Double Dip in Housing: More Bad News for Senior Living Providers

I received my Senior Living Services E-Newsletter from ParenteBeard on the impact of the downturn in housing prices on senior living providers, and thought it was a very interesting article.  Read it here.

CMS Releases Two Rules Affecting Home Health Services

The below Information Bulletin was sent to members of the Home Health Section and FALs.

CMS Releases Two Rules Affecting Home Health Services

The Centers for Medicare and Medicaid Services (CMS) released two rules on July 5, 2011 that affect home health services.  The first is the proposed Home Health Prospective Payment System (HH PPS) update for calendar year (CY) 2012 and the second is a proposed rule for Medicaid.  APTA has provided brief summaries of these rules below.  APTA will continue to analyze these rules and post comprehensive summaries shortly.  On behalf of its members, the American Physical Therapy Association (APTA) will submit comments in response to these rules.

Medication Administration Train-the-Trainer

Information on the Medication Administration Training course can be found here.

June 2011 Part A Newsletter

The Part A Newsletter for June 2011 can be found here.

New PC Forms

Per the Department of Public Welfare, Adult Residential Licensing:

CLICK HERE - Adult Resident Assessment - Support Plan 7.1.11

CLICK HERE - ARL Documentation of Medical Evaluation 7.1.11

CLICK HERE - ARL Preadmission Screening 7.1.11

We believe that these forms adhere more closely to the requirements of Chapter 2600, and that their use will result in improved resident care and fewer regulatory violations. These forms look very different from the forms currently in use, so they will require careful review.  Some of the most significant changes include:

•  Combining the assessment and support plan on a single document, the Resident Assessment-Support Plan, or RASP.
• Allowing homes to complete portions of the Documentation of Medical Evaluation (DME) form, as long as an in-person evaluation by a medical professional occurs and the medical professional signs the form.
• Explanatory instruction sheets that specify what will and will not result in a regulatory violation and why proper completion of the forms benefits both residents and homes.

Please be advised that use of these forms is not required until July 1, 2012, although homes may begin using them immediately if they choose to do so. 

IMPORTANT 5010/D.0 IMPLEMENTATION ITEMS FROM CMS

Each month during the transition to HIPAA Versions 5010 and D.0, we will email this updated message to remind you of important items and dates that may be of specific interest to the Medicare Fee-for-Service (FFS) provider/supplier community. Please see below for important reminders and a calendar of current, upcoming, and past events that have occurred during this implementation process.

IMPORTANT 5010/D.0 IMPLEMENTATION ITEMS

ANNOUNCEMENT  –  January 1, 2011 marked the beginning of the 5010/D.0 transition year!

REMINDER  –  Versions 5010 & D.0 FAQs Now Available!

REMINDER  –  National Testing Day Message Now Available! 

REMINDER  –  5010/D.0 Errata requirements and testing schedule can be found here

REMINDER  –  Contact your MAC for their testing schedule

READINESS ASSESSMENT  –  Have you done the following to be ready for 5010/D.0?

READINESS ASSESSMENT  –  What do you need to have in place to test with your MAC?

READINESS ASSESSMENT  –  Do you know the implications of not being ready?

5010/D.0 IMPLEMENTATION CALENDAR

CURRENT EVENTS:

July 2011

20^th                  MAC Hosted Outreach and Education Session – Troubleshooting with your MAC

UPCOMING EVENTS:

August 2011

24^th                         National MAC Testing Day

31^st                         CMS-hosted Medicare FFS National Call – MAC Panel Questions & Answers

September 2011

14^th                         CMS-hosted Medicare FFS National Call – Question & Answer Session  (NEW)

October 2011

5^th                           MAC Hosted Outreach and Education Session – Last Push for Implementation

24^th - 27^th              WEDI 2011 Fall Conference*

December 2011

31^st                         End of the transition year, and the beginning of 5010 production environment!

PAST EVENTS (AFTER THE JUMP!)

More Info on ICD-10 Transition

• CMS Sponsored ICD-10 Teleconferences
• Procedure Coding System Files
• American Health Information Management Association: ICD-TEN (Top Emerging News)

Will music improve MDS 3.0 scores?

Interesting guest column in McKnight on the value of music therapy can be found here.

Helpful Material on the ICD-10 Transition

On January 1, 2012, standards for electronic health care transactions change from Version 4010/4010A1 to Version 5010. These electronic health care transactions include functions like claims, eligibility inquiries, and remittance advices.  Unlike the current Version 4010/4010A1, Version 5010 accommodates the ICD-10 codes, and must be in place first before the changeover to ICD-10. The Version 5010 change occurs well before the ICD-10 implementation date to allow adequate Version 5010 testing and implementation time.

State Medicaid programs can extend financial protections to same-sex spouses in nursing homes

"The Centers for Medicare & Medicaid Services has sent a letter o state Medicaid programs clarifying the ability to offer same-sex couples the same protections opposite-sex couples receive when one partner needs facility-based long-term care."  Read the rest of the McKnight's article here."

Training Materials from CMS

MDS 3.0 Training Materials from CMS can be found here.

Medicare Preventative Services

Helpful chart re: Medicare Preventative Services can be found here.

Carlyle plans $500 million IPO for HCR ManorCare

Read the article from McKnight's here.

Great Article!

Great article in the Pittsburgh Tribune-Review about the changing demographics of residents in skilled nursing facilities: Nursing homes facing younger challenges.  Interesting fact from the article: The number of under-65 residents in nursing facilities has risen steadily from 11.7% in 2002 to 14.9% in 2010.

Teleconference: Skilled Nursing Facility (SNF) Rehabilitation Resource Utilization Group (RUG) Codes - June 07, 2011 (2:00PM EST)

Teleconference: Skilled Nursing Facility (SNF) Rehabilitation Resource Utilization Group (RUG) Codes - June 07, 2011 (2:00PM EST)

The Part A Provider Outreach and Education department is hosting a teleconference on SNF RUG Codes. We will discuss important Skilled Nursing Facility (SNF) updates, SNF Resource Utilization Group (RUG) Codes, SNF RUG Code Comprehensive Error Rate Testing (CERT) and Medical Review (MR) Errors, the Comprehensive Error Rate Testing (CERT) Program and Self Service Options. The handout material is now available.

https://www.highmarkmedicareservices.com/calendar/parta/teleconferences.html

50 Fascinating Aging Facts for Older Americans Month

Thanks to Kelly for this great e-mail!

50 Fascinating Aging Facts for Older Americans Month

Aging is an inevitable part of living, and can be fascinating for people of any age. Lives change, minds and bodies change, and time goes on. Here we will take a look at 50 interesting facts about aging in honor of Older Americans Month.

Population

Aging Americans are an important part of the population-learn about their impact here.

1.     The over 65 population should reach 86.7 million: Estimates put the 65+ population at 86.7 by 2050.

2.     Life expectancy is increasing at a faster rate: Between 1900 and 1960, life expectancy increased by 2.4 years, but since 1960, it has increased by 3.5 years.

3.     The older population is nearly 40 million strong: In 2009, there were 39.6 million people aged 65 and older.

4.     Minorities make up almost half of the older population: 42% of people 65 and older in the US are part of minority groups.

5.     Many elderly are poor or close to it: 16.8% of the elderly in America are poor or near poor.

6.     There are more people over age 60 than under 15: Those over age 60 outnumber those under 15.

7.     The elderly are the fastest growing age group: The US Census Bureau indicates that individuals 85 and up are the fastest growing age group by percentage.

Medicare Benefit Policy Manual

Medicare Benefit Policy Manual; See Section 80.4: http://www.cms.gov/manuals/Downloads/bp102c15.pdf

Medicare Claims Processing Manual

Radiology Services: http://www.cms.gov/manuals/downloads/clm104c13.pdf

Joint Replacements for Baby Boomers

Interesting article in today's Huffington Post: Joint Replacements for Baby Boomers

Pennsylvania Health Law Project website

Valuable resource.  Visit the Pennsylvania Health Law Project website: Resources & Publications: Long-Term Care

PA Claim Submission Errors Teleconference: Wed., May 25 at 10 a.m. EST

Teleconference discussing the top ten (10) claim submission errors (and their resolutions) in Pennsylvania.  Teleconference will be held on Wed., May 25 @ 10 a.m. EST.  No pre-registration required.  To participate, dial 1-888-276-8689 and enter the participant code 454822 when prompted. 

Excluding Certain HCPCS Billing Codes from Skilled Nursing Facility Consolidated Billing

It has come to the attention of the Centers for Medicare and Medicaid Services (CMS) that several new Healthcare Common Procedure Coding System (HCPCS) billing codes created for January 2011 should have been excluded from the Skilled Nursing Facility (SNF) consolidated billing bundled payment and allowed to be paid separately.

https://www.highmarkmedicareservices.com/bulletins/all/news-05192011.html

Introduction to Medicare Part A

Really great resource & overview of the Medicare Part A system!

Medicare Part A Presents: Introduction to Medicare Part I

Medicare Part A Presents: Introduction To Medicare Part II

McKnight's: E-stim breakthrough: paralyzed patient able to take steps

Click here for a great article on the use of e-stim for paralysis patients.

CMS Proposed Methodologies for Setting 2012 Rates

Read more here.  Looks like SNF's are either looking at a 1.5% increase in reimbursement rates or an 11.3% decrease to account for RUG IV's ineffectiveness in reducing Medicare spending.

Turnover in LTC

Great article on staffing!  LTC turnover rate for CNA's is 71% and 49% for nurses!  Read more here.

Over-prescribing Psychotropic Meds for Nursing Home Residents

A newly published report from the Office of the Inspector General found that one (1) in seven (7) nursing home residents is erroneously prescribed psychotropic medications.  Read more here.

Using Twitter as a Marketing Tool

Great article on using Twitter as a marketing tool.  Kind of like Twitter 101.  Check out the article here.

Medicare Insights Weekly Podcasts

Don’t have time to keep up with Medicare changes? Missing an important change or instruction can mean denied or delayed claims! Don’t miss another Medicare update! Subscribe to our the free podcast,Medicare Insights Weekly. Medicare Insights Weekly will present important Medicare updates in a concise audio program you can listen to while you work, in the car or at home! Download this free program to your MP3 player or computer and never miss another update.  Sign up for Medicare Insights Podcasts for Part A and Part B services here.

How many?

There are over 16,000 nursing homes, 20,000 retirement and assisted living communities and some 5,000 senior home care agencies provide medical and non-medical assistance nationwide.

Baby Boomers

70 million baby boomers will reach retirement age by 2030.

Home Health Therapy Services Manual Updates

The long awaited update to the Home Health Services Medicare Manual has arrived.  The updates go into effect on Thursday, May 5, 2011.  You can find copies of the updates here.

Growth in LTC Industry

Researchers expect the market for Long-Term Care services to grow at a rate of 5% to 6% per year, with the greatest growth for providers offering a continuum of care!  Read more.

Wonderful article on the Medicare Enrollment Process

Check out an article I found in this month's ABA Health Law Section journal entitled, "The Medicare Enrollment Process - CMS's Most Potent Program Integrity Tool."  A copy of the article can be found here.  A fabulous summary of the background and actual provider enrollment process.

COST OF INSURANCE DEPARTMENT EXAMINATIONS

Pursuant to 31 Pa. Code §12.1 et seq., Insurance Department examinations are conducted to verify the financial condition of the examinee and ascertain whether the examinee has complied with the laws of the Commonwealth.  Section 907 of the act (40 P. S. §  323.7) provides that the expenses incurred in and about the examination of an entity, including compensation of Department employees assisting in an examination and other professionals or specialists retained as examiners, shall be charged to and paid by the examinee.

How Nursing Homes Can Cut Expenses and Still Give Good Raises and Benefits

A really great McKnight's editorial on reducing the cost of employee benefits (without reducing the quality) through use of a health reimbursement account can be found here.

March 2011 PA Health Law Newsletter

March 2011 PA Health Law Newsletter can be found here.

CMS Implements New Law on Home Health, Hospice

The rule requires the healthcare professionals who make certification decisions to provide documentation saying they met with the patient in person. The face-to-face meetings must take within 90 days before the start of services or 30 days after care begins. If an individual is already receiving Medicare home health or hospice services, a hospice physician or nurse practitioner should meet with the patient before the patient's 180th day recertification, as well as each subsequent recertification.  Read the article here.

Certificate of Need States

check out this website for a great summary/history of the Certificate of Need (CON) Process, and a listing of states which require CON: Certificate of Need: State Health Laws and Programs

Assisted Living State Regulatory Review 2011

A great summary!  Click here for the Assisted Living State Regulatory Review 2011 from the National Center for Assisted Living.  The section on Pennsylvania starts on page 165.  I scanned in the PA only section, which can be found here.

DPW's Annual Report on PCH just released!

A copy of DPW's 2010 Annual Report on Licensed Personal Care Homes can be found here.

Vendor Info - McKnight's online expo

Vendor information from the McKnight's online expo can be found here.

Fwd: PALA's 2011 Spring Conference "Session in the Spotlight"

2011 PALA Spring Conference "SESSION IN THE SPOTLIGHT"  Listening and Responding to the Resident's Unmet Need Often caregivers stop or hesitate to communicate because they feel inadequate in their ability to communicate with individuals who have memory loss. As a result we often do not adequately meet their basic human needs to be listened to, to have meaning and purpose, or to feel loved and secure. During this session at PALA's Spring Conference, participants will also practice some verbal and nonverbal Validation techniques which will enable them to better listen, communicate and connect with persons with memory loss. -Rita Altman, National Memory Care Director, Sunrise Senior Living Pennsylvania Assisted Living Association   Spring Conference  April 18-19, 2011  Eden Resort & Suites, Lancaster 12 CEU's!  Over 30 Vendors! View the Conference Brochure HERE Pennsylvania Assisted Living Association 105 North Front Street, Suite 106 Harrisburg, Pennsylvania 17101 p.717.695.9734  f.717.695.9735  e.info@pala.org www.pala.org

Payment Rate Calculation Tools and Other References

• RUGs-IV Rate Calculation Tool: This tool calculates the skilled nursing facility (SNF) Medicare Part A payment for FY 2011, effective Oct. 1, 2010.
• RUGs-III, RUGs-IV Comparison Rate Tool: This tool will automatically calculate your total Medicare payments for FY 2010 and FY 2011 separately, and provide you with an estimate of the difference in payment as a consequence of the new RUGs-IV implementation. The model (updated July 16, 2010) calculates rates using the +1.7% market basket update for FY 2011. This tool should be used after reviewing Getting Stated: Understanding RUGs-IV©
• SNF Market Basket Updates (FY2004 - FY2010): List of all the market basket final updates from 2004 to most recent.

McKnight's officially unveils new products-and-services website: SearchEldercare.com

This article was sent to you by: alexis.wukich@gmail.com

McKnight's officially unveils new products-and-services website:  www.SearchEldercare.com
McKnight's is announcing the official debut of SearchEldercare.com, a new website dedicated to providing long-term care professionals with the most up-to-date guide of new products and services.

Read the full article here:
McKnight's officially unveils new products-and-services website: SearchEldercare.com

PIECING TOGETHER QUALITY LONG-TERM CARE: A Consumer's Guide to Choices and Advocacy

I received this from the Disability Rights Network today:

"March 23, 2011 - Today, on the first anniversary of the Affordable Care Act (ACA), the National Consumer Voice for Quality Long-Term Care (formerly NCCNHR), announces the launch of its new guide Piecing Together Quality Long-Term Care:  A Consumer's Guide to Choices and Advocacy.  The guide is intended to educate people with disabilities and older adults about their options for long-term services and supports and empower them to be self-advocates for quality long-term care.  The guide also provides information and resources to assist people currently living in nursing homes to move back into the community.

 
Get a copy of the guide here.

Medication Management in Assisted Living

Interesting article on Medication Management in Assisted Living Residences from LeadingAge (formerly American Association of Homes and Services for the Aging [AAHSA]) can be found here.

Long-Term Care in Westmoreland County Facts (as compared to Pennsylvania's other counties)

Overall Population

• Westmoreland County's projected population is 357,681 for 2015 and 353,578 for 2020.
• It is the 10th largest county (of 67) in PA and is expected to remain so through 2020.
• Of all PA counties, Westmoreland County ranks 12th in its population aged 65 years or older (projected to rank 7th by 2020) and 21st in its population aged 85 years or older (projected to rank 6th by 2020

Skilled Nursing Facilities

• In 2007, there were 2,219 nursing home residents in Westmoreland County for the 10th most people living in skilled nursing facilities in PA.
• Westmoreland County has the 9th highest number of skilled nursing beds - 2,451 as of 2007.
• Even though Westmoreland County has the 9th highest number of beds, it ranks 57th out of 67, in terms skilled nursing capacity - averaging 3.7 beds per 100 elderly (people aged 65+) residents.  The statewide average is 4.9 skilled nursing beds per 100 elderly residents.

Personal Care Homes

• Westmoreland County has the 5th most people living in Personal Care Homes (PCH).
• In Westmoreland County, the number of people living in PCH has decreased since 2001.
• The occupancy rate in PCH is 70.4% in Westmoreland County and 69.2% statewide.
• Westmoreland County ranks 24th amongst all PA counties in terms of PCH capacity per elderly, averaging 4.1 PCH beds per 100 elderly versus the statewide average of 3.6 PCH beds per 100 elderly.

Assisted Living Residence Regulations

Pennsylvania's newly adopted regulations for Assisted Living Residences can be found here: 55 Pa. Code §2800.

Assisted Living Residence Presentations & FAQ

Link to the notes from the "Assisted Living Residences" Presentation by Dawn L. Richards, Esq. from Capozzi & Associates (10/7/2010) can be found here.

Links to the notes from the "Administrator Orientation Program for Assisted Living Regulations" Presentation by the Office of Long-Term Living (1/6/2011) can be found here.

Frequently Asked Questions (FAQ) and answers from the PA Dept. of Aging can be found here.

FW: DON'T MISS OUT - Register TODAY - PALA's 2011 Spring Conference

PALA'S 2011 SPRING CONFERENCE   Looking to see Keynote Speakers back by popular demand?  Looking to go back to basics with key seminars?  Looking to see what the future of ALR is?  Looking to hear from the Corbett administration regarding their vision of assisted living residences, personal care homes, and long term care policy?   Then confirm your attendance TODAY for PALA's Spring Conference!                      Featuring a multitude of past Conference speakers, including such favorites as Dr. Kay Potetz, a motivational speaker and management consultant with over 25 years of management and administrative experience in Health Care!      Do Not Miss a keynote address by Jeffrey Snowell of Snowell Consulting, Inc - an educational and human resources firm specializing in designing and delivering training and development solutions.  Snowell is a dynamic speaker who lectures extensively on staffing, stress management, and diversity!         Plan on Attending PALA's Spring 2011 Conference?   Interested in seeing who is presenting & speaking during the Conference?      CLICK HERE to view the "PALA 2011 Spring Conference" Agenda and Registration Form   Interested in being a Vendor in April? Space is still available for any interested company - but space is selling out!  CLICK HERE to view the Vendor Application  Interested in Sponsoring PALA's Spring 2011 Conference? PALA has a myriad of sponsorship opportunities fit for any level of interest  CLICK HERE to view the Sponsor Application  To see additional information about PALA's Spring 2011 Conference (including Eden Resort information/rates), please go to www.pala.org    NOT A PALA MEMBER?    The Pennsylvania Assisted Living Association (PALA) is a professional not-for-profit trade association representing Personal Care Homes and Assisted Living Residences that vary in size from small owners to large state and national corporations. We are recognized as an association dedicated to helping Personal Care and Personal Care Providers address relevant issues and challenges as they arise in the emerging industry.         Whether from our Public Policy Representation or our Professional Development Services, PALA is here for YOU!      Visit our website www.pala.org - or click on our membership application - to find out more information (membership services/rates) on how PALA membership impacts your community, organization, or company!   The Pennsylvania Assisted Living Association  has been selected by the Assisted Living Federation of America as the 2011 recipient of the Horace D'Angelo Jr. Memorial Award.  The ALFA Horace D'Angelo Jr. Memorial Award is presented annually to ALFA state affiliates for their achievement, success, and efforts to align state regulations with ALFA's public policy positions.     We invite all industry leaders, legislative leaders, and those in the Assisted Living and Personal Care Home field to join PALA for our "ALFA Award Celebration" taking place during our Spring 2011 Conference starting Monday, April 18th, 2011 at 4:30pm at the Eden Resort and Suites in Lancaster, PA.  PALA Board members, staff, and Conference attendees will be on hand to share in PALA's success.  PALA welcomes all to attend for this exciting night of acknowledgement, and industry networking! To see the press release celebrating this achievement, please CLICK HERE! PALA'S Spring Conference "Vendor in the Spotlight" Expect to see this exciting vendor at our 2011 Spring Conference in April: Founded in 1975, Bayada Nurses provides nursing, rehabilitative, therapeutic, and personal home health care services to children, adults, and seniors in the comfort of their own homes. Bayada Nurses has over 13,000 nurses, home health aides, and therapists working from more than 170 offices in 18 states.

Skilled Nursing Facility Prospective Payment System

The Medicare Learning Network has created a very helpful fact sheet on SNF PPS.  The fact sheet can be found here.

Long-Term Care Facility Regulations

Pennsylvania LTC Regs

Federal LTC Regs

Personal Care Regulations

The Pennsylvania regulations for Personal Care Homes can be found here: PA PCH Regs

Nursing Care Facility Locator for Pennsylvania

Nursing Care Facility Locator (Pennsylvania)