Planning for a large renovation project can be a daunting task. This Direct Supply webinar recording highlights the importance of renovation planning and detail the elements of a successful upgrade. Attendees will understand the purpose of one's investment, the foundations of a successful project, and the importance of visibility and communication.
Watch the webinar.
This article was reprinted with permission from Direct Supply.
What:
On July 25, 2016, the Centers for Medicare and Medicaid Services (CMS) proposed 3 new models that continue the trend of episodic payment demonstrations for Medicare reimbursement. The 3 models are 2 new cardiac conditions, heart attack and bypass surgery, and expand the previously established hip and knee joint replacement by adding hip and femur fracture surgeries to the Comprehensive Care for Joint Replacement (CCJR) Model. The full text of the proposed rule is online.
This is an attempt by CMS to continue to move payment from quantity to quality by creating financial incentives for hospitals to deliver better care at a lower cost. The idea being these models reward hospitals that work together with physicians and other providers, including our post-acute care members, to avoid complications, prevent hospital readmissions, and speed recovery.
When:
The new models would begin in July 2017 and run for 5 years with the amount of potential savings and losses increasing over the period. Also, the target pricing would be based on a blend of hospital specific and regional performance with the emphasis on regional performance growing over time.
Where:
The cardiac bundles will be implemented in 98 randomly selected metropolitan statistical areas (MSAs). The hip/femur fracture model will be implemented in the existing 67 MSAs required in the CCJR model. Of particular note, rural counties are excluded from the models. In addition, CMS proposes to limit financial risk for the remaining rural hospitals that are located in participating MSAs, such as sole community hospitals, Medicare-dependent hospitals, and rural referral centers. Specifically, these hospitals’ total losses are limited to 3% for the 2nd through 4th quarters of 2018 and 5% for 2019 through 2021.
How:
Each year, CMS would set target prices for different episodes based on historical data on total costs related to the episode for Medicare fee-for-service beneficiaries admitted for heart attacks, bypass surgery, or surgical hip/femur fracture treatment, beginning with the hospitalization and extending 90 days following discharge. Target prices would be adjusted based on the complexity of treating a heart attack or providing bypass surgery.
For example, CMS proposes to adjust prices upwards for those heart attack patients who need to be transferred to a different hospital during their care to reflect the most resource-intensive cardiac care provided during the hospitalization. For heart attack patients, target prices would also differ depending on whether the patient was treated with surgery or medical management.
Under the proposed bundled payment models, hospitals that delivered higher-quality care would be eligible to be paid a higher amount of savings than those with lower quality performance. Specifically, an individual hospital’s quality-adjusted target price would be based on a 1.5% to 3% discount rate relative to historical spending, with the lowest discount percentage for those hospitals providing the highest-quality care. Payments would be based on a quality-first principle: only hospitals meeting quality standards would be paid the savings from providing care for less than the quality-adjusted target price.
Why:
While once again, post-acute and long-term services and supports providers are not in a position to lead the participation in the demonstration, nonetheless CMS is proposing to allow hospital participants to enter into financial arrangements with other types of providers (for example, skilled nursing facilities and physicians), as well as with Medicare Shared Savings Program Accountable Care Organizations (ACOs). Those arrangements would allow hospital participants to share reconciliation payments, internal cost savings, and the responsibility for repayment to Medicare with other providers and entities that choose to enter into these arrangements, subject to the limitations outlined in the proposed rule.
For purposes of this rule, the existing CCJR MSAs will be impacted by the addition of the hip/femur fracture model. It is proposed that the 98 MSAs required to participate in the cardiac bundles be randomly selected from the possible list of included MSAs listed in the proposed rule. This proposed rule might foreshadow future bundling rules to be promulgated before the end of the current administration. The proposed rule indicates that CMS plans to build on its Bundled Payments for Care Improvement (BPCI) Initiative. This includes a new voluntary bundled payment program that would begin in 2018, and could also potentially qualify as an Advanced APM under MACRA.
All post-acute and long-term services and supports members that deal with Medicare have the potential to be impacted either directly by being included in a selected MSA or through the growth of commercial or other public bundled payment models.
CMS is taking feedback on the proposals for 60 days, until Sept. 24.
LeadingAge will be preparing comments on the proposed rule and asks for your input to be sent to Aaron Tripp, director of long-term care policy and analytics.
Join BKD for a discussion on the newly mandated Payroll-Based Journal (PBJ) system, which will take effect July 1, 2016. This session will cover compliance for skilled nursing facilities (SNF) and provide guidance on managing common program pain points and categorizing direct care staff into the appropriate job title code to capture “double-hatters.”
Learning Objectives
Upon completion of this webinar, participants will be able to:
Increasingly, senior living executives leverage their dining programs to address a range of strategic priorities. Without a clear strategy, many of these efforts will fall short of their goals.
The process for developing a dining strategy is complex. That is why Unidine developed the Dining Strategy Toolkit. The Toolkit represents a completely different way of looking at dining services, and will help you to:
The toolkit includes a Dining Strategy Executive Brief, a Dining Strategy Webinar and the Lead with Dining eBook.
Dining Strategy Information Session
Unidine’s approach begins with a free information session in which we explain the methodology used to develop a dining strategy roadmap. If you decide to move forward, we lead a strategy session based on our proprietary Dining Strategy Roadmap Workbook and Action Plan Worksheet.
You receive a customized report that summarizes your strategic priorities and maps your route to success.
Complete the form to access the toolkit.
This Fresh Food Toolkit from Unidine for senior living and long-term care communities will help you develop your vision for dining services. You will get a better understanding of your current dining program and learn how to leverage its strategic potential to boost occupancy rates and improve clinical outcomes.
The toolkit includes:
Complete the form for access to these useful resources.
This eBook is part of an executive series that details the Lead With Dining model and how it can help your organization meet and exceed its strategic objectives.
Trinity Senior Living Communities (TSLC) collaborated with Unidine to design an occupancy strategy around its dining program. Called Lead With Dining, occupancy in the TSLC’s assisted living segment increased from 85% to over 92%, and occupancy in its memory care segment jumped from 88% to 98%. Through an integrated approach, TSLC was able to:
Complete the form for access to these useful resources.
This article was reprinted with permission from Unidine.
LeadingAge and OnShift Partner for Payroll-Based Journal Reporting
OnShift’s Software and Resources Available to LeadingAge Members to Meet New Reporting Requirements
July 5, 2016, CLEVELAND — OnShift, a leader in human capital management software for post-acute care and senior living, and LeadingAge, an association of nonprofit aging services providers, today announced a partnership to help LeadingAge members meet the Payroll-Based Journal (PBJ) reporting government mandate. As part of the agreement, OnShift is offering its Payroll-Based Journal Reporting software through an exclusive special discount program to LeadingAge members.
“LeadingAge members voiced their concerns to us about managing the complex PBJ process, and we listened. We found a cost-effective, efficient solution: OnShift Payroll-Based Journal Reporting software,” said Katie Smith Sloan, president and CEO of LeadingAge. “We are excited to work with OnShift to offer this product to our members so they can continue to deliver quality care to the millions of older adults they serve every day.”
“Many providers are struggling with the new PBJ reporting requirements, lacking the processes, resources, and systems necessary to accurately report their staffing information,” stated Mark Woodka, CEO of OnShift. “We are thrilled to partner with LeadingAge to offer their members our easy-to-use software and educational resources, so they can overcome PBJ reporting complexities and successfully submit their staffing data to CMS.”
OnShift Payroll-Based Journal Reporting software helps skilled nursing providers meet CMS’ staffing reporting requirements in three easy steps. OnShift’s PBJ software collects staffing information, including agency and contractor hours; provides a centralized view into staffing information so it can be easily reviewed and edited prior to submission; and delivers a submission-ready report that can be easily uploaded to CMS’ Payroll-Based Journal system.
LeadingAge members: visit this page to learn more about how the program can help http://www.leadingage.org/OnShift_PBJ_Software.aspx
About Payroll-Based Journal Reporting
In accordance with Section 6106 of the Affordable Care Act (ACA) all skilled nursing facilities are required to collect and electronically submit direct care staffing information electronically starting July 1, 2016. To facilitate the reporting process, CMS has developed the Payroll-Based Journal system. This system is to be used by providers to submit total direct care hours worked, including agency and contract staff, employee hire and termination date, and facility census.
About OnShift, Inc.
OnShift delivers cloud-based human capital management software and proactive services to solve everyday workforce challenges in healthcare. Our suite of products for hiring, scheduling and workforce analysis drives quality care, lower costs and higher performance by empowering providers to staff consistently and efficiently. Intuitive design, predictive analytics and customer success management are why thousands of post-acute care and senior living organizations rely on OnShift. For more information, visit www.onshift.com.
About LeadingAge
The mission of LeadingAge is to expand the world of possibilities for aging. Our 6,000+ members and partners include not-for-profit organizations representing the entire field of aging services, 39 state associations, hundreds of businesses, consumer groups, foundations and research centers. LeadingAge is also a part of the International Association of Homes and Services for the Aging (IAHSA), whose membership spans 30 countries. LeadingAge is a 501(c)(3) tax-exempt charitable organization focused on education, advocacy and applied research.
Contact
Marti Bowman
VP Marketing
OnShift, Inc.
216-920-5038
Amanda Marr
VP Communications
LeadingAge
202-508-1219
The mandatory Payroll-Based Journal (PBJ) reporting requirement to collect and electronically submit direct care hours starts July 1, 2016 – making daily staffing strategies critical to your success.
Watch this on-demand webinar to learn the ins and outs of the PBJ requirements and walk away with staffing best practices to collect, review and submit the required information to CMS.
You will learn how to:
• Gain an in-depth understanding of the new PBJ requirements
• Find out what hours to count and what not to count
• Learn staffing best practices you should implement today to get ready
This article was reprinted with permission from OnShift.
While the Centers for Medicare & Medicaid Services (CMS) have provided an updated manual (Version 2.1) for implementing their payroll-based journal (PBJ) ruling, nursing facilities have questions on certain situations that were given minimal guidance. For instance, specific PBJ reporting programs for time and attendance and payroll systems have not yet been fully developed to properly create the files needed to upload to the CMS PBJ entry tool. Similarly, therapy and other outsourced care providers have struggled to create tools that will automate the proper reporting of their time to their nursing customers. These situations have left nursing facilities uncomfortable about meeting the PBJ requirements by July 1, 2016, according to CliftonLarsonAllen.
Reporting software is a common hurdle for many providers. Some facilities have received PBJ file creation programs from their time and attendance systems that have allowed them to successfully submit a practice submission for employee hours. A handful of third-party software providers have also tried to meet the market need with innovative programs that can accept a multitude of file formats from timekeeping systems for both employees and contracted care providers. A few of these programs can even calculate the proper time split between calendar days for those who work over a midnight cutoff. While there are some signs of progress, most nursing facilities still have work to do.
PBJ implementation requires planning and executing a fairly long to-do list that will include tasks such as:
As nursing facilities move forward, several key concerns can be closely monitored by asking the following questions:
Nursing facilities need to ensure that all of the components required by PBJ are addressed, and this requires consistent project management. If you are struggling with some of the questions above, CLA can help you understand your options, including how to outsource the reporting process. We provide PBJ readiness assessments and recommendations that can help organizations prepare for the PBJ data collection and submission process.
CLA professionals can help you:
The PBJ requirements will require the time and attention of nursing facility leadership. The deadline is approaching fast.
Learn how to prepare for the PBJ requirements. Watch CliftonLarsonAllen’s webinar
Carl Moellenkamp, Director, Health Care, carl.moellenkamp@CLAconnect.com or 630-954-8112
This article was reprinted with permission from CliftonLarsonAllen.
A common challenge facing senior living executives, as well as corporate management in all industries, is in the recruitment and retention of quality employees. In addition to these challenges, another source of great concern is ensuring that current employees remain motivated and engaged in their roles.
In keeping with this, Sodexo has identified nine key Quality of Life trends that are impacting today's workforce in its 2016 Workplace Trends report. The annual report provides details on trends, including everything from healthy lifestyle initiatives in the workplace, to office layout designs for facilitating teamwork and communication. Specifically, as it relates to Senior Living, two Quality of Life trends that are of particular interest include:
