UPDATE IS GETTING A MAKEOVER - EXCITING CHANGES ARE COMING IN 2019 As announced in January, this spring NCHCFA is giving UPDATE a new look and format to keep our membership up-to-date on the most pressing issues. The Association’s newsletter began its first publication on May 31, 1977. Through the years it has gone through several aesthetic changes but has always remained true to its original goal. As stated in the first issue, “The purpose of this new method of communication is to better inform you of what is going on in your association when you are not there.” Today’s edition is the first of several changes you will see in the coming weeks. This new format will shift into a web-based application that will link articles directly to NCHCFA’s website and ultimately be more user-friendly. NCHCFA appreciates your patience during this brief transition. If you have any questions, please do not hesitate to contact the Association office at (919) 782-3827.

THANK YOU NCHCFA LEGISLATIVE CONFERENCE PARTICIPANTS NCHCFA would like to thank all members that attended our new Legislative Conference this week in Raleigh, NC. This event allowed attendees to schedule appointments with their elected representatives in the North Carolina House and Senate and advocate for important long term care issues at the North Carolina Legislature. I am pleased to report our members sent a powerful message of unity on behalf of our state's skilled nursing community.  Thanks to their participation, thirty-two decision makers in our state now better understand who we are caring for, and what they can do to help! Again, NCHCFA appreciates you taking an active role in our advocacy efforts and making this event a success.

REGISTER TODAY FOR PHASE 3 REQUIREMENTS OF PARTICIPATION SEMINAR Long term care facilities must be compliant with Phase 3 Requirements of Participation by November 28, 2019. This phase introduces several items that have never been surveyed before, including the full implementation of a compliance and ethics and QAPI program, presence of a qualified infection preventionist, and certain staff training requirements. Cindy Deporter, MSSW, State Survey Agency Director, Division of Health Service Regulation, will be teaching a full day session (three locations) on an overview of Phase 3 Requirements of Participation with extra emphasis on those that have not been phased in (in part). The review will include: Abuse & Neglect Coordination with QAPI Program Care Planning & Providing Culturally Competent & Trauma-Informed Care Standards of Practice, Systems, & Staff Competency Related to Trauma-Informed Care QAPI Program Infection Preventionist Compliance & Ethics Program Bedside Resident Call System Training Requirements In addition, there will be a segment devoted to the revised State Operations Manual, Appendix Q – Core Guidelines for Determining Immediate Jeopardy. The dates and locations remaining are: April 16, 2019 – The Grandover Resort, Greensboro, NC May 2, 2019 – The Ballast Hotel, Wilmington, NC Click here to register online. Click here to download the brochure with registration form.

UPDATED MATERIALS FOR PATIENT DRIVEN PAYMENT MODEL (PDPM) Last week, the Centers for Medicare & Medicaid Services (CMS) released an array of updated Patient-Driven Payment Model (PDPM) materials. First, CMS updated its frequently asked questions (FAQs) related to PDPM policy and implementation. PDPM FAQs: The FAQ documents constitute sub-regulatory guidance for the new payment system. In this document, CMS provides updates and additions to the CMS policy. One of the updates addresses the modification to the timeline for states that use RUGs to set nursing facility rates (case-mix). Previously, CMS had indicated that the optional state assessment (OSA) would be supported by CMS through September 30, 2020. However, the guidance just released indicates that “There is currently no definitive timeline for retiring the OSA. Once states are able to collect the data necessary to consider a transition to PDPM, CMS will evaluate the continued need for the OSA, in consultation with the states.” Second, CMS released additional updated resources relevant to PDPM implementation, including various coding crosswalks and classification logic. PDPM Classification Walkthrough: In this document, CMS lays out how patients are classified in the PDPM components (e.g., Physical Therapy, Occupational Therapy, Speech Language Pathology, Nursing, and Non-Therapy Ancillaries) Case Mix Groups (CMGs) and related Case Mix Indices. PDPM GROUPER Logic (SAS): The GROUPER logic materials provide technical programming guidance for software which classifies patients into component CMGs. PDPM ICD-10 Mappings: For PDPM, CMS mapped an array of ICD-10 codes to clinical categories. In this excel file, CMS has updated the ICD-10 diagnosis codes (ICD-10-CM) codes which map to the clinical categories. If you have questions, suggestions or concerns, please contact AHCA at pdpm@ahca.org.

PROVIDER TRANSITION TO MEDICAID MANAGED CARE NC Medicaid recently launched a Webinar series to support providers and practices during their transition to NC Medicaid Managed Care. “General” Webinars are overviews of significant changes and features of the managed care program. “Topical” Webinars are in-depth reviews of specific managed care topics. Upcoming topics: Provider Payment and Contracts, NC Medicaid Managed Care 102-Thursday, April 11, 2019, Noon-1:00 PM Value Based Payments and Quality Measurement in Medicaid Managed Care, NC Medicaid Managed Care 103-Thursday, April 25, 2019, Noon-1:00 PM Provider Policies, NC Medicaid Managed Care 104-Thursday, May 9, 2019, Noon-1:00 PM For additional information on previous and upcoming topics, including registration, click here. Prepaid Health Plan Meet and Greet Sessions: Regional sessions will offer providers an opportunity to meet with health plan representatives, ask specific questions about provider network participation and Medicaid Managed Care transition. Health Plans and NC Medicaid subject matter experts will be on hand to respond to provider inquiries. For more information, click here. Virtual Office Hours: Virtual office hours (VOH) will provide an interactive format for providers to have their questions answered. For the first VOH session, the focus will be on Medicaid provider enrollment and credentialing. A panel of NC Medicaid subject matter experts on this topic will be available to answer questions. For more information, click here.

NC MUST ADMINISTRATOR AUDIT There is a planned audit of the documented NC MUST Administrators and their registered users. This is an effort to ensure the accuracy of the list of registered users. Jenny Abramson, Business Systems Analyst with ITD, will be sending an email to all of the NC MUST Administrators. If needed, follow up phone calls will be made.

NATIONAL CARE TRANSITIONS AWARENESS (NCTA) DAY – APRIL 16, 2019 Alliant Quality is hosting a Webinar event to celebrate National Care Transitions Awareness Day (NCTA) on April 16, 2019 - 3:00-4:00 PM Alliant Quality invites you to join the webinar event:   “A Story of HOPE: Forming a SNF Collaborative” presented by Heather Jacobson MHA, MS, CCC-SLP, Senior Planning and Strategic Services Analyst, Population Health Management Office at Duke University Health. The HOPE Skilled Nursing Facility Collaborative consists of 23 skilled nursing facilities across 6 North Carolina Counties. Learn more about how this collaboration is working to provide shared patients with better, more coordinated care. Registration Instructions:  Click or Copy and Paste this URL to your web browser: https://qualitynet.webex.com/ec. Locate the event titled: Care Transitions: A Story of HOPE: Forming a SNF Collaborative Click Register Once approved, you will receive a confirmation email with the meeting information and the registration ID that will be used to log into the WebEx portion of the meeting Please note, this email may go to your spam or junk folder. It will come from the email address messenger@webex.com. Please join the event 15 minutes prior to the start time to ensure the automatic system set-up has been properly established. Event Password: Care Dial in to the teleconference: (800) 747-5150 Access Code: 2575789# Or register by direct link at:  https://qualitynet.webex.com/qualitynet/onstage/g.php?MTID=ec7aea2c6376deff7c6fdd736bf01014b.

REGISTER FOR YOUR NCHCFA SPRING DISTRICT MEETING NCHCFA has scheduled the Spring district meetings. Each space will be limited to 50 individuals. There will be a small registration fee of $50.00. Lunch will be provided. This program will offer 3.0 contact hours for nursing home administrators. The North Carolina Health Care Facilities Association is a Registered Sponsor of continuing education with the NC State Board of Examiners for Nursing Home Administrators. Comments regarding the Registered Sponsor Course may be addressed to: NCBENHA, 3733 National Drive, Suite 110, Raleigh, NC 27612. Click here to download and print the brochure and registration form. April 23rd - District I April 25th - District II April 30th- District III May 7th - District IV May 8th - District V Agenda 10:00 AM – 10:30 AM Alliant Quality (QIN-QIO) Alliant Quality will present an update on NC’s facilities’ quality measures. 10:30 AM – 1:30 PM Drug Diversion in LTC: Safe Practices, Handling, and Disposal Methods In this session, attendees will learn of narcotic diversion principles within long term care and how handling, storage, and safeguards play a role daily in your facility. Implementation of Facility action plans will be discussed along with best strategies to prevent diversion within your facility. Proper narcotic disposal methods of medication waste will be defined along with new federal regulations.

Thank you District I Meeting Sponsor:

Thank you District III Meeting Sponsor:

AMERICAN RED CROSS EMERGENCY DISASTER PREPAREDNESS TRAINING On May 2, 2019, the Lumber River Council of Governments’ Area Agency on Aging will be hosting a free emergency disaster preparedness training in Pembroke, NC taught by the American Red Cross. According to the organizers, this is an opportunity for health care providers to come and learn about what you can do to prepare your organization to continue to serve your clients during and after a disaster, and also how the state of North Carolina is preparing. Space is limited. For more information, including RSVP instructions, click here.

REGISTER FOR NCBENHA 2019 PRECEPTOR TRAINING The NC State Board of Examiners for Nursing Home Administrators (NCBENHA) will offer the 2019 Preceptor Seminars on April 29-30, 2019 and April 30-May 1, 2019 at the Kingston Plantation, Myrtle Beach, SC.  You will need to choose the first seminar dates for Renewal Preceptor Certification and the second seminar dates for Initial Preceptor Certification and Continuing Education Only. The seminars will be open to all nursing home administrators seeking continuing education credits and/or preceptor certification.  This is the only preceptor seminar being planned for 2019 by the NC State Board of Examiners for Nursing Home Administrators. The deadline to register is April 19th! Click here to download more information along with the registration form.

SOUTHERN PARTNERS ACTION COLLABORATIVE FOR EXCELLENCE (SPACE) WEBINAR April 18, 2019 Antimicrobial Stewardship-Practical Approaches for the Long Term Setting Monthly Webinar Event Time: 1:00 - 2:00 PM (ET) Prior to the Event Date, please  Register Here Please join the event 15 minutes prior to the start time to ensure the automatic system set-up has been properly established. Instructions: Click "Join" (located to the right of the event title) Enter your registration ID as prompted If the text boxes and "Join Now" button are inactive, refresh your web browser Enter the password: SPACE The automatic system set-up should start at this point. If a dialogue box appears, click run. Please note, the automatic system set-up does take a few minutes to complete. Dial in to the teleconference: Teleconference Number: (800) 747-5150 Access Code: 2323667# If you have any questions or problems accessing the web portion of this meeting, please call the Ventech Solutions WebEx Helpline at (571) 598-1988.

REGISTER FOR THE NEXT LUNCH AND LEARN WEBINAR The next Lunch and Learn Webinar is scheduled for Thursday, April 18, 2019 at 12:00 PM. Sam Clark, VP of Finance, NCHCFA, will be presenting an overview of PDPM, Medicaid Managed Care and other upcoming changes. Click here to register today.

REVIEW AND UPDATES FROM THE STATE SURVEY AGENCY NOTEBOOK If you were unable to attend one of our sessions with Cindy Deporter, Review and Updates from the State Survey Agency, the notebook used in the training is now available for purchase. Email Donna Snyder to order a notebook for your facility at donnas@nchcfa.org. The cost is $25.00 plus tax and shipping.

NEED TO KNOW Stop using these morale-killing phrases - Phrases such as "I'm the boss" or "You're doing it wrong," deflate people's motivation, writes Lolly Daskal. "When you're in a leadership position, it's especially important to think before you speak," she argues.

DID YOU KNOW? Pie Town, New Mexico’s name comes from an early bakery known for making dried-apple pies. Pie Town is the location of a "Pie Festival" on the second Saturday of each September.