November 15, 2016 LeadingAge Missouri Hotline – page 1

November 15, 2016

LeadingAge Missouri News

Bill’s Perspective At Annual Conference, I make it a point to visit with members, like new Business Member Lyon Software. I stopped by Lyon’s booth in the Exhibit Hall to learn about its products and services. Visiting with members is one way I learn. The Lyon representatives provided a good education and planted a seed for this Perspective. Lyon Software helps clients collect, track and report Social Accountability information. While Social Accountability is not government-mandated (yet?), Lyon makes a strong case for a program. Not-for-profit status is an important way LeadingAge Missouri members distinguish themselves. A robust Social Accountability program and report makes telling the not-for-profit story easy. It may sound a bit corny or contrived, but Social Accountability is simply the “right thing to do”. Historically, senior living and health care communities were born in faith and community-based organizations committed to serving elderly persons unable to care and provide for themselves. LeadingAge members continue to pursue missions focused on senior care through housing, food and health care. However, the distinction between seniors in a residential community and seniors within the continuum of health care is sometimes blurred. Social Accountability programs help us put feet to our

LeadingAge Missouri Board

of Directors Carla Baum Lutheran Senior Services Roger Byrne Bethesda Health Group Anthony Columbatto Village Care Center (John Knox Village) Chris Crouch Bethesda Southgate Carol DiSanza Cape Albeon Paul Ewert Beth Haven Bruce Gosser Innova Healthcare Solutions Rodney McBride John Knox Village Paul Ogier Lutheran Senior Services Michael Riggins Cardinal Ritter Senior Services Dawn Smith Fulton Presbyterian Manor Lynne Spriggs Melissa Steck Bishop Spencer Place Robyn Tweedy St Luke’s Hospital’s Surrey Place Bill Bates, CEO

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The LeadingAge Missouri Hotline is a “resource-of-resources” for aging service providers across the entire continuum of senior care.

Table of Contents

Click on a topic below and go directly to that page.

LeadingAge Missouri News 1 Member News 3 Professional Development 4 What Your Association Does For You 6 Assisted Living News 7 CCRC News 7 Federal News 8 Home and Community Based Services News 9 Home Health Care News 10 Hospice News 10 Housing News 10 Information of Interest 11 LeadingAge News 12 Medicaid News 14 Nursing Facility News 15 State News 16 Career Center 16 If you have suggested content for a future edition of the Hotline e-mail LeadingAge Missouri. If you do not want to receive future editions of the Hotline e-mail LeadingAge Missouri with your contact information so we may remove you from the distribution list. If you wish someone else in you organization to be added to the Hotline distribution list e-mail LeadingAge Missouri with their contact information so we may add them to the distribution list. The inclusion of advertising in the Hotline does not constitute an endorsement of the accuracy of the ad by LeadingAge Missouri or the products or services advertised.

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LeadingAge Missouri News - continued mission statements…to walk the walk, not just talk the talk. Moreover, not-for profit organizations receive certain benefits from society. Some taxes do not apply to not-for-profits and donor contributions are usually tax deductible. In exchange for such benefits, not-for-profits are expected to “give back” to their communities and relieve the burden of government and society. Social Accountability programs help prove we are good stewards of societal resources (the taxes we don’t pay and other benefits we receive).

For example, through financial assistance (charity care/benevolence) and covering Medicaid shortfalls, we relieve the burden of government by continuing care for residents who outlive their resources. In addition, beyond our own residents, Social Accountability shows how we give back to the greater community and earn our tax exempt status. Most LeadingAge members offer community space for groups to meet, or contribute money, time or other resources to support community projects. Some members work with students seeking a certificate, license or degree in health care or senior services. Other members include the community at large in social events (reducing isolation) or education (sharing our expertise). The list of community support goes on and on. Every day there are opportunities to show how our organizations benefit the broader community.

Finally, showcasing Social Accountability with current, relevant information delivers valuable PR and Marketing benefits. Many of our current and future residents are used to volunteering in their communities and want to be a part of an organization committed to “giving back”. Legislators and city leaders see us as valuable partners, working together for the common good, thereby raising our status as an important voice in the community.

So, to sum up: Why is Social Accountability tracking and reporting important? Because it helps us live our mission, preserve our tax-exempt status, and tell our story to important stakeholders, including present and future residents. Social Accountability is part of who we are and what we do as aging services providers. It’s nice that organizations like Lyon Software and others exist to work with us. That’s my Perspective!

Member News

Presbyterian Manors of Mid-America wins award in National

Health Information Awards Program Presbyterian Manors of Mid-America’s 2016 Art is Ageless® Calendar received a Silver Award from the National Health Information Awards Program. Art is Ageless is a trademarked program of Presbyterian Manors of Mid-America, a faith-based not-for-profit organization with 17 retirement communities in Kansas and Missouri. Each community

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holds a juried art competition exclusively for people age 65 and older. Winning art may be chosen to appear in a calendar or note cards. Periodic programs and classes are held throughout the year to encourage seniors to express their creativity. Art is Ageless began in 1981 when resident art was featured in a calendar. Knowing how a creative outlet can benefit the mind, body and spirit is just one reason that in 2006 PMMA opened its Art is Ageless competition to all seniors in the area. Learn more about the program at www.ArtIsAgeless.org. The National Health Information awards program is coordinated by the Health Information Resource Center, a national clearinghouse for consumer health information programs and materials.

Professional Development

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Thank you to our generous sponsors: Concordance HealthCare Paric Martin Brothers Rehab Care Because of their support, this year’s event is free to our organizational members!!!!!!!!!!!!!!! Click here for organizational member registration Business Members Click Here Click here to donate an item for the silent auction

Click here to register

Busy Doing Nothing? How to Foster Purpose and Meaning for

Seniors in LTC.

Kathleen Weissberg from Select Rehabilitation will present the webinar on December 1, 2016, at 11:30 a.m. – 12:45 p.m. CT.

Are your residents busy doing nothing? Are they actively engaged? Research evidence indicates today’s seniors prefer continued engagement in meaningful and purposeful activities and occupations. Those who are occupationally active show positive therapeutic benefits, demonstrate fewer negative behaviors, need less help with self-care tasks, report positive mood, and describe greater quality of life.

This session will explore meaningful activities by focusing on the intersection of the individual, his/her occupations, and the environment. Participants will be guided through what it means to foster engagement and strategies to connect seniors to their

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environment, improve community involvement, resident choice in the facility, and help individuals lead. Participants will be guided through a narrative interview for soliciting preferences and be offered four different standardized tools for soliciting individual preferences, interests, roles, and hobbies and using these to encourage client choice and control over activities.

Click here to register

Therapy Coding and Billing Changes – Are You Ready?

Catherine Gill, MS, PT, MHA from LW Consulting will present this webinar on December 14, 2016 from 11:30 AM – 12:30 PM CST

Beginning January 1, 2017, the existing physical and occupational therapy evaluation and re-evaluation CPT codes will no longer be accepted by Medicare for Part B services, and 6 new codes will be required in their place. To prevent interruptions in your cash flow due to claims denials, it is important that your key staff know the new billing codes, that software and process are modified to handle the new codes and that therapy services are properly documented to support the new codes.

This presentation, for facility management and billing staff, will explain the changes in the CPT codes and the new documentation requirements that must support the new codes. It will also review steps you should be taking now to prepare for this change, and steps you should be talking after January to ensure the therapy billing that is done is compliant with these new requirements. Click here to register

What Your Association Does For You

LeadingAge Missouri Offers Cost Effective Certification

Services Is your facility an approved training agency for nurse aides, medication technicians, insulin administration and/or restorative aides? Are you looking for ways to save money? If you answered “yes” to these questions, look to LeadingAge Missouri as your certifying

agency. Since 1994 LeadingAge Missouri has been a Department of Health and Senior Services approved certifying agency for nursing assistants, medication technicians, and insulin administration. LeadingAge Missouri offers competitive prices for certifications and discounts to our members. If you have questions or need assistance, direct them via e-mail to debbieklindt@leadingagemissouri.org or via phone to (573) 635-6244. LeadingAge Missouri will issue a certificate to individuals who have

successfully completed the approved course or challenged the examination according to

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DHSS regulations and will send the certificate, ID card and pin to the training agency within 15 days of receipt. Students' information will be added to LeadingAge Missouri's permanent register and submitted to DHSS for placement on the federally mandated register. Member fee: CNA/CMT/Insulin Administration certificate and ID card - $10.00 each CNA Pin (optional) - $8.00

Assisted Living News

New Data Document the Benefits of Assisted Living It’s not unusual for families to delay their search for assisted living for an older relative, either because the older relative does not want to move or because family members have a negative view of assisted living. But a new survey from senior living referral service A Place for Mom suggests that the majority of older adults and their family caregivers experience measurable increases in quality of life after an older relative moves to assisted living. The survey was conducted in collaboration with Sage Projections, a Seattle-based research and consulting company. Full Article

CCRC/Life Plan Community News

Why Life Plan Communities Should Care about Walkability Future residents of life plan communities may want to hang up their car keys on most days – and walk. That may come as a shock to communities whose current residents depend so heavily on their cars to stay mobile and to preserve their sense of autonomy and independence. But that’s the coming trend, according to a recent article in The New York Times. According to the newspaper, more older consumers will be looking to live in mixed-use neighborhoods, “where they can enjoy a full life without a car,” over the next few decades.

Full Article

November 15, 2016 LeadingAge Missouri Hotline – page 8

Federal News

Feds Double Down on Improper Payments with New RAC

Contracts The Centers for Medicare & Medicaid Services has awarded five new contracts for its recovery audit contractor program, a move one expert suggests reflects the agency's renewed efforts to cut improper payments in Medicare. Four companies received the new contracts to identify and correct improper Medicare Part A and Part B payments through post-payment reviews, CMS said October 31st. A fifth contract was given to a company to review payments for medical equipment, home health and hospice claims.

Full Article

MDS Accuracy, Staffing Data Among Most Cited Deficiencies,

CMS Reveals Deficiencies in Minimum Data Set accuracy and posted nurse staffing information were the most commonly cited among MDS 3.0 Focused Surveys conducted in fiscal year 2015, according to a new report. The FY 2015 MDS Focused Survey Summary, released by the Centers for Medicare & Medicaid Services, includes the scope and severity of deficiencies cited in the survey, as well as the top cited deficiencies. Full Article

OIG to Take on Nursing Home Reimbursements, Complaints

in FY 2017 Federal health officials will take a closer look at Medicare reimbursements and therapy billing in nursing homes during fiscal year 2017, according to a report issued November 10th . The Department of Health and Human Services' Office of Inspector General plans to review skilled nursing facility reimbursements over the course of the year, the agency said in its Fiscal Year 2017 Work Plan, with a special focus on therapy documentation. Full Article

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Plans for Emergency Preparedness Rule Implementation This Letter provides general information regarding implementation plans for the final Emergency Preparedness Rule, published 9/16/16 and effective 11/15/16.

Providers and suppliers affected by this rule [including nursing homes, home health, inpatient hospice, PACE] have until 11/15/17 to implement the new requirements. Surveyors will begin surveying against the new requirements after 11/15/17.

Interpretive guidelines and survey procedures will be developed with publication anticipated in spring, 2017.

CMS is developing web-based surveyor training, anticipated to be available in spring, 2017.

Full Article

OIG Plans Review of Medicaid Waivers, Employee

Background Checks, More Reviews of Medicare and Medicaid payments, fraud and abuse, and employee background check efforts are some of the items on the agenda for the Department of Health and Human Services Office of Inspector General, according to a 2017 work plan released November 10th. Full Article

Home and Community Based Services News

Bayada Offers Customized Uber Rides to Jobseekers With the competition for home health workers fierce, companies are always trying to get an edge in hiring. Moorestown, New Jersey-based Bayada Home Health Care, one of the 10 largest providers in the nation, is hoping to gain such an edge through a new pilot utilizing the popular ride-hailing application Uber. Now, when job seekers access the webpages of local Bayada offices through a mobile device, they encounter a “Get a Ride with Uber” link. Clicking on this link opens the Uber app, with the exact coordinates of the Bayada office pre-loaded.

Full Article

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Home Health Care News

CMS Finalizes $130 Million Medicare Payment Cut in 2017 The final numbers represent fewer payment cuts than the proposed changes announced earlier this year by CMS. The agency previously proposed reducing home health care payments by $180 million in 2017, or 1%. Since the proposed payment changes were announced in June, the Medicare agency upped the home health payment update from a 2.3% ($420 million) increase to a 2.5% ($450 million) increase.

Full Article

Hospice News

Annual Hospice Rate Change

The MO HealthNet Division (MHD) hospice payment rates effective for October 1, 2016,

through September 30, 2017, are provided in Attachment A. As in previous years, these rates are listed by Core Based Statistical Area (CBSA). Please note that separate rates are listed for hospice providers who have submitted the federally required quality data to the Centers for Medicare & Medicaid Services (CMS), and lower payment rates for those providers who failed to comply with CMS’ quality data submission requirements. Full Article

ousing News

National Academy of Medicine Will Explore Housing Plus

Services on Dec. 12 The role of housing as a social determinant of health will be the topic for discussion on Dec. 12 when the National Academy of Medicine (NAM) holds an all-day public workshop focusing on the affordability, availability, and importance of housing for vulnerable older adults and people with disabilities. Dr. Robyn Stone, executive director of the LeadingAge Center for Applied Research, and a NAM member, will participate in the workshop, which will:

Summarize the state of the knowledge on housing as a platform for health and independence.

Highlight successful and promising collaborations to provide affordable and accessible housing.

Explore sustainable and scalable strategies, policies, and practices to support linking affordable housing with services to benefit health and optimize independence.

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Identify data needs and research gaps to measure effectiveness of models of housing with supportive services.

As a NAM member, Stone has been instrumental in raising awareness about housing plus services models among her colleagues on NAM’s Board of Health Sciences Policy. The workshop is a direct result of those efforts.

Full Article

Information of Interest

Food Trucks Come to Senior Living Providers have been working to make senior housing more of a community destination, and one broader food trend could help dramatically. Enter food trucks, mobile stations known for their convenience and diverse, artisanal food selections. Senior Housing News pinpointed food trucks as a major trend from which senior living can benefit in its new report, “Innovative Food and Dining Trends in Senior Living.” On the surface, food trucks might not seem to have a place in senior living, given that most communities have extensive dining programs to begin with. Since food trucks have grown in popularity in recent years and senior living providers are constantly looking for ways to please their residents and attract the community at large, though, the prospect of hiring them for events and marketing them to the surrounding neighborhood has become more plausible. Full Article

61 Indictments Allege Scams Against 15,000 Seniors and

Others Fifty-six individuals and five call centers have been charged for allegedly scamming more than 15,000 seniors and others in the United States out of hundreds of millions of dollars, the Justice Department and several additional government agencies announced October 27th. Assistant Attorney General Leslie R. Caldwell said the announcement is the “first-ever multi-jurisdiction enforcement action targeting the India call center scam industry.”

Full Article

Court Upholds NLRB Decision that Nurses aren't Supervisors,

Can Unionize An appeals court on November 1st denied a review of a case between a South Carolina nursing home and its nursing staff, effectively upholding a decision by the National Labor Relations Board. Registered nurses and licensed practical nurses at Prince George

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Healthcare Center in Georgetown, SC, sought to unionize and begin the collective bargaining process. Prince George officials argued that the nurses counted as supervisors since they have the authority to direct and discipline the certified nursing assistants who work under them, and therefore did not have collective bargaining rights. Full Article

Home Care Agency to Pay $125,000 Over ‘Genetic

Discrimination’ Charges A home care agency based in New York will pay the U.S. Equal Employment Opportunity Commission (EEOC) $125,000 to settle a genetic discrimination lawsuit that was filed after the company was found in violation of the Genetic Information Non-Discrimination Act (GINA). BNV Home Care Agency, Inc., which provides companionship and home care services for seniors in Brooklyn, the Bronx, Manhattan, Queens, Staten Island and Westchester, unlawfully asked its employees and applicants for genetic information by asking them questions about their family medical history on one employee health assessment form, according to a press release issued last week from the EEOC. Full Article

It's Time to Talk about Long-Term Care's Diversity Problem Long-term care leadership has a diversity problem. Don't believe it? Travel to a national long-term care convention and look around — what do the majority of attendees look like? They look the same, if you ask those who attended and spoke at a roundtable discussion on diversity held at last week's LeadingAge annual meeting in Indianapolis. It was the first real, open dialogue on the issue that the group held at one of its national meetings, the speakers noted. And it couldn't come at a more critical time Full Article

Consumer Groups, Lawmakers Disappointed but Hopeful

after Arbitration Ban Blocked

Advocates for the federal ban on pre-dispute arbitration agreements expressed disappointment this week that a court stopped the ban from taking effect, but say they remain hopeful that the rule eventually will be implemented. Sen. Al Franken (D-MN) told Bloomberg BNA that he was “disappointed” by the court's decision on Monday, but that he remains “hopeful that we can get this rule implemented. Full Article

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Amazon ‘Home Assistants’: The New Home Care Provider? Amazon just about does it all, but one area that it is just dipping its toes into is “Home Assistants,” a new service to help keep customers’ homes clean. The tip off was when a job posting was released in October for “Home Assistants,” according to a report from Engadget. Home assistants would perform tasks such as laundry, tidy up people’s homes and put groceries away. Originally, the service was said to be offered as an added bonus for Amazon Prime customers, but the company has now removed any link to Prime, which means this could be a service available to any Amazon user in the future. Full Article

LeadingAge News

LeadingAge Provides Phase 1 Implementation Summary The new Requirements of Participation (RoPs) for Nursing Homes are complex and comprehensive, with a number of items that must be in compliance by November 28, 2016 (Phase 1). As a general statement, most of the Phase 1 requirements have to do with documentation and policy. At the very least you need to go through your policy and procedure (P&P) manuals and make sure that you have corrected for new definitions and have policies in place for areas that are specifically called out. Click here to see this check-list.

Conquering Ageism is LeadingAge's New Vision, Sloan Says LeadingAge's new vision is to “permanently change the image of aging in our society,” the organization's president and CEO, Katie Smith Sloan, told those attending the opening general session of its annual meeting October 30th in Indianapolis. Board members unanimously agreed on the vision, Sloan said, and she called on members to discuss ageism at the meeting and speak out against it when they return home. Full Article

Workforce Pressures: It's Not About Just Millennials

There's been a lot written and said lately about managing the youngest wave of workers — and rightfully so. This 18-35-year-old crowd is going to be HALF of long-term care's workforce within five years, experts predict. That's right, half. But to take your eye off the ball with your Generation Xers (remember the fretting over them just a few years ago?) or baby boomers would be a huge mistake. That was the common-sense, yet eye-opening

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message at a packed session at the LeadingAge annual meeting October 31st in Indianapolis.

Full Article

Medicaid News

Medicaid Managed Care Success Hinges on Provider Input,

Experts Say With the number of states adopting managed long-term services and supports programs rising, providers hoping to benefit must make their thoughts and concerns known to managed care stakeholders, experts stressed October 31st. Providers must stay engaged as Medicaid managed care becomes more prevalent, said Julie Weinberg, director of Medicaid policy at UnitedHealthcare Community and State, speaking during a session at LeadingAge's 2016 Annual Meeting & Expo. Full Article

Kansas Fight over Medicaid Managed Care Could set

Precedent A public debate over Medicaid managed care and its effect on Kansas residents with disabilities could send a ripple through other states. The fight began when a former state legislator and current CEO of the Association of Developmental Disabilities Providers wrote an opinion piece for the Wichita Eagle, in which he said the Centers for Medicare & Medicaid Services should axe Gov. Sam Brownback's efforts to renew KanCare past 2018. “The nation has been watching the Kansas social-service system experiment that has failed. Now the nation looks to how KanCare can be fixed, if at all,” wrote Gary Blumenthal. Full Article

Seniors Suffer Amid Widespread Fraud by Medicaid

Caretakers An Alaska man developed gangrenous toes. A Philadelphia woman froze to death on the street. An Illinois woman died emaciated, covered in excrement. These patients suffered as their government-paid caretakers neglected them, collecting paychecks under a Medicaid program that gives elderly and disabled people non-medical assistance at

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home. In some cases, the caretakers convicted of neglect were the victims’ own family members. Full Article Article Courtesy of Kaiser Health News

Nursing Facility News

Kindred Leaving U.S. Skilled Nursing Business Kindred Healthcare Inc. announced plans Monday to exit the skilled nursing facility business, citing “dynamic changes” to the healthcare industry. The decision to leave the skilled nursing sector is the “final step in a process that began years ago,” Benjamin Breier, president and CEO of the Louisville-based long-term care provider said in a press release. Full Article

Kindred Strikes $700 Million Deal with SNF Landlord Ventas Kindred Healthcare (NYSE: KND) has made further progress in its efforts to exit the skilled nursing facility business and focus more wholly on home health and other segments. The Louisville-based post-acute care giant is expected to purchase the 36 skilled nursing facilities (SNFs) currently owned by Ventas Inc. (NYSE: VTR) for $700 million. The news comes one week after Kindred, the largest home health provider in the nation, announced that it intends to exit the SNF sector entirely, doubling down on its other business lines. Full Article

Study: Infection Control Lapses Likely to Blame for Record-

Setting SNF Hepatitis C Outbreak A 2013 hepatitis C outbreak at a North Dakota nursing home that made headlines as one of the largest outbreaks in U.S. history was likely due to “infection control lapses,” researchers reported last week. In a study published online in the American Journal of Infection Control, investigators with the Centers for Disease Control and Prevention found through epidemiologic and molecular data analysis that the virus was likely spread patient to patient in “facility A” — the ManorCare Health Services-Minot in Minot, ND, where more than 40 residents were infected. Full Article

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State News

CDS Reporting Requirements Missouri Medicaid Audit and Compliance (MMAC) wishes to remind Consumer Directed Services (CDS) providers about reporting requirements. Please visit the MMAC website at mmac.mo.gov to review the "From the Director" post dated February 23, 2016. CDS providers are required to file quarterly service and financial reports, annual service reports, and annual financial audits. CDS providers who fail to submit these reports may face sanctions, so providers are encouraged to contact MMAC at MMAC.IHSCONTRACTS@dss.mo.gov with any questions.

Technology

Online Social Interactions Linked to Longevity The results of a newly published study of 12 million Facebook users suggests that using the social network is associated with living longer, but there's a catch: the benefit appears to come when using Facebook serves to maintain and enhance someone's real-world social ties. “Interacting online seems to be healthy when the online activity is moderate and complements interactions offline,” said William Hobbs, Ph.D., the first author of the study, which is published in the Proceedings of the National Academy of Sciences. He worked on the study as a doctoral student in political science at the University of California, San Diego, and is now a postdoctoral fellow at Northeastern University. “It is only on the extreme end, spending a lot of time online with little evidence of being connected to people otherwise, that we see a negative association,” he added Full Article

Career Center There are several new job opportunities posted in our Career Center. Please stop by to check them out. If you have a position you would like us to post send it to nanciemcanaugh@leadingagemissouri.org . Click here for openings

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