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382 Results

  • AHCA PDPM Compliance Guide and Best Practice Model Policies Toolkit

    Contains 1 Component(s)

    The AHCA PDPM Compliance Guide and Best Practice Model Policies Toolkit will include several tools and resources to help providers prepare for successful transition to PDPM. These include ideas and tools on how to address compliance risk areas identified by the Centers for Medicare and Medicaid Services, The Office of Inspector General, and other government agencies. All members can access the Compliance Policies and Procedures Checklist Tool. Best practice policies be added for PDPM Academy Registrants as developed.

    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 AHCA PDPM Compliance Guide and Best Practice Model Policies Toolkit will include several tools and resources to help providers prepare for successful transition to PDPM.  These include ideas and tools on how to address compliance risk areas identified by the Centers for Medicare and Medicaid Services, The Office of Inspector General, and other government agencies.  All members can access the Compliance Policies and Procedures Checklist Tool.  Best practice policies be added for PDPM Academy Registrants as developed.

  • Top 10 Most Common E-tags of 2018

    Contains 1 Component(s)

    Top 10 Most Common E-tags of 2018

    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.

     

    Speaker: 

    Jason Belden
    Disaster Preparedness Program Manager/OSHPD Policy Analyst/Fire Life Safety Analyst of the California Association of Health Facilities

  • Bronze Early Submission - Step by Step

    Contains 1 Component(s) Recorded On: 01/14/2019

    January 14, 2019 is the early Bronze application submission date! Join Quality Award staff for a step by step how to (including live Q & A) on submitting your Bronze Quality Award application and payment. Meet this early submission and be entered into a raffle for a waived application fee.

    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.

     

    January 14, 2019 is the early Bronze application submission date! Join Quality Award staff for a step by step how to (including live Q & A) on submitting your Bronze Quality Award application and payment. Meet this early submission and be entered into a raffle for a waived application fee.

    Speaker:

    Urvi Patel
    Director Quality Improvement

    Urvi Patel (Moderator)

    Director Quality Improvement, AHCA

    image


    You are encouraged to review the National Quality Award Criteria Series before beginning your application journey. As you watch the series, remember that you can always submit questions to qualityaward@ahca.org.

    imageBronze Criteria Series 

    Applicants of this award level are encouraged to view the Bronze Criteria Series, developed to help applicants understand and meet the demands of the Bronze Criteria. 

    image Silver Criteria Series 

    Before beginning the application process, you should review the 2019 Silver Application Packet, containing the important program information and instructions, as well as the Silver criteria

    image Gold Criteria Series

    At this level, applicants must show superior performance in areas of the criteria including leadership, strategic planning, and customer and staff satisfaction. View the Gold Criteria Series before beginning the application process. 

  • AHCA ICD-10 PDPM Pre-Training

    Contains 2 Component(s)

    AHCA’s recommends a slow deliberate pace as trainees move through both the coder and non-coder versions. To aid with placing the ICD-10 content on perspective, we recommend watching the following pre-recorded webinars: PDPM Basics; and Walk-Through of CMS’ ICD-10 Mapping Tool

    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’s recommends a slow deliberate pace as trainees move through both the coder and non-coder versions.  To aid with placing the ICD-10 content on perspective, we recommend watching the following pre-recorded webinars:

    • PDPM Basics; and
    • Walk-Through of CMS’ ICD-10 Mapping Tool

    Daniel Ciolek, PT, MS, PMP

    Associate Vice President, Therapy Services, AHCA

    Dan Ciolek is the Associate Vice President of Therapy Advocacy with the American Health Care Association. Mr. Ciolek's clinical and healthcare policy experience spans 30 years. He has practiced as a physical therapist clinician, manager, and business owner in a variety of settings including acute inpatient, inpatient rehabilitation, skilled nursing facility, home health, outpatient, and industrial health. He previously earned the Geriatric Physical Therapy Specialist certification, and is currently a certified Project Management Professional. Before joining AHCA in 2013, Dan served in the Subject Matter Expert and Project Manager capacities in numerous Centers for Medicare and Medicaid contracts. Specific to therapy services, Dan's CMS work has included: national outpatient therapy utilization analysis for PT, OT, and SLP services; medical review; workgroup facilitation; development of policy recommendations; development of Medicare Learning Network and 1-800-Medicare content, and Physician Quality Reporting System reporting enhancements.  Additionally, Dan has contributed to therapy health policy activities at the University, State, Chapter and National levels. These activities included: elected and appointed positions; adjunct faculty/lecturer; author of professional articles; invited speaker; technical expert panelist, and invited contributor of health policy concepts to professional and provider organizations. Dan's advocacy efforts have been recognized through his receipt of two national professional awards for Policy Making and Advocacy for Older Adults. Overall, Dan is recognized as a leading expert in therapy policy and research, including a focus on reimbursement issues. His efforts have contributed directly to numerous Medicare policy changes. 

    Mike Cheek

    Senior Vice President, Reimbursement Policy and Legal Affairs, AHCA

    Mike Cheek is the Senior Vice President for Reimbursement Policy and Legal Affairs. Before joining AHCA/NCAL, Mike was the long term care director for the District of Columbia Medicaid agency in the Fenty administration. Before joining AHCA/NCAL, Mike also worked as a consultant at The Lewin Group and Avalere Health with clients such as health plans, post-acute and long term care organizations, pharmaceutical companies, and states. Mike also worked extensively with state agencies. He was the deputy director with the association of state aging agencies and was the lead staff person on eligibility and long term care with the National Association of Medicaid Directors. Mike holds a Bachelor of Science from the College of William and Mary.

  • How do I use LTC Trend Tracker as a Skilled Nursing Facility?

    Contains 9 Component(s)

    Learn how to use LTC Trend Tracker as one of your tools for Quality Improvement. In these videos, you will learn how to utilize and modify the skilled nursing dashboard, provide an overview of several key LTC Trend Tracker features & reports, and uploading skilled nursing data.

    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.

     

    image


    Learn how to use LTC Trend Tracker as one of your tools for Quality Improvement. In these videos, you will learn how to utilize and modify the skilled nursing dashboard, provide an overview of several key LTC Trend Tracker features & reports, and uploading skilled nursing data. 

    Learning Objectives:

    1. Learn how to utilize and customize the skilled nursing dashboard
    2. Select benchmark groups to best demonstrate your facility’s strengths
    3. Understand the measures and upload data

    Speaker:

    Lonnita Myles, MBA, Manager, Quality & LTC Trend Tracker, AHCA

  • Assisted Living Action Plan Response for Adverse Events

    Contains 5 Component(s)

    It is critical to address and mitigate adverse events and potential adverse events. An action plan, otherwise known as a mitigation plan, is a necessary response to adverse events and potential adverse events. For many such events, it is important to respond and start the mitigation process immediately. These tools were initially developed by members of AHCA’s Survey/Regulatory Committee and adapted for assisted living communities to assist providers in addressing adverse events and potential adverse events, documenting and tracking the steps they have taken, and identifying best practices for ongoing improvement. Communities may use different titles or terms than the action plans, such as Director of Health Services instead of Director of Nursing, or service plan instead of care plan. Please adapt the plans to reflect your AL community. Use of these tools does not guarantee regulatory compliance nor mitigate potential liability. Providers should adapt their tools, policies, and processes as needed to ensure compliance with current federal and state requirements and use both professional judgement and the advice of legal counsel in determining whether or how to share these mitigation tools.

    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.

     

    It is critical to address and mitigate adverse events and potential adverse events. An action plan, otherwise known as a mitigation plan, is a necessary response to adverse events and potential adverse events. For many such events, it is important to respond and start the mitigation process immediately.

    Examples of adverse events/potential adverse events include:

    • Falls (not following the care plan, use of gait belt, one vs. two-person transfers)
    •  Falls with a mechanical lift
    •  Elopement
    •  Allegation of abuse or neglect
    •  Water too hot
    •  Smoking (supervised vs. unsupervised, with oxygen, defined smoking area, all about safety)
    •  Bedrails (entrapment, assessment for use)
    •  Significant medication errors such as cardiac medications, chemo, insulin, morphine, Coumadin
    •  Infection Control – outbreaks (e.g. scabies, bedbugs, MRSA, C-Difficile, Noro Virus, Legionella)
    •  Lack of timely or complete evaluation of a change in condition
    •  Pressure ulcer – lack of prevention or following prevention measures
    •  Grievances and resident/tenant council feedback

    Objectives:

    1. Identify adverse events that could potentially have a negative impact on residents/tenants as well as on a community’s regulatory compliance.   
    2.  Establish a routine root cause analysis process to identify the specific/source, root cause or causal factor of the problem.  
    3.  Create a structured process for developing a mitigation plan to address the adverse event/potential adverse event and minimize similar events for all residents/tenants:
      1. Complete the Initial Mitigation Action Plan 
      2. QAPI members complete the formal documentation of the Mitigation Action Plan
    4.  Use information learned by sharing results and Plan with the QAPI committee for continued monitoring.

    Note: These tools were initially developed by members of AHCA’s Survey/Regulatory Committee and adapted for assisted living communities to assist providers in addressing adverse events and potential adverse events, documenting and tracking the steps they have taken, and identifying best practices for ongoing improvement. Communities may use different titles or terms than the action plans, such as Director of Health Services instead of Director of Nursing, or service plan instead of care plan. Please adapt the plans to reflect your AL community. 

    Use of these tools does not guarantee regulatory compliance nor mitigate potential liability. Providers should adapt their tools, policies, and processes as needed to ensure compliance with current federal and state requirements and use both professional judgement and the advice of legal counsel in determining whether or how to share these mitigation tools. 

  • Replacing RUGs – CMS’ New SNF Payment System & How to Get Ready (a video recording from the 2019 AHCA Convention Intensive)

    Contains 9 Component(s), 4 credits offered Recorded On: 10/10/2018

    The Patient-Drive Payment Model (PDPM) is now final with implementation scheduled for October 2019. AHCA’s educational approach to PDPM will be to offer a holistic picture of how PDPM impacts SNFs and will incorporate PDPM interactions with: • Requirements of Participation, • Survey and Licensure, • SNF Re-Hospitalization Measure Value-Based Purchasing, • IMPACT Act Quality Reporting Program, and • Other payers’ (Medicare Advantage and Medicaid) and their probable responses to PDPM. In addition to in-depth training on the PDPM final rule, a member’s only tool kit will be introduced that will contain the core competencies framework and a readiness review tool that will help you track your operational readiness for PDPM. The intensive will also cover data gathered from 12 companies testing impacts of PDPM and provide hospital and discharge pattern data that could be helpful in member markets. Finally, a panel discussion of AHCA members will discuss opportunities and potential pitfalls for SNFs as they consider operational changes necessary to be successful under PDPM.

    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 Patient-Drive Payment Model (PDPM) is now final with implementation scheduled for October 2019. AHCA’s educational approach to PDPM will be to offer a holistic picture of how PDPM impacts SNFs and will incorporate PDPM interactions with: • Requirements of Participation, • Survey and Licensure, • SNF Re-Hospitalization Measure Value-Based Purchasing, • IMPACT Act Quality Reporting Program, and • Other payers’ (Medicare Advantage and Medicaid) and their probable responses to PDPM. In addition to in-depth training on the PDPM final rule, a member’s only tool kit will be introduced that will contain the core competencies framework and a readiness review tool that will help you track your operational readiness for PDPM. The intensive will also cover data gathered from 12 companies testing impacts of PDPM and provide hospital and discharge pattern data that could be helpful in member markets. Finally, a panel discussion of AHCA members will discuss opportunities and potential pitfalls for SNFs as they consider operational changes necessary to be successful under PDPM. 

    Learning Objectives:

    • Discuss how Patient-Driven Payment Model (PDPM) will impact MDS assessments and claim payment components
    • Describe how PDPM will require changes to current SNF operations
    • Explain how facilities are preparing for PDPM implementation

    Speakers:

    Mike Cheek – Senior Vice President, Reimbursement & Legal Affairs, AHCA/NCAL

    Daniel E. Ciolek, PT, MS, PMP – Associate Vice President, Therapy Advocacy, American Health Care Association

    Robin L. Hillier, CPA, STNA, LNHA, RAC-MT – Director Reimbursement and Quality Metrics, Welcome Nursing Home

    Nate Ovenden, RAC-CT – Senior Medicare & Managed Care Consultant, Good Samaritan Society

    Deb Bielek, MS CCC SLP – Therapy Resource Education and Programs, Ensign Services, Inc.

    Anne Tumlinson – CEO, Anne Tumlinson Innovations, LLC

    Francine Rainer, MA, CCC-SLP – Senior Vice President, Reimbursement, PruittHealth

    Session Price: $199 for AHCA members only

    CEs Available: Up to 4 NAB approved CEs are available.

    • 2 CEs available after completing Part 1. 
    • 4 CEs are available if you complete recording in its entirety. 

    Mike Cheek

    Senior Vice President, Reimbursement Policy and Legal Affairs, AHCA

    Mike Cheek is the Senior Vice President for Reimbursement Policy and Legal Affairs. Before joining AHCA/NCAL, Mike was the long term care director for the District of Columbia Medicaid agency in the Fenty administration. Before joining AHCA/NCAL, Mike also worked as a consultant at The Lewin Group and Avalere Health with clients such as health plans, post-acute and long term care organizations, pharmaceutical companies, and states. Mike also worked extensively with state agencies. He was the deputy director with the association of state aging agencies and was the lead staff person on eligibility and long term care with the National Association of Medicaid Directors. Mike holds a Bachelor of Science from the College of William and Mary.

    Daniel Ciolek, PT, MS, PMP

    Associate Vice President, Therapy Services, AHCA

    Dan Ciolek is the Associate Vice President of Therapy Advocacy with the American Health Care Association. Mr. Ciolek's clinical and healthcare policy experience spans 30 years. He has practiced as a physical therapist clinician, manager, and business owner in a variety of settings including acute inpatient, inpatient rehabilitation, skilled nursing facility, home health, outpatient, and industrial health. He previously earned the Geriatric Physical Therapy Specialist certification, and is currently a certified Project Management Professional. Before joining AHCA in 2013, Dan served in the Subject Matter Expert and Project Manager capacities in numerous Centers for Medicare and Medicaid contracts. Specific to therapy services, Dan's CMS work has included: national outpatient therapy utilization analysis for PT, OT, and SLP services; medical review; workgroup facilitation; development of policy recommendations; development of Medicare Learning Network and 1-800-Medicare content, and Physician Quality Reporting System reporting enhancements.  Additionally, Dan has contributed to therapy health policy activities at the University, State, Chapter and National levels. These activities included: elected and appointed positions; adjunct faculty/lecturer; author of professional articles; invited speaker; technical expert panelist, and invited contributor of health policy concepts to professional and provider organizations. Dan's advocacy efforts have been recognized through his receipt of two national professional awards for Policy Making and Advocacy for Older Adults. Overall, Dan is recognized as a leading expert in therapy policy and research, including a focus on reimbursement issues. His efforts have contributed directly to numerous Medicare policy changes. 

    Robin L. Hillier, CPA, STNA, LNHA, RAC-MT

    Director Reimbursement and Quality Metrics, Welcome Nursing Home

    Robin L. Hillier is a healthcare executive dedicated to post-acute and long term care. She is a Certified Public Accountant, a State Tested Nursing Assistant, a Licensed Nursing Home Administrator, and is Resident Assessment Coordinator Certified and a Master Teacher through the American Association of Nurse Assessment Coordination (AANAC). Throughout her career she has been involved in all aspects of facility operations, including ownership roles. She is currently the Director of Reimbursement and Quality Metrics for Welcome Nursing Home in Oberlin, Ohio, and President of RLH Consulting, which provides operational and reimbursement consulting to providers of skilled nursing, assisted living and intellectual or developmental disabilities. Ms. Hillier served on the Board of Governors and Executive Committee of the American Health Care Association from 2010 through 2017, and currently serves on the Reimbursement Cabinet. She is Past Chair of both the Ohio Health Care Association (OHCA) and its’ Educational Foundation (EFOHCA). She also serves on the AANAC Expert Advisory Panel. Ms. Hillier was a recipient of the 2015 Joe Warner Patient Advocacy award, the 2004 OHCA President’s award, and the 2018 AANAC Contributor of the Year. She is a graduate of both the AHCA Future Leader and Political Ambassador programs and represented AHCA at the 2014 White House Summit on Working Families. 

    Nate Ovenden, RAC-CT

    Senior Medicare & Managed Care Consultant, Good Samaritan Society

    Nate Ovenden, RAC-CT, Senior Medicare & Managed Care Consultant, Good Samaritan Society. Nate has been working in the Medicare compliance and revenue area for Good Samaritan Society (GSS) for seven years. He has provided training and education to the 160 plus Skilled Nursing Facilities owned and operated by GSS. Nate helped develop all RCS-1 & PDPM education materials and has traveled the country providing education on the new payment model. He is currently focusing on developing and implementing the strategic goals related to PDPM. Nate and his team provide four Medicare & Managed Care annual workshops and also travel the country providing regional education on an annual basis. Under the current RUG-IV model, Nate developed an audit tool that has recouped more than $3 million over the last three years. 

    Deb Bielek, MS CCC SLP

    Therapy Resource Education and Programs, Ensign Services, Inc.

    Deb Bielek, MS, CCC-SLP is a Speech-Language Pathologist and serves as the Therapy Education and Programs Resource with Ensign Services, Inc. She has spent most of her career in the post-acute industry, working in various roles as both a clinician and leader. Deb provides program development and education support to greater than 200 post-acute care facilities throughout her organization. In addition to leading education and development, she also serves as a regulatory liaison, representing her organization and providing expertise to various industry panels, clinical and technical work groups and councils throughout the post-acute care industry. She is currently a member of the Therapy Policy Advisory Group and the Reimbursement Committee of the American Health Care Association. She is also a member of the Clinical Focus Workgroup for Optima Healthcare Solutions. One of her areas of specialty is helping teams develop models of care that meet the needs of their individual healthcare communities through the delivery of well-coordinated, patient-centered, outcomes-based care. Deb facilitates discussion and learning with therapy, nursing and operations teams throughout her organization and other industry providers on topics of post-acute regulatory change and implementation strategy, functional outcomes with focus on the shift to value-based payment, and clinical programming to support innovative healthcare models such as managed care, BPCI, and ACO’s. Recent speaking engagements include: Co-Presenter at the Regional Multi-facility Council Meeting for American Health Care Association; Co-Presenter of the Comparison of RUGIV and RCS1 American Health Care Association; IMPACT Act Leads Change for an interdisciplinary continuing education event. 

    Anne Tumlinson

    CEO, Anne Tumlinson Innovations, LLC

    Anne Tumlinson is the founder of Anne Tumlinson Innovations and Daughterhood with 25 years of research and consulting experience in post-acute and long-term care financing and delivery. Anne’s work helps organizations respond successfully to payment and delivery reform, and develops innovative ideas and strategies for public policy change – especially important as we prepare the country for demographic shifts. Anne has testified before the House Energy and Commerce Committee and Senate Aging Committee, and appeared before the Congressional Long-Term Care Commission, and the Bipartisan Policy Center. Her testimony has consistently emphasized that the under-financing of long-term care is an economic problem for families and caregivers, and stifles innovation needed to help them. In support of this work, Anne researches, writes and speaks about innovation in aging services, contributing to Health Affairs and McKnight’s Long Term Care News. Anne has also created a consumer website, Daughterhood.org, to generate and improve information for caregivers navigating the health and elder care systems. Daughterhood is a nationwide community of caregivers who educate and inform others. Anne served previously as a Senior Vice President at Avalere Health, where she founded and led Avalere’s post-acute and long-term care consulting practice for 14 years. She created, developed and launched a data-based provider navigation tool for post-acute care placement and led many analytic and modeling projects for a wide variety of clients. Prior to that, she led Medicaid program oversight at the federal Office of Management and Budget.

    Francine Rainer, MA, CCC-SLP

    Senior Vice President, Reimbursement

    Francine Rainer, MA, CCC-SLP is the Senior Vice President of PruittHealth. She has served in the Post-Acute Care industry for 19 years. Fran began her career as a speech-language pathologist, where she enjoyed enhancing the lives of our most vulnerable citizens. Fran spent more than 10 years as a clinician while managing teams of therapists. In 2008 Fran joined PruittHealth as the Post-Acute Care Coordinator. In that role, she worked to develop clinical and rehabilitation programs to support PruittHealth’s expanding model of care. Fran supported and coordinated training for more than 80 skilled nursing facilities across the southeast in comprehensive programming for aquatic therapy, balance re-training, respiratory programs, pain management, infusion therapy, cardiac rehabilitation, and restorative nursing programs. In 2011 Fran matriculated into clinical reimbursement. As the SVP of Reimbursement Fran and her team of reimbursement consultant support and train skilled nursing facilities related to the RAI process including reimbursement and regulatory requirements. She developed an onboarding/ training manual for the MDS coordinator that lead to improvement in retention in that role. Fran served as the project lead for a successful transition from ICD-9 to ICD-10. In the role of SVP of Reimbursement, Fran assists PruittHealth to be positioned to be prepared for CMS initiatives such as the requirements of participation (ROP), value-based purchasing (VBP) and the SNF Quality Reporting Program (QRP). 

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    PDPM ACADEMY is Both In-Person Training and Continuing Updates and Support

    Provider members of AHCA and the STATE AFFILIATE who register for the PDPM ACADEMY will have access to:

    • PDPM 101 workshop webinar
    • One-day, in-person training workshop in your state
    • Monthly workshop webinars on key topics and emerging PDPM issues
    • “How To” webinars on implementing additional tools developed by AHCA

    At the in-person workshop, participants will go in-depth with hands on experiential learning by:

    1. Aligning buildings and companies to transition to PDPM using AHCA’s PDPM Readiness Tools© and the related core competencies;
    2. Classifying residents in case mix groups;
    3. Assessing market position in a PDPM environment; and
    4. Using organizational, business, and management tools to reconfigure business planning.
    • CEs if you attend the optional PDPM 101 workshop webinar
    • CEs if you do not attend the PDPM 101 workshop webinar

    Who should register:

    To be successful with PDPM, Administrators, MDS/billing staff, nurses/DONs, and therapists must be included in the training and education process.

    To Register: Contact your local State Affiliate

  • Quality Initiatives in Medicaid

    Contains 3 Component(s)

    Our quality-focused webinar will discuss quality initiatives in Medicaid. Included will be potential performance measure development in both fee-for-service and managed care environments. This webinar will also include Value-Based Purchasing, and the technical assistance AHCA/NCAL can provide.

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    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.

     

    Our quality-focused webinar will discuss quality initiatives in Medicaid. Included will be potential performance measure development in both fee-for-service and managed care environments. This webinar will also include Value-Based Purchasing, and the technical assistance AHCA/NCAL can provide.

    Learning Objectives:

    1. Learn about key Medicaid VBP rate elements
    2. Understand how state affiliates and AHCA have advocated for VBP programs with state Medicaid agencies
    3. Learn about AHCA VBP support
  • Nursing Centers Action Plan Response for Adverse Events

    Contains 5 Component(s)

    It is critical for nursing centers and assisted living communities to address and mitigate adverse events and potential adverse events. An action plan, otherwise known as a mitigation plan, is a necessary response to adverse events and potential adverse events. For many such events, it is important to respond and start the mitigation process immediately. These tools were developed by members of AHCA’s Survey/Regulatory Committee. Use of these tools does not guarantee regulatory compliance; nursing centers should adapt as needed to ensure compliance with current federal and state requirements. They are not intended as legal advice and should not be used or relied upon as legal advice.

    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.

     

    It is critical for nursing centers and assisted living communities to address and mitigate adverse events and potential adverse events. An action plan, otherwise known as a mitigation plan, is a necessary response to adverse events and potential adverse events. For many such events, it is important to respond and start the mitigation process immediately.

    Examples of adverse events/potential adverse events include:

    • Falls (not following the care plan, use of gait belt, one vs. two-person transfers)
    • Falls with a mechanical lift
    • Elopement
    • Allegation of abuse or neglect
    • Water too hot
    • Smoking (supervised vs. unsupervised, with oxygen, defined smoking area, all about safety)
    • Bedrails (entrapment, assessment for use)
    • Significant medication errors such as cardiac medications, chemo, insulin, morphine, Coumadin
    • Served/consumed wrong consistency of food or liquids
    • Infection Control – outbreaks (e.g. scabies, bedbugs, MRSA, C-Difficile, Noro Virus, Legionella)
    • Fluid restriction not managed or monitored by facility, physician parameters not followed
    • Lack of timely or complete assessment of a change in condition
    • Pressure ulcer – lack of prevention or following prevention measures
    • Grievances and resident council feedback

    Objectives:

    1.  Identify adverse events that could potentially have a negative impact on residents as well as on a center’s regulatory compliance.   
    2.  Establish a routine root cause analysis process to identify the specific/source, root cause or causal factor of the problem.  
    3.  Create a structured process for developing a mitigation plan to address the adverse event/potential adverse event and minimize similar events for all residents:
      •  Review the guidance for determination of avoidable versus unavoidable event
      • Complete the Initial Mitigation Action Plan
      • QAPI members complete the formal documentation of the Mitigation Action Plan
    4. Use information learned by sharing results and Plan with the QAPI committee for continued monitoring.

    Note: These tools were developed by members of AHCA’s Survey/Regulatory Committee to assist centers and communities in addressing adverse events and potential adverse events, documenting and tracking the steps they have taken, and identifying best practices for ongoing improvement. Use of these tools does not guarantee regulatory compliance nor mitigate potential liability. Providers should adapt their tools, policies, and processes as needed to ensure compliance with current federal and state requirements and use both professional judgement and the advice of legal counsel in determining whether or how to share these mitigation tools. 

  • Improving Clinical Outcomes through Competent Gerontological Nurses

    Contains 1 Component(s) Recorded On: 11/08/2018

    Gerontological nursing competency is fundamental to operating successfully within a value based purchasing reimbursement structure. This webinar will discuss how specialized training such as the Gero Nurse Prep course improves nursing competence, improves clinical outcomes and prepares nurses for board certification in gerontological nursing through the American Nurses Credentialing Center.

    image

    How to Register in ahcancalED 

    Easy as 1, 2, 3 !

     

    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.

     

    Gerontological nursing competency is fundamental to operating successfully within a value based purchasing reimbursement structure. This webinar will discuss how specialized training such as the Gero Nurse Prep course improves nursing competence, improves clinical outcomes and prepares nurses for board certification in gerontological nursing through the American Nurses Credentialing Center.

    Speakers:

    David Kyllo, VP, Insurance and Member Programs
    Heidi Keeler, Director of Continuing Nursing Education, UNMC School of Nursing

NCAL AHCA