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384 Results

  • 2019 HUD Updates on Residential Care Facilities Asset Management

    Contains 1 Component(s) Includes a Live Event on 10/01/2019 at 3:00 PM (EDT)

    In this webinar, representatives from HUD's Office of Residential Care Facilities (ORCF) will discuss the Section 232 program, which provides mortgage insurance for residential care facilities, including nursing homes, assisted living facilities, and board and care homes. In this webinar, get an overview about programs offered through ORCF and detailed information related to the recent changes in the HUD-published documents that are required for use by borrowers and operators in performing asset management functions in their facilities.

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     Please Note: this webinar is open to everyone and AHCA members. If you are not a member of AHCA, registering for this webinar will not change your status to AHCA member. 

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the CREATE ACCOUNT button.

    Non-members can create an account with your first, last name and email. 

    AHCA/ NCAL Members - *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    In this webinar, representatives from HUD's Office of Residential Care Facilities (ORCF) will discuss the Section 232 program, which provides mortgage insurance for residential care facilities, including nursing homes, assisted living facilities, and board and care homes. In this webinar, get an overview about programs offered through ORCF and detailed information related to the recent changes in the HUD-published documents that are required for use by borrowers and operators in performing asset management functions in their facilities.

    Learning Objectives:

    • Understand the updated form and procedures for Reserve for Replacement and Residual Receipt withdrawals.
    • Understand the updated form to request access to the 232 Healthcare Portal.
    • Understand the requirements and forms for changes in participants of residential care facilities that currently have FHA-insured financing.
    • Understand the updated form for adding or submitting changes to the  Accounts Receivable Financing for your facility.
    • Understand the requirements and updated form for requesting a Loan Modification.
    • Understand the updated form for certification of completion of Non-Critical Repairs.
    • Understand the requirement and updated form for notification to HUD of threats to permits and approvals for your facility.

     

    Speakers:

    • John Hartung, Director, Policy, Risk Analysis and Lender Relations Division, Office of Residential Care Facilities, HUD
    • Philip Head, Director, Asset Management Division, Office of Residential Care Facilities, HUD
    • Rita Dockery, Supervisory Account Executive, Office of Residential Care Facilities, HUD

    Please note: this webinar is open to everyone and AHCA members. 

    If you are not a member of AHCA, registering for this webinar will not change your status to AHCA member. 

  • Week One of PDPM – “One-Time” Transitional Policies

    Contains 1 Component(s) Includes a Live Event on 09/17/2019 at 3:00 PM (EDT)

    During this 90- minute live webinar, the presenters will discuss details related to unique challenges providers will face during the SNF PPS transition period from the RUG-IV to PDPM. Many of these are related to “one-time” transitional policies for residents receiving Part A services under RUGs in September and transitioning to PDPM on October 1. Specific topics to be discussed include: 1) Handling RUG-IV assessments and billing for late September admissions expected to extend into October; 2) Use of the 5-Day PDPM assessment versus the Transitional IPA Assessment during week one in October; 3) Interrupted stay policy during week one in October; 4) Assessment considerations for payers that may have continued with RUG-III or RUG-IV payment models (i.e. Medicaid, Medicare Advantage, VA); and 5) Strategies to troubleshoot and resolve payment challenges should they occur. AHCA will also post an on-demand recording of the live webinar as well as written Q&A responses to all questions submitted shortly after the live webinar.

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    During this 90- minute live webinar, the presenters will discuss details related to unique challenges providers will face during the SNF PPS transition period from the RUG-IV to PDPM.  Many of these are related to “one-time” transitional policies for residents receiving Part A services under RUGs in September and transitioning to PDPM on October 1.  Specific topics to be discussed include: 1) Handling RUG-IV assessments and billing for late September admissions expected to extend into October; 2) Use of the 5-Day PDPM assessment versus the Transitional IPA Assessment during week one in October; 3) Interrupted stay policy during week one in October; 4) Assessment considerations for payers that may have continued with RUG-III or RUG-IV payment models (i.e. Medicaid, Medicare Advantage, VA); and 5) Strategies to troubleshoot and resolve payment challenges should they occur.  AHCA will also post an on-demand recording of the live webinar as well as written Q&A responses to all questions submitted shortly after the live webinar.

    Presenters:  Mike Cheek, Senior Vice President, Reimbursement Policy, AHCA and Dan Ciolek, Associate Vice President, Therapy Advocacy AHCA

  • Sexuality and the Resident With Dementia

    Contains 1 Component(s) Recorded On: 09/10/2019

    This session provides a shared human and clinical perspective on how to approach matters of sexuality for all residents, but with focused considerations for those with dementia or other special needs. The matters of consent, capacity and resident education will be addressed. Suggested approaches will be offered for care planning for issues involving suspected sexual abuse, cases of unwanted sexual contact or contact in circumstances where one or both parties lack capacity to consent.

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    This session provides a shared human and clinical perspective on how to approach matters of sexuality for all residents, but with focused considerations for those with dementia or other special needs.  The matters of consent, capacity and resident education will be addressed.  Suggested approaches will be offered for care planning for issues involving suspected sexual abuse, cases of unwanted sexual contact or contact in circumstances where one or both parties lack capacity to consent.

    Learning Objectives:

    1. Demonstrate an understanding of the regulatory requirements relative to Residents’ Rights for privacy, dignity and choice in matters of sexual expression;
    2. Create policy and procedure that supports compliance and quality care, addresses capacity and the special considerations for residents with dementia, mental illness or other cognitive or intellectual deficit; and
    3. Develop staff education and training programs that ensure sensitivity and appropriate accommodation of the human need for sexual expression.

    Intended Audience: Appropriate to all staff, with a concentration on the clinical care team

    Speaker: Barbara Speedling, Quality of Life Specialist

    Barbara Speedling (Moderator)

    Quality of Life Specialist

    Barbara Speedling Personally dedicated to the creation of meaningful, satisfying lives for all those who rely on another’s care

    An inspirational and motivational speaker, Barbara is an author, educator and management consultant at the forefront of person-centered care. 

    An innovator with more than 30 years of practical experience within the adult care community, she is the expert providers turn to when they want to ensure that the services they provide meet not only the physical needs of their residents, but their emotional and psychosocial needs as well.

    Working from a core belief in the dignity and individuality of all people, Barbara has helped countless adult care communities implement her unique training and education programs that:

     

    • Improve the quality of care for those living with Alzheimer’s disease
    • Bring better quality of life to such residents, as well as to those who live with disease-related dementia, a mental illness, or a brain injury
    • Encourage staffers to use newly developed cultural empathy to form better relationships with those in their care
    • Offer new strategies for promoting harmony among increasingly diverse, younger and assertive populations
    • Open new pathways to maintaining regulatory compliance 
    • Support leadership and organizational development

    In addition to her degree in healthcare administration, Barbara is an accomplished musician and artist.  She uses those talents to develop new and creative ways of reaching out to those who are cognitively diminished.  She was also certified in 2015 by Dr. Susan Wehry as a Master Trainer for the OASIS education program for improved care of residents with dementia.

     

    The author of two books devoted to common sense advice for meeting the holistic needs of an increasingly diverse and challenging community, both Why is Grandma Screaming and Toward Better Behavior:  Yours Mine & Everyone Else’s are now widely distributed to staff members at community, residential and long-term care facilities across the country and in Canada.

     

    Blessed with boundless energy and tireless enthusiasm, Barbara also volunteers in her free time to offer caregiver education and support to families who need it most.  Through her affiliations with local artists and musicians in her native New York City, she also arranges therapeutic music, dance and wellness programming that improves the quality of life for local seniors.

  • Behavioral Health and Trauma Informed Care

    Contains 5 Product(s)

    Phase 3 of the RoPs goes into effect on November 28, 2019. AHCA has developed resources to help you navigate the new requirements. This package includes resources applicable to Behavioral Health and Trauma Informed Care.

    Phase 3 of the RoPs goes into effect on November 28, 2019. AHCA has developed resources to help you navigate the new requirements. This package includes resources applicable to Behavioral Health and Trauma Informed Care. Such as:

    • Trauma-Informed Care: How Do I Start
    • Trauma-Informed Care Providing Mental Health Services in Long Term Care
    • Toward Better Behavior: Yours, Mine, and Everyone Else's
    • Sex, Drugs and Rolling Walkers
    • Sexuality and the Resident With Dementia
  • Member Comments on RoP Proposed Rule

    Contains 6 Component(s)

    The proposed rule provides a 60-day public comment period that provides AHCA and member centers an opportunity to submit comments to CMS. All comments must be submitted to CMS by 5:00pm Eastern Time on Monday, September 16th, 2019. The following are resources and templates to assist you with submitting your comments to CMS before the September 16 deadline:

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    On July 16, the Centers for Medicare & Medicaid Services (CMS) issued the proposed rule that aims to ease some of the administrative and paperwork burdens of the Requirements of Participation (RoPs). The proposed rule includes changes to the current long-term care RoPs and survey process designed to reduce excessively burdensome and overly prescriptive regulations, while allowing centers to focus on providing high-quality care. AHCA has provided a detailed summary of the proposed rule here.

    The proposed rule provides a 60-day public comment period that provides AHCA and member centers an opportunity to submit comments to CMS. All comments must be submitted to CMS by 5:00pm Eastern Time on Monday, September 16th, 2019.  

    The following are resources and templates to assist you with submitting your comments to CMS before the September 16 deadline:

  • State Exec Webinar -PDPM

    Contains 1 Component(s)

    State Exec Webinar - PDPM

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the CREATE ACCOUNT button.

    Non-members can create an account with your first, last name and email. 

    AHCA/ NCAL Members - *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    State Exec Webinar - PDPM

  • Arbitration: tips and tools for implementing CMS’s recent final rule on arbitration

    Contains 1 Component(s) Recorded On: 08/29/2019

    AHCA will host a webinar on the Centers for Medicare & Medicaid Services (CMS) final arbitration rule on Thursday, August 29 at 2 pm ET. As a reminder, last month CMS issued the final rule that reverses the Obama-era ban on the use of arbitration agreements. This rule makes it very clear that we have the ability to use pre-dispute agreements, while at the same time adding provisions intended to make sure that residents and/or their representatives understand the agreements into which they are entering. Additionally, the rule prevents a facility from making the signing of an agreement a precondition of admission.

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

    click the image button found in the upper right corner of your screen or follow these three easy steps below! 

     

    Step 1

    image

    Go to the ahcancalED site at https://educate.ahcancal.org/and log in using the orange button in the upper left hand corner.

    Use your usual user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  


    Don’t have one or can’t remember?

    Click the log in button and follow the directions found under the search button that reads-“If you need help retrieving your Username or Password, click here”.

    *Please note* you must add your member facility name to your login


    Once you are in and can see your name in the upper left hand corner, you are ready to go.

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or Trending Now) For this demonstration, let’s try hovering over Webinars until upcoming webinars displays. 

    Under “upcoming webinars” go to a product in which you are interested. Click on the title.

    You’ll be redirected to the site where you can register for the product. This allows you to view the overview, handouts or resources associated with that product.

    Step 3

    image

    Almost there!

    Click the green register button.

    Fill out the registration details and voila! The products are yours to use indefinitely and can be found in your dashboard.

    FYI: after registering, you will be automatically notified when the recording of the webinar is ready.


    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    AHCA will host a webinar on the Centers for Medicare & Medicaid Services (CMS) final arbitration rule on Thursday,August 29 at 2 pm ET. As a reminder, last month CMS issued the final rule that reverses the Obama-era ban on the use of arbitration agreements. This rule makes it very clear that we have the ability to use pre-dispute agreements, while at the same time adding provisions intended to make sure that residents and/or their representatives understand the agreements into which they are entering. Additionally, the rule prevents a facility from making the signing of an agreement a precondition of admission.

    Speakers:

    Mark Reagan, Managing Shareholder, Hooper, Lundy & Bookman, PC

    James Segroves, Partner, Reed Smith LLP

  • 11th hour PDPM Transition Guide

    Contains 1 Component(s)

    During this 90- minute live webinar, the presenters will discuss how providers can use a concise and downloadable 11th hour PDPM Transition Guide tool we developed to help providers answer these questions over the remaining days leading up to October 1. In addition, the presenters will share important recent PDPM implementation updates from the Centers for Medicare and Medicaid Services (CMS) including: 1) Policy changes and clarifications discussed in the recently published SNF PPS FY 2020 Final Rule, 2) FAQs from the CMS August 8 SNF Open Door Forum call, and 3) Key PDPM-related MDS updates/clarifications discussed in the CMS August 13-14 SNF QRP/MDS/PDPM two-day provider training, and any other billing guidance issued by CMS prior to the webinar. There will be a Q&A period of approximately 30 minutes following the presentation. In addition to the downloadable 11th hour PDPM Transition Guide tool and webinar slides, AHCA will also post an on-demand recording of the live webinar as well as written Q&A responses to all questions submitted shortly after the live webinar.

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    During this 90- minute live webinar, the presenters will discuss how providers can use a concise and downloadable 11th hour PDPM Transition Guide tool we developed to help providers answer these questions over the remaining days leading up to October 1.  In addition, the presenters will share important recent PDPM implementation updates from the Centers for Medicare and Medicaid Services (CMS) including: 1) Policy changes and clarifications discussed in the recently published SNF PPS FY 2020 Final Rule, 2) FAQs from the CMS August 8 SNF Open Door Forum call, and 3) Key PDPM-related MDS updates/clarifications discussed in the CMS August 13-14 SNF QRP/MDS/PDPM two-day provider training, and  any other billing guidance issued by CMS prior to the webinar.  There will be a Q&A period of approximately 30 minutes following the presentation.  In addition to the downloadable 11th hour PDPM Transition Guide tool and webinar slides, AHCA will also post an on-demand recording of the live webinar as well as written Q&A responses to all questions submitted shortly after the live webinar.

    Recommended Participants:  SNF Administrators, Directors or Nursing, MDS Coordinators, Rehabilitation Directors, Billers, and other staff responsible for assessment of Medicare Part A SNF PPS residents. 

    Presenters: 

    Mike Cheek, Senior Vice President, Reimbursement Policy, AHCA and 

    Robin Hillier, Robin Hillier Consulting, LLC



  • CMS Allowable ICD-10 Codes for the MDS Item I0020B Primary Reason for SNF Stay Field

    Contains 2 Component(s)

    PDPM requires an acceptable ICD-10 diagnosis code to be entered into MDS item field I0020B top represent the primary reason for the SNF stay. ICD-10 codes not on the list of allowable codes, often referred to as “return-to-provider” codes will not classify into a PDPM clinical category. CMS publishes a list ICD-10 codes that are approved for use in MDS Item field I0020B for PDPM classification purposes. The file includes the following information: 1) Alphanumeric ICD-10 code; 2) Code Description; 3) Default Clinical Category; 4) Whether a MDS Section J Surgery Code Indicating That the Resident Had a Prior Major Surgical Procedure is Needed to Refine the Default Clinical Category; 5) PT and OT Component Clinical Category; and 6) SLP Component Clinical Category. If a code is not listed in this file, it cannot be used in the MDS I0020B item field. CMS provides this file in a Microsoft Access Format. AHCA converted the CMS file into Microsoft Excel for providers that are not familiar with Microsoft Access.

    Click the image button found in the upper right corner of your screen 

    OR 

    Follow these three easy steps below! 

     

    Step 1

    image

    Click the orange log in button in the upper left hand corner.

    Use your user name and password that you would use for LTC Trend Tracker or the AHCA NCAL website.  

    Don’t have an account or can’t remember?

    Click the NEED HELP button and the next button that reads-Are you new to the site? Create an Account”.

    *Please note* you must add your member facility name to your login

    Once you are in and can see your name in the upper left hand corner, you are ready to go!

    Step 2

    image

    From the home page click on a category (Resources, Training, Webinars or On-Demand Training) For this demonstration, let’s try Webinars- Upcoming Live

    On the “upcoming webinars” page go to a product in which you are interested. Click the green REGISTER button.

    Or click the title of the webinar and you will be redirected to the page where you can view the overview, handouts or resources associated with that product. You can also click REGISTER in the upper right hand corner. The content will be available in your dashboard

    Step 3

    image

    Almost there!

    If the resource you are trying to access is a paid-for product, fill out the registration details and voila! The products are yours to use and can be found in your dashboard.

    Need further help? Email us at educate@ahca.org

    We’ll walk you through it.

     

    PDPM requires an acceptable ICD-10 diagnosis code to be entered into MDS item field I0020B top represent the primary reason for the SNF stay.  ICD-10 codes not on the list of allowable codes, often referred to as “return-to-provider” codes will not classify into a PDPM clinical category.  CMS publishes a list ICD-10 codes that are approved for use in MDS Item field I0020B for PDPM classification purposes.  The file includes the following information: 1) Alphanumeric ICD-10 code; 2) Code Description; 3) Default Clinical Category; 4) Whether a MDS Section J Surgery Code Indicating That the Resident Had a Prior Major Surgical Procedure is Needed to Refine the Default Clinical Category; 5) PT and OT Component Clinical Category; and 6) SLP Component Clinical Category.  If a code is not listed in this file, it cannot be used in the MDS I0020B item field.  CMS provides this file in a Microsoft Access Format.  AHCA converted the CMS file into Microsoft Excel for providers that are not familiar with Microsoft Access. 

  • PDPM and Medicare Advantage Toolkit

    Contains 4 Component(s)

    Because SNF providers contract directly with MA plans, it is essential that both parties understand any changes in resident assessment and claims processing that may be necessary to assure that beneficiary access and provider cash flow are not interrupted. To assist, AHCA has added new resources to the PDPM and Medicare Advantage Toolkit that providers can use to help prepare for discussions with Medicare Advantage (MA) plans prior to October 1 to help assure a seamless transition as the SNF PPS transitions to PDPM.

    Because SNF providers contract directly with MA plans, it is essential that both parties understand any changes in resident assessment and claims processing that may be necessary to assure that beneficiary access and provider cash flow are not interrupted. To assist, AHCA has added new resources to the PDPM and Medicare Advantage Toolkit that providers can use to help prepare for discussions with Medicare Advantage (MA) plans prior to October 1 to help assure a seamless transition as the SNF PPS transitions to PDPM. The Toolkit includes:

    • For Providers – PDPM Impact on Medicare Advantage - PDPM Impact on Medicare Advantage, containing an overview of the impact that PDPM may have on your existing MA contracts and out of network payments, as well as suggested questions for health plans to ease the transition.
    • Sample PDPM Survey for Medicare Advantage Health Plans - with sample questions to ask plans to better understand what operational and billing procedures regarding MA residents you may have to change on 10/1.
    • PDPM in Medicare Advantage Contracts Readiness Checklist - to ensure you are fully prepared under your existing MA contracts and for out of network payments.
    • PDPM Impact on Medicare Advantage Webinar - which reviews the recommendations and resources above.
NCAL AHCA