Announcement from CMS – National Provider Call: QIO Program Transition

You are invited to join the Centers for Medicare and Medicaid Services (CMS) – Center for Clinical Standards and Quality, for a discussion on the restructuring of Quality Improvement (QIO) Program effective August 1, 2014.  We recognize the unique impact of the changes on the provider community as it relates to areas such as provider’s procedures for notifying beneficiaries regarding rights to appeals of discharge determinations, addressing quality of care concerns, provision of medical records, working on quality improvement initiatives and receiving technical assistance on value and incentive programs.  The purpose of this meeting is to share an overview of the QIO Program changes, provide an update on the transition process, discuss its impact on the provider community, share critical resources, and to answer any questions.

We have scheduled the National Provider Call for Wednesday, July 23, 2014 from 11:00 am – 12:00 pm EDT (10:00 am – 11:00 am CDT) via webinar.

Here is how you can join:

Audio:  Telephone Number: 1-877-267-1577

MeetingPlace ID: 993 182 797 (This meeting does not require a password.)

Webinar:  https://webinar.cms.hhs.gov/qio-provider-call/

Users without an Adobe Connect login may sign-in as a guest.  Pre-registration is not required.  This session will be recorded.  Thank you for your participation in this call to advance health care quality for Medicare beneficiaries.  We look forward to hearing from you.

Ghostbusters and QIO Program Turn 30: Who You Gonna Call for Medicare Concerns?

Primaris will no longer handle Missouri Medicare case reviews beginning August 1

Thirty years ago, Ghostbusters made the question “Who you gonna call” go viral long before the days of social media.

1984 was the same year Quality Improvement Organizations (QIOs), like Missouri-based Primaris, began answering the call of Medicare patients.  Primaris serves Missourians with Medicare by examining concerns about their care, or by reviewing cases where patients feel services ended too soon – for example, an early discharge from a hospital.

Beginning August 1, 2014, Missourian patients and providers will no longer call health care quality-improvement consulting company Primaris.  All current and future beneficiary quality review case work and appeals will be conducted by KEPRO, located in Seven Hills, Ohio.

For more information, please visit Primaris at http://primaris.org/quality-today/ghostbusters-and-qio-program-turn-30-who-you-gonna-call-for-medicare-concerns.

The DON Institute: Essential Tools for the Director of Nursing in Long Term Care

September 23 – 24, 2014: Get ready for an energetic and eye-opening conference that will get you charged up!  Tips you can take back to your home and implement right away will be shared.  Whether you are a new DON or a seasoned one, this conference is right for you.  We will give you the confidence, knowledge, direction and motivation needed to help you better perform your important role as a DON.  Please view the brochure here:  MLN DON Institute 2014, or visit the Missouri League for Nursing (MLN) at www.mlnmonursing.org/DON%20Conference.

MDS System Requirements

Please note effective October 1, 2014 (FY 2015), CMS will no longer support Windows XP or Internet Explorer v8.0.  This means after October 1, 2014, you will not be able to transmit MDS and/or retrieve CASPER reports until you upgrade your internal system.  The recommended operating system is Windows 7 and the recommended browser is Internet Explorer v9.0.  Visit the QIES Technical Support Office at https://www.qtso.com/ to view Minimum System Requirements for Home Health Agencies, Hospice Providers, Long Term Care Facilities, Inpatient Rehabilitation Facilities and Long Term Care Hospitals.  NEW: FY2014 System Requirements [PDF 22KB].

This information is also available on the CMS MDS 3.0 System Welcome Page.

If you have any questions, please contact Joan Brundick, State RAI Coordinator at 573-751-6308 or joan.brundick@health.mo.gov, or contact Danette Beeson, State Automation Coordinator at 573-522-8421 or danette.beeson@health.mo.gov.

Navigating the 2014 Advancing Excellence Website – Free Webinar

July 9, 2014:  Advancing Excellence has a new website.  While the new site contains all the information from the old site, things have moved.  Join the webinar for a cruise around the website, including:

  • Logging in
  • Downloading the data collection tools
  • Looking at the resources
  • Uploading aggregate data to the AE website
  • Viewing your progress
  • Signing up for the newsletter, viewing the calendars, etc.

Plenty of time will be available for questions and answers.  To learn more, please visit www.nhqualitycampaign.org.

CMS Memorandum S&C 14-34-NH: Advance Copy of Revised F371; Preparation of Eggs in Nursing Homes

CMS Memorandum S&C 14-34-NH:  Advance Copy of Revised F371; Interpretive guidance and Procedures for Sanitary Conditions, Preparation of Eggs in Nursing Homes

Summary:

  • Guidance for Nursing Homes: Skilled nursing and nursing facilities should use pasteurized shell eggs or liquid pasteurized eggs to eliminate the risk of residents contracting Salmonella Enteritidis (SE).  The use of pasteurized eggs allows for resident preference for soft-cooked, undercooked or sunny-side up eggs while maintaining food safety.  In accordance with the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) standards, skilled nursing and nursing facilities should not prepare nor serve soft-cooked, undercooked or sunny-side up eggs from unpasteurized eggs.
  • Guidance for Surveyors: Signed health release agreements between the resident (or the resident’s representative) and the facility that acknowledges the resident’s acceptance of the risk of eating undercooked unpasteurized eggs are not permitted.  Pasteurized eggs are commercially available and allow the safe consumption of eggs.  If the facility prepares or serves unpasteurized or undercooked eggs which are not cooked until both the yolk and white are completely firm, surveyors should consider citing deficiencies at F371.  Determination of the appropriate scope and severity shall be based upon the actual or potential negative resident outcomes in accordance with guidance given at F371.  We are revising F371 to clarify this section; a revised F371 is attached.

View the memo here:  S&C 14-34-NH or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-34-.html?DLPage=1&DLSort=2&DLSortDir=descending.

CMS Memorandum S&C 14-30-NH: Grant Solicitation for the Reinvestment of Federal Civil Money Penalty (CMP) Funds

CMS Memorandum S&C 14-30-NH:  Grant Solicitation for the Reinvestment of Federal Civil Money Penalty (CMP) Funds to Benefit Nursing Home Residents

Summary:

  • Grant Solicitation for the Reinvestment of Civil Money Penalty (CMP) Funds to Benefit Nursing Home Residents: As part of the 2010 Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) is soliciting proposals for a grant opportunity in which Federal CMP Funds will be utilized to support and further expand the National Partnership to Improve Dementia Care in Nursing Homes.
  • Funds: A total of $500,000 for FY2014-2015 will be available for a three year period of performance.  Funding will be awarded in 12 month budget periods.
  • Terms: Further information about this new initiative may be accessed at http://www.grants.gov.

View the memo here:  S&C 14-30-NH or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-30.html?DLPage=1&DLSort=2&DLSortDir=descending.

CMS Memorandum S&C 14-25-NH: Advance Copy – Single Use Device Reprocessing under Tag F441

CMS Memorandum S&C 14-25-NH:  Advance Copy – Single Use Device Reprocessing under Tag F441, Revisions to Interpretive Guidance in Appendix PP, State Operations Manual (SOM) on Infection Control

Summary:

  • Advance Copy: The guidance under Tag F441, Infection Control, Preventing Spread of Infection/Indirect Transmission has been revised.
  • Single-Use Device Guidance: Nursing homes may purchase reprocessed single-use devices when these devices are reprocessed by an entity or a third party reprocessor that is registered with the Food and Drug Administration.
  • Single-Use Device (SUD): A SUD is a device that is intended for one use on a single patient during a single procedure.
  • Reprocessed SUD: A reprocessed SUD is an original device that has previously been used on a patient and has been subjected to additional processing and manufacturing for the purpose of an additional single use on a patient.

View the memo here:  S&C 14-25-NH or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-25.html?DLPage=1&DLSort=2&DLSortDir=descending.

Highest Practicable Level of Well-being is Required by Regulation – Conversations with Carmen

Highest Practicable Level of Well-being is Required by Regulation

June 20, 2014:  Conversations with Carmen

Guest:  LaVrene Norton, MSW, Action Pact Founder and Executive Leader, with Carmen Bowman, Edu-Catering, Regulator turned Educator, Hostess of Conversations with Carmen.

LaVrene Norton was one of the leaders of the culture change movement who identified the seven essential domains of well-being in 2002.  Together LaVrene and hostess Carmen Bowman will “take it up a notch” by showing how CMS nursing home regulations require that the highest practicable level of well-being be maintained or attained for each person and how the domains of growth, comfort, security, identity, autonomy, connectedness, meaning and joy are not only what really matter to people but are also embedded in regulatory requirements.  To learn more and register for this web-based talk show, please visit http://actionpact.com/calendar/event_details/conversations_with_carmen_webinar.

Cardiopulmonary Resuscitation (CPR) in Nursing Homes – Updated Guidance Clarification Addressing Transportation

 (see bolded, italicized information below)

The Section for Long-Term Care Regulation (SLCR) wants to make certified providers aware that updated guidance from CMS (S&C: 14-01-NH) now requires “certification” of some nursing home staff as part of the nursing home’s compliance with regard to CPR.  Previously, if a question arose during a federal regulatory process regarding whether someone could perform CPR properly, a surveyor may have needed to ask for an explanation of appropriate technique from some available staff member to verify compliance with that requirement, but verifying the certification of a particular staff member typically was not necessary.

This most recent memo states that “certification” of some staff members is mandatory, but the memo does not clarify which certifying agencies are acceptable (i.e., American Heart Association).  SLCR and the Kansas City Regional CMS office requested a clarification of this point.

We have received guidance indicating that the purpose of this memo was to, “…ensure that facilities do not implement facility-wide ‘no CPR’ policies and that facilities have CPR-certified staff available at all times,” but that CMS does not intend to review or approve all certification agencies.

A wide range of organizations offer CPR certification – some are based online and some are conducted in-person.  To this point, CMS has clarified that while S&C: 14-01-NH does not require the use of any specific certifying agency, there are two components that are required with regard to CPR certification:

  • The certification must be designed for healthcare providers (therefore, CPR courses for laypersons which teach chest compressions, but not mouth breathing, are not sufficient); and
  • Nursing home policies should address how staff members should maintain and document their CPR certification.

The American Heart Association certification is acceptable under this guidance, but it is not the only acceptable certification.  Many homes in Missouri are currently obtaining CPR certification through the American Safety & Health Institute (ASHI), which is also acceptable, as are others, as long as they are designed for professional healthcare providers.

In addition, this guidance also applies to nursing home residents who are being transported or accompanied by facility staff to various appointments, outings or events.  Nursing homes will need to ensure that staff who are CPR certified accompany residents during such transports.

You may view the memo here: CMS Memo S&C: 14-01-NH, or visit

http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-01.html?DLPage=4&DLSort=2&DLSortDir=descending.

View all CMS Memos at http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions.html.

Outcomes Congress – One Day Program

FREE to attend!  Be a part of the Congress!  Join Primaris for an exciting one-day program that will help you apply quality improvement across all settings, yielding lessons for every area of patient care.

For more information, please view the brochure here:  Outcomes Congress July 2014 or visit Primaris at http://primaris.org/calendar.

Call for Poster Presentations will be announced soon!  For more information, contact Lori Bonnot at 573-635-5355 or lori@mlnmonursing.org.

MC5 Regional Meetings – July 2014

Please visit the Missouri Coalition Celebrating Care Continuum Change (MC5) website at www.momc5.com/regional-meetings.html or click on the regional links below to view upcoming meetings near you!

Central (Jefferson City/Columbia)
East (St. Louis)
East Central (Rolla)
North Central (Chillicothe)
Northeast (Macon)
Northwest (St. Joseph)
Poplar Bluff
Route 71 (Nevada)
Southeast (Cape Girardeau)
Southwest (Springfield)
West (Independence)
West Central (Sedalia)

 

One-Day Workshop: The Nurse’s Guide to Person-Centered Care

June 25, 2014:  Kansas City, Ks.

Sleeping, waking, bathing – we want to live according to our own daily life rhythms.

This culture change workshop is designed for nurses who believe that residents should be able to continue to direct their own lives while living in a nursing home. REGISTER HERE or view the flyer:  Nurses Guide to Person-Centered Care Workshop June 25, 2014.

To learn more, please visit the Action Pact website at http://actionpact.com/calendar/event_details/nursing_and_home_integrating_quality_care_with_life.

Dr. Bill Thomas’ Second Wind Tour – Spring 2014

The Second Wind Tour – This Changes Everything

May 22, 2014 in Kansas City, Mo. Dr. Bill Thomas-Second Wind Tour

Inspired by Thomas’ new book examining the baby boom generation’s reluctant generational second coming of age – Second Wind: Navigating the Passage to a Slower, Deeper and More Connected Life – the Second Wind Tour will bring a unique “non-fiction” theater experience blending the spoken word, innovative set design, film, and music to 25-cities in the spring of 2014.  To learn more, visit The Eden Alternative at www.edenalt.org/events-and-offerings/special-events/, or visit http://secondwindtour.org/.

Special Notice:  The Eden Alternative has a number of tickets remaining to distribute in Kansas City and would like to invite you to share the registration link.  Tickets are free and available on a first come, first serve basis – please visit: www.eventbrite.com/e/second-wind-tour-kansas-city-mo-tickets-10696853577?aff=eden.

ICD-10 Coding Basics National Provider Call – Registration Now Open June 2014

June 4, 2014

12:30 p.m. – 2:00 p.m. Central Time

To Register:  Visit MLN Connects™ Upcoming Calls.  Space may be limited, register early.

HHS expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015.  Providers would have an extra year to prepare.  During this MLN Connects™ National Provider Call, join us for a keynote presentation on more ICD-10 coding basics by Sue Bowman from the American Health Information Management Association (AHIMA), along with updates from CMS.  A question and answer session will follow the presentation.

Agenda:

  • CMS updates, including the partial code freeze and 2015 code updates
  • Why ICD-9-CM is being replaced with ICD-10-CM
  • Benefits of ICD-10-CM
  • Similarities and differences from ICD-9-CM
  • Coding: Process of assigning a diagnosis code, 7th character, placeholder “x,” excludes notes, unspecified codes, external cause of injury codes, type of encounter
  • Documentation tips
  • How to obtain answers to coding questions
  • How to request modifications to ICD-10-CM

Target Audience:  Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers.  Continuing education credit may be awarded for participation in certain MLN Connects Calls.  Visit the Continuing Education Credit Information web page to learn more.

Keep up with the latest news regarding ICD-10, visit http://cms.gov/Medicare/Coding/ICD10/Latest_News.html.

New PEPPER Release for Skilled Nursing Homes – May 2014

A new release of the Program for Evaluating Payment Patterns Electronic Report (PEPPER) is now available for skilled nursing homes.  PEPPERs will no longer be mailed to providers who previously received their PEPPERs by mail.  They will now be able to access them through a secure website portal, http://pepperresources.org/PEPPER/SecurePEPPERAccess.aspx.

Those providers who have been receiving their PEPPERs through QualityNet will continue to do so.  The Chief Executive Officer, President, or Administrator of the provider can obtain their PEPPER.  Information on accessing and downloading the PEPPER is available in the Secure PEPPER Access Guide.

Training and Resources are available on the website: www.pepperresources.org/TrainingResources/SkilledNursingFacilities.aspx.

PEPPER Training Update (May 2014):

PEPPERresources.org is the official site for information, training and support.  If you have questions about the PEPPER reports, you may submit questions on this website through the Help/Contact Us tab.  Please do not contact your state QIO or state survey agency for assistance with PEPPER.

Dementia Beyond Disease – Conversations with Carmen

Dementia Beyond Disease

May 16, 2014:  Conversations with Carmen

Guest: Al Power, MD, Board-certified Geriatrician, Eden Educator, Author of Dementia beyond Drugs and Dementia beyond Disease.  To learn more and register for this web-based talk show, please visit www.actionpact.com/calendar/event_details/conversations_with_carmen_webinar.