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Clinical Update from KHCA Consultant Linda Farrar
Without creating a flurry of questions and confusion, if possible, everyone should be aware that CMS updated several Critical Element Pathways, including the Infection Prevention, Control & Immunizations this month. Providers need to use caution in making more of this new guidance than the intent. The regulation itself gives good guidance and providers should not get “too far into the weeds”. To the Pathway, Enhanced Barrier Precautions (EBP) was added to the Pathway. Specifically, they added a section:
Enhanced Barrier Precautions (EBP):
EBP use is evaluated when investigating specific care activities, such as wound care, enteral feeding, urinary catheter care, etc.
EBP are indicated during high contact care activities for residents with infection or colonization with a CDC targeted MDRO (when contact precautions do not apply) or for any resident who has a chronic wound and/or indwelling medical device.
High-contact resident care activities include dressing, bathing/showering, transferring, toileting, providing hygiene, changing linens or briefs, device care or use: central line, urinary catheter, feeding tube, tracheostomy/ventilator, or wound care: generally, for residents with a chronic wound(s), not skin breaks or tears covered with an adhesive bandage (e.g., Band-Aid) or similar dressing.
Interview staff to determine if they are aware of which residents require the use of EBP prior to providing high-contact care activities?
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Nursing Home Sector Taking Issue With Medicare Payment Proposals
Skilled Nursing News (4/5, Stulick) reported the proposed Medicare payment increase for next year is "not sitting well with the nursing home sector, with financial experts and operators raising concerns that the bump fails to compensate for inflation-induced operating costs – and a staffing proposal anticipated to cost in the billions each year." American Health Care Association President and CEO Mark Parkinson has called the increase "woefully inadequate" in view of the expected cost of federal staffing requirements.
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Medicare Advantage rule finalizes independent appeals process, helping providers ‘stuck in the middle’
McKnights Long-Term Care News (4/8, Henreckson) A final rule announced by the Centers for Medicare & Medicaid Services Thursday revised the appeals process for Medicare Advantage beneficiaries who have been denied coverage. The new rule should be a significant help for both beneficiaries and long-term care providers, sector leaders said Friday.
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A Message from the President & CEO Linda MowBray: Our Kansas Commitment
The final week of session before first adjournment was full of late-night conference committees and “repackaging” of items under discussion. The mega agency budget bill was no exception. With 19 ledger pages full of differences, the committee includes Representatives Waymaster, Helgerson and Hoffman along with Senators Billinger, Claeys and Pettey worked to reach compromises across all agencies. Our KDADS budget was one of those compromises.
The original position of the House was to include a $20 per Medicaid patient per day for July 2024 through June 30, 2025. The Senate version was $10 per Medicaid patient per day for July 2024 through June 30, 2025. A compromise was reached at $15 per Medicaid patient per day for July 2024 through June 30, 2025.
On the Assisted Living and Home Plus side, the House language “Add $48.3 million, including $18.6 million SGF, to increase the average reimbursement rate for agency-directed personal care services on the Frail Elderly (FE) waiver to $30.00 per hour for FY 2025” was agreed to by the Senate. This should be welcome news to our HCBS providers, moving the per unit fee from $5.55 to $7.50.
Finally in the budget, a proviso was accepted to “add language for FY 2025 directing the agency to study and report information to the 2025 Legislature on involuntary discharges and transfers from state licensed adult care homes. And add further language requiring the agency to establish a system to track data concerning involuntary discharges.” This proviso does two things: first it stopped legislation from requiring an appeals process for involuntary discharges and it specifies that KDADS will be the agency responsible for tracking the data. There was a great deal of concern that the data would be tracked by the Ombudsman’s office, so this is a win for providers.
Although there are procedural steps in both chambers that need to occur before moving on to the Governor’s office, the negotiations are finished and we are sitting in a very good position.
In the conference committee on Senate and House Health, a group of bills were bundled including moving CCRC certification from the Insurance Department to KDADS and prohibiting Fire Marshals’ from using body cameras during routine inspections. We achieved favorable language in this bundle. The committee members were Representatives Landwehr, Eplee and Ruiz as well as Senators Gossage, Erickson and Pettey.
The House Appropriations Committee held a subcommittee hearing on contract nursing agencies. Members of the subcommittee were Representatives Mason, Landwehr, Helgerson, Ballard and Concannon. The hearings were held April 1-3, 2024 and recommendations made on Thursday, April 4, 2024. We will provide details on the recommendations and next steps as soon as they are available.
Last but not least, the Medicaid Inspector General and the Attorney General released an audit earlier this week that puts Nursing Homes with CCRC designation in the cross-hairs. For a copy of the report, click here. For the Associated Press (AP) report on the political backdrop for the audit, click here. For the response from KHCA/KCAL, click here. See the article in Skilled Nursing News by clicking here. This is an on-going story and we will keep you updated on new developments.
Should you have questions or comments, please feel free to reach out to me. As always, I am grateful for the opportunity to serve you.
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Looking for additional resources on EBP? Join the LTC NIPF!
The Long-Term Care National Infection Prevention Forum is available through AHCA Connect for KHCA Members. Click here for instructions on how to join and links to additional education on EBP.
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Behavior problems — not financial motivation — most often precede forced SNF discharges: OIG
Nursing homes most often initiated a discharge because a resident’s behavior endangered the resident or others in the facility, a rationale fully within their rights, a government watchdog reported Wednesday.
But some are still not fully documenting facility-initiated discharges, undermining residents’ rights to appeal or plan for a move, the Health and Human Services Office of Inspector General said in a companion report. READ MORE
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Want to Improve Your Facility Vaccination Rates? KFMC, a member of HQIN, Can Help!
Vaccines protect us all from illness and disease, but they are especially critical for our most vulnerable populations. Particularly, the COVID-19 vaccine provides increased protection to adults ages 65 years and older.
In our continued effort to support the health and well-being of older adults, KFMC Health Improvement Partners, a member of the Health Quality Innovation Network (HQIN), provides FREE vaccination clinic support to Kansas nursing homes, through a partnership with CPESN-USA, a clinically integrated network of community-based pharmacies. READ MORE
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2024 AHCA/NCAL Awards Program- Now Open!
Nominations for the 2024 AHCA/NCAL Awards Program are now open! AHCA/NCAL members are strongly encouraged to nominate those inspiring leaders and unsung colleagues who go above and beyond to provide exceptional service in the long term care profession.
The AHCA Awards Program honors individuals who are dedicated to improving the quality of lives of residents and their surrounding communities. All AHCA member facilities are encouraged to apply, including skilled nursing facilities, short and long term care facilities, Not for Profit (NFP) long term care providers, intellectual and developmental disabilities (ID/DD) residential services providers (including intermediate care facilities for individuals with intellectual disabilities (ICFs/IID), and other individuals who work in the long term care field, including direct care, education, research, and resident advocacy. READ MORE
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Register and Get Inspired at the National Quality Summit
Explore innovative strategies and get inspired at the AHCA/NCAL Quality Summit, May 20-22, 2024. Discover the keys to transformative leadership and performance excellence.
The goal of the Quality Summit 2024 is to offer innovative ideas, strategies, and inspiration to help you provide the highest quality of care to your residents. At the Summit, you will learn from experts and discover best practices on effective leadership, strategic planning, customer engagement, data management, workforce, and more.
Education sessions this year are based on the seven categories of the Baldrige Criteria for Performance Excellence, the cornerstone of the AHCA/NCAL National Quality Award Program.
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Make Your Voice Heard at Congressional Briefing
Join hundreds of long term care professionals to advocate for the profession in Washington, DC June 3-4, 2024 for AHCA/NCAL’s Congressional Briefing. Seize the opportunity to personally engage with your elected representatives and discuss the challenges and opportunities you face within the long term care sector.
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Assisted Living Conference
April 19, 2024
8:00AM - 4:00PM
Lawrence, KS
A full day of education for those working in the Assisted Living, Residential Health Care and Home Plus settings.
Education Topics Include:
· Igniting Creative Courage – Opening Keynote
· Update from the Office of the State Fire Marshal
· Enhancing Senior Care Through Collaborative Partnerships – Jill Schewe, NCAL
· A New Approach to Recruitment and Retention
· Navigating Challenging Personalities
Creative Engagement
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Webinar: Deconstructing Immediate Jeopardy Mitigation: Navigating Top Risk Areas: Reducing Risks Related to Quality of Care
4/9/24 - 1:30PM-2:30PM
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Leadership for Charge Nurses
4/16/24 - 9:30AM-3:15PM - Salina, KS
This class is at capacity. Please email khca@khca.org to be added to the waitlist.
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Webinar: Documentation in Depth: Supportive Documentation for Elopement Risk and Incidents
4/16/24 - 1:30PM-2:30PM
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Webinar: Caring for a New Generation in Assisted Living
4/17/24 - 1:00PM-2:00PM
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Assisted Living Conference
4/19/24 - 8:00AM-4:00PM - Lawrence, KS
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Resident Care Coordinator Training for Nurses in Assisted Living
5/3/24 - 8:30AM-3:30PM - Salina, KS
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Webinar: Deconstructing Immediate Jeopardy Mitigation: Navigating Top Risk Areas: Reducing Risks Related to Infection Control
5/14/24 - 1:30PM-2:30PM
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Webinar: Documentation in Depth: Supportive Documentation for Dialysis Care
5/21/24 - 1:30PM-2:30PM
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Administrator in Training (AIT) Program
Looking for an AIT Program? Click here for more details on KHCA's Program.
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Kansas Health Care Association and the Kansas Center for Assisted Living
1100 SW Gage Blvd. | PO Box 4770 | Topeka, KS 66604
PH: 785-267-6003 FAX: 785-267-0833
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