July 31, 2018
Volume II, Issue 6
In this edition:
-Breaking News
-Money Matters
-Coming Down the Pike
-In Effect and Important
-ACT Senior Living
    Consulting Services

ACT supports our communities in OH, PA, and WV. We are passionate about being involved in charitable events and causes. Since June, we have participated in the YMCA Corporate Cup, Habitat for Humanity, and several local events. This is just one way we honor our core values of integrity, responsibility, respect, continuous improvement, action and accountability, and having a "can do," positive attitude.
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Breaking News
The Centers for Medicare and Medicaid Services (CMS) has announced that Payroll Based Journal (PBJ) audit teams will begin examining the information being reported by facilities. The goal of the audits is to determine whether submitted data is accurate. The on-site and off-site audits will include review of the data submitted from payroll and timekeeping systems, as well as invoices for contracted staff (if used). Interviews with the individuals who are responsible for PBJ data entry may be conducted. Facilities who are being audited will receive notification via a letter. Failure to comply with the audit may result in the CMS posting a negative icon next to the facility's name on the Nursing Home Compare website.

Money Matters
Are you getting paid for the services your staff provide? When it comes to the Minimum Data Set (MDS), knowledge is key to providing quality services. Correctly coding the MDS promotes quality by providing guidance in individual care, in developing care systems, and in reimbursement rates. Quality, in part driven by accuracy, is key to much more than payment. Quality helps promote better care outcomes; improved staff retention; higher levels of resident/family satisfaction; better survey outcomes; and lower risks related to bad publicity, fines, or litigation. What is one of the best ways to positively impact your bottom line and be prepared for future changes to rules, regulations, payment systems? A high level of knowledge and accuracy in completing the Resident Assessment Instrument, which includes the MDS.

Coming Down the Pike
The new proposed payment system, the Patient Driven Payment Model (PDPM), is currently one of the main topics for seminars, articles, and newsletters. It is important for facility and company leaders to maintain knowledge about possible changes in LTC processes, including payment systems. To lend support, and to help you keep spending down to learn about a topic that could change multiple times before it makes it to the final format, we are tuned in and plan to communicate important information early enough in the process to provide an ample learning curve. In the meantime, this is the perfect opportunity for you to take a deep dive into your therapy services model and identify opportunities for improvement.

In Effect and Important
For those facilities that are out of compliance with the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP)... CMS posted non-compliance notifications in the QIES CASPER folder on July 9, 2018. To submit a request for reconsideration, you must submit an email no later than August 7, 2018. For more information, visit the SNF Quality Reporting Reconsideration and Exception & Extension website.

Blended surveys are serving up mixed results. The updated Guidance to Surveyors does not leave as much room for interpretation in the situations or conditions that tend toward consideration for additional tags or for Severity Level 4 Considerations: Immediate Jeopardy (IJ). Citations at the IJ level continue to rise. Additionally, some facilities have shared that their total number of deficiencies has risen due to citations that are duplicative in nature. On the opposite side of the pendulum, more facilities are claiming fewer citations with a higher number of "deficiency free" surveys being publicized. What does this mean? It will still take a while to gather enough information to accurately measure survey outcomes.

In the meantime, becoming familiar with the Long Term Care Survey Process (LTCSP) Procedure Guide that became effective on May 6, 2018, may be helpful. This surveyor tool, along with the survey pathways, care areas, and other helpful survey tools and information can help your team be prepared and successful!

ACT Senior Living Consulting Services
The ACT Senior Living Consulting team can help you in many of your daily facility operations. Some of the projects we help our clients with include:
  1. Business office audits, education, support in re-organization, and accounts receivable processes
  2. Development of job descriptions, performance evaluations, and development or performance plans
  3. Staff training for job specific duties and skills, including clinical competencies
  4. Staffing analysis based on hours per resident day, acuity, service lines, and other unique cultural factors
  5. MDS and therapy reviews, evaluations, and recommendations (quality, operational, financial, compliance)
  6. Mock surveys, survey readiness binder preparation, and survey training for new Administrators, Directors of Nursing, and other staff
  7. Market analysis and strategic planning for future success

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!