparently has become suspicious of MDS coding by SNFs. ODM recently released a request for information (RFI) for a contractor to re-start exception reviews. ODM previously utilized agency staff to do them. ODM follows in the footsteps of the Department of Developmental Disabilities, which began conducting exception reviews of ICF/IID assessment two years ago, with somewhat controversial results. The ODM RFI calls for responses by October 26, 2016, but does not specify when the exception reviews will begin. The RFI gives some idea of what ODM has in mind:

It is expected the MDS exception review process would include MDS-trained clinical staff to evaluate risk factors such as: 1) Clinical inconsistencies, 2) RUG distribution outliers; 3) Significant quarterly Case Mix Index (CMI) changes; 4) Presence of specified software issues by State and Nursing facility providers; 5) RUG data fields; 6) Centers for Medicare and Medicaid Services (CMS) Quality Measures; 7) statewide data comparisons; rehabilitation levels; and 8) results of prior MDS reviews and other risk factors.

Exception reviews are governed by a set of statutes and rules that date back to the original exception review program. ODM is responsible for taking any action against a provider’s rate resulting from the exception review findings, and due process is required. The rules also spell out thresholds for findings and payment take-backs.

Processing of Pro-rated Patient Liability; Unprocessed 9401s
Diane Dietz
In a call this morning with the Ohio Department of Medicaid (ODM), it was acknowledged that Ohio has seen a slowness across the board with County Departments of Jobs and Family Services (CDJFS) processing all facets of Medicaid applications under the new Ohio Benefits system. Some of the issues surround the manual processing of patient liability and pro-rated patient liability while other involve enhanced training. ODM reaffirmed that upon the death of an individual, the 9401 is to go to the county and they are to enter the date of death into Ohio Benefits and manually prorate patient liability. Should you experience a significant delay in the prorated patient liability appearing in MITS, please send a note toNFStay@medicaid.ohio.gov and they will attempt to intercede. ODM also indicated that they are requesting additional resources to assist with processing the overwhelming number of “thousands and thousands” of unprocessed 9401s that they did not anticipate prior to the August 1st go live date for Ohio Benefits.They remain committed to getting these processed as soon as possible and appreciated our patience. Please continue to send unprocessed 9401s toNFStay@medicaid.ohio.gov.

QMBs/SLMB/QIs in Ohio Benefits
Diane Dietz
OHCA has reported to ODM continued issues with Qualified Medicare Beneficiaries (QMBs), Specified Low-Income Medicare Beneficiaries (SLMBs) and Qualifying Individuals (QIs) being entered in Ohio Benefits so nursing facilities can bill for Medicare co-insurance and when applicable, eventual long term care services. Under the old 9401 process, nursing facilities were required to notify a county of all admissions, including an admission of a QMB/SLMB/QI, so the beneficiary could be entered into CRIS-E and nursing facilities could bill for Medicare co-insurance. Should the QMB/SLMB/SI beneficiary end of staying long term (now defined as 90 days), ABD SIL-based Medicaid would be explored. Under the new 9401 process, we believe this population was inadvertently overlooked. Due to the fact that QMBs/SLMBs/QIs already have open Medicaid cases, no-one classified them as a new Medicaid applicant for which NFs are required to complete a 9401 and send it to their local PAAs. As a result, they were not being entered into Ohio Benefits, and nursing facilities were not able to bill for Medicare co-insurance. We have brought this to the attention of ODM and while ODM indicated they are preparing a guidance for these beneficiaries, we believe strongly the guidance will result in: 1) the nursing facility sending a 9401 to the PAAs signifying they are new to entering a long term care facility and 2) marking the box indicating the facility is seeking a LOC exemption because they are in a Medicare Part A stay. Certainly if you wish to add to the comment field that fact that you believe these individuals are QMBs/SLMBs/QIs, that would be helpful too. We hope the new guidance and further training on this population will result in the PAAs entering them quickly into Ohio Benefits so nursing facilities can bill for Medicare co-insurance. We anticipate the guidance coming soon, and will discuss how to communicate should these QMBs/SLMBs/QI need to stay long term and have their Medicare explore against the ABD SIL-based Medicaid criteria for institutional, nursing facility services.

Clarification of When LTC Detail Screen Needs Completed for Processing of Medicaid Applications
Diane Dietz
ODM has acknowledged that there is confusion over when a LTC detail screen needs to be completed in Ohio Benefits before county caseworkers can process new Medicaid applications. For MAGI cases and base Medicaid ABD cases (ABD beneficiaries with a monthly income limit of 75% of FPL or $743), a LTC detail screen, which includes a LOC, is not needed for the counties to technically complete the Medicaid financial eligibility application. Please note, nursing facilities still need an approved LOC to bill for our room and board services; however, to complete MAGI and ABD base Medicaid financial eligibility cases, one is technically not needed. Only higher-income ABD beneficiaries who are evaluated for Medicaid against the institutionalized, special income level (SIL) ABD criteria are required to have a level of care detail screen, which includes an approved LOC, prior to completing the Medicaid application. ODM believes that many of the delays reported by OHCA and our members, whereby we have reported counties telling providers that they cannot complete the Medicaid application because the LOC detail screen is not complete, is due to this confusion. OHCA will continue to follow this issue and report accordingly to ODM.

QIT Opt Out Letter Issued by AHS
Diane Dietz
OHCA has reported to ODM issues surrounding a new “Opt Out of Qualified Income Trust” form that is being issued by Automated Health System (AHS) when a family chooses not to engage the services of AHS to establish a QIT but rather communicates the nursing facility is assisting them. The form implies that the family is opting out a completing a QIT, as opposed to opting out of needing the services of AHS, which is causing confusion and undo stress on families. OHCA communicated our concerns to ODM. ODM did confirm that they approved this form as a way to monitor AHS and ensure families were receiving the needed information about establishing a QIT. ODM did acknowledge that the wording on the form was misleading and at minimum, needing correcting. However, ODM went on to say that they are reevaluating this entire process and feel some verbal acknowledgement that a family did not need AHS services would probably suffice. Please stay tune as more information becomes available.

Regulatory

Planning a Private-Pay Rate Increase in January?
Pete Van Runkle
If you are, please be aware that the new federal survey regulations (Requirements of Participation) mandate 60 days’ advance notice for any change to the charges SNFs make for items or services not covered by Medicare or Medicaid. Under this requirement, which is in Phase 1 of the regulations and will take effect November 28, 2016, the deadline for notifying patients of a January 1, 2017, rate increase is November 1, 2016. It is not crystal clear that the 60-day notice requirement applies to private-pay rate increases, and it also is not clear when the surveyors will begin to look for compliance with the provision, but the prudent course would be to give notice by November 1.

Expedited Initial Licensure Request
Mandy Smith
During the ODH/Provider Meeting last month, ODH reported that the agency would post additional guidance regarding Expedited Initial Licensure Surveys. The department recommends not submitting the Notice of Readiness until the provider is within ten days of being ready. By licensure regulations, the Department must survey within ten days of receiving a completed packet. The department recommends that providers submit all other requirements and forms to ODH, and then the notice of readiness will complete the packet once submitted. The Ohio Department of Health Office of Health Assurance and Licensing has issued Nursing Home Interpretive Guidance 2016 – 1, indicating that applicants submitting an application for an expedited initial license application should be ready for a survey inspection by the Ohio Department of Health within ten (10) business days of filing all required documentation with the Department. Applicants should submit a Notice of Readiness for Inspection containing a date of availability for inspection that is no more than ten (10) business days following the date of submission of the Notice of Readiness.

New Proposed Food Handler Requirements
Mandy Smith
The Ohio Department of Health (ODH) recently held another stakeholders meeting for all who would be affected by the Ohio Restaurant Association’s proposal to extensively expand the requirements for Level I Food Handler Certifications. ODH has agreed that due to the current extensive oversight, federal, state, and local requirements, and already requiring a Level II certified individual to oversee the dietary department of skilled nursing facilities and soon to be assisted livings in Ohio, that long term care including skilled nursing facilities, residential care facilities, and ICF-IID centers would be exempted from this requirement. This requirement, if it had moved forward, would have meant that almost every employee would require a Level I Food Handler Certification that works in an assisted living community, nursing facility, or ICF-IID that has more than 16 residents. Due to the person centered nature of our communities, many employees, not just food service employees would fall under this definition. OHCA thanks ODH for recognizing this unnecessary increase in regulations and exempting long term care providers as this would have been a great increase in costs to providers.

AHCA to Post ROP Seminar Materials
Pete Van Runkle
At the outset of the AHCA convention, the association offered two three-hour “intensives” on the new Requirements of Participation (ROPs) for SNFs. Many people, including convention attendees who did not arrive early enough, were not able to participate in the seminars. AHCA plans to post the materials from the programs on its ahcancalED website. The slides and other items – which include a detailed checklist of required policies and other changes mandated by the ROPs – will be available on ahcancalED “very soon,” according to AHCA. AHCA has made ahcancalED the hub of its member resources on the ROPs.

New ACA Nondiscrimination Notice, Taglines Must be in Place Now
Steve Mould
As reported by OHCA’s legal counsel, Rolf Goffman Martin Lang LLP, all providers accepting Medicare and/or Medicaid funds must be aware of the new Affordable Care Act nondiscrimination rule, which requires covered entities to take numerous steps immediately, including modifying all “significant communications” to patients and residents. All significant communications to residents, including resident admission materials, must be revised to include a specific nondiscrimination notice and taglines in at least the top 15 languages spoken by individuals with limited English proficiency in the applicable state. The top 15 language by state can be viewed here, along with the taglines for each language here. The Implementation date was October 16, 2016 for providers to modify their significant communications. For information on this and other new Affordable Care Act nondiscrimination requirements, see ROLF’s blog post here.

Top 10 LSC Citations
Steve Mould
With the Life Safety Code survey process changing to reflect the adoption of the 2012 Life Safety and Health Care Facility Codes the OHCA LSC/ Disaster Management Committee has been reviewing frequently cited deficiencies (see the top 10 LSC citations for 2016 below, with old and new K Tags indicated) . Beginning November 1, 2016 ODH will begin surveying Ohio nursing facilities reflecting the requirements of the 2012 codes. We encourage members to provide OHCA with their LSC statement of deficiencies beginning November so that the Committee may track common issues across Ohio and the impact of the new codes. Please send a copy of reports to Steve Mould at the Association offices.

New K Tag	Old K Tag	Description	% Homes Cited
K271	K038	Exits	25.90%
K918	K144	Generator Testing	25.00%
K353	K062	Sprinkler System	22.40%
K920	K147	Electrical	18.00%
K712	K050	Fire Drills	17.30%
K341	K052	Fire Alarm System	17.30%
K321	K029	Hazardous Areas	16.50%
K351	K056	Sprinkler System	15.40%
K363	K018	Corridor doors	14.70%
K372	K025	Smoke Walls	13.10%

NFPA 99 Health Care Facilities Code
Steve Mould
There are many new inspection, testing and maintenance items required by the adoption of the 2012 NFPA 101 Life Safety Code and NFPA 99 Health Care Facility Code. The OHCA LSC/Disaster Planning Committee, Chaired by Kenn Daily, is reviewing the new code and will provide regular items in News Bites identifying important provisions, as well as educational programs.

Earlier this year CMS announced the adoption of the 2012 edition of the Health Care Facilities Code (HCFC), NFPA 99. The HCFC applies to all long care facilities and is intended for professionals involved in the design, construction, maintenance, and inspection of health care facilities. The HCFC requires facilities to evaluate the risk level of systems and equipment in the long term care facility. Depending on the risk assessment findings the long care facility are then instructed to meet minimum criteria for the following systems: gas and vacuum system, electrical system, electrical equipment, HVAC and gas equipment. The OHCA LSC/Disaster management committee has developed two risk assessment templates for long term care facilities. Competing these is required by CMS and maintained for surveyor review. A new K Tag – K901 has been established to confirm a facility’s compliance with the risk assessment requirement. OHCA also plans a webinar on the NFPA 99 on December 8, 2016; please watch for details.

Hazard Vulnerability Analysis
Steve Mould
In its final rule for Emergency Preparedness released earlier this year, CMS is requiring all facilities to complete an "all-hazards" approach prior to establishing an emergency plan. The all-hazards risk assessment will be used to identify the essential components to be integrated into the facility emergency plan. This approach is specific to the location of the provider and considers the particular types of hazards most likely to occur in their areas. The OHCA LSC/Disaster Management Committee has reviewed two hazard vulnerability tools which are available for facility’s to choose and complete, which will aide in developing the facility’s disaster management plan: 1) Kaiser Permeate Hazard Vulnerability Evacuation Tool and 2) FEMA’s Hazard Vulnerability Business Ready Risk Assessment Table. The OHCA LSC/Disaster Management Committee recommends the Kaiser tool as it offers a much more dynamic risk analysis for facilities. AHCA'sanalysis of the regulation is here.

BELTSS Proposes Rule Changes for Registration, Fees
Mandy Smith
BELTSS is proposing to modify OAC 4751-1-10.1 -- Timely Renewal of Certificate of Registration, and 4751-1-16 -- Fees. Rules and Business Impact Analysis forms are posted on the BELTSS website under “Rule Changes.” Please contactDeborah Veley, Executive Director of BELTSS, with any comments (please copy csipubliccomments@governor.ohio.gov) by November 15, 2016.

Other News

Apply Now to Speak at 2016 Long Term Care Convention
Kathy Chapman
Anyone can apply to be a presenter at the Annual Convention, including facility staff, consultants, associate members and professional speakers. The educational program for the convention is designed to ensure that attendees leave each session equipped with effective strategies to achieve operational excellence in skilled nursing centers, assisted living and ID-DD. For years, we have offered a remarkable lineup of education and networking opportunities targeting the needs and concerns of facility staff in all departments and with varying experience. This year's event is scheduled for May 1 - May 4, 2017 in Columbus, Ohio. The annual convention features sessions for all employees of OHCA, OCAL and OCID members as well as non-members of the Association. Over 1,500 people attended the 2016 event from all facility types and departments. Take this opportunity to share your best practices, strategies and great ideas with veteran health care professionals and colleagues, and increase your visibility within the long-term care community. Applications are submitted online and must be completed by December 5, 2016. Click here for the convention call for presentations application.

EFOHCA Elects New Leadership
Diane Dietz
The Association is pleased to announce that Jill Herron, Owner/Administrator of Welcome Nursing Home has been elected at the Chairman of The Educational Foundation of OHCA (EFOHCA). Jill also serves as Chairman of OHCA District 5 and is the Secretary/Treasurer of the OHCA Board of Directors. Joining her in leadership are EFOHCA Vice Chairman Bert McQueen, Owner/Administrator of Jac-Lin Manor and member of the OCID Board of Directors and EFOHCA Secretary/Treasurer William B. Levering, President and CEO of Levering Management and OHCA District 6 Chairman. The Association also wishes to extend a heartfelt thank you to Kathie Will, President of Morrison Healthcare, for her two years of services to EFOHCA as the outgoing Chairman of the Board. Thank you Kathie and congratulations to our new EFOHCA Leadership.

Interested in Going to School? Complete a FAFSA Today to be Eligible for EFOHCA Scholarship and $180 Billion in Federal Aid
Diane Dietz
Changes have been made to the Free Application for Federal Student Aid (FAFSA) in an effort to promote more college students applying for the $180 billion in federal financial aid available to them. As opposed to year’s past whereby federal financial aid applicants had to wait until they had their current year’s tax information in hand to apply for federal aid for the upcoming year, the federal government is now allowing applicants to use their previous year’s tax information to apply for current year aid. As a result, the FAFSA opened for the 2017-2018 school year on October 1, 2016 and applicants can now use their 2015 tax information to apply for 2017-2018 financial aid. OHCA member employees currently enrolled in school or thinking of applying to school next year are encourage to complete their FAFSA now to not only see if they are eligible for a portion of the $180 billion in federal aid, but also to apply for a 2017 EFOHCA scholarship. The FAFSA has been part of the EFOHCA scholarship program for the past several years, giving our reviewers the opportunity to objectively determine an applicant’s financial need. The EFOHCA scholarship application for the 2017-2018 calendar year will be available soon online through the OHCA website, interested applicants can get a jump start by completing their FAFSA now. Please take a minute to share with your employees that opportunities that are available to them to seek financial assistance in going to school by completing the FAFSA. In this day of staff shortages, helping to advance the skills of your current staff through encouraging them to pursue advanced degrees could result in benefits to them and to your organization. For more information about the FAFSA and to apply, please click here.

"Your Top Line" Publication Now Available to Members
Mandy Smith
AHCA/NCAL is providing a new publication to members which highlights metrics and graphics outlining progress on Five-Star performance, the AHCA/NCAL Quality Initiative, SNF Value-Based Purchasing relative to peers in your market, and other necessary data to help you achieve your desired goals. "Your Top Line from Long Term Care Trend Tracker" will be distributed each quarter; the publication will also include links for resources from AHCANCALed that will help members with specific goals. To log on to Long Term Care Trend Tracker and download your publications, click here. Once logged on, members can also change which buildings will be included in their download, and can run other reports to benchmark their centers against different peer groups and view trends over time.

SNF Quality Reporting Program Post-Training Materials Available
Mandy Smith
Post-training materials from the June 21 and 22, 2016, SNF QRP Provider Training in Atlanta, GA, are now available under the download section of the SNF QRP Training webpage. These include the PowerPoint presentations with answers to polling scenarios and collateral material used to facilitate the integrated case study and other classroom activities. A playlist with recordings of each presentation is posted on YouTube. Also, a four-part video series on Section GG has been added to a playlist available from one link. The playlist is available via the CMS YouTube channel. For more information, visit the SNF QRP Training webpage.

Deficiency-Free Information Needed
Steve Mould
As reported last week, ODH reports that the agency has suspended its practice of sending providers deficiency free letters, and will no longer provide OHCA/OCAL/OCID a list of deficiency free surveys so that we can recognize our members who achieve this success. OHCA would like providers to notify the association if they have a deficiency free survey by contacting OHCA Communications Director Steve Mould and providing him their 2567 report. For recognition from OHCA, deficiency free is considered having no citations in certification (F-Tag or W-Tag), licensure (N-Tag or R-Tag), and life safety code (K-Tag). To order “We’re Deficiency Free!” buttons for your staff, please download the order form and mail or fax your order to the Association offices.

Education Updates

2016 OHCA Fall Conference -- Relevant. Meaningful. Insightful. Current.
Kathy Chapman
Come Join Us November 8 - 9, 2016 for the 2016 OHCA Fall Conference, a 2-day executive-level briefing featuring updates on the most pressing issues facing long term care providers. The program will include sessions providing information on:

Ohio Medicaid: Recap of Key Initiatives and New Developments
Ohio Benefits: Update on System Conversion, DDR, 9401 and LOC Next Steps
Building Preparation & Patient Safety: Compliance with 2012 NFPA and New Emergency Preparedness Rule
Enhanced Regulations: Understanding CMS' New Requirements of Participation
Immediate Jeopardies: How Not to Fall Victim to Increased Citations
Alternative Payment Systems: Recap of Today's Models and What's to Come
Market Forces: The Intricacies of 5-Star and Rehospitalizations on Your Business Success
What's Changed in 2016: Recap of Regulatory Changes and Reimbursement Highlights
And much, much more!!

9 CEUs are available for NHAs, nurses and accountants. The program will be held at the Hilton Columbus/Polaris, 8700 Lyra Drive, Columbus, Ohio 43240, 614-885-1600. For registration and details please go to www.efohca.org.

Human Resources Conference: Complexities of the Workplace - Critical Issues & Creative Solutions
Kathy Chapman
Don't miss the 2016 long term care human resources conference scheduled for November 14 at the Nationwide Conference Center, Lewis Center, Ohio. The Conference is designed to provide executives, managers and human resources professionals with timely information they need on recruitment, retention, and the legal and operational topics that impact employment and management practices. Packaged into a one-day format to take into consideration the time needs of our registrants, the program packs a lot of punch into a tight package. Providers can send executives, human resources personnel and other managers to the conference without key staff members missing multiple days or incurring overnight expenses. For registration and details please go to www.efohca.org.

The Essential MDS 3.0 Course
Kathy Chapman
Understanding the MDS 3.0 is critical to all departments within the skilled nursing facility. This class will review the MDS 3.0 in detail from start to completion. A thorough review of each section of the MDS will be held. The course reviews all components of the Minimum Data set, the rules governing it's completion and the management of the MDS process. The class is designed to follow a logical progression from the use of the MDS manual through the use of the completed MDS and its data including an explanation of the Care Area Assessments. A current MDS manual is included in the registration fee for this program. A must attend for new MDS nurses, anyone considering becoming a MDS nurse as well as any department within the SNF that works with the MDS. This 11-hour program is scheduled for November 1 - 2 at the Association offices. For registration and details please go to www.efohca.org.

RAC-CT Workshop
Kathy Chapman
The Ohio Health Care Association has teamed up with the American Association of Nurse Assessment Coordination (AANAC) to present the most respected MDS certification program to long-term care professionals in Ohio. This intensive, three-day program provides all the courses you need to sit for the exam. We invite all professionals involved in the RAI process to consider this important and valuable certification. AANAC's Resident Assessment Coordinator - Certified (RAC-CT) certification is the distinguishing characteristic of an expert in resident assessment. AANAC's RAC-CT program has long set the national standard for skilled nursing facility PPS and MDS education. More and more employers are requesting RAC-CT certified applicants in their job postings as it has become the mark of a professional who is committed to their career and residents. Constantly reviewed and updated by a team of experts, the RAC-CT program will help you to distinguish yourself as a valuable asset to any long-term care organization. In this program, you will immerse yourself in clinical assessment and care planning, completion of the MDS, and the regulatory body surrounding the RAI/MDS process. The program is scheduled for November 8, 9, 10 at the Association Offices. For registration and details please go towww.efohca.org.

Medicare Part D - Navigating the New Normal
Kathy Chapman
As the Medicare Part D benefit continues to evolve, this session will focus on how to best navigate this new normal in LTC. Session will include a brief overview of Medicare Part D basics and what participants need to know for 2017. How will long term care facilities be impacted and partner with their pharmacy providers to further mitigate their financial risk? Participants will learn the basics of Medicare Part D, changes under Medicare Part D for 2017 and the impact to long term care. They will also learn how to collaborate with their pharmacy provider to minimize financial risk to the facility and its residents. This webinar is scheduled for 2 p.m. on November 15. For registration and details please go to www.efohca.org.

ICD-10-CM Coding Update
Kathy Chapman
On October 1, 2016 the ICD-10-CM changes for FY 2017 became effective. In addition updates and changes were made in the Official Coding Guidelines. This webcast will cover the new, revised and deleted codes and description, alphabetic index revision, tabular list revisions such as includes notes, excludes notes and use additional code notes along with a review and discussion of updates and changes to the Official Coding Guidelines. This course is designed for personnel who are responsible for coding in long term care facilities. The Webinar is scheduled for November 15 at 2 p.m. For registration and details please go to www.efohca.org.

Why Fraudsters Commit Fraud and How to Prevent it
Kathy Chapman
The best way to combat occupational fraud is to understand why fraudsters commit it and then create procedures and internal controls that address the fraudsters reasons. This session will provide reasons why fraudsters commit fraud using statistics from the Association of Certified Fraud Examiners Report to the Nations on occupational fraud and abuse. Understanding the why is not enough and therefore, this session will also offer prevention and detection techniques and real life case studies of business fraud. This webinar is scheduled for 2 p.m. on November 16. For registration and details please go to www.efohca.org.

Association News/Services

2016 Photo Contest Open for Voting
Steve Mould
The 2016 OHCA/OCAL/OCID Photo Contest "Capturing Life and Caregiving Through Photography" is now open for voting! To vote for your favorite photos, please go to theOHCA/OCAL/OCID Facebook page and thePhoto Contest album. Please be sure to "Like" the OHCA/OCAL/OCID Facebook page, and then click the "Like" button and add your comments on your favorite photos. The photos with the most "Likes" will be selected as this year's winners. Voting is open until 8:00 p.m. on Monday, November 7. Winners will be announced on Tuesday November 8.

AHCA Professional Liability Resources, Tools
The fifth product to be available as part of the AHCA Professional Liability Toolkit is the litigation that provides background and guidance for when nursing and assisted living providers choose to fight negative advertisements in court. Initiating litigation can work to stop ads from being published; but providers must proceed with caution. Before going to court, center staff need to carefully analyze the content of the unfavorable advertisements and determine if there is a strong chance a judge would decide that the advertisement is misleading, inaccurate and should stop. Before implementing any of the guidance suggested in the litigation strategy, be sure to determine with legal counsel if this strategy is in your best interest. If you have questions regarding this strategy, please contact staff liaisons Dianne De La Mare or Tom Burke.

Learn How OHCA's Private Exchange Can Help Control Employee Benefit Costs
Diane Dietz
OHCA has partnered with Assured Neace Lukens/Assured Options to provide the most technologically advanced private exchange available today. This is a new benefits strategy that combats rising benefits cost with employee choice and empowerment. Nationally, the results have been truly eye opening and employers are reducing their overall spend without negatively impacting their employee populations. In fact, employees almost unanimously are also saving money while getting a level of value from their benefits that has not previously been achieved. A recording of a special member update teleconference which reviewed the basics of the plan, and how it can benefit your business is now available. The people behind the technology were on hand to provide the details answer questions. To review the information please go to "Private Exchange." A copy of the accompanying slides in handout form may be downloaded here.

AHCA/NCAL's Affordable Care Act Online Resource
AHCA and NCAL are proud to offer members access to its Affordable Care Act (ACA) web page, which features all of the latest health reform analysis and tools for long term care providers. In addition to important resources and ACA updates, the site also features a critical timeline regarding upcoming deadlines and compliance programs. For more information, send an email to insurancecoverage@ahca.org.

Heroes Needed!
Steve Mould
Nominate your Hero of Long-Term care today! The OHCA/OCAL/OCID Heroes of Long-Term Care program honors individual long-term care employees for their service to residents, the facility, 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 atHeroes of Long-Term Care.

Free Job Posting Available to Members
Steve Mould
Members may post openings in the "Job Opportunities" section of the OHCA/OCAL/OCID 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.

OHCA News Bites
OHCA News 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 Stephen L. Mould, APR (smould@ohca.org), including the individual's name, company, and email address. Individuals will be added to the email listing for all of OHCA's electronic bulletins and publications.

Elevating the Post-Acute and Long Term Care Profession

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Elevating the Post-Acute and
Long Term Care Profession