February 23, 2018
Volume II, Issue 2
In this edition:
-Breaking News
-Money Matters
-Coming Down the Pike
-Follow-up to January
-ACT Senior Living
    Consulting Services

The leaders and team members of ACT contributed to our communities during the past three months through fundraising efforts that benefited the following:  St. Jude's, Boy Scouts of America, Girl Scouts of America, United Way, Thomas Health Foundation, Toys for Tots, the WV Child Advocacy Network and several Christmas and holiday related events and charities located throughout Ohio, Pennsylvania, and West Virginia.
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New Castle
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Breaking News
SNF Quality Reporting Deadline Extended
The Skilled Nursing Facility (SNF) Quality Reporting Program submission deadline is extended to
May 15, 2018, for CY 2017 data. However, SNFs are encouraged to review their data submission on at least a quarterly basis. Visit the SNF Quality Reporting Program Data Submission Deadlines webpage for a list of required measures.

Certification and Survey Provider Enhanced Reports "CASPER" User Guide Updated
The MDS 3.0 Quality Measure (QM) Reports of the CASPER Reporting User's Guide has been updated to include the new quality measure information. The updated CASPER Reporting User's Guide is located on the Center for Medicare and Medicaid Services' (CMS) Quality Improvement and Evaluation System (QIES) Systems for Providers website. 

Money Matters
The President's proposed budget for Fiscal Year 2019 bears a close watch. With content aimed at both Medicaid reform and a unified payment system for Post-Acute providers, as well as other measures that may impact almost every type of provider, we need to stay tuned in and knowledgeable. It isn't quite time to raise the alarm or attempt to throw the baby out with the bathwater, but staying informed and involved are necessary.
Coming Down the Pike - a NEW SNFABN
CMS is releasing a newly revised Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNFABN) along with newly developed, concise and separate instructions for form completion. The revised SNFABN has the requirements from the Denial Letters and looks similar to the ABN with three different options for Original Fee For Service (FFS) Medicare beneficiaries to choose from. We will be discontinuing the five SNF Denial Letters and the Notice of Exclusion from Medicare Benefits - Skilled Nursing Facility (NEMB-SNF). Since the NEMB-SNF was used as a voluntary notice for care that is never covered by Medicare, we will continue to encourage providers to issue the revised SNFABN in this voluntary capacity. The revised SNFABN will be mandatory for use on
May 7, 2018 . During the interim, SNFs may continue to use the old version of the SNFABN, the Denial Letters or the NEMB-SNF; however, it is recommended that the revised SNFABN be used as soon as possible.
For Part A items and services: SNFs must use the newly revised SNFABN as the liability notice.
For Part B items and services: SNFs must use the Advance Beneficiary Notice of Non-coverage (ABN), Form CMS-R-131. The ABN and information on this notice can be found at https://www.cms.gov/Medicare/Medicare-General-Information/BNI/ABN.html .

Follow up to January
In January, we touched on the new survey process. The information providers began hearing about mid-2017 came to fruition and the new survey process went into effect at the end of November 2017. What outcomes are worth noting?
  1. Surveyors are becoming more familiar with the process and have begun to embrace the addition of surveying in a more subjective manner
  2. While the number of deficiencies appears to be on the rise, there are facilities sharing that the surveyors were more reasonable in deciding whether to cite a deficiency
  3. Immediate Jeopardy citations are on the rise for issues that would have been cited at a lower level in the past (i.e. not performing Cardiopulmonary Resuscitation (CPR) if a body is rigid, a smoking resident having a lighter, an unlocked door to an area housing unattended chemicals/cleaners, etc.)
  4. It is still a process that everyone is learning.  If you are concerned about a survey outcome or have additional information to provide that may mitigate a citation, contact the appropriate person at your state survey agency - it is working for some Administrators (including removal of citations that were not discussed during exit)
  5. If the information surveyors require on entrance is prepared and organized, and requested documents are quickly provided during survey, exits are being held within four days on average

  ACT Senior Living Consulting Services
The ACT Senior Living Consulting team can help you achieve success in 2018! We offer a wide array of services, including:
  1. Resident Assessment Instrument (RAI) system evaluation and training
  2. Operational guidance and support
  3. Nursing system review and help in achieving improved compliance
  4. Mentoring for new Administrators, Nursing leaders, and other key positions
  5. Financial services, including business office support and training, cost report preparation, PBJ guidance and review, fund management solutions
  6. IT services, including risk analysis
  7. Staff training and roll-out of best practices

Contact us by email to determine how we can meet your needs at  actseniorlivingconsulting@actcpas.com.

Stay up-to-date with important news by accessing this newsletter and more in the Knowledge Center on our ACT website!