RIPPED FROM THE HEADLINES

AHCA Chief Looks To Bolster Health Information Exchange

Saying the state needs to be able to help consumers and providers in the same fashion as ride-sharing service Uber, a top health official said Thursday that Florida needs to overhaul the way it collects health-care data.

Former Gov. Rick Scott pushed to force health maintenance organizations and insurers to turn over claims data. But Agency for Health Care Administration Secretary Mary Mayhew told members of a state advisory council Thursday she wants their insight on ways the state can move ahead with getting real-time information to everyone involved in using or paying for health care.

“What is the future? What do the next 12 months look like? What do the next three years look like?” Mayhew said.

Mayhew, who was appointed secretary in January by Gov. Ron DeSantis, told members of the State Consumer Health Information and Policy Advisory Council that she wants “ to support rapid-cycle improvement” so that data can be turned over to health care providers and insurance companies in a way that is “actionable” and is as easy to use as an Uber app. Read More...

Source: Christine Sexton / News Service of Florida

 Sponsored Content

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 REGULATORY

Avoiding the Fifth Most Cited Tag - F684

To avoid being cited for the fifth most cited tag, F684, I suggest first understanding how surveyors are directed to use this tag. F684 states: Quality of care is a fundamental principle that applies to all treatment and care provided to facility residents. Based on the comprehensive assessment of a resident, the facility must ensure that residents receive treatment and care in accordance with professional standards of practice, the comprehensive person-centered care plan, and the residents’ choices.

The intent of this regulation is to ensure facilities identify and provide needed care and services that are resident centered, in accordance with the resident’s preferences, goals for care, and professional standards of practice that will meet each resident’s physical, mental, and psychological needs.

Surveyors are directed to use this tag for review of concerns which have caused or have potential to cause a negative outcome to a resident’s physical, mental, or psychological health or well-being that is not specifically addressed by any other tag. Specifically, this tag is used when there are issues with non pressure-related skin ulcers/wound, hospice and palliative care.

It is important to understand that in the surveyor’s interpretative guidelines it states “at the time of the assessment and diagnosis of a skin ulcer/wound, the clinician is expected to document the clinical basis e.g. underlying condition contributing to the ulceration, ulcer edges and wound bed, location, shape, condition of surrounding tissues.”

In the examples of deficiencies sent today, it shows how surveyors identify a non-pressure related wound/skin issue (i.e. skin tear, central venous catheter, moisture related skin issues, etc.) followed by how they look for the assessment and the treatment orders as identified on the care plan. The surveyor then looks to the clinical record for evidence the orders have been carried out.

Surveyors will assume a treatment is not carried out when the clinical record is not complete.

To avoid this tag timely, identify all skin issues, assess and document them, obtain treatment orders, add the skin issue to the care plan with appropriate treatment orders, place on the treatment or medication record, and then document each time the treatment is carried out.

Connie Cheren, RN, MSW, LeadingAge Florida's Clinical and Compliance Specialist, can be reached via email or phone at (678) 778-0561 to help answer questions before, during and after your surveys. As a value-added service provided by LeadingAge Florida, Connie can help nursing home and assisted living facility members improve regulatory compliance and clinical outcomes, in addition to offering suggestions about corrective plans of action to improve your surveys.

ADVOCACY

FREE Attendance for Legislative Days: Advocacy in Action
Registration Now Open

Attendance at this year's Legislative Days: Advocacy in Action is FREE to LeadingAge Florida Community Members! Don't miss out on this important opportunity to meet with your state legislators and advocate for the issues that matter the most to you and your residents!

Legislators listen to constituents, because they answer to them! This event will give you the opportunity to speak with lawmakers while they are making critical decisions about the state budget, long-term care, and senior housing. By telling them your story, you can personalize the issues and influence the outcome of pending legislation. Legislators need to hear from you so services and programs for senior Floridians are treated fairly. As a provider, your credibility makes you the perfect expert advocate for your community and the elders you serve. Your attendance is needed to make LeadingAge Florida’s unified voice heard loud and clear.

MEMBER SPOTLIGHT

South Florida Elected Officials Will Hold Senior Living Town Hall in Boca Raton

Elected officials in South Florida at the state and federal levels will be taking part in a town hall focused on senior living early next month.

Sinai Residences, LeadingAge Florida, Jewish Family Services, the Jewish Federation and Life Care Services announced this week they will hold the town hall on October 2 from 1:15 to 3 pm. The event will be held at Zinman Hall in Boca Raton.

“This event is an excellent opportunity for our residents to build relationships with their local legislators and have their voices heard on issues that matter most to them,” said Chris Newport, the executive director of Sinai Residences. “Having a presence and consistently communicating key issues with legislators is critical to bringing about important change.”

“We are very pleased to host and co-sponsor this opportunity for local seniors to learn and be heard on issues of interest and concern, and to get to know their state and federal elected officials,” said Matthew Levin, the president and CEO of the Jewish Federation of South Palm Beach County. “Our Federation is continually engaged in advocacy for our seniors. We look forward to having our residents join us in that effort.” Read More...

Source: Kevin Derby / Florida Today

FLORIDA MEDICAID ALERT

Nursing Facilities/Long Term Care (LTC) Submission Updates for Institutional Health Care Claim: (X12 837I) Transactions

Beginning September 27, 2019, Long Term Care (LTC) information on LTC claims and encounter transactions must be changed to allow proper processing by the Florida Medicaid Management Information System (FMMIS).

Currently, Long Term Care encounter transactions and Fee-for-Service (FFS) Medicaid claims are billed using Version 5010 X12 837 Institutional Health Care Claim, with the Level of Care (LOC) reported in elements NC101 and CN104 of Loop 2300.

To align with the HIPAA 5010 X12 Guidelines, the LOC information will no longer be reported in the CN1 segment (CN101, CN102, and CN104 of loop 2300).

NOTE:

• Health plans will continue reporting Contract Type in the CN1 segment for encounter transactions.
• There are no changes to Direct Data Entry/Web Portal.
• This reporting change is based on date of submission.
  

Beginning September 27, 2019, the Level of Care information will be reported in the NTE segment of Loop 2300. Read More...

HOUSING

Expansion of HUD 202 Program on the Line

The House and Senate will soon begin negotiating the differences between their fiscal year 2020 HUD spending bills.

LeadingAge’s top priority is to expand the supply of affordable housing provided through HUD’s Section 202 Housing for the Elderly program.

The House bill provides $140 million for new Section 202 homes in FY20. The Senate bill provides no funding for new Section 202 homes. We greatly appreciate the Senate bill’s $17 million and the House bill’s $5 million for new Service Coordinators, which are greatly needed. LeadingAge urges that funding for new 202 homes and for new Service Coordinators be in the final FY20 HUD funding bill.

Your representative and senators need to hear from you:

• We need significant expansion of funding for new homes under HUD’s Section 202 program.
• Now is not the time to roll-back recent progress new Section 202 homes.
• The final FY20 HUD funding bill must include at least the House’s $140 million for new Section 202 homes.
• The Senate bill’s zero funding for new Section 202 homes is unacceptable.

We are getting closer to the finish line and need your help. Send a message to your elected officials in Congress and urge them to expand and preserve affordable housing for older adults. Your voice will make a difference as we work with Congress to finish the job on funding for these vital programs.

• Call or email your lawmakers TODAY!
• Share this information with the residents in your community and suggest that they call as well.
• Forward this action alert to your network.

MEMBERSHIP DATA FORMS

Electronic Membership Data Forms are Due by October 4th

Each year, LeadingAge Florida asks our member communities to provide updated annual revenue amounts from their organizations, and that data is used to calculate annual membership dues. Historically, the process has required our members to fill out pages of paper forms, often duplicating data that is already on file at LeadingAge Florida. Last year, LeadingAge Florida launched an online form you can use to report your annual revenue totals. The process should take only a few minutes to complete, and will:

• Simplify the process for you
• Eliminate needless duplication, and
• Eliminate the need to fill out paper forms

Our goal is to make the data collection and dues calculation process as easy as possible for our members.

Email messages with instructions on how to upload your information were distributed to each member community’s leader last week. Your updated information is due by Friday. October 4, 2019.

If you have questions or need assistance, please contact Dawn Jiménez at (850) 671-3700 or by email djimenez@LeadingAgeFlorida.org.

SENIOR DINING ASSOCIATION

SDA One-Day Experience

The Senior Dining Association (SDA) is hosting the SDA One Day experience on October 24, 2019, at the Edgewater at Boca Pointe in Boca Raton, an Acts Retirement Community. The One Day Experience offers a wide range of learning opportunities as well as a chance to network with committed professionals in your local area. The event provides an unmatched opportunity to pick up essential skills and remind yourself why you’re passionate about senior dining.

Leading experts in the senior dining space will be on hand to present recent trends and best practices, while SDA chats give you the opportunity to ask questions and share your experience. Registration is for senior living industry professionals only. All other operators are encouraged to attend.

Event Page: https://seniordining.org/sda-one-day
Registration Page: https://seniordining.wildapricot.org/event-3480901
Registration Code: LEADINGAGEFL2019

Continued underlying eligibility issues are causing claims denials statewide.

This week every FAHA H&S member was sent a spreadsheet to complete with the outstanding denied claims due to underlying eligibility issues. The purpose of gathering this information is to provide specific examples and trends of the claims being denied to AHCA to work towards a fix for these claim denials. Read More...

VALUE FIRST

Through our partnership with Vizient (formerly MedAssets), and an expanding portfolio of nearly 500 vendors, Value First helps you save money in all four purchasing categories – Medical, Food, Environmental/Janitorial/Sanitation, and Office Supplies and Capital Equipment.

Our program works in concert with your purchasing, finance and leadership teams to analyze current expenses and provide a price comparison on exactly how much you can save. Additionally, we can assist you with obtaining capital equipment quotes. You provide the project specifications, and we will work to get the best possible prices available. You receive ALL of this, at NO FEE TO YOU. Consider Value First to be an extension of your staff. Currently, there are approximately 500 communities enrolled in the Value First program in Region 8. We have had some successful cost studies recently in food and medical so please take advantage of this service.

I look forward to speaking with you and visiting your community. As a bonus to our members, please click on the “The BIG SAVINGS “graphic on the right, all employee’s full-time or part-time are eligible to accesses these employee savings by just registering their name. No fee, no commitment on the part of the community. All this for being a LeadingAge Florida Value First member.

This month, don't miss out on a group special from Direct Supply! Click here for more information. In addition to Direct Supply, Sherwin Williams Group will have a buy special for September and October. Click here for more information. 

For those attending LeadingAge National Annual Conference in San Diego, please stop by the Value First booth #2923 , hope to see you there.

Each LeadingLink newsletter has the latest Value First/Vizient-Provista Vendor Catalog. Check it out and get started with savings today. If you have any questions please email or give me a call.

See you on the road!

Robert "Bobby" Bernal, Value First Regional Southeast Manager

O: (850) 671-3700 | C: (850) 509-8112 | Email

COMING ATTRACTIONS

OCTOBER

PDPM Triple Check Process and Billing Accuracy Webinar
10/2/2019 @ 2:00 PM
This session will review best practices to decrease potential billing errors and promote accurate reimbursement for PDPM claims through internal interdisciplinary auditing processes. Key roles of interdisciplinary team members in completion of a collaborative triple check process and key data collection, billing, and monitoring process pertinent to PDPM will be emphasized.

Reimbursement and Regulations - Strategies for Success Workshop
10/2/2019 @ 9:30 AM - 4:00 PM
We are heading into the final home stretch of the Mega Rule changes and PDPM! Not one, but two, major changes for long term care facilities are coming. Join industry expert and LeadingAge Florida Regulatory Expert Connie Cheren, RN, MSW at this workshop designed to assist nursing homes in determining if they are ready for Phase 3 regulations and PDPM.

Interested in Exhibiting and/or Sponsoring at this Event?
Click here for details.
For assistance, contact Julie Copeland via email or call (850) 702-0317

LeadingAge Florida's State Night Reception on the USS Midway!

10/28/2019 | 6:30 - 8:00 PT
USS Midway Museum | San Diego, CA
In conjunction with LeadingAge's Annual Meeting
Click here for more information | Click here to register as a sponsor