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317 Results

  • 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.

  • Tools to Prevent and Address Resident to Resident Mistreatment

    Contains 3 Component(s)

    ​It is critical for nursing centers and assisted living communities to address and mitigate reported incidents of resident-to-resident mistreatment. While mistreatment may or may not meet the definition of abuse, it would include negative and aggressive physical, sexual, or verbal interactions between long-term care residents that is unwelcome and have high potential to cause physical or psychological distress in the recipient.

    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.

     

    It is critical for nursing centers and assisted living communities to address and mitigate reported incidents of resident-to-resident mistreatment. While mistreatment may or may not meet the definition of abuse, it would include negative and aggressive physical, sexual, or verbal interactions between long-term care residents that is unwelcome and have high potential to cause physical or psychological distress in the recipient.

    Objectives:

    1. Conduct a thorough investigation with proper documentation, follow up, and monitoring and care planning as needed.  
    2. Create a structured self-assessment process to address the resident-to-resident mistreatment and minimize similar events for all residents. This includes a need to:
      • Document immediate interventions;
      • Conduct a root cause analysis process to identify the specific/source, root cause or causal factor of the problem; and
      • Identify future actions to ensure sustained efforts to identify and prevent potential resident-to-resident mistreatment.
    3. Identify existing AHCA/NCAL resources to support providers in addressing resident-to-resident mistreatment. 


    Note: These tools were developed by members of AHCA/NCAL’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.

  • PDPM and Medicare Advantage Toolkit

    Contains 6 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.
  • 2019 HUD Updates on Residential Care Facilities Asset Management

    Contains 1 Component(s)

    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. 

  • LTC Trend Tracker – PDPM Top Line Reports

    Contains 1 Component(s)

    LTC Trend Tracker – PDPM Top Line Reports

    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.

     

  • PDPM- One Week Out

    Contains 1 Component(s)

    As providers approach the imminent October 1 implementation of the SNF PPS transition from the RUG-IV to PDPM, the Centers for Medicare and Medicaid Services (CMS) continues to issue last-minute updates including corrections to policies, software, billing guidance, and educational resources. During this 90- minute live webinar, the presenters will discuss key resources that CMS has updated recently that providers should pay attention to. In addition, the presentation will cover several frequently asked questions associated with the payment model transition that members have submitted to the pdpm@ahca.org helpdesk. After the presentation, webinar participants will also have the opportunity to submit questions to be responded to during the webinar. 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 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.

     

    As providers approach the imminent October 1 implementation of the SNF PPS transition from the RUG-IV to PDPM, the Centers for Medicare and Medicaid Services (CMS) continues to issue last-minute updates including  corrections to policies, software, billing guidance, and educational resources.  During this 90- minute live webinar, the presenters will discuss key resources that CMS has updated recently that providers should pay attention to.  In addition, the presentation will cover several frequently asked questions associated with the payment model transition that members have submitted to the pdpm@ahca.org helpdesk.  After the presentation, webinar participants will also have the opportunity to submit questions to be responded to during the webinar.  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.      

  • CMS PDPM HIPPS Coding Web Page Resources (posted 9/20/19)

    Contains 1 Component(s)

    This web page contains information related to the use and maintenance of the Health Insurance Prospective Payment System (HIPPS) codeset. The Centers for Medicare and Medicaid Services (CMS) are named in the ASC X12 837 Institutional Claim Implementation Guide as the code source for HIPPS codes. The following files contain specific details regarding the SNF PPS PDPM HIPPS code construction as well as a master list of all valid HIPPS codes applicable to PDPM. • Definition and Uses of HIPPS Codes (see file below) • HIPPS Code Master List (see file below) - an Excel spreadsheet that provides a complete list of all valid HIPPS codes, with their effective dates, payment settings and code definitions.

    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 web page contains information related to the use and maintenance of the Health Insurance Prospective Payment System (HIPPS) codeset. The Centers for Medicare and Medicaid Services (CMS) are named in the ASC X12 837 Institutional Claim Implementation Guide as the code source for HIPPS codes.  The following files contain specific details regarding the SNF PPS PDPM HIPPS code construction as well as a master list of all valid HIPPS codes applicable to PDPM.

    • Definition and Uses of HIPPS Codes (see file below)
    • HIPPS Code Master List (see file below) - an Excel spreadsheet that provides a complete list of all valid HIPPS codes, with their effective dates, payment settings and code definitions.

     

NCAL AHCA