HERE - Georgia Health Care Association

Joanne Grubbs, RN
VP of Quality Advancement
& Regulatory Affairs
2014 Fall Council Meeting
www.gainsurance.org
Click on Fire Marshal
 Under “Our Sections” – scroll to
Rules/Regulations
 Rules/Regulations – 120-3-3
State Minimum Fire Safety Standards
1-30-2014

www.mmis.georgia.gov



Click on Provider Information
Scroll to Policies/Procedures for
Medicaid Part I – 7/1/14
Nursing Facility – Part II Oct 14
www.dch.ga.gov
 Click on Division & Office
 Click on Healthcare Facility
Regulations
 Click on HFR Laws & Regulations (left
side of the page)

Scroll to Nursing Home Chapters 1118-56 and click
http://rules.sos.state.ga.us/cgi-bin/page.cgi?d=1
Scroll to Georgia Department of
Community Health Chapter 111
 Healthcare Facility Regulations
 Nursing Homes – Chapter 111-8-56

Timeline
 Monday, October 27th – Mail Sealed
Survey to my Innerview
 Friday, October 31 – My Innerview’s
due date for accepting surveys
 Friday, November 7 – Reports
published on-line by end of business
day
 Daily – view comments
www.nationalresearch.com/myinnerview
Expand & Strengthen Five Star Quality
Rating System Beginning 2015:
 Nationwide focused survey inspections;
 Payroll-based staffing reporting;
 Additional quality measures;
 Timely & complete inspection data; and
 Improved scoring methodology.
Intent to Apply Deadline for Bronze,
Silver and Gold Applicants:
November 13, 2014 (all deadlines are at
8:00pm EST)
$75.00 Fee

Bronze – Commitment to Quality: Deadline

Silver – Achievements in Quality: Deadline

Gold – Excellence in Quality: Deadline
January 29, 2015
February 12, 2015
February 12, 2015
***Bronze, Silver & Gold applications are accepted
online – December 1, 2014
***To learn more and apply for the 2015 AHCA/NCAL
National Quality Award Program visit ga.ahcancal.org

http://www.cdc.gov/vhf/ebola/hcp/
Fall Council Tour
Reimbursement
Update
2014
News / Changes
The

good news!!
DCH info / deadlines
 12/1/14
 DCH
Revalidation process – 60 days to complete
 12/4/14
Center

ICD-10
have to bill online
Medicaid Fair at Macon Marriott City
PASRR

Payment edits are turned off now

Workgroup’s task

Prepare for them

Codes
 3001
– research, then call 1-800-766-4456,
option 5
 3011
 3058
- 1-877-523-4978 ext. 8104104 or fax to
1-866-550-8741 to get level 2
Medicaid Eligibility




Changes effective October 1 for ABD
Customers, providers and authorized
representatives are contacted via phone to
expedite the interview
Designated group of workers with ABD expertise
Also policy experts who will
Review cases
 Attempt to contact provider before denying


Geographically based Customer Service Unit
Respond to ABD questions
 Conduct appointment changes
 Grant extensions on verification, if needed


[email protected]
ACA - 1

Shifting employees to the exchanges

Can employers help their employees pay for
their insurance on the Exchanges with a “taxfree” contribution?

No! The IRS considers these “arrangements”
and NOT in compliance with the ACA!!

$100/day excise tax per employee

Taxable implications for eligible employees
that receive these cash contributions
ACA - 2

Workers eligible for COBRA continuation
coverage when leaving a job, may choose to
instead purchase coverage through the Health
Insurance Marketplace.

Required model
notification
forms
for
employee
 http://www.dol.gov/ebsa/modelgeneralnotice.doc
 http://www.dol.gov/ebsa/modelelectionnotice.doc

You MUST be using these forms for employee
notification
ACA - 3

If you have an October, November or
December plan year for health insurance,
your penalties will kick in 4th quarter of
2014.

If you have an ERISA plan date of January 1
but health care plan date later in the year,
penalties kick in January 1.
ACA - 4
Questions??
Emergency
Preparedness
Tiffany Hanshaw, MPH
Emergency Preparedness Coordinator
Georgia Health Care Association
2013-2015 Strategic Goals

Conduct relevant Emergency Preparedness education

Educate facilities on Regional Healthcare Coalition and
Regional Exercise meeting dates

Develop and educate SNFs on an emergency plan
specific to Tornado with exercise tools

Develop and educate SNFs on an emergency plan
specific to Active Shooter with exercise tools

Increase utilization of GHA911.org by nursing facilities
statewide from 80% to 90%

Educate all nursing facilities statewide on Twenty First
Century Communications (TFCC) when available
Accomplishments

Evacuation Plan Guide-finalized and presented at the
Summer Convention

Tornado Plan and Exercise component templatesfinalized and will be presented at the GHCA Winter
Convention

Nursing Home Generator Grant-113 nursing homes
received a grant up to $12,000 to purchase and/or
install a generator in their facility

Emergency Management Guide Book Grant-provides a
ready reference go-to source for critical information
during emergencies situations that could affect a
facility
GHA911.org Weekly Drills
Northwest Council
Brian Center Health & Rehab-Canton
Calhoun Health Care Center, Inc.
Canton Nursing Center
Cartersville Heights Care And Rehabilitation
Cedar Springs Health & Rehabilitation LLC
Cedar Valley Nursing & Rehab Center
Chatsworth Health Care Center
Chulio Hills Health & Rehab
Dade Health & Rehab
Etowah Landing Care And Rehabilitation Cente
Evergreen Health & Rehabilitation Center
Fifth Avenue Health Care & Rehab
Gilmer Nursing Home
Golden LivingCenter - Rome
Gordon Health And Rehabilitation
Grandview Health Care Center
Hutcheson Medical Center Sub Acute Care
Maple Ridge Health Care Center
NHC Healthcare, Rossville
9/10/2014
10/15/2014
10/15/2014
10/15/2014
10/1/2014
10/15/2014
10/8/2014
10/15/2014
10/8/2014
9/24/2014
10/15/2014
10/15/2014
8/6/2014
10/15/2014
10/15/2014
10/15/2014
8/18/2014
N/A
N/A
GHA911.org Weekly Drills
Northwest Council
NHC HealthcareFt. Oglethorpe
Oakview Health And Rehabilitation
Parkside at Hutcheson
PruittHealth - Blue Ridge
PruittHealth - Fort Oglethorpe
PruittHealth - Jasper
PruittHealth - LaFayette
PruittHealth - Rome
PruittHealth - Shepherd Hills
Quinton Memorial Health & Rehabilitation
Regency Park Health Care Center
Ridgewood Manor Health and Rehabilitation
Rockmart Nursing & Rehab Center
Townsend Park Health and Rehabilitation
Wellstar Paulding Nursing Center
Wildwood Health Care
Winthrop Health And Rehabilitation
Wood Dale Health And Rehabilitation
Woodstock Nursing & Rehab Center
10/15/2014
8/27/2014
10/15/2014
4/2/2014
10/1/2014
10/15/2014
10/15/2014
9/24/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
10/1/2014
10/15/2014
9/17/2014
8/6/2014
10/15/2014
10/15/2014
GHA911.org Weekly Drills
Northeast Council
Bell Minor Home
Brown Memorial Convalescent Center
10/15/2014
10/15/2014
Chatuge Regional Nursing Home
10/15/2014
Chestnut Ridge Nursing & Rehab Center
10/15/2014
Comer Health Care Center
Cumming Nursing Center
D. Scott Hudgens for Skilled Nursing
10/1/2014
10/15/2014
9/17/2014
Delmar Gardens of Gwinnett
Friendship Health & Rehab
Gateway Health & Rehab
Gold City Convalescent Center
Gwinnett Extended Care Center
Habersham Home
Hart Care Center
Hartwell Health Care Center
Heardmont Nursing Home Inc.
High Shoals Health & Rehabilitation
8/21/2013
10/15/2014
10/15/2014
8/20/2014
10/15/2014
10/15/2014
10/15/2014
10/9/2014
10/15/2014
9/24/2014
GHA911.org Weekly Drills
Northeast Council
Hill Haven Nursing Home
Life Care Center Of Gwinnett
Life Care Center of Lawrenceville
10/15/2014
8/21/2013
3/12/2014
Madison Health & Rehab Center
10/15/2014
Morgan Memorial Hospital TCU
Mountain View Health Care
Nancy Hart Nursing Center
New Horizons Lanier Park
New Horizons Limestone
New London Health Center
Northridge Health And Rehab Center
5/22/2013
10/8/2014
8/27/2014
10/15/2014
10/8/2014
10/8/2014
9/10/2014
Park Place Nursing Facility
PruittHealth - Athens Heritage
PruittHealth - Forsyth
PruittHealth - Grandview
PruittHealth - Lanier
PruittHealth - Lilburn
N/A
5/15/2014
10/15/2014
9/24/2014
10/15/2014
8/27/2013
GHA911.org Weekly Drills
Northeast Council
PruittHealth - Monroe
PruittHealth - Spring Valley
PruittHealth - Toccoa
Quiet Oaks Health Care Center
Sceptor Health and Rehab
Social Circle Nursing & Rehab Center
6/25/2014
8/27/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
The Oaks - Athens
The Oaks - Limestone
The Oaks - Scenic View
Union County Nursing Home
10/15/2014
10/8/2014
10/15/2014
10/15/2014
University Nursing and Rehabilitation Center
Walton Regional Nursing Home
8/6/2014
N/A
Willowbrooke Court At Lanier Village Estates
10/16/2014
Willowwood Nursing Center
Winder Health Care & Rehab Center
10/15/2014
10/15/2014
GHA911.org Weekly Drills
East Central Council
Amara Healthcare & Rehab
Azalea Health and Rehabiltiation
Boswell-parker Health and Rehabilitation
10/14/2014
10/15/2014
10/15/2014
Brandon Wilde Pavilion
Brentwood Health And Rehabilitation
Browns Health & Rehab Center
Eagle Health & Rehabilitation
Emanuel Medical Center Nursing Home
10/8/2014
10/1/2014
9/3/2014
10/15/2014
10/15/2014
Georgia War Veterans Nursing Home
Gibson Health & Rehabilitation
Golden Livingcenter - Augusta
Golden LivingCenter - Windermere
Greene Point Health and Rehabilitation
Heritage Inn Health & Rehabilitation
10/15/2014
10/1/2014
10/1/2014
N/A
9/17/2014
8/13/2014
GHA911.org Weekly Drills
East Central Council
Heritage Inn of Sandersville Health & Rehabi
Kentwood
Keysville Nursing Home & Rehab Center
10/8/2014
10/15/2014
10/8/2014
Lake Crossing Health Center
9/24/2014
Oconee Health and Rehabilitation
10/1/2014
Orchard Health And Rehabilitation
8/7/2014
Pleasant View Nursing Center
Providence of Sparta Health and Rehabilitati
10/8/2014
10/16/2014
PruittHealth
PruittHealth
PruittHealth
PruittHealth
PruittHealth
PruittHealth
10/15/2014
10/15/2014
10/8/2014
10/15/2014
11/20/2013
10/2/2014
- Augusta
- Augusta Hills
- Bethany
- Old Capitol
- Swainsboro
- Washington
GHA911.org Weekly Drills
East Central Council
Smith Medical Nursing Center
Sparta Health & Rehabilitation
Stevens Park Health & Rehabilitation Center
Syl-View Health Care Center Inc.
The Place at Deans Bridge
The Place at Martinez, Inc.
Thomson Health And Rehabilitation
Treutlen County Health And Rehabilitation
10/1/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
10/8/2014
10/15/2014
10/8/2014
Twin View Health Care Center
Vero Health and Rehab
Warrenton Health and Rehabilitation
Washington County E.C.F.
Westwood Extended Care
Westwood Nursing Center
10/15/2014
10/1/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
GHA911.org Weekly Drills
Metro Atlanta Council
A. G. Rhodes @ Wesley Woods
A. G. Rhodes Health and Rehab
A. G. Rhodes Home - Cobb
Anderson Mill Health & Rehabilitation Center
Arrowhead Healthcare Center
Autumn Breeze Health Care Center
Bonterra Nursing and Rehab
Briarcliff Haven Healthcare and Rehab Center
Budd Terrace At Wesley Woods
Christian City Convalescent Center
College Park Health Care Center
Crestview Health & Rehab Center
Delmar Gardens Of Smyrna
East Lake Arbor
Fairburn Health Care Center
Fountainview Ctr. for Alzheimers Disease
Fox Glove Court Care and Rehabilitation Cent
Golden LivingCenter - Briarwood
Golden Livingcenter - Decatur
Golden LivingCenter - Glenwood
Golden Livingcenter - Kennestone
10/15/2014
10/1/2014
10/8/2014
10/1/2014
9/30/2014
4/23/2014
7/2/2014
6/11/2014
2/19/2014
10/15/2014
10/14/2014
9/18/2014
5/21/2014
10/8/2014
10/15/2014
9/10/2014
7/16/2014
N/A
10/15/2014
2/26/2014
10/15/2014
GHA911.org Weekly Drills
Metro Atlanta Council
Golden Living Center - Northside
Grace Healthcare of Tucker
Jonesboro Nursing & Rehabilitation
Lake City Nursing & Rehab
Laurel Park
Legacy Nursing and Rehabilitation Center
Lenbrook Square
Manor Care Rehabilitation Center - Decatur
Manor Care Rehabilitation Center - Marietta
Meadowbrook Healthcare
Northeast Atlanta Health & Rehab Center
Nurse Care of Buckhead
Our Lady of Perpetual Help Home
Park Springs Health Center
Powder Springs Nursing and Rehab
Presbyterian Village
PruittHealth - Austell
PruittHealth - Brookhaven
PruittHealth - Covington
PruittHealth - Decatur
PruittHealth - Fairburn
PruittHealth - Marietta
5/9/2013
9/17/2014
5/14/2014
10/15/2014
7/30/2014
8/13/2014
9/24/2014
2/13/2013
N/A
10/15/2014
10/8/2014
10/8/2014
9/27/2014
9/17/2014
10/15/2014
10/15/2014
N/A
10/1/2014
5/21/2014
10/16/2014
10/9/2014
10/15/2014
GHA911.org Weekly Drills
Metro Atlanta Council
PruittHealth - West Atlanta
Reliable Health & Rehab At Lakewood
Riverdale Place Care and Rehabilitation Cent
Riverside Health Care Center
Rockdale Health Care Center
Rosemont At Stone Mountain
Ross Memorial Health Care Center
Roswell Nursing And Rehabilitation Center
Sadie G. Mays Health & Rehab Center
Signature Healthcare of Buckhead
Signature Healthcare of Marietta
Specialty Care of Marietta
St. George Village Retirement Community
Traditions Health and Rehabilitation
Wesley Woods of Newnan - Peachtree City
Westbury Health & Rehab - Conyers
Westbury Health and Rehab Center - McDonough
Westminster Commons
William Breman Jewish Home
9/24/2014
10/8/2014
10/15/2014
10/15/2014
10/8/2014
N/A
10/15/2014
10/8/2014
7/30/2014
N/A
5/7/2014
N/A
N/A
10/15/2014
N/A
10/15/2014
10/15/2014
10/15/2014
10/14/2014
GHA911.org Weekly Drills
West Central Council
Ansley Park Health and Rehabilitation
Avalon Health And Rehabilitation
Azalea Trace Nursing Center
Brightmoor Health Care Inc.
Carrollton Manor, Inc.
Carrollton Nursing & Rehabilitation Center
Countryside Health Center
Douglasville Nursing & Rehabilitation Center
Florence Hand Home
Fountain City Care & Rehabilitation
Golden Livingcenter - Thomaston
Hamilton House Nursing & Rehab Center
Haralson Nursing & Rehab Center
Heritage Inn of Barnesville Health & Rehabil
Lafayette Nursing & Rehab Center
LaGrange Nursing and Rehab
Magnolia Manor of Columbus - East
Magnolia Manor of Columbus - West
Magnolia Manor Of Marion County
Miona Geriatric & Dementia Center
Molena Health & Rehab
10/15/2014
10/1/2014
10/15/2014
10/15/2014
N/A
8/4/2014
7/9/2014
10/15/2014
10/8/2014
5/15/2014
5/21/2014
10/15/2014
10/15/2014
10/8/2014
N/A
8/13/2014
10/8/2014
10/8/2014
10/15/2014
N/A
10/8/2014
GHA911.org Weekly Drills
West Central Council
Montezuma Health & Rehabilitation
Muscogee Manor & Rehabilitation Center
Newnan Hospital Nursing & Rehabilitation Ctr
Oak View Home
Pine Knoll Nursing & Rehab Center
Providence Health & Rehab Center, Inc.
PruittHealth - Franklin
PruittHealth - Greenville
PruittHealth - Griffin
Renaissance Care & Rehab Ctr
Riverside Health and Rehabilitation
Roberta Healthcare Center
Southern Traditions
Southland Health and Rehabilitation
Spring Harbor at Green Island
Taylor County Health and Rehabilitation
The Oaks - Carrollton
The Oaks Nursing Home Inc.
Twin Fountains Home
Warm Springs Medical Center Nursing Home
Westbury Medical Care Home, Inc.
2/5/2014
10/15/2014
10/15/2014
8/6/2014
10/15/2014
N/A
10/15/2014
10/8/2014
10/8/2014
10/1/2014
10/15/2014
4/3/2013
10/8/2014
3/26/2014
10/15/2014
10/15/2014
10/1/2014
10/1/2014
10/15/2014
10/15/2014
10/15/2014
GHA911.org Weekly Drills
Southwest Council
Abbeville Healthcare & Rehab.
Agape Health and Rehab
Bainbridge Health Care
Berrien Nursing Center, Inc.
Calhoun Nursing Home
Camellia Gardens of Life Care
Cook Senior Living
Cordele Health & Rehabilitation
Crisp Regional Nursing & Rehab Center
Crossview Care Center
Dawson Health and Rehabilitation
Early Memorial Nursing Home
Fort Gaines Healthcare
Four County Health And Rehabilitation
Glenn-Mor Nursing Home
10/15/2014
10/1/2014
9/24/2014
10/8/2014
10/15/2014
10/15/2014
10/15/2014
10/8/2014
10/8/2014
10/15/2014
10/1/2014
8/21/2013
10/8/2014
10/15/2014
10/8/2014
GHA911.org Weekly Drills
Southwest Council
Golden LivingCenter - Thomasville
Golden Livingcenter - Tifton
Joe-Anne Burgin Nursing Home
Lee County Health and Rehabilitation
Life Care Center, Inc.
Lillian G. Carter Health and Rehabilitation
Magnolia Manor Nursing Center
Memorial Manor Nursing Home
Miller Nursing Home
Mitchell Convalescent Center
Palemon Gaskins Memorial Nursing Home
Parkwood Developmental Center, Icf/mr
Pelham Parkway Nursing Home
Pinehill Nursing Center
PineWood Nursing Center
Presbyterian HomeQuitman
PruittHealth - Ashburn
7/23/2014
10/15/2014
10/15/2014
10/8/2014
10/9/2014
10/15/2014
10/15/2014
10/16/2014
2/27/2013
10/15/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
6/23/2014
GHA911.org Weekly Drills
Southwest Council
PruittHealth - Crestwood
PruittHealth - Fitzgerald
PruittHealth - Holly Hill
PruittHealth - Lakehaven
PruittHealth - Magnolia Manor
PruittHealth - Moultrie
PruittHealth - Ocilla
PruittHealth - Palmyra
PruittHealth - Sunrise
PruittHealth - Sylvester
PruittHealth - Valdosta
Rehabilitation Center of South Georgia
Seminole Manor Nursing Home
SGMC-Lakeland Villa
Thomasville Nursing & Rehab Center
Wynfield Park Health And Rehabilitation
10/15/2014
9/15/2014
10/15/2014
10/15/2014
10/15/2014
10/8/2014
10/15/2014
9/17/2014
10/8/2014
2/19/2014
3/5/2014
10/15/2014
10/1/2014
10/15/2014
10/1/2014
10/15/2014
GHA911.org Weekly Drills
Middle Georgia Council
Bolingreen Health And Rehabilitation
Bryant Nursing & Rehabilitation Center
Carlyle Place
Chaplinwood Health & Rehabilitation
Cherry Blossom Health and Rehabilitation
Church Home Rehabilitation and Healthcare
Dublinair Health & Rehabilitation
Eastman Healthcare & Rehab.
Eastview Nursing Center
Eatonton Health and Rehabilitation Center
Elberta Health Care
Fort Valley Healthcare LLC
Georgia War Veterans Home
Goodwill Nursing and Rehab Center
Gray Health and Rehabilitation
Green Acres Health and Rehabilitation
Heart of Georgia Nursing Home
Jeffersonville Health and Rehabilitation
Laurel Baye Healthcare Of Macon
10/15/2014
3/20/2013
10/1/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
5/28/2014
10/15/2014
10/15/2014
10/8/2014
10/8/2014
9/22/2014
10/15/2014
8/27/2014
5/23/2014
10/15/2014
10/15/2014
GHA911.org Weekly Drills
Middle Georgia Council
Lynn Haven Health And Rehabilitation
Medical Management Health & Rehab Center
10/15/2014
10/8/2014
Oconee Reg Med Center - SNU
Peachbelt Health & Rehab Center
Pinewood Manor Nursing Home
Porterfield Health and Rehab
PruittHealth - Macon
PruittHealth - Peake
PruittHealth - Toomsboro
Rosewood Nursing Center, Inc.
Scott Health and Rehabilitation
Shamrock Nursing & Rehab Center
Southland Healthcare and Rehab Center
Summerhill
The Retreat
Warner Robins Rehabilitation Center
Wrightsville Manor Nursing Home
Zebulon Park Health and Rehab
10/1/2014
10/8/2014
7/16/2014
10/1/2014
3/12/2014
10/8/2014
10/8/2014
6/14/2013
10/15/2014
10/15/2014
N/A
10/15/2014
10/15/2014
10/8/2014
10/8/2014
10/8/2014
GHA911.org Weekly Drills
Southeast Council
Abercorn Rehabilitation Center, LLC
Altamaha Healthcare Center
Appling Nursing & Rehab Pavilion
Azalealand Nursing Home
Baptist Village, Inc.
Bayview Nursing and Rehab
Bryan County Health & Rehab
Camellia Health & Rehabilitation
Clinch Healthcare Center
Coastal Manor
Effingham County Extended Care Facility
Folkston Park Care and Rehabilitation Center
9/17/2014
10/15/2014
10/15/2014
10/1/2014
10/15/2014
10/8/2014
10/1/2014
10/15/2014
10/15/2014
8/13/2014
10/15/2014
10/1/2014
Glenvue Health And Rehabilitation
Glenwood Healthcare
Golden LivingCenter - Jesup
10/15/2014
9/3/2014
10/15/2014
GHA911.org Weekly Drills
Southeast Council
Gracemore Nursing & Rehab
Hazlehurst Court Care and Rehabilitation Ctr
10/8/2014
9/3/2014
Jesup Health Care
Lumber City Nursing And Rehabilitation
Magnolia Manor of St. Simons
Marshs Edge
Mcrae Manor
Oceanside Nursing and Rehabilitation Center
Oxley Park Health and Rehabilitation
Pierce County Nursing Home
PruittHealth - Savannah
Riverview Health & Rehab Center
Satilla Care Center
Savannah Beach Nursing & Rehab Center
9/17/2014
1/8/2013
10/8/2014
1/29/2014
10/15/2014
10/15/2014
10/15/2014
10/15/2014
10/8/2014
9/17/2014
10/15/2014
10/15/2014
Savannah Rehabilitation and Nursing Center
2/14/2014
Savannah Square Health Center
9/3/2014
GHA911.org Weekly Drills
Southeast Council
Sears Manor
SGHS Senior Care Center - Brunswick
SGHS Senior Care Center - St. Marys
Shady Acres Health and Rehabilitation
St. Josephs TCU/Candler Hospital
Sub-Acute Unit at Candler Hospital
Tara
Tattnall Healthcare Center
The Oaks - Bethany
The Oaks at the Marshes of Skidaway Island
The Place at Pooler
Twin Oaks Convalescent Center
Waycross Health & Rehabilitation
Westview Nursing & Rehab Center
Woodland Health Care
10/8/2014
10/15/2014
10/15/2014
10/15/2014
N/A
N/A
10/8/2014
10/15/2014
10/8/2014
11/13/2013
9/11/2013
10/15/2014
10/13/2014
10/8/2014
10/15/2014
Allied Membership:
Assisted Living and Personal Care
GHCA is not just SNF anymore
Brittany Todd, Director of Assisted Living
Definition:
Allied Members are any SOURCE organization, long
term facility licensed as an assisted living community,
or a personal care facility with 25 beds or more. A
personal care facility with less than 25 beds is also
eligible provided that any such facility is owned by or
under common ownership with a Regular Member
and meets the requirements of GHCA.
as of January 2014
Current Allied- AL/PCH Members
Andrews Terrace
Bethany Assisted Living, Inc.
Brightmoor Senior Living
Cobblestone at Park Springs
Day Break Village at Kennesaw
Emeritus at Flint River
Hollander Senior Living
John Wesley Villas of Savannah
Jonesboro Assisted Living Center
Magnolia Manor of Columbus
Magnolia Manor of Macon
Magnolia Manor of St Mary
Magnolia Manor of St Simons
Magnolia Manor on the Coast
Magnolia Manor Retirement
Magnolia Manor South
The Mann House
Marsh's Edge
Mattie H Marshall Center
The Oaks - Carrollton Assisted Living
The Oaks - Peake Assisted Living
The Oaks - Scenic View Assisted Living
Parc at Duluth
Scepter Personal Care Center
The Southern Living Center
Sparks Inn Assisted Living
Spring Harbor at Green Island
Stone Brooke Suites
The Suites at Oak View
Summers Landing at Warner Robins
Treutlen Living Center
Veranda East
as of Sept 2014
The Village at Renaissance
What do we have to offer?
Advocacy and Public Policy
Education and Professional
Development
Networking
NCAL and AHCA
Membership
Information and Resources
Media and Public Relations
Recognition and Consumer
Connection
Education
Advanced CALD
Certified Assisted Living Director (CALD)
• Senior Living University certificate course
• Examines role of Executive Director
• Explore clinical areas and programs to
support resident population
• Identifies tools for resident care
management and nurses’ expanding role
• Covers AL and PCH regulations, licensure,
and compliance
• Addresses community and family
relationships, sales/marketing, finance,
etc.
• Designed to provide strong foundation
for existing EDs but also as a
development tool for newer EDs
•
•
•
•
Focuses on leadership
Presented by current GA AL leaders
Offered at January 2015 Convention
Topics: building teams, becoming an
effective leader, handling complaints,
resident service plans, hospice,
avoiding lawsuits, investigations,
workers' compensation, risk
management tools, maximizing dining
dollars, increasing revenue, pitfalls of
marketing and sales, marketing
regulations, and budget analysis.
•
•
•
•
•
•
The Administration, CMS and other federal
agencies frequently seek out NCAL’s opinions
and guidance on proposed laws, regulations and
rules.
NCAL Quality Initiative is designed specifically for
assisted living professionals.
NCAL’s National Patient Safety Organization for
Assisted Living (PSO) allows NCAL members to
collect and benchmark key clinical performance
data that will help providers thrive in the new
post-acute care marketplace
NCAL provides multi-tiered training programs for
your staff that are easily accessible throughout
the year.
The AHCA/NCAL Quality Awards Program
provides an opportunity for communities to
achieve national recognition of their quality
efforts.
Providers use the benefits of their NCAL
membership to increase their competitiveness in
the marketplace and stay ahead of their
competition.
Currently, more than 713,000 Americans live in
more than 22,000 assisted living or residential care
communities across the United States
http://www.ahcancal.org/ncal/Pages/index.aspx
What’s Next for Allied AL/PCH?
Establishing governance
More training
Community tours
Questions?
Brittany Todd
[email protected]
678.902.9225
2014 GHCA Fall Council Tour
Quality Measure Update
Date: October 20-30, 2014
Presented by: Nancy Fendler
Task Lead, Acute & Post-Acute Care
10/30/2014
55
QIO Approach
Goals
Aims
Make care safer
Strengthen person and
family engagement
Foundational principles:
Promote effective communication
and coordination of care
•
Enable innovation
•
Foster learning
organizations
Promote effective prevention
and treatment
•
Eliminate disparities
•
Strengthen infrastructure
and data systems
Promote best practices
for healthy living
Make care affordable
Program structure
Program Collaboration Center
BFCC Oversight &
Review Center
Independent Evaluation Center
Value Incentives and
Quality Reporting Centers
BFCC NCC
O&E Hospital
Inpatient-PsychCancer
O&E ASC and
Outpatient
M&E /Analytics
Validation
Support
BFCC – QIOs
BFCC
QIO
Area 1
KEPRO
BFCC
QIO
Area 2
Livanta
BFCC – Beneficiary and Family Centered Care
O&E – Outreach and Education
QIN NCC
QIN - QIOs
14 QIO AREAS
# and distribution of
awards based on
results of full-andopen competition
Appeals
M&E – Monitoring and Evaluation
QIN – Quality Innovation Network
NCC -- National Coordinating Center
Clinical Focus of 11th SOW Activities
A.1 Excellence in Operations
BETTER HEALTH
BETTER CARE
LOWER COST
B.1 Improve Cardiac
Health and Reduce
Cardiac Healthcare
Disparities
C.1 Reduce HealthcareAssociated Infections in
Hospitals
D.1 Support Quality
Reporting with an
Emphasis on
Improvement
B.2 Reduce Disparities in
Diabetes Care
C.2 Reduce HealthcareAcquired Conditions in
Nursing Homes
E.1 Perform Quality
Improvement Initiatives
as Requested
B.3 Using Immunization
Information Systems to
Improve Prevention
Coordination
C.3 Improve Coordination
of Care
B.4 Collaborate with
Regional Extension
Centers and Promote
Meaningful Use of HIT
C.3 Reduce Adverse Drug
Events
Opportunity to Propose
Projects that Meet
Regional Needs
Reducing Healthcare-Acquired Conditions
in Nursing Homes
Aligned with the Nursing Home
Action Plan:
•Include residents and families in
peer-coaching groups
•Support adoption of QAPI
framework for quality improvement
•Focus on systems issues that affect
quality (e.g., consistent staff
assignment) as well as specific
issues such as increasing mobility
•Reducing avoidable hospitalizations
•Decreasing HAIs
Recruit at least 75% of all
nursing homes for an 18 month
National Nursing Home Quality
Care Collaborative
Special attention to recruiting
“One-Star” homes
Recruit high performing homes
as “Peer-coaches”
Nursing Homes
►
►
►
►
Led by Advisory Board of stakeholders
Recruited 101 NHs to participate in a
collaborative for 18 months
Statewide 26.4% in antipsychotic use
Goal: Composite score <6
– 27 had >20% improvement
– 9 made the goal
– 17 had >40% antipsychotic reduction
►
►
Prevented 117 pressure ulcers
109 fewer restraints used
Improve Coordination of Care
Develop community
coalitions that reach 60% of
beneficiaries in the state
Target recruitment to improve
care for beneficiaries that are:
Do a community
root cause analysis and
build a logic model
to identify appropriate
intervention
•Dual-eligible
•Have multiple chronic
conditions, behavioral health
issues or dementia
•Or impacted by
socioeconomic status
Provide quarterly hospitalspecific readmission reports
to all acute care and critical
access hospitals
Reducing Readmissions
Across Georgia
►
Worked with 12
communities across
the state
►
Statewide readmissions
have fallen 28.94%
►
In Georgia, 7292 fewer
readmissions occurred
in 2013 than in 2010
30-Day Readmission Rates by GA Region: Q413-Q114
25.0%
21.8%
20.3%
20.0%
GOOD
19.6%
19.5%
19.1%
19.0%
18.2%
18.2%
17.7%
15.0%
10.0%
5.0%
0.0%
Middle
Georgia
Northwest
East
Central
West
Central
Northeast Statewide
Metro
Atlanta
Southwest Southeast
Quality Measures
High Risk Pressure Ulcer - GA vs. Nation
Georgia
National
12.0%
% High Risk Pressure Ulcers
11.0%
10.8%
GOOD
10.0%
8.0%
7.6% 7.6%
7.6%
7.0%
6.8%
7.4%
7.4%
6.7%
6.5%
6.0%
4.0%
2.0%
0.0%
Q409
Q410
Q411
Q412
Q413
Q114
High Risk Pressure Ulcer Rates by GA Region: Q413-Q114
10.0%
9.0%
8.82%
GOOD
8.06%
8.0%
8.04%
7.63%
7.50%
7.0%
7.40%
6.63%
6.54%
6.0%
6.27%
6.04%
5.0%
4.0%
3.0%
2.0%
1.0%
0.0%
East Central
Metro
Atlanta
Middle
Georgia
Southwest
West
Central
Statewide Southeast
National
Northeast Northwest
Long-Term Physical Restraints - Georgia vs. Nation
Georgia
National
3.5%
GOOD
3.0%
3.0% 3.0%
2.5%
2.3%
2.1%
2.0%
1.8%
1.7%
1.5%
1.6%
1.3%
1.3%
1.1%
1.1%
1.0%
0.5%
0.0%
Q409
Q410
Q411
Q412
Q413
Q114
Restraint Rates by GA Region: Q413-Q114
2.5%
GOOD
2.0%
1.94%
1.5%
1.36%
1.28%
1.06%
1.0%
1.06%
0.95%
0.94%
0.71%
0.71%
0.64%
0.5%
0.0%
Northeast
Middle
Georgia
West
Central
National
Statewide East Central
Metro
Atlanta
Southwest Northwest Southeast
Falls (Long-Term) Rates by GA Region: Q413-Q114
4.5%
4.17%
3.98%
4.0%
3.86%
3.5%
3.81%
3.76%
GOOD
3.61%
3.58%
3.46%
3.41%
3.0%
2.69%
2.5%
2.0%
1.5%
1.0%
0.5%
0.0%
Northeast
West
Central
Middle
Georgia
Southeast Northwest Southwest Statewide East Central National
Metro
Atlanta
Antipsychotic Rates (Long-Term) by GA Region: Q413-Q114
25.0%
22.64%
22.27%
21.88%
21.63%
20.64%
20.24%
20.0%
GOOD
20.07%
19.86%
18.94%
15.94%
15.0%
10.0%
5.0%
0.0%
Middle
Georgia
Southeast Northwest
East
Central
Southwest
West
Central
Statewide Northeast
National
Metro
Atlanta
Composite Score - Comparing NHs in Georgia to National Average
State
Nation
10
9.8
9.77
9.66
9.58
9.61
9.6
9.44
9.4
9.51
9.5
9.35
9.29
9.33
9.2
9.63
9.56
9.25
9.18
9.22
9.25
9.15
9.2
9.13
9.1
9.07
9
9.00
9
8.91
8.8
8.88
8.86
8.89
8.96
8.89
8.74
8.7
8.6
8.4
8.2
8
Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14
*Each data point is a 6-month rolling average of Composite Scores
Composite Scores by GA Region: Q413-Q114
GOAL is 6.00 or better (lower)
10
9.55
9.5
9.31
9.26
9.15
9.12
9
9.04
9.02
8.70
8.52
8.5
8.19
8
7.5
West
Central
Middle
Georgia
Northeast Southeast
Metro
Atlanta
Statewide Northwest
National
Southwest East Central
Recruitment for
~ SPACE ~
Southern Partners
Action Collaborative for Excellence
Continue working with GMCF’s Quality Advisors
Melody
Brown
Jennifer
Judson
Quality Advisor,
Georgia
Quality Advisor,
Georgia
Southern Partners Action Collaborative
for Excellence
►
►
Collaborative I:
─
Recruitment: October 2014
(NOW!) – March 2015
─
Learning & Action Network:
April 2015 – September 2016
Collaborative II:
─
Recruitment: October 2016 –
March 2017
─
Learning & Action Network:
April 2017 – September 2018
Goals of the Collaborative
Reduction in percentage of long-stay residents who
received ANTIPSYCHOTIC MEDICATIONS
► Percent of long-stay residents with IMPROVED
MOBILITY
► Quality Composite Score of 6.0 OR LESS by January
2019 (with or without vaccines included)
► Peer Coaches serving as Mentors
► Residents involved in Learning & Action Network
(LAN) and Quality Improvement
►
Get Involved
►
This afternoon’s two-hour Quality Education Session
►
Complete the Participation Agreement
─
Fax to GMCF ~ 678-527-3030
─
Email to Nancy Fendler ~ [email protected]
►
Plan to attend the session on the Composite Score
at the January Trade Show
►
Collaborative Begins April 2015!!
Websites to save to favorites!
http://qioprogram.org
http://www.alliantquality.org
Medicare Quality Improvement Organization for Georgia, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health
and Human Services. The contents presented do not necessarily reflect CMS policy. Publication No. 11SOW-GMCFQIN-C2-14-05
Grassroots/PAC
Update
SARAH RALSTON
DIRECTOR OF GRASSROOTS & PAC
2014 General Election
General Election
 General election to be held Tuesday, November 4th
 Several key races are still extremely close, including the
contest for Governor and the U.S. Senate seat
 Complete list of candidates in your packet
 Early voting began Monday, October 13th and ends
Friday, October 31st
 Find all information regarding polling locations, hours,
sample ballots, etc. on the Secretary of State’s ‘GA Votes’
mobile app or the My Voter page
(www.mvp.sos.ga.gov)
Voter Information
Possible Runoffs?
Several key races have more than two candidates, making runoff elections possible
December 2nd
January 6th
State and local races, including Governor
Federal races, including the U.S. Senate
 Winner of election must
receive 50% plus one vote.
 The state of Georgia keeps
separate election
schedules for state and
federal races.
 It is possible to have
runoffs on different days.
Joint Study Committee on Emergency
Relocation of Abused Adults
 Co-chaired by Sen. Unterman and Rep. Benton
 Barbara Baxter, of Woodstock Health & Rehabilitation




Center, serves on this 9-person committee as a
Governor’s appointee
Main goal is to improve the transition of at-risk adults
from substandard personal care homes or residential
facilities to a safer, more secure environment.
First meeting was held on September 2nd in
Lawrenceville and looked at the rise in the number of
unlicensed personal care homes in Georgia.
Next meeting: November TBD
Committee will report its findings/suggestions by
December 31st.
GA Alzheimer’s and Related Dementias
Council
"Our goal is to make Georgia a more dementia-capable state,”
-Dr. James Bulot, chairperson of the council and director of the Georgia Department of
Human Services Division of Aging Services
 The Georgia state plan features 5 recommendation areas:
1) Healthcare, Research, and Data Collection
2) Workforce Development
3) Service Delivery
4) Public Safety
5) Outreach and Partnerships
 Council is comprised of organizations across the state,
including GHCA, and is tasked with collaborating and
developing legislative and budget priorities.
 Council meets quarterly, with smaller workgroups
meeting more frequently.
2015-16 Legislative Priorities
 Budget:

Obtain the current year’s cost report
 Skilled Nursing Facility Liability Reform:
Negligence Per Se
 Voluntary Arbitration Agreements

Liability Reform
 Negligence Per Se:
 Amend the Georgia Evidence Code to prevent the ability to use
federal and state regulations in civil cases against SNFs
 Voluntary Arbitration Agreements:
 Legislation would clearly spell out which family members have
the ability to sign arbitration agreements on behalf of the
resident.
Meetings are being held throughout the fall with
advocates and potential sponsors to author the
legislation in the upcoming legislative session.
Social Media Update
facebook.com/GHCA.info
twitter.com/ghcainfo
Making Progress!
Upcoming Events
• 2014 LONG TERM HEALTH
CARE ACADEMY
&
• GHCA PAC BREAKFAST &
RAFFLE
2014 Long Term Health Care Academy
 Immediately following the November 4th election,
GHCA will be holding its academy for legislators,
DCH board members and key staffers.
 Governor Mark Parkinson will be the keynote
speaker, as well as other leaders within the provider
community.
 The purpose is to educate this important audience on
the long term care profession and the challenges it
faces.
GHCA PAC Breakfast & Raffle
 When: Thursday, January 22nd 7:30- 8:50 am
 Where: Foyer of the Renaissance Waverly
Breakfast ticket: $30
Raffle tickets: $25/each
and includes a complimentary
bloody mary or mimosa!
Lanyards: $20/each
Questions?
CONTACT SARAH RALSTON
678-783-1704
[email protected]
Association Update
96
Fall Council Tour 2014
Jon S. Howell, LNHA
President & CEO
97
98
You might be getting older if…
99
FY2015 State Budget Status
• Governor’s FY2015 budget included $40.7M total funds to
update to the 2012 cost reports and fair rental value system.
The state plan amendment was approved by CMS on Sept 25
and new rates are in effect. Retro mass adjustment still
pending.
• SOURCE case managers’ 5% rate increase still pending due
to the Elderly & Disabled Waiver process and Home &
Community Based Transition Plan.
• Nursing home change of ownership language will likely to
be taken up in the supplemental budget writing process.
Authorization language present, but funds were not
appropriated in the general budget.
10
0
Major Stakes Involved in the
Midterm Elections
101
2014 Senate Election Forecast
Source: Washington Post: Election Lab
Senate Seats Projected to Flip Parties
Source: Washington Post: Election Lab
102
103
Georgia – U.S. Senate Race
*According to Washington Post:
Election Lab, GA has a 67% chance of
remaining with the GOP
2014 House Election Forecast
104
Source: Washington Post: Election Lab
House Seats Projected to Flip Parties
Source: Washington Post: Election Lab
105
106
Gubernatorial Race
107
POLL CHART
2014 Georgia Governor: Deal vs. Carter

108
Policy Updates
109
Status of the Medical Coordination
Program for ABD
 DCH’s original request for a proposal (RFP) has been
receded due to cost containment difference between
the department’s expectation and potential contractors’
ability to provide savings.
 New RFP forthcoming, a renewed timeline for
implementation has not been established.
11
0
Medicaid Managed Care
2011 – 11 states
2014 – 27 states
111
Medicare Advantage Penetration Rates
MA Penetration Rate
Source: AHCA analysis of CMS enrollment files
112
% Change in MA Penetration
Increase 2 ppt +
Increase 1 ppt – 1.9 ppt
Increase 0.01-0.9 ppt
Decrease
No Change
Source: AHCA analysis of CMS enrollment files
113
Looking Ahead
 Preparing for the November election outcomes
 New deadlines
 GA General Assembly Session – Jan 2015
SGR / Doc Fix – April 1, 2015
National Debt Ceiling – Spring 2015
 Federal Budget – October 1, 2015
 CMS actions through the rule
 Changing payment models – both Medicare and
Medicaid
114
Our Proactive Plan
 Offering policy solutions
Regular meetings with DCH/CMS
Therapy meetings with CMS leadership
 Developing payment model solutions
Payment Reform Task Force (State & Federal)
 Significant Advocacy Campaign
Political and Lobbying Efforts
Media Campaign
Media Campaign Example
115
116
SNF Rehospitalization Linked to
Reimbursement
 Protecting Access to Medicare Act of 2014 (Sustainable Growth Rate/Doc Fix)
 Skilled Nursing Facility Value-Based Purchasing
 Measure specified 10/01/16 (all-cause all-condition, risk-adjusted
potentially preventable hospital readmission)
 10/01/16 Quarterly Feedback Reports Regarding Outcomes
 10/01/17 Public Reporting of Measure
 10/01/18 SNF VBP Applies to Payment (FY ‘19)
 Uses a Withhold Approach
 2% “Mathematical” Withhold Creates Incentive Pool
 Incentive payments is greater than or equal to 50% and no greater than
70% of the withhold
117
•
SNF Rehospitalization Linked to Payment
Incentive Pool is “Returned” to Facilities Based on their Ranked
Rehospitalization Performance Score
Performance score is based on rehospitalization rate OR degree of
improvement from prior year(s)
Highest Ranking Receive Highest VBP Incentive (top
performers receive most of their withhold and possibly more)
SNF Lowest Ranking Receive Lowest VBP Incentive
Lowest 40% Ranking Payment Rate Less than Rates for other
SNFs (potential payment penalty)
•
First adjustment to a SNF’s market basket will be in Oct 2018 (FY 19)
but likely will be based on performance from Oct 2016 to Oct 2017
118
“Some is not a number. Soon is not a
time.” – Dr. Donald Berwick
Safely reduce 30-day hospital readmissions by 15% by March 2015
Reduce clinical staff turnover by 15% by March 2015
NCAL: Maintain nursing staff turnover below 30%
Increase customer satisfaction to 90% by March 2015
Safely reduce the off-label use of antipsychotics by 15% by the
end of 2013
119
Improving Lives by Delivering Solutions
for Quality Care
120
Questions?
[email protected]