Elevating the Post-Acute and
Long Term Care Profession

News and Information exclusively for members of OCID - please do not forward to non-members
October 21, 2016
Top Stories

Additional Benchmarks Created for 2024 Service Delivery
Debbie Jenkins
The Strategic Planning Leadership Group (SPLG) met earlier this week to finalize some additional benchmarks for ID/DD services for the year 2024. Draft benchmarks had been created during several meetings over the past five months. During this week’s meeting, members continued discussion on the draft benchmarks and voted on which ones would be implemented. DODD staff did not participate in the voting and a 75% majority was required for any benchmark to be approved. The following six benchmarks related to employment, waiver services and staffing will be added to the benchmarks previously set by the SPLG:

  • By 2024, 65% of young adults will be competitively employed at least 20 hours a week at minimum wage or higher within the first 2 years of exiting high school, and/or are participating in post-secondary (independently recognized) educational opportunities leading to careers of their choice.
  • By 2024, all people will have access to flexible, integrated, community-based, safe and affordable transportation for employment, facility based services and other activities.
  • By 2024, a flexible funding model for everyone will be developed that will be directed by the person served and their circle of support to experience adult life in the way they desire.
  • By 2024, 40% of people (families) will experience increased independence and quality of life through education on and use of technology across the lifespan.
  • By 2024, Ohio will have a statewide regional network of at least 200 people with disabilities who are paid to deliver training and mentoring.
  • By 2024, all DSPs and IPs will have the opportunity to earn higher wages based upon training/competencies that are supported by tiered Medicaid rates.

CMS Action to Delay Implementation of Changes to Adult Day/Employment Services
Debbie Jenkins
Earlier this week, DODD released an announcement that the proposed changes to the adult day and employment related waiver services will be delayed until further notice. This comes after DODD received notification from CMS that they would be sending Ohio a formal RAI (request for additional information). Once the formal RAI is sent, the clock for CMS’s approval is stopped pending DODD’s response. Following DODD’s submission of their response, CMS will have another 90 days to review and either approve, deny or submit an additional request for information. No indication of CMS’s concerns/questions has been shared with OHCA/OCID. Services being delayed include: 

  • Rate modifications for adult day services, including implementation of the behavior add-on, medical add-on, and the new community integration add-on 
  • Availability of Group Employment Supports, Individual Employment Supports, and Career Planning services 
  • Availability of Money Management services 
  • Budget limitation increases 
  • Community inclusion- personal care hour units change to fifteen minute units and removal of service limitations 

As many of you are aware, County Boards of DD have been working feverishly over the past month or so to update PAWS with authorization of the new/modified services to begin November 1, 2016. We have been informed that PAWS Authorizations that county boards made to change the billing codes from Supported Employment-Community, Supported Employment- Enclave and Integrated Employment to the 2 replacement service codes DO NOT NEED TO BE CHANGED at this point. DODD has stated that it does not matter what codes are on the PAWS for these services, MBS will pay using the old codes. However, if a revision to a PAWS is needed for a person who receives these services anytime after 11/1, the county board will need to make the correction in those specific service codes at that point. If a change has been made in PAWS for the SELF Community Inclusion 15 minute billing unit, these also will not be change, but providers will continue to bill in hourly units. If a county board authorized the 2 brand new services, Career Planning or Money Management, the PAWS WILL NEED TO BE CHANGED since these services are not approved waiver services yet. Providers will NOT be able to bill for these 2 new services at this point. In addition, the behavior, medical and community integration add-ons for adult day services will not be able to be billed.

However, the day services combo code is still being eliminated and will not be able to be used beginning November 1, 2016. In a follow up memo, DODD clarified that providers will still be able to submit claims for the Adult Day Support daily rate or the Vocational Habilitation daily rate when delivering between 5 – 7 hours a day of one or both services. When a provider delivers between 5 – 7 hours of a combination of Adult Day Support and Vocational Habilitation, the provider may either submit a daily billing unit reflecting the services provided for the majority of the day, or the provider may submit 15-minute billing units for each discrete service.

If you provide day or employment services, please make sure that you read the DODD announcement carefully and take measures to ensure accurate billing of services to avoid unnecessary delays in payment.


Regulatory

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, seeROLF’s blog post here.

National Core Indicators Data Collection to Begin Soon
Debbie Jenkins
DODD Director John Martin released a statement late last week that Ohio will once again participate in the National Core Indicators (NCI) Project. Interviews will be conducted with approximately 700 consumers of services across Ohio. The results of the interviews will allow Ohio to review outcomes of services with standard measures across states. The project will span the next couple of months and providers will be contacted by the Nisonger Center at The Ohio State University if any of the people they serve are selected to participate.

DODD Proposes Rule Changes
Steve Mould
DODD has issued notice of its intent to rescind, adopt, and amend the following rules on or about January 1, 2017, and to conduct a public hearing:

Rule 5123:2-7-12 entitled Intermediate Care Facilities - Medicaid Cost Report, Record Retention, and Disclosure Requirements is being rescinded and replaced by a new rule of the same number entitled Intermediate Care Facilities for Individuals with Intellectual Disabilities - Cost Report. The rule sets forth standards and requirements for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFIID), other than state-operated ICFIID, to submit cost reports to the Department and maintain supporting documents and records. Revisions incorporated into new rule 5123:2-7-12 include:

  • Aligning the rule with the current practice for submitting cost reports and requesting filing extensions;
  • Correcting references to the Revised Code, the Administrative Code, and the Ohio Department of Medicaid;
  • Incorporating provisions of currently effective rule 5123:2-7-19 (which is being rescinded); and
  • Reordering the rule in a more logical manner.

Rule 5123:2-7-19 entitled Intermediate Care Facilities - Nonreimbursable Costs is being rescinded because its provisions are being incorporated into new rule 5123:2-7-12. Rule 5123:2-7-19 sets forth costs that are not reimbursable to ICFIID through the prospective cost reporting mechanism.

Rule 5123:2-9-39 entitled Home and Community-Based Services Waivers - Waiver Nursing Services Under the Individual Options Waiver is being amended. The rule defines Waiver Nursing Services and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service. The rule is being amended to align payment rates with payment rates set forth in rule 5160-46-06 for the same service available under the Ohio Home Care Waiver administered by the Ohio Department of Medicaid.

Rule 5123:2-9-56 entitled Home and Community-Based Services Waivers - Personal Care Aide Services Under the Transitions Developmental Disabilities Waiver is being amended. The rule defines Personal Care Aide Services and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service. The rule is being amended to align payment rates with payment rates set forth in rule 5160-46-06 for the same service available under the Ohio Home Care Waiver administered by the Ohio Department of Medicaid.

Rule 5123:2-9-59 entitled Home and Community-Based Services Waivers - Waiver Nursing Services Under the Transitions Developmental Disabilities Waiver is being amended. The rule defines Waiver Nursing Services and sets forth provider qualifications, requirements for service delivery and documentation of services, and payment standards for the service. The rule is being amended to align payment rates with payment rates set forth in rule 5160-46-06 for the same service available under the Ohio Home Care Waiver administered by the Ohio Department of Medicaid.

The rules are available for review at the Department's website and at the Register of Ohio website. The rules are also available for review at each county board of developmental disabilities. A public hearing on the proposed rule actions will be held on November 15, 2016 in the Lobby Hearing Room of the Rhodes State Office Tower located at 30 East Broad Street, Columbus, Ohio 43215. Written comments on the proposed rule may be sent to Becky Phillips, Administrative Rules Coordinator, by email; by fax to 614/752-8551, or by U.S. mail to 30 East Broad Street, 12th Floor, Columbus, Ohio 43215-3414. Please send copies of any comments to Steve Mould at OCID.

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. 


Other News

DODD Offering A Variety of Trainings/Webinars
Debbie Jenkins
We recommend that members check the DODD Training Website often to see the training opportunities available, especially given all of the changes that occur. DODD is currently offering a training for the new Money Management service. They have also announced a Provider Certification Webinar to guide users through the process of entering applications for certification through the Provider Certification Wizard to guide users through the process of entering applications for certification through the Provider Certification Wizard. You can register for the Provider Certification webinar here.

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.

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, pleasedownload the order form and mail or fax your order to the Association offices.

2016 HOME Choice Conference
The HOME Choice Consumer Advisory Council (HCCAC) has announced the fourth annual HOME Choice Conference: “Breaking Down Barriers to Community Living,” scheduled for November 1 at the Hilton Downtown Columbus. This year’s conference will focus on how to break down barriers consumers face when he or she transitions from a long-term care facility into the community. Registration information and details are available here.


Education Updates

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.

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.

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 the OHCA/OCAL/OCID Facebook page and the Photo 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 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 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.


OCID Bites
OCID 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 OCID's electronic bulletins and publications.

With Support from OHCA Champion Partners