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A Message from the President & CEO Linda MowBray: Our Kansas Commitment
Monday marked the start of the 2024 legislative session with the normal formalities of gaveling in. The Kansas Legislature runs on a two-year cycle and 2024 is the second year in this biennium. What this means is that any bills introduced in 2023 that were not signed into law or vetoed are still available to be worked this session. Things that we successfully kept at bay last year may rise up again and require our attention. Many new pieces of legislation will be introduced as well and with the help of our lobby team Federico//Duerst, we will keep you updated on issues of importance.
The members of our KHCA Board of Directors met today and we discussed the session's priorities and Association business. Our reimbursement committee met yesterday to discuss our on-going strategies for stabilizing Medicaid rates. Part of that discussion revolved around the Governor’s proposed budget and its impact on nursing home rates. As our subcommittees continue to meet, we will be asking for your input as well as sharing our legislative priorities for the coming year.
One issue that I want to highlight is the recommendations that were made by the special legislative interim committee dealing with our Medicaid rates. Below is the list that will be presented during the early part of the session. As you will read, I believe that our message was heard loud and clear. Should you have questions or comments, please feel free to reach out to me. As always, we are grateful for the opportunity to serve you.
Recommendations from the 2023 Special Committee on Nursing Facility
Reimbursement Rate Methodology
The 2023 Special Committee on Nursing Facility Reimbursement Rate Methodology, chaired by Rep. Les Mason, was charged to take a “holistic view of the nursing facility reimbursement rate methodology, including cost center caps and an acuity-based add on.” The Committee advanced several proposed recommendations, including the following:
- KDADS should explore and provide a report to the Legislature on the benefits and challenges of shifting the nursing facility reimbursement rebasing process to include one year of cost reports rather than three.
- The Legislature should extend the Medicaid add-on for nursing facilities based on the number of Medicaid residents served for fiscal year (FY) 2025.
- KDADS should review the following and provide a report to the House Committee on Social Services Budget: Ownership structures of nursing facilities in Kansas; how many are owned by Kansas individuals and businesses; the use of holding companies; the current cost-reporting process and structure; financial information reviewed when a nursing facility is sold; and the differences between for-profit and nonprofit nursing facilities, including quality of care. Further, the House Committee on Social Services Budget should consider requesting the Legislative Post Audit Committee to approve an audit by the Legislative Division of Post Audit on the topic.
- The Legislature should review the facility survey process and compare the process in Kansas to processes in other states, including fine amounts, metrics, surveyor education, and the role the state agency can play in ensuring facilities are aware of and understand federal guidelines and requirements.
- The Legislature and KDADS should explore the use of incentives, including the following: encouraging facilities that focus on behavioral health programs and services, supporting facilities owned by Kansas individuals and businesses, and encouraging energy efficient facilities. In addition, the Legislature should explore the ability to add state funding to enhance the availability of incentives.
- KDADS should provide the Legislature with information on options to apply the Critical Access Hospital Model to nursing facilities.
- KDADS should provide a report to the Legislature on the nursing facility provider assessment and formula for distributing funds.
- The Legislature should explore methods to support nursing facilities in managing the proposed CMS rule governing staff ratios, including staff incentives, and consider methods to partner with educational institutions to grow the nursing workforce.
- The Legislature should review methods to reimburse treatment for dementia care, including adjusting the case mix index (CMI) or creating an add-on incentive factor. In addition, the Legislature should explore the number of facilities specifically equipped to provide this level of care.
- The Kansas Legislative Research Department (KLRD) should explore the licensing requirements for the nursing home administrator position in other states, including practicum requirements, and efforts other states have made to make these positions more accessible. KLRD should review which requirements are federally set and those that the state can adjust.
Linda MowBray
President/CEO
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CMS Outlines Plans To Enforce MA Rules Changes For 2024
McKnight’s Long-Term Care News (1/12, Henreckson) reports, "Despite early fears, long-term care leaders have some reason to be optimistic that changes to Medicare Advantage rules for 2024 will be enforced." The article adds, "CMS intended the rule changes, which went into effect Jan. 1, to broaden protections under MA – including clarifying coverage rules, limiting plan denials and restricting when technology could be used to make decisions about ending coverage." However, "associations and consumer advocates saw worrying signs that MA plans were unlikely to significantly change their policies in reaction to the rules." The agency "outlined their plans to enforce the changes in a Jan. 3 call with a coalition of long-term care leaders and advocates – such as the American Health Care Association."
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KMAP Web Update
The KMAP Public Portal has been updated with General Bulletin 23351 regarding private rooms in Nursing Facilities and Intermediate Care Facilities.
Manual Update
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Many skilled nursing operators will need to reclassify their existing relationships with independent contractors and rethink future ones in the wake of a final rule issued by the Department of Labor on Tuesday. READ MORE
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Four Tips Provided To Help Facilities Ensure Accuracy Of Section GG Items
American Association of Post-Acute Care Nursing Curriculum Development Specialist Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, writes in Provider Magazine (1/9, 151K), "To ensure the accuracy of section GG’s self-care and mobility items, interdisciplinary team (IDT) involvement and a process to determine usual performance are essential." It might "seem preferable to streamline the process and assign the nurse assessment coordinator or therapist to complete this section, but it will likely lead to an inaccurate result." McGill offers four tips to "help facility teams develop a process to ensure the accuracy of section GG items."
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Rural Nursing Homes Struggling Amid Ongoing Financial, Staffing Challenges
McKnight’s Long-Term Care News (1/8, Marselas) reports on the impact that financial and staffing challenges are having on rural nursing homes. There is "an increasing concern that those who need rehab or long-term care will end up going instead to facilities at least 30 miles away, even if many of those buildings are restricting admissions." Furthermore, "many of the technology options that have helped metro-area nursing homes transform the kind of care they can provide still present hurdles for old buildings in far-off locations." The "alternative payment models that have started to pump some much-needed staffing and financial resources into nursing homes in population hubs have in large part left rural nursing home operators out of the mix." And "what staff can be lured to rural locales or from competitors in the same geographic regions – especially the travel or agency nurses needed to plug constant holes – are demanding pay that undercuts facilities’ long-term financial sustainability." The greatest "concern for many providers is the federal government’s planned staffing mandate, which virtually no rural nursing homes could meet, according to" CMS estimates. The rule, American Health Care Association President and CEO Mark Parkinson "said at a recent event exploring rural health care needs, is ‘literally a death sentence for nursing homes in rural areas.’" The article adds, "Rural nursing homes made up 31% percent of all nursing home closures since 2020, according to AHCA data."
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Clinical Update from KHCA Consultant Linda Farrar
There are some very interesting infection control issues occurring related to a rise in COVID cases, and a reduction in COVID vaccine rates and the governments change in reimbursement for the vaccines.
Per a Provider Magazine article, the vaccine rates in nursing home residents was “lowest in the most socially vulnerable counties”. CDC attributes the low rates in nursing homes involves: “vaccine fatigue, inaccurate health information, and vaccine hesitancy”. They make no mention that finding reimbursement for the vaccines is very difficult for nursing facilities, thus putting the cost onto the facilities themselves. READ MORE
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Are you a current AIT Preceptor or are you interested in becoming one?
We have a high need for Preceptors in the KC area!
If you are a current Preceptor we would love to have you on our list. Please contact Teresa with your Preceptor number at tkeating@khca.org. Are you interested in becoming an AIT Preceptor and shaping the future of the profession? Our team is happy to walk you through that process. Click here for the KDADS information and give Teresa a call at 785-267-6003.
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Call for presentations
An essential service to our association is offering high quality training and education to our members. We invite you to join us in our commitment to delivering timely, relevant, and engaging information as we prepare for our 2024 Education Calendar.
We are looking for topics that fit skilled nursing, assisted living, home plus and residential health care communities.
Click here to learn more on our needs and how you can submit a proposal.
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Join us for Aging Services Day 2024!
Aging Services Day is a collaborative event put together by Kansas Health Care Association/Kansas Center for Assisted Living, LeadingAge Kansas and Kansas Adult Care Executives where Long Term Care Providers gather at the State Capitol to champion the needs of our elderly in Kansas. We will meet in the morning for education then walk together across the street to the Capitol for a full afternoon of legislative advocacy on issues that are crucial to the LTC Profession with our Kansas Legislators. It’s a powerful opportunity to allow your voice to be heard and influence positive change for LTC providers and the population we care for. Be part of the movement for better aging services.
Priority deadline to ensure a meeting with a legislator is January 22, but registration for the remainder of the day’s events will remain open until the day before the event.
𝐒𝐩𝐨𝐧𝐬𝐨𝐫𝐬 𝐟𝐨𝐫 𝐭𝐡𝐢𝐬 𝐞𝐯𝐞𝐧𝐭 𝐢𝐧𝐜𝐥𝐮𝐝𝐞:
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Webinar: Documentation in Depth: Supportive Documentation for Falls and Accidents
1/16/24 - 1:30PM-2:30PM
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Webinar: Survey Trends in Assisted Living
1/18/24 - 1:00PM-2:15PM
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Webinar: Care Plans for SSD's
1/23/24 - 1:00PM-2:30PM
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RAC-CT Certification In-Person Workshop
1/29/2024 8:00AM - 1/31/2024 5:00PM
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Aging Services Day - 2024
2/1/2024 8:30AM - 4:00PM
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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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