August 13, 2013
Top Stories
Waiver
Rate Increase Decisions
Pete Van Runkle
A stakeholder
workgroup discussing how to implement the additional funding provided in the
state budget to increase rates for DODD waiver programs reached a conclusion
for State Fiscal Year 2014. The increase will be divided between transportation
and on site on call. It will apply to both agency and independent providers and
to both the IO and Level 1 waivers. The transportation rate is expected to go
up to 45 cents per mile, and the on site on call rates will be adjusted to use
the remaining funding. The increases will have to be approved by the Centers
for Medicare and Medicaid Services. The group assumed that the increases will
take effect January 1, 2014, but it could be sooner. The workgroup next will
look at what to do for State Fiscal Year 2015, which has a larger funding
allocation.
ICF Rates
Out, Small Glitch Found
Pete Van Runkle
The Department
of Developmental Disabilities is mailing packages to all Ohio ICFs with their
Medicaid rates for July 1, 2013. OCID has everyone’s rates as well. Please
email Pete Van Runkle if you would like to receive your rate before the official
package arrives. There is one caveat. OHCA Platinum Champion Partner Howard
Wershbale identified an error in the return on equity (ROE) portion of the
department’s calculation that will affect some providers’ ROE rates but also
will have a slight effect on the rollback, which is currently pegged at 1.48%.
Next week’s payments may end up being issued with the erroneous rates. Although
it may rise a little because of the ROE adjustment, we still are pleased to see
that the rollback came in below the 1.69% target that we used when putting
together the rate calculation parameters for this fiscal year. All parties to
the budget bill negotiations agreed that next fiscal year, the rollback will be
eliminated altogether.
DODD
Employment First Rule
Pete Van Runkle
The Department
of Developmental Disabilities issued a draft rule on the Employment First
policy that creates a presumption that all individuals can work in the
community and promotes mechanisms to maximize the number of individuals in
community employment. The rule will create requirements for county boards and
for providers of employment services. Employment services include several
specific services funded under the Individual Options, Level 1, and SELF waivers.
Employment services providers will be required to prepare 6 month progress
reports on individuals’ movement toward employment goals and submit data to the
department. It is our understanding that the rule does not cover habilitation
centers operated by ICF-IID providers that do not furnish the specified waiver
services.
Legionella
Outbreaks Raise Concerns
Mandy Smith, Steve
Mould
TThe news
of a central Ohio facility faced with 6 resident deaths and more than 35 others
with symptoms from Legionella (Legionnaires’ Disease, LD) has caused widespread
concern in long term care communities, the general public and media, and with
health officials. Legionnaires' disease is caused by a type of bacterium called
Legionella. The bacterium is named after a 1976 outbreak, when many people who
went to a Philadelphia convention of the American Legion suffered from this
disease, a type of pneumonia (lung infection/ progressive pneumonia with a 2 to
10 days incubation period that may be accompanied by cardiac, renal and
gastrointestinal involvement). Residents who contract Legionella (Legionnaires’
Disease) are often afflicted as the result of preventable exposure to
inadequately managed building water systems. The OHCA Life Safety Code/Disaster
Planning Committee and Regulatory Committees are developing a White Paper
addressing the operational and clinical considerations for prevention,
identification and treatment of LD in health care facilities. In the meantime,
resources are available from the following resources, and a webinar titled
Water Safety, Legionella and ASHRAE has been scheduled for September 11 at 2
p.m. Please go to www.efohca.org
for details and registration.
Regulatory News
Elimination
of Time-Limited Certification Agreements
Steve Mould
We have had
questions from some members concerned because ODH surveyors had not yet
arrived, and the end date on their certification award letter was near. CMS in
February issued S&C:
13-11-ICF/IID, which indicated that intermediate care facilities for the
intellectually disabled were no longer certified under time-limited agreements.
The regulations were changed to provide that provider agreements for ICFs would
remain in effect as long as the facility remains in compliance with the
Conditions Of Participation. The letter also indicates that ICFs are to be
surveyed for re-certification an average of every 12 months and at least once
every 15 months.
CMS
Requests Comments on National Background Check Program
In
April, CMS issued the Report
of the National Background Check Program Long-Term Care Criminal Convictions
Work Group. The initial release did not provide an opportunity to comment on
the report. CMS has updated and reissued the S&C
memo that accompanied the report and will now accept comments until August
30, 2013. If you have comments that you would like to be included with AHCA’s
comments, please send them to Lyn Bentley
at AHCA by August 19.
Clinical and
Operational Updates
New Federal
Guidelines for Managing Occupational Exposures to HIV
Mandy Smith
New guidelines published in Infection Control and Hospital Epidemiology http://www.jstor.org/stable/full/10.1086/672271
emphasize the immediate use of a PEP regimen containing three or more
antiretroviral drugs after any occupational exposure to HIV. The PEP regimens
recommended in the guidelines encourage the consistent use of a combination of
three or more drugs, that are better tolerated than those recommended in the
previously published guidelines from 2005, for all occupational exposures to
HIV. The guidance eliminates the previous recommendation to assess the level of
risk associated with individual exposures to help determine the appropriate
number of drugs recommended for PEP.
If a newer
4th generation HIV antigen/antibody combination test is used for follow-up
testing, an option to conclude HIV testing at 4 months, rather than the
recommended 6 months after exposure, is provided. Many of the revised
recommendations are intended to make the PEP regimen better tolerated,
increasing the possibility that healthcare personnel complete the full regimen.
CDC has made available an infographic http://www.cdc.gov/hai/pdfs/HIV/HIVPEPinfographicFINAL.pdf
that may be helpful to healthcare personnel. It provides a plain language and
boiled down version of the main points of the updated guideline. The guidelines
were developed by an interagency Public Health Service working group comprised
of representatives from the CDC, National Institutes of Health, Food and Drug
Administration and the Health Resources and Services Administration.
Affordable
Care Act Webinar Series Available Online
On
July 16, AHCA/NCAL held a webinar focused on the Affordable Care Act’s (ACA’s) employer
requirement. As many provisions of the employer requirement remain in
place, AHCA/NCAL will continue to host focused sessions and place requirement
materials on its ACA website as a resource. Another ACA webinar occurred
earlier today and focused on several areas that are critical to developing the
health insurance marketplaces and what this will mean for providers as
employers and from a business perspective, including the Small Business Health
Options Program (SHOP); remaining timelines; employer mandate readiness; and
employer sponsored insurance interaction with other types of coverage. Be sure
to check out AHCA/NCAL’s Affordable
Care Act (ACA) Web page, which features all of the latest health reform
analysis and tools for long term care providers. For any ACA related questions
you may have, please send an email to insurancecoverage@ahca.org.
Provider News
OCID Sponsors
2013 Ohio Direct Support Professional Recognition Event
Steve Mould
The 2013
Ohio Direct Support Professional Recognition Event is an opportunity for
employers to send their staff to a much needed day of fun and camaraderie. This
year Rachel Simon, the author of "Riding the Bus with My Sister,"
will be featured. OCID is a Platinum Sponsor of this event. The program will be
held at Xenos, 1340 Community Park Drive, Columbus, OH 43229. Details and registration
is available at DSP
Recognition.
Partnership
to Improve Dementia Care Releases Antipsychotic Drug Use Trend Update
Mandy Smith
The National Partnership to Improve Dementia Care is committed to improving the
quality of care for individuals with dementia living in nursing facilities. The
Partnership has a mission to deliver health care that is person-centered,
comprehensive and interdisciplinary with a specific focus on protecting
residents from being prescribed antipsychotic medications unless there is a
valid, clinical indication and a systematic process to evaluate each
individual’s need. CMS is tracking the progress of the Partnership by reviewing
publicly reported measures. The official measure of the Partnership is a the
percent of long-stay nursing home residents who are receiving an antipsychotic
medication, excluding those residents diagnosed with schizophrenia,
Huntington's Disease or Tourette’s Syndrome. In 2011Q4 23.9% of long-stay
nursing home residents were receiving an antipsychotic medication; since then
there has been a decrease of 9.0% to 21.7% in 2013Q1. Success has varied by
state and CMS region, with some states and regions having seen a reduction of
greater than 10%. A three-quarter measure is posted to the Nursing
Home Compare website. The long-stay measure on Nursing Home Compare shows
each facility’s score averaged over the last three quarters in order to give
consumers information on the past history of each facility. A quarterly trend
update from the National Partnership to Improve Dementia Care is available here.
One-Stop
Website Launched to Educate Business Owners About Affordable Care Act
The
Obama Administration has launched Business.USA.gov/healthcare,
a one-stop-shop website which will provide employers of all sizes educational
materials on how the Affordable Care Act may affect businesses and help them
compete. The site includes a wizard tool that is tailored based on size and
location, so businesses can learn how the law helps them provide affordable
coverage options to their employees while still meeting their bottom line. The
site will act as a user-friendly hub that connects employers to informational
content on tax credits and other provisions of the law from the Small Business
Administration, the Department of Health and Human Services (HHS), and the
Treasury Department.
RN, APRN
Renewal Reminder
All
RNs and APRNs, that haven't already renewed their licenses and certificates
should renew today. For APRNs to have completed the renewal process, you must
renew your RN, each Certificate of Authority (COA) and your Certificate to
Prescribe (CTP), if applicable, individually. This may require you to log back
into the system for additional renewal sessions in order to complete each
credential's renewal process. For more information please see the FAQ,
and visit the Ohio
Board of Nursing website.
Scripps
Releases New Report on Ohio LTC
Pete Van Runkle
The Scripps
Gerontology Center at Miami University periodically issues reports assessing
the state of the long-term care system in Ohio, as well as other reports on
more specific topics. This year’s report titled “Maybe
Elephants Can Dance: Two Decades of Progress in Delivering Long-Term Services and Supports in Ohio” marks the
20 year point on the center’s longitudinal study and highlights the state’s
progress in developing home and community based services across that period.
The report contains a wealth of interesting data about Ohio’s long-term
services and supports and changes over time.
2012
Economic Census Responses Past Due
The
2012 Economic Census, the U.S. Government’s official five-year measure of
American business and the economy, is currently underway. For those businesses
that were mailed a form but have not yet responded to this mandatory survey,
the response is past due and recipients are urged to complete the form and
submit it as soon as possible. Report online at econhelp.census.gov.
Education Updates
Save the
Date -- OCID ICF/IID Summit
Mark your
calendar now for the first OCID ICF/IID Summit, scheduled for October 1, 2013,
at the Embassy Suites Columbus Airport. This day of education will include
updates on policy, regulatory, operational and legal issues from both the Ohio
and national level.
AHCA
Convention ID/DD Day
The AHCA
Intellectual and Developmental Disabilities (ID/DD) Day during the Annual
Convention will be held October 6, 2013 from 8:00 a.m. – 4:30 p.m. The program
offers 7.25 CEUs, and features a keynote presentation by Scott D. Osterfeld,
M.S.; a CMS update on the ICF/IID program; and programs on grant funding,
behavior supports and antipsychotics, among others. For more information go to
ID/DD Day; full registration information is available on the AHCA
Convention website.
Bridging
the Expectations Gap
Kathy Chapman
This program is designed to equip front-line supervisors to improve staff
retention, increase customer satisfaction, and reduce cost. Scheduled for
September 5 from 2:00 - 3:30 p.m. this webinar will teach participants a
different way of approaching supervision of direct care-givers and other
front-line staff; coaching skills vs. traditional methods. Coaching skills
empower the supervisor to strengthen the work relationship with the employee,
resulting in reduced staff turnover, enhanced clinical and satisfaction
outcomes, and reduced operating cost to the organization. For additional
information and registration please go to www.efohca.org.
Member Services
Deficiency
Free Facilities
Steve Mould
As part of
an ongoing effort to recognize member facilities for their quality improvement
efforts, the Association recognizes member facilities that ODH identifies as
having completed their annual survey with no deficiencies. The following member
facilities have recently received a deficiency-free survey, and the Association
would like to congratulate them on their efforts:
- Elmwood
Village, Green Springs -- Kathy Hunt, Administrator -- May 2013
- Jac-Lin
Manor, Loudonville -- Bert MacQueen, Administrator -- May 2013
ODH
regularly provides the Association with information on facilities with a
deficiency-free survey, from which this report is developed. 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.
New
Associate Members Support OHCA/OCAL/OCID
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. In addition to this new
member we have nearly 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 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.
- Community
Emergency Medical Service -- Wheelchair Transportation -- Phil Koster
- Gilmore,
Jasion & Mahler, LTD -- Accounting, Reimbursement & Consulting -- Jamie Dixon
AHCA/NCAL
Adds New CFO
AHCA/NCAL
has announced that the organization has hired a new Chief Financial Officer
(CFO). Jim Elder is a CPA with 30 years of CFO and controller experience in the
non-profit sector in the Washington D.C. area. He spent 10 years at National
Public Radio and 10 years at the American Nurses Association. He was selected with
the help of the AHCA/NCAL Board and leadership, and AHCA President & CEO
Mark Parkinson indicates that he is an excellent fit for the organization.
AHCA
Quality Award Program Adds Recertification
The
AHCA/NCAL National Quality Award program is implementing a new Quality Award recertification
policy, effective in the 2014 awards cycle, which impacts all current and
previous AHCA/NCAL National Quality Award recipients. Under this policy, Bronze
and Silver Quality Award recipients will have a limited amount of time to apply
for the next award level (Silver or Gold) before being designated as a “past
recipient” of the award, a status that requires the facility to reapply at the Bronze
level if it decides to participate in the program again. This policy was
written by the AHCA/NCAL National Quality Award Board of Overseers and approved
by the AHCA Board of Governors. The purpose of the new policy is to maintain
the integrity of the program, embrace new standards of care, and promote
continued growth of centers on the quality journey. Due to the constant
development of standards in quality care, a need developed to ensure that all
centers who represent the AHCA/NCAL National Quality Award program remain
accountable to the quality standards for which they received an award. Please
contact quality-award@ahca.org with
questions about the policy or a center’s current status.
Heroes Needed!
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 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/OCAL/OCID website for 30 days at no cost. To post an opening, go to www.ohca.org
and click on the "LTC Jobs" emblem. 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.
OCID Briefings
OCID's Briefings
is distributed electronically each month. 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.
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