E-News Update Articles

The Centers for Medicare & Medicaid Services (CMS) has posted on its website updates to the following documents: New Long Term Care Survey Process and Slide Deck LTC Survey Pathways LTC Survey Procedure Guide LTC Interim Revisit Instructions

The Advance Beneficiary Notice (ABN) of Noncoverage Interactive Tutorial Educational Tool and the The Medicare Advance Written Notices of Noncoverage Booklet are available on the CMS MLN website.

The Massachusetts Senate has acted on a number of amendments related to nursing home care. We are pleased to report that the Senate adopted Senator Julian Cyr's EMAC Assessment Hardship Waiver, which directs the Department of Unemployment Assistance to develop a hardship waiver that may be approved for an employer experiencing a financial hardship due to its liability.

Partners HealthCare will be accepting applications for participation in Year 6 of the Skilled Nursing Facility Collaborative Network beginning June 1, 2018 through June 30, 2018 at 5 PM. Participation in the Collaborative Network is an opportunity for skilled nursing facilities to join a bi-directional, quality-based collaborative emphasizing quality improvement and education. All facilities that are interested in participating in Year 6 of the Collaborative Network will be required to apply for inclusion. To indicate interest in applying to the

Nearly 200 nursing facility staff, residents and residents' family members took to the State House on Tuesday to deliver an urgent message that increased funding for frontline staff and resident care is immediately needed in order to meet the care needs of vulnerable nursing home residents who can no longer live safely in the community. The program at Advocacy Day featured Matt Salmon, Chairman of Mass Senior Care, Tara Gregorio, President of Mass Senior Care, Senate President Harriette Chandler and

The Department of Public Health has released proposed revision to 105 CMR 153.000 Licensure Procedure and Suitability Requirements for Long-Term Care Facilities for review and comment. We are pleased that the proposed revisions include recommendations submitted by Mass Senior Care members including the following:

David Bell has been elected President of the Massachusetts Chapter of American College of Health Care Administrators. David has been a licensed long term care administrator since 1984 and has been an Administrator of Meadow Green Rehab and Nursing Center in Waltham since 1988.

In response to member concerns, Mass Senior Care has been working with the Department of Public Health and the American Health Care Association on guidance related to F700 Bedrails.

In accordance with the SFY 2018 Budget Act, MassHealth will be sending a message text notifying providers that MassHealth will once again delay processing nursing facility claims for May 2018 dates of service. As you may recall, MassHealth has applied this temporary cash management delay for the last eight fiscal years. For the current year, this effectively means that nursing facility payments for May 2018 claims received by MassHealth in May or June will be pushed back by ten days, from June 25th to July 5, 2018.

In accordance with the SFY 2018 Budget Act, MassHealth will be sending a message text notifying providers that MassHealth will once again delay processing nursing facility claims for May 2018 dates of service.

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The US Department of Health and Human Services, Office of Inspector General (OIG) has released its updated list which reflects all OIG exclusions and reinstatement actions. This new file is meant to replace the updated List of Excluded Individuals/Entities (LEIE) database file available for download last month. Individuals and entities that have been reinstated to the federal health care programs are not included in this file. The updated files are posted on the OIG’s website and healthcare providers have an

The Massachusetts Senior Care Foundation's annual scholarship program assists long term care staff in meeting their personal and professional goals through furthering their education. Since 1985, the Foundation has awarded $2.8 million in scholarships to nearly 1,600 "Foundation Scholars" across Massachusetts. The Foundation is now accepting applications for its 2018 scholarship awards. Scholarships from $500 to $2,000 will be awarded to selected applicants to help cover direct, out of pocket expenses for tuition, fees, books and supplies during the 2018

The Committee on Senate Ways and Means (SWM) today released its state fiscal year (SFY) 2019 budget recommendation. The Committee’s recommendation includes level funding for the current year's $35.5 million direct care add on and restores the $7.5 million cut proposed by Governor Baker in his SFY 2019 budget recommendation.

Local legislators, town officials, and policy-makers met at John Scott Rehab and Nursing Center in Braintree on May 8 to discuss current issues related to the skilled nursing industry and the impact those issues are having on nursing home residents and employees across the state. Pictured Below: Richard Bane, President and CEO of BaneCare Management and a member of the Mass Senior Care Association Board of Directors , addresses issues facing the nursing home industry. Attendees included: Mayor Joe Sullivan

From May 13-19, 2018, National Skilled Nursing Care Week (NSNCW), formerly known as National Nursing Home Week, provides an opportunity to recognize the role of skilled nursing facilities in caring for America’s seniors and individuals with disabilities. The 2018 NSNCW theme announced by AHCA, “Celebrating Life’s Stories”, serves as a tribute to life’s most significant events, relationships and experiences that shape the unique perspectives of residents, families, staff, and volunteers in long term and post-acute care. ​Facilities will be encouraged

In honor of National Nurses Week on May 6-12, 2018, Blaire House of Tewksbury celebrated their dedicated nursing staff. The residents wrote thank you notes on heart cutouts for their nursing staff and hung these on all three units of the facility. Pictured are: Ashley Podzycki, RN, resident Dorothy Rogers, a former U.S. Navy nurse, and Jennifer Reid, RN.

Join us on Thursday, May 31 st at 10:00 am for this important one-hour webinar, Massachusetts’ New Pay Equity Law – Where to Begin, What to do Next, and Why it is Important to Include Your Legal Counsel! The general purpose of the Massachusetts Pay Equity Act—scheduled to take effect in July 2018—is to close the gender gap and make it unlawful for employers to pay men and women different rates for "comparable work", a term that was not previously

The Centers for Medicare & Medicaid Services (CMS) issued on Friday, April 27, 2018 its proposed federal fiscal year 2019 (FFY 2019) Medicare SNF PPS rule and Pre-Rule on Possible New Payment System. AHCA has created a summary document with a highlights section and preliminary overview of the payment updates, the SNF value-based purchasing (VBP) program proposed new components, the IMPACT Act quality reporting additions, and an overview of the payment reform discussion. Highlights of CMS’s proposed actions include: Market

A recent Massachusetts Senior Care Association member survey documents that the Trump Administration’s decision to end the temporary protected status (TPS) for Haitians living in the United States will have a negative impact on the ability of skilled nursing facilities to provide quality care to frail and disabled residents. Massachusetts nursing facilities, like other human service providers, rely heavily on first-generation Americans and immigrants to meet resident care needs. Eliminating TPS for Haitians would undoubtedly exacerbate the sector’s staffing shortages

Jennifer Gizmunt has been appointed Chief Executive Officer of Salter HealthCare communities where she will oversee the daily operations for Aberjona, Winchester and Woburn Rehabilitation & Nursing Centers. Gizmunt joins Salter from Lahey Health Continuing Care where she was Senior Vice President & Chief Operating Officer. Gizmunt succeeds Robert Driscoll, former MSCA Board member, who retired earlier this year.

On April 25, 2018, the Centers for Medicare & Medicaid Services (CMS) published new Five-Star ratings that include Payroll-Based Journal (PBJ) staffing data on its Nursing Home Compare (NHC) website. The American Health Care Association (AHCA) has analyzed the new data and provided the following detailed summary. The summary notes that the following measures on NHC have been updated based on PBJ data from October 1 - December 31, 2017: Physical therapist hours per resident day RN hours per resident

From May 13-19, 2018, National Skilled Nursing Care Week (NSNCW), formerly known as National Nursing Home Week, provides an opportunity to recognize the role of skilled nursing facilities in caring for America’s seniors and individuals with disabilities. The 2018 NSNCW theme announced by AHCA, “Celebrating Life’s Stories”, serves as a tribute to life’s most significant events, relationships and experiences that shape the unique perspectives of residents, families, staff, and volunteers in long term and post-acute care. Facilities will be encouraged

The House of Representatives has finalized its state FY 2019 budget recommendation for the Medicaid program. We are pleased to report that the House adopted a consolidated budget amendment for the FY 2019 Medicaid budget which includes $20.3 million more in funding for quality nursing home care than the Governor’s FY 2019 House 2 budget recommendation The House’s Medicaid budget amendment for nursing homes would (1) add $2.8 million to the current FY 2018 direct care add on program (2)

Fourth quarter FY 2017 Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) are available for hospices, Skilled Nursing Facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), Inpatient Psychiatric Facilities (IPFs), Critical Access Hospitals (CAHs), and Long-term Acute Care Hospitals (LTCHs). These reports summarize provider-specific data statistics for Medicare services that may be at risk for improper payments. Use your data to support internal auditing and monitoring activities. For instructions on obtaining your PEPPER, read the Secure PEPPER Access Guide. Visit the PEPPER

In response to employer concerns and a large volume of appeals, the Department of Unemployment Assistance (DUA) has posted a new form on its website to allow employers to request that MassHealth review information in certain cases to determine the validity of the EMAC Supplement assessment. MassHealth and/or the Connector will investigate the referral. If the information provided by the employer results in a determination that an employee was enrolled in a qualifying employer sponsored insurance or was not eligible

The Massachusetts Department of Public Health is continuing to offer a free monthly webinar series called “Bug of the Month,” which will feature Healthcare Associated Infection/Antibiotic Resistant pathogens of concern. The next webinar is "Super Bugs, Super Strategies: Where are we with CRE?" scheduled for Tuesday, May 1, 2018, 12:00-1:00 pm. Click here to register.

On April 11th, the Committee on House Ways and Means (HWM) released its version of the state FY2019 budget. The Committee's recommendation includes $17.8 million more in funding for quality nursing home care than Governor Baker's FY 2019 House 2 recommendation that would cut $7.5 million from current spending. Mass Senior Care is grateful to Speaker Robert DeLeo, House Ways and Means Chairman Jeffrey Sanchez and the House of Representatives for their support of quality nursing home care. Two important

As we reported at our regional member meetings, the Executive Office of Health and Human Services is actively working to convert to an MDS payment system for MassHealth nursing facility residents. MMQ/MDS conversion has long been a priority of the Association and MassHealth is working rapidly to develop both the policy and coding technology necessary to implement the conversion as early as the Fall of 2018. As a result of the coding work being performed, members will receive a notice

The April 15, 2018 reporting deadline of healthcare personnel influenza vaccination data is quickly approaching. Beginning with the 2017-2018 flu season, all licensed adult day health programs, non-ambulatory surgical center clinics, nursing homes, and rest homes must submit influenza vaccination reports through the web-based application SurveyMonkey. Click here to access the SurveyMonkey application to submit the data for your facility. The vaccination reporting questions can be accessed here so that you may keep a copy of your facility-specific submission. You

On April 6, 2018, the Center for Clinical Standards and Quality/Quality, Safety and Oversight Group at the Centers for Medicare & Medicaid Services (CMS) issued a memorandum, "Transition to Payroll-Based Journal (PBJ) Staffing Measures on the Nursing Home Compare tool on Medicare.gov and the Five-Star Quality Rating System." Our national association, AHCA, has issued this full summary regarding the technical information in the CMS memorandum. AHCA has also provided below this brief summary of the information included in the CMS

The US Department of Health and Human Services, Office of Inspector General (OIG) has released its updated list which reflects all OIG exclusions and reinstatement actions up to, and including, those taken in February 2018. This new file is meant to replace the updated List of Excluded Individuals/Entities (LEIE) database file available for download last month. Individuals and entities that have been reinstated to the federal health care programs are not included in this file. The updated files are posted

At the April 11, 2018 Board of Registration in Nursing (Board) meeting, the Board revised Advisory Ruling 9324: Accepting, Verifying, Transcribing and Implementing Medication Orders to ensure compliance with current statutes, regulations and scope of practice standards. The revisions include: a) Requiring range orders specify specific, objective measures that must be collected and assessed prior to administering the correct dosing. Range orders that do not contain these elements involve diagnosing and prescribing; activities that are outside the scope of RN

Please join us for informative presentations and the opportunity to network with colleagues at Mass Senior Care Association’s Human Resources Committee meeting on Friday, April 20, 2018 from 10am-12 noon at Mass Senior Care’s office in Waltham (click here for directions). Please confirm your attendance at this meeting with Denise DeSimone, at ddesimone@maseniorcare.orgor 617.558.0202. Note: Mass Senior Care HR meetings are open to Mass Senior Care facility members only. If you have any questions, please contact Carolyn Blanks at cblanks@maseniorcare.org.

The Committee on House Ways and Means released its state FY 2019 budget recommendation, totaling $41 billion, representing a nearly 3% increase over the current year FY 2018 budget. The Committee’s recommendation includes $17.8 million more in funding for quality nursing home care than Governor Baker’s FY 2019 House 2 recommendation that would cut $7.5 million from current spending. Mass Senior Care is grateful to Speaker Robert DeLeo, House Ways and Means Chairman Jeffrey Sanchez and the House of Representatives

Secretary of State William Galvin certified the Department of Public Health’s final revisions of 105 CMR 150.000 Standards for Long-Term Care Facilities, which became effective March 23, 2018. Please click here for the official copy of the revised regulations.

On April 6, 2018, the Center for Clinical Standards and Quality/Quality, Safety and Oversight Group at the Centers for Medicare & Medicaid Services (CMS) issued a memorandum, "Transition to Payroll-Based Journal (PBJ) Staffing Measures on the Nursing Home Compare tool on Medicare.gov and the Five-Star Quality Rating System."

Massachusetts is not a NAB (National Association of LTC Administrator Boards) mandated state for continuing education. Continuing education for Administrators in the state of Massachusetts is approved by the Board of Registration of Nursing Home Administrators. However, if you plan to receive continuing education credit for classes that you attend that are put on by NAB certified sponsors (outside the state of MA), you will need to have a registry ID# with NAB. Please click on this link to get

We are sorry to share with you the sad news that our dear colleague, Margaret 'Peggi' Leoni, passed away unexpectedly on Wednesday, March 28, 2018. Peggi, a valued colleague and a friend to many in the nursing home community, had previously served as MSCA's Vice President of Regulatory Affairs from 2005 to 2011. Most recently, she provided her invaluable expertise as a presenter and educator at the Association's regulatory compliance and leadership training programs. Peggi's passion, knowledge and commitment to quality nursing home care will be sorely missed by all.

On March 30, 2018, CMS issued Transmittal 4011, with CMS Medicare Claims Processing Manual changes revising the Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNF ABN), Form CMS-10055. With this revision, CMS is discontinuing the 5 SNF Denial Letters and the Notice of Exclusion from Medicare Benefits (NEMB-SNF), Form CMS-20014; the revised SNF ABN replaces the formerly used SNF ABN, the 5 SNF Denial Letters, and the NEMB. SNFs must use the revised SNF ABN to inform beneficiaries of

A revised Provider Compliance Tips for Skilled Nursing Facility Services Fact Sheet for Skilled Nursing Facility Services is not available. The revised Fact Sheet includes information on reason for denials, how to prevent claims denials and documentation requirements.

Commonwealth Corporation has released a case study on the Care Transitions Education Project (CTEP) developed and administered by Mass Senior Care Association to equip frontline nurses with the foundational knowledge and skills needed to lead and improve care transitions and reduce costs. The project was overseen and received funding from the Commonwealth Corporation through the Health Care Workforce Transformation Fund, which supports training programs that address workforce skill needs iden­tified by health care providers to improve patient care and reduce

Please note Mass Senior Care’s Greater Boston regional membership meeting will be held on Wednesday, April 4, 2018 from 10:00am - 12:00pm at Mass Senior Care’s office (800 South Street, Suite 280, Waltham, MA 02453 - Click for directions). The original meeting on March 13th was rescheduled due to weather. As part of Mass Senior Care's ongoing membership engagement efforts, the Association has held regional membership meetings throughout the state. The regional meetings offer a great opportunity for members to

The Centers for Medicare & Medicaid Services (CMS) will adjust Medicare payments to providers based on how well they manage hospital readmissions performance through its SNF Value Based Purchasing (VBP) program starting on October 1, 2018. The calendar year 2017 performance window used to measure the SNF VBP Readmission Measure (RM) rates for the first year of the program has now passed. While the data has already been collected, the SNF RM rates have not been finalized. Providers have until

Beginning in April, the Centers for Medicare & Medicaid Services (CMS) will be mailing all Medicare beneficiaries new Medicare cards that remove their social security numbers. The change is intended to prevent fraud and identity theft. CMS will be mailing the new cards in waves between April and June 2018, with more details on the timing here. CMS has created an informational page for providers explaining what they need to do to get ready. Source: AHCA

The Supportive Planning and Operation Team (SPOT) Initiative is a collaborative effort to support nursing home teams to develop effective quality assurance and performance improvement (QAPI) programs. Effective quality assurance and performance improvement (QAPI) programs can prevent adverse events, promote safety and quality, and reduce risks to residents and caregivers. With funding from Center for Medicare & Medicaid Services, The Bureau of Health Care Safety and Quality (BHCSQ) of the Massachusetts Department of Public Health (BHCSQ) launched the Initiative in

Honoring Choices Massachusetts is a consumer oriented non-profit organization focused on the rights of every adult to direct their health care choices and make a plan to receive the best possible care that honors their values and choices, all through their lives. Every adult can access free information and tools on the Honoring Choices website to make his/her own health care plan.

MassHealth requires that nursing facilities and chronic disease and rehabilitation inpatient hospitals account for the balances of personal needs allowance (PNA) account funds. MassHealth has issued its annual LTC Bulletin for the accounting of balances of personal needs allowances (PNA) for residents in LTC facilities. For 2017, if a provider does not submit the PNA form by Monday, April 30, 2018, or if the filing is incomplete and not reconciled to the bank statement, the provider may be subject to

On March 16, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a Medicare Learning Network (MLN) Matters article that announced several technical changes to the Medicare Eligibility and Entitlement, Benefit Policy, and Claims Processing manuals that impact skilled nursing facility (SNF) services. CMS states the “…changes are intended only to correct various minor technical errors and omissions…to clarify the existing content and no policy, or systems changes are anticipated.” The implementation and effective date for these changes is

In response to the Trump Administration’s decision to end Temporary Protected Status (TPS) for Haitians living in the United States, Mass Senior Care was recently featured in an article published in Kaiser Health News and The Washington Post, “ As Trump targets immigrants, elderly and others brace to lose caregivers.” Tara Gregorio, Association President say the repeal of the TPS designation will further exacerbate workforce shortage concerns facing skilled nursing facilities who provide quality care to frail and disabled residents