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390 Results

  • PDPM Status Updates - for AHCA SNF Members

    Contains 8 Component(s) Includes Multiple Live Events. The next is on 11/21/2019 at 3:00 PM (EST) Recorded On: 10/31/2019

    PDPM Status & Updates Webinar - for AHCA SNF Members

    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.

     

    The webinars will be recorded and available within 24 hrs after the live date. After registering, you will be notified of the recordings availability. Please note we anticipate large participant numbers. If we are unable to respond to your question due to the number of participants, please direct questions to the pdpm@ahca.org email address. We incorporate questions submitted at the email address into our FAQ documents.

    If you are unable to hear the streaming audio, please check your sound settings and press F5 to refresh your connection. 

  • Member Briefing - Medicaid Fiscal Accountability Proposed Regulation: How this impacts your state’s provider tax program

    Contains 1 Component(s) Recorded On: 11/18/2019

    AHCA/NCAL CEO Mark Parkinson and Senior Vice President for Reimbursement Policy Mike Cheek will provide an overview of the proposed rule CMS recently issued.

    AHCA/NCAL CEO Mark Parkinson and Senior Vice President for Reimbursement Policy Mike Cheek will provide an overview of the proposed rule CMS recently issued.

  • Veterans Administration (VA) SNF Payment Policies Impacted by PDPM

    Contains 10 Component(s)

    ​The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year. Community providers are a vital part of VA’s high-performing health care network; making sure Veterans who have served our country and their families get the timely, high-quality health care they need. With community care, Veterans and their family members (dependents) can receive care from a local provider in their community depending on specific eligibility requirements, their medical needs and circumstances, care available at VA, and other factors.

    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.

     

    The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.  Community providers are a vital part of VA’s high-performing health care network; making sure Veterans who have served our country and their families get the timely, high-quality health care they need.  With community care, Veterans and their family members (dependents) can receive care from a local provider in their community depending on specific eligibility requirements, their medical needs and circumstances, care available at VA, and other factors.  

    Community-based skilled nursing providers may furnish short-term and long-term care to veterans under VA benefits under one of the three programs identified below:   

    • 1.Patient-Centered Community Care (PC3) is a nation-wide network of community providers VA uses to refer Veterans to community care under specific circumstances. PC3 is intended to provide eligible Veterans with access to medical care when services are not readily available or accessible at their local VA medical facility.
    • 2.Community Care Network (CCN):  In an effort to streamline VA’s community care programs, the president signed the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018, referred to as the “MISSION Act,” into legislation on June 6, 2018, providing more choices and robust care coordination for Veterans using one consolidated program instead of multiple programs. A significant component of having one method for Veterans to receive care from community providers, although not dependent on the legislation, are the Community Care Network (CCN) contracts to be awarded to as many as four contractors covering an established set of regional boundaries to ensure health care services and resources are available to our diverse Veteran population.  To establish the new CCN, VA released a request for proposal for private sector companies to develop and administer regional networks of high-performing licensed health care providers who will work together with VA providers and practitioners to provide medical, dental, and pharmacy services to Veterans who are unable to receive care at local VA medical centers. The CCN contracts were developed with a focus on transparency, accountability, quality, and increased communications between VA and Veterans.
    • 3.Veterans Care Agreements (VCA):  VA may enter into agreements with certain community providers to care for Veterans when they are not part of VA’s contracted community care network. These agreements are known as Veterans Care Agreements (VCA), which are intended to be used in limited situations where contracted services through VA’s community care network are either not provided or not sufficient to ensure Veterans can get the care they need. VA may only purchase care for Veterans through these contract vehicles such as the Patient-Centered Community Care (PC3) network or the Community Care Network (CCN), or by establishing a VCA.  Providers interested in establishing a VCA should contact their closest VA medical facility.  In some cases, VA medical facilities may reach out to community providers to request they establish a VCA where there is a need for services not adequately covered through VA’s contracted network.

     

    VA Relationship with PDPM:  Historically, the VA program payments to SNFs have varied regionally, with many locations having based payments on the Medicare SNF PPS RUGs payment model.  While certain parts of the VA system are transitioning to PDPM on October 1, 2019, other parts appear to be continuing to base payments to SNFs under the RUGs model, or under other previously established contracted rates with individual providers, for at least a short period.  This toolkit contains the most current available information related to the VA SNF payment policies.      

  • Requirements of Participation: Action Briefs

    Contains 18 Component(s)

    ACTION BRIEFS - provide highlights, specific information, tips and resources about a particular topic.

    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.

     

    Purpose & intent of the Action Briefs is to help centers with some strategies and tips on ways to get started in creating success around the Requirements of Participation.

  • CMS PDPM-Related PDPM/MDS/SNF QRP Resources

    Contains 63 Component(s)

    On May 7-8, 2019 and again (with minor updates) on August 13-14, 2019 the Centers for Medicare and Medicaid Services (CMS) conducted a two-day train-the-trainer session on the October 1, 2019 updates to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP). Examples of agenda items directly relevant to PDPM include: discussions on how to properly code Section GG of the MDS, Changes in Sections A, I, J, and O of the MDS, PDPM: What is changing and what is not, and Integrated coding & PDPM Case Study. This PDPM Academy toolkit includes all available CMS agenda, slides, and video resources related to these training dates. Additionally, this toolkit contains a direct link to the CMS PDPM-Related MDS-RAI Resources webpage containing the most current minimum data set resident assessment instrument (MDS-RAI) manual. Scroll to the bottom of the page and download the file under “Related Links” labeled MDS 3.0 RAI Manual v1.17 October 2019. • Chapter 2 contains a significant rewrite due to the elimination of the RUG-IV scheduled and unscheduled assessment types, and the introduction of the new SNF PPS Interim Payment Assessment (IPA) as well as the new Optional State Assessment (OSA). • Chapter 3 contains instructions for completion of new or revised MDS items that impact PDPM and SNF QRP, including new Sectikon J2100-J5000 surgery items and I0020B primary reason for the SNF stay ICD-10 diagnosis code. • Chapter 6 is a complete rewrite of the SNF PPS resident classification process and other policies including the new IPA, interrupted stay, and late assessment/default payment policies.

    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.

     

    On May 7-8, 2019 and again (with minor updates) on August 13-14, 2019 the Centers for Medicare and Medicaid Services (CMS) conducted a two-day train-the-trainer session on the October 1, 2019 updates to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP).  Examples of agenda items directly relevant to PDPM include: discussions on how to properly code Section GG of the MDS, Changes in Sections A, I, J, and O of the MDS, PDPM: What is changing and what is not, and Integrated coding & PDPM Case Study.  This PDPM Academy toolkit includes all available CMS agenda, slides, and video resources related to these training dates.

    Additionally, this toolkit contains a direct link to the CMS PDPM-Related MDS-RAI Resources webpage containing the most current minimum data set resident assessment instrument (MDS-RAI) manual.  Scroll to the bottom of the page and download the file under “Related Links” labeled MDS 3.0 RAI Manual v1.17 October 2019.

    • Chapter 2 contains a significant rewrite due to the elimination of the RUG-IV scheduled and unscheduled assessment types, and the introduction of the new SNF PPS Interim Payment Assessment (IPA) as well as the new Optional State Assessment (OSA).
    • Chapter 3 contains instructions for completion of new or revised MDS items that impact PDPM and SNF QRP, including new Sectikon J2100-J5000 surgery items and I0020B primary reason for the SNF stay ICD-10 diagnosis code.
    • Chapter 6 is a complete rewrite of the SNF PPS resident classification process and other policies including the new IPA, interrupted stay, and late assessment/default payment policies.
  • Workforce - What Works!

    Contains 2 Component(s) Recorded On: 05/09/2019

    Workforce is consistently noted as one of the top challenges that providers face. This course contains a series of short webinars where providers share solutions that have helped them combat some of the top workforce challenges - from recruitment to staff engagement. Additional webinars will be posted throughout the year, so check back for more!

    Workforce is consistently noted as one of the top challenges that providers face. This course contains a series of short webinars where providers share solutions that have helped them combat some of the top workforce challenges - from recruitment to staff engagement. 

    Additional webinars will be posted throughout the year, so check back for more! 


    Heidi Geel

    RN, SDC/QAPI of Maine Veterans’ Homes-Machias, Maine

    For the past 24 years, I have worked in various settings as a Registered Nurse; I love the diversity that this profession offers!  Just over 4 years ago, I arrived at MVH-Machias, as the QAPI and Staff Development Coordinator.  In my previous job, I had visited the facility many times and I love to tell people that there is a reason I work where I do now.  MVH-Machias is one of the best assisted living facilities in Maine, and now one of the best in the country, as evidenced by winning the prestigious AHCA/NCAL GOLD Quality Award in 2018.  Being part of the quality award journey was a difficult but exciting experience, one of great learning and transformation.    

    I have lived most of my life in a tiny community in rural Maine with my husband, sons and their families.  I love my role as an RN but the role of ‘Nana’ to my 4 grandchildren is my favorite.  

  • CMS MDS Section GG Training Resources

    Contains 6 Component(s)

    The SNF PPS Patient Driven Payment Model (PDPM) relies on accurate coding of several MDS Section GG mobility and self-care items that impact the PT, OT, and Nursing component per-diem case-mix payment rates. This toolkit contains a collection of Section CC training materials that the Centers for Medicare and Medicaid Services (CMS) has provided on their website that may be useful for provider PDPM training of nurses, certified nursing assistants, and therapists.

    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.

     

    The SNF PPS Patient Driven Payment Model (PDPM) relies on accurate coding of several MDS Section GG mobility and self-care items that impact the PT, OT, and Nursing component per-diem case-mix payment rates.  This toolkit contains a collection of Section CC training materials that the Centers for Medicare and Medicaid Services (CMS) has provided on their website that may be useful for provider PDPM training of nurses, certified nursing assistants, and therapists. 

  • CMS PDPM Program Manual Updates

    Contains 4 Component(s)

    The Centers for Medicare and Medicaid Services (CMS) has issued sub-regulatory guidance related to the Skilled Nursing Facility Medicare Part A Prospective Payment System (SNF PPS) Patient Driven Payment Model (PDPM) in recent Progrram Manual update transmittals. The most current updates and related resources are provided in this folder.

    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.

     

    The Centers for Medicare and Medicaid Services (CMS) has issued sub-regulatory guidance related to the Skilled Nursing Facility Medicare Part A Prospective Payment System (SNF PPS) Patient Driven Payment Model (PDPM) in recent Progrram Manual update transmittals.  The most current updates and related resources are provided in this folder. 

    • Medicare General Information, Eligibility, and Entitlement Manual PDPM Updates (October 4, 2019)  (Bobbie – use the R126GI file)
    • Medicare Benefit Policy Manual PDPM Updates (October 4, 2019)  (Bobbie – use the R261BP file)
    • Medicare Claims Processing Manual PDPM Updates (October 4, 2019)  (Bobbie – use the R261CP file)
  • Communication Tools

    Contains 3 Component(s)

    This toolkit includes: Talking Points, Template Letter for Families, Template Letter for Referral Sources/Payors

    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.

     

    This toolkit includes: 

    • Talking Points
    • Template Letter for Families
    • Template Letter for Referral Sources/Payors
  • TRICARE SNF Payment Policies Impacted by PDPM

    Contains 3 Component(s)

    ​TRICARE provides health care benefits to active military personnel and their families. TRICARE has three regions: East, West, and Overseas. Each TRICARE region has its own managed care support contractor (MCSC) who is responsible for administering the TRICARE program in each region. The MCSCs establish the provider networks and conduct provider education. At a minimum, all TRICARE providers must be authorized/certified under TRICARE Regulation and must have their authorization/certification status verified by the managed care support contractors (MCSCs) in each region. There are two types of TRICARE-authorized providers: Network and Non-Network Providers

    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.

     

    TRICARE provides health care benefits to active military personnel and their families.  TRICARE has three regions: East, West, and Overseas.  Each TRICARE region has its own managed care support contractor (MCSC) who is responsible for administering the TRICARE program in each region. The MCSCs establish the provider networks and conduct provider education.  At a minimum, all TRICARE providers must be authorized/certified under TRICARE Regulation and must have their authorization/certification status verified by the managed care support contractors (MCSCs) in each region.  There are two types of TRICARE-authorized providers: Network and Non-Network Providers 

    Network Providers:  To become a network provider, a SNF will sign a contractual agreement with the MCSC in the applicable region. In the contract the SNF will: 1) Agree to provide care to TRICARE beneficiaries at a negotiated rate, 2) Accept the beneficiaries' copayment or cost share as payment in full, and 3) File claims with TRICARE for the remaining amount.

    Non-Network Providers:   If a SNF doesn’t want to sign a contract, the center can be a non-network provider, but the SNF must be certified by the MCSC.  As a non-network provider the SNF can decide to be a "participating provider" or a "non-participating provider".  Participating providers agree to file claims for beneficiaries, to accept payment directly from TRICARE and to accept the TRICARE allowable charge as payment in full for their services.  Non-participating providers do not agree to accept the TRICARE allowable charge or file beneficiary claims. Non-network providers can choose to participate on a claim-by-claim basis. A SNF doesn’t have to be participating or non-participating all of the time.

    TRICARE Relationship with PDPM:  Historically, the TRICARE coverage and payments to SNFs have mirrored the Medicare SNF PPS payment model, however it appears that TRICARE is not converting to PDPM at this time.  This toolkit contains the most current available information related to the TRICARE SNF payment policies.

NCAL AHCA