Aug. 7, 2019

Featured News

DHS Seeks Public Comments on Third Set of HCBS Setting Evidentiary Packages

On August 6, 2019 by Bobbie Guidry

The Minnesota Department of Human Services (DHS) has posted for public comment the third round of evidentiary packages for Home and Community Based Services (HCBS) settings. This batch includes settings that have been identified as Prong 3 and includes Adult Day, Customized Living and Foster Care providers.  

Prong 3 settings are those that have the effect of isolating people who receive Medicaid HCBS from the broader community of people who do not receive Medicaid HCBS.  

An evidentiary package must be written for each setting DHS believes to be an HCBS setting. Evidentiary packages focus on the criteria Minnesota has determined would overcome the presumption of isolation. These criteria emphasize how people are engaged and integrated in the broader community.

The public comment period is Aug. 5 – Sept. 4. You may submit comments about any of the evidentiary packages by:

1. Reviewing the list of settings available for public comment on the HCBS settings heightened-scrutiny process page under the Public comment tab.
2. Completing the public comments on HCBS rule setting-specific evidentiary packages survey.

Settings need to meet the HCBS Standards established by CMS in order to maintain eligibility as a provider of HCBS waiver services. As part of the public comment process, providers in the group must:

• Print a copy of your setting’s Evidentiary Package and e-list announcement
• Post it in a prominent location in the setting where people receive services
• Notify each person that it is available for their review and comment and provide instructions on how to provide feedback – this can be done via newsletter, notice, or direct contact, with sensitivity to the needs and ability of the individual.

List of Candidates for “Special Focus Facility” Status is Now Public

On August 6, 2019 by Jonathan Lips

At the request of the U.S. Senate Special Committee on Aging, the Centers for Medicare & Medicaid Services (CMS) is now publishing a list of nursing homes in each state that are candidates for “Special Focus Facility” (SFF) status. For many years CMS has published a list of facilities that currently hold SFF designation, and that monthly publication now includes the names of facilities at risk of being designated.  

Our review of the July 24, 2019 update shows that no LeadingAge Minnesota member facility is currently a candidate for SFF status, but it is important to know that CMS updates the list each month.

CMS Administrator Seema Verma explained the methodology for identifying SFF candidates in a May 2019 letter to U.S. Senator Bob Casey of Pennsylvania. In short, it’s the same methodology used in the health inspection domain of the Five-Star Quality Rating System. The results of each facility's surveys for three cycles of inspection are converted into points, and the facilities with the most points become candidates for the SFF program. Because SFF candidacy is based on survey outcomes, the list of candidates changes monthly.

Each month in Minnesota there will be two facilities that are designated as SFF and ten candidates for designation.  When one of the two existing SFFs makes enough improvement to graduate off the list (or is de-certified because the facility fails to improve after a period of time), the Minnesota Department of Health will then designate one of the ten candidates as a new SFF.

CMS will post the monthly list of SFFs and candidates on its certification and compliance page.  For additional information about the selection of SFFs and the progressive enforcement implemented by the program, see Survey & Certification Memo S&C: 17-20-NH.

Recognition Challenge: Make Zero Harm Possible

On August 6, 2019 by Jodi Boyne

Recognition is the greatest motivator! We are launching a Recognition Challenge as part of our Safe Care for Seniors program. Between now and Sept. 15, we challenge you to nominate individuals and/or staff teams in your setting for a Make Zero Harm Possible award. 

The Make Zero Harm Possible award recognizes those who are honoring their commitment to the Safe Care for Seniors Pledge:

Respect & Dignity: Individuals or teams who go above and beyond in getting to know a resident as a person, such as finding new ways to get to know their history and likes and dislikes or engaging them in activities that they truly enjoy.

Prevent Harm: Individuals or teams from their organizations who spoke up to prevent a potential safety event, such as a situation that may put a resident at risk of a medication error or being persistent in getting care for a resident who has had a change in condition that has not been resolved. 

TAKE THE CHALLENGE TODAY!

To nominate someone or a staff team, complete the Make Zero Harm Possible nomination form.

Questions? Contact Julie Apold at japold@leadingagemn.org

State News

MDH Releases New Bulletin on Assisted Living and Home Care Protections

On August 6, 2019 by Bobbie Guidry

The Minnesota Department of Health (MDH) has issued Information Bulletin 19-03 informing the public about the home care and assisted living protections strengthened by the Minnesota Legislature as part of the Elder Care and Vulnernable Adult Protection Act of 2019. 

As previously reported in Advantage, the new changes include increased fine amounts for violations, new fines established for maltreatment violations under the Minnesota Vulnerable Adults Act, immediate imposition of fines, and a new Maltreatment Compensation Fund for clients subjected to maltreatment. 

Also communicated in the bulletin is the department’s intention to prioritize investigation of complaints relating to service terminations in assisted living settings through July 31, 2021.

HCBS Educational Scholarship for 2020 Now Open

On August 6, 2019 by Jenna Kellerman

The Minnesota Department of Health is soliciting grant proposals from providers of adult day care, home care, and housing with services to provide educational scholarships for their employees. Find the HCBS Program detail, application, and forms here.  

Due in part to our advocacy during the 2017 legislative session for additional funding for this program, there is approximately $1,450,000 available to distribute. The estimated award range is $15,000 - $100,000.

Grants will run for 24 months, starting on Jan. 2, 2020 and ending Dec. 31, 2021. Applications are due by Friday, Sept. 27.

If you are interested in educational resources that qualify for these funds, review this suggested resource list. Please know that this list is not exhaustive, and other programs may be eligible. Education that has received funding in the past includes:

• Nursing school
• Nursing Assistant Training
• Trained Medication Aide Training
• Dementia care training (beyond requirements)
• Dietary management
• Activity professional certification
• Social work degree
• Conference and professional development opportunities
• Therapy staff specialty certifications
• ServSafe training
• Antibiotic Stewardship Training
• Wound Care Certification
• And more!

Questions may be directed to Sonya Borgeson at sonya.borgeson-bethke@state.mn.us. Members can also contact Jenna Kellerman at jkellerman@leadingagemn.org. 

State to Award Local and Regional Dementia Grants

On August 6, 2019 by Jonathan Lips

The Minnesota Board on Aging has issued a Request for Proposals for local and regional projects that will increase awareness of Alzheimer’s disease, increase the rate of cognitive testing, promote the benefits of early diagnosis, or connect caregivers of persons with dementia to education and resources.  

The application deadline is 4 p.m. on Aug. 30, so interested organizations should begin exploring the opportunity as soon as possible. An applicant may request a grant up to a maximum of $150,000. The grants are anticipated to last for 12 months (Oct. 1, 2019 – Sept. 30, 2020). 

The grants are intended to stimulate collaboration and coordination, and to strengthen community relationships and partnerships that promote the benefit of physician consultation for all individuals suspected of having a memory or cognitive problem, to promote the benefits of early identification of Alzheimer’s disease and other dementias, to provide services, informational materials and proven tools for persons with dementia and families who are caregiving, as well as other resources.

For more information, visit the Board on Aging’s website or contact Aaron Cotter.

Federal News

Have an Hour Free on Thursday? Join CMS for its Nursing Facility Open Door Forum

On August 6, 2019 by Jonathan Lips

The Centers for Medicare & Medicaid Services (CMS) will share information on fiscal year 2020 skilled nursing facility payment policies during a Skilled Nursing Facilities (SNF)/Long Term Care Open Door Forum this Thursday, Aug. 8, at 1 p.m.  

The full agenda includes updates on payment policies, the SNF Quality Reporting Program and Value Based Purchasing Program, Payroll Based Journal, and an open question-and-answer session.

To participate by phone, call 1-888-455-1397 and use Conference Passcode 9375124. TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

An “Instant Replay” audio recording of this call can be accessed by dialing 1- 203-369-3586 and entering the Conference Passcode 1234. Instant Replay begins 1 hour after the call has ended. The recording expires after 3 business days.

For ODF schedule updates and E-Mailing List registration, visit the CMS website.

New Guidance on Heightened Scrutiny Review of Newly-Constructed Presumptively Institutional Settings

On August 6, 2019 by Bobbie Guidry

The Centers for Medicare & Medicaid Services (CMS) has provided clarifications to questions about the heightened scrutiny process for newly-constructed presumptively institutional settings. The information can be found in the Informational Bulletin issued last week. 

The Bulletin revises the guidance first issued in 2016, changing the ability to demonstrate compliance with the HCBS Settings Rule based on the experience of non-Medicaid beneficiaries. Previous guidance stated that for settings under development or new construction, CMS would only be able to determine whether a setting overcame its institutional presumption after the setting was operational and occupied by Medicaid beneficiaries who were receiving services in the setting.  

A state is now allowed to submit a setting to CMS for a heightened scrutiny review while only non-Medicaid beneficiaries are receiving services in the new setting. 

The bulletin clarifies two issues:

• With respect to newly constructed facilities, CMS can perform a heightened scrutiny review based on how non-Medicaid beneficiaries are receiving services in the new setting at the time a state conducts and submits information for a heightened scrutiny review.
• Should CMS determine that a new presumptively institutional setting overcomes that presumption and adheres to the home and community-based settings criteria, Federal Financial Participation for Medicaid-funded HCBS will be available. Timelines are included for several scenarios.

Aug. 27 Call: Understand Your SNF VBP Program Performance Score Report

On August 6, 2019 by Jeff Bostic

Do you understand the Value-Based Purchasing Performance Score Card? Are you interested in results from payment year one? Join the Centers for Medicare & Medicaid Services (CMS) for a call on Tuesday, Aug. 27 from 12:30 p.m. to 2 p.m. for a high-level summary of the program and a review of the FY2019 program year.   

Register for this call.

A question and answer session will follow the presentation. Participants may email questions in advance to SNFVBP@rti.org with "SNF VBP Aug 27 NPC" in the subject line. These questions may be addressed during the call or used for other materials following the call. For more information, visit the SNF VBP website.

Spending Caps Deal Allows Funding Bills to Move

On August 6, 2019 by Jodi Boyne

The White House and Congress reached a deal to raise the federal budget caps for fiscal years 2020 and 2021.  

The budget deal, passed by the House and expected to be passed by the Senate prior to its departure for August recess, would raise federal non-defense discretionary spending by $56.5 billion above the fiscal year 2019 cap over the two-year period.

For FY20, nondefense discretionary spending would increase from $605 billion in FY19 to $632 billion; in FY21 nondefense discretionary funding would increase to $634 billion. An increase to the caps is critical to FY20 and FY21 appropriations for non-defense discretionary spending for HUD and Older Americans Act programs.

While the budget deal as passed by the House, would eliminate sequestration for so-called discretionary programs like senior housing and community-based services, it would extend the 2% Medicare payment cut sequestration through fiscal year 2029.

The budget deal makes it more likely appropriations bills will be completed closer to the Oct. 1 start of FY20 and represents a shift in policy for the White House, which had requested Congress keep the FY20 caps in place. 

Don’t Forget: Change from KEPRO to Livanta Requires Action by Medicare Providers

On August 6, 2019 by Jonathan Lips

As we reported earlier this summer, Livanta replaced KEPRO as the Beneficiary and Family Centered Care (BFCC) Quality Improvement Organization (QIO) for Minnesota effective June 8, 2019. The purpose of the BFCC-QIO is to conduct quality of care reviews, beneficiary complaint reviews, and discharge and termination of service appeals in various Medicare provider settings. Livanta requires a Memorandum of Agreement (MOA) from providers.  To complete a new MOA and read frequently asked questions (FAQs), click here. 

Skilled nursing facilities need to take action in relation to the transition to Livanta, and we can expect questions from surveyors relating to the transition:

Update Your Appeals Notices: Post-acute providers must update the Notice of Medicare Non-coverage with Livanta’s phone number for Minnesota’s region. See the table on this Livanta webpage for phone numbers.  If your facility uses pre-printed notices, please note that it is acceptable to use labels to cover the existing BFCC-QIO information on the appeals notices. The typeface must be clear, bold and 12 point or larger.  You may also hand-write over pre-printed notices, although this is not preferred.

Update Your Bill of Rights Forms:  Residents admitted on or after June 8, 2019, should receive a copy of the Bill of Rights (BOR) that includes the Livanta contact information, rather than the KEPRO contact information.  The “Resources” section of the combined federal and state bill of rights includes a listing for the Medicare Beneficiary and Family Centered Care Quality Improvement Organization.  As shown below, the BOR should list Livanta rather than KEPRO:

Medicare Beneficiary and Family Centered Care Quality Improvement Organization

LIVANTA LLC

10820 Guilford Road, Suite 202

Annapolis Junction, MD 20701-1105

1-888-524-9900 (TTY: 1-888-985-8775)

For members with existing inventory of Bill of Rights (whether you are using the MDH form, the LeadingAge Minnesota form or your own internal form), you may prepare your labels to cover the existing KEPRO information and replace it with the Livanta contact information.

Posting of Livanta Contact Information:  Federal regulations at F575 require facilities to post a list of names and contact information for various state agencies and advocacy groups.  The list of organizations that a facility must post is the same as the organizations identified in the Resources section of the Bill of Rights booklet that facilities distribute to residents. As a result, the posted information must also be updated to reflect the change to Livanta.  If you need a template to assist with meeting this posting requirement, we have one posted on the LeadingAge Minnesota website.

Notable News

Checking In on PDPM: Checklists, Milestones and Outcomes

On August 6, 2019 by Jeff Bostic

It’s happening in less than 60 days. The new Patient Driven Payment Model (PDPM) goes into effect on Oct. 1. Are you prepared for this major change in how you document and are reimbursed for care?  

A recent blog post by PointRight in McKnight’s Long-Term Care News provides key milestones that you should have achieved by now, as well as the essential things you should between now and Oct. 1 and a few questions to ask six months and one-year post-implementation to help you assess whether you are meeting your goals.

To read more, see PDPM: Where providers should be now, on Oct. 1 and at 6 and 12 months post implementation.

How Well Do You Know Your Team?

On August 6, 2019 by Jenna Kellerman

“A person’s name is to him or her the sweetest and most important sound in any language.”  -Dale Carnegie. Yet one thing we hear periodically on staff satisfaction surveys is, “my supervisor doesn’t even know my name.” 

Making an effort to truly know your staff is an indication if your organization’s culture.

Knowing each staff member as an individual is important, especially considering older adults services is such a relationship-based profession. Knowing someone as a person means they matter. As a leader, you may know your direct-reports well. But do you know the names of your indirect reports? How about your frontline staff? Or those who work evening or overnight shifts?

Need to develop this skill? Check out these tips on How to Remember Names from Witt Communications.

Get more information in the Workforce Center. Questions? Contact Jenna Kellerman.

Member News

Foundation Golf Tournament Raises More Than $60,000

On August 6, 2019 by Jenny Prosser

With workforce pressures reaching unprecedented levels, the 2019 LeadingAge Minnesota Foundation Golf Fundraiser helped raise funds for our next round of caregiver scholarships. The golf event was held on July 30 at Prestwick Golf Club in Woodbury. View foursome photos sponsored by CBS Construction Services. 

“Thank you all for participating in the seventh annual LeadingAge Minnesota Foundation Golf Fundraiser,” cheered Tournament Chair Dennis Anderson, Senior Vice President & CFO at Pathway Health, as he welcomed a happy crowd of golfers to celebrate after a day of fun, comradery and powerful fundraising. In total, thanks to golfers, sponsors, volunteers and ticket sales, the event raised over $60,500 before expenses.

“As many of you know, the Foundation supports initiatives designed to transform how we care for aging Minnesotans – including building the workforce of tomorrow, developing future leaders and furthering collaborations that transform the experience of aging,” said LeadingAge Minnesota Foundation Board Chair Bob Dahl. “This annual golf fundraiser specifically raises money to fund a statewide scholarship program available to all members of LeadingAge Minnesota and their staff. The money raised today will help those called to serve older adults advance their skills and find continued growth in their careers as caregivers.”

Prize Winners

• 1^st Place Team: Ryan Beduhn, Chris Knoll Justin Uhrich and Ryan Young
• 2^nd Place Team: Matt Kinne, Jason Wenell, Eric Worke and Jason Worke
• 17^th Place Team: Eric Hinz, Jon Kenner, Jennifer Pfeffer and Candas Schouvieller
• Longest Drive Men: Grange Farr
• Longest Drive Women: Kali Wachter
• Closest to Pin Men: Steve Mork
• Closest to Pin Women: Carol Raw
• Longest Putt: Joe Hysell
• Closest to the Line: Grange Farr
• Putting Challenge: Kathy Hedlund
• Most Fun Tee Box Sponsor: CFS Interiors & Flooring

Event Sponsors

• Top Dog Sponsor: CBS Construction Services.
• Foursome Sponsors: Anderson Companies, Bluespire, CFS Interiors & Flooring, Dougherty & Company LLC, EduCare by Mirabelle Management, In-House Senior Services, Kraus-Anderson, Sonus Interiors, St. Croix Hospice and Ziegler.
• Tee Box Sponsors: annLeo LLC, Aruba Networks, bdh+young interiors | architecture, CFS Interiors & Flooring, Computer Integration Technologies (CIT), Eldre Solutions Group, Hoglund Bus Company, In-House Senior Services, Pathway Health, PointClickCare, Senior Care Solutions, Sterling LTC Pharmacy, Thrifty White Pharmacy and Voigt, Rodè, Boxeth & Coffin, LLC.
• Electronic Leaderboard Sponsor: OnTrack (powered by EduCare).
• Putting Green/Putting Challenge Sponsor: Sonus Interiors.
• Driving Range Sponsor: Bluespire.
• Giveaway Sponsor: Healthcare Purchasing Connection.
• Flag Sponsors: Bluespire, Bluestone Physician Services, Essential Decisions Inc. (EDI) and Ziegler.

I want to offer special thanks to our Foundation Golf Fundraiser Committee: Dennis Anderson, Gigi DesLauriers-Knop, Cheryl Gustason, Brian Holbrook, Laura Johnson, Kevin Kiemen, Andy Marden and Katie Shelander. Events like this wouldn’t be possible without the amazing volunteer efforts of our members pulling together to make a difference. Thank you all. 

Now Available: 2019 Unemployment Insurance Toolkit for Nonprofits

On August 6, 2019 by Jodi Boyne

A new toolkit to help management unemployment risk is now available.  

The 2019 Nonprofit UI Toolkit, from LeadingAge's Member Solutions Partner UST, features tools that offer exclusive access to unemployment claims management tips, how-to-guides and an informative webinar recording. Plus, you can learn about best practices for unemployment compensation and the ideal approach to take when dealing with unemployment hearings. Resources include:

• Best Practice Tips - Keys to Unemployment Compensation
• Webinar Recording: Unemployment & HR Risk Management with UST
• Unsatisfactory Job Performance vs. Willful Misconduct
• Unemployment Hearings - Just the Facts
• Understanding Unemployment Insurance
• Controlling Unemployment Costs
• Employee Considerations
• Unemployment Cost Analysis Form

Download Your Toolkit Now!

Education Solutions

2019 Annual Meeting Important Dates and Updates

On August 6, 2019 by Heidi Simpson

Annual Meeting 2019 will be here soon. Friday, Aug. 16 is the deadline for early bird registration and scholarship applications for our annual leadership conference that takes place Sept. 17-20 at Madden’s. 

Madden’s lodging is sold out. Overflow lodging is available at Kavanaugh’s. Find complete conference details, lodging, registration and other information at www.LeadingAgeMN.org/AnnualMeeting.

350 HCBS Professionals to Converge at Connect Conference

On August 6, 2019 by Heidi Simpson

In less than two weeks, more than 350 professionals in home- and community-based service settings will converge on Earle Brown Heritage Center in Brooklyn Center for the first annual Connect Conference for two days of networking, learning and meaningful dialogue about the future of service and care for older adults.  

We are very excited to introduce this new experience that breaks down silos to bring you interactive learning, fresh ideas and smart solutions to the challenges and opportunities we all have in common. There is still time to register for this new conference that is shaping up to be the biggest event of the summer.

Popular Dementia Care Certificate Program Returns in 2019

On August 6, 2019 by Heidi Simpson

We are pleased to reintroduce our popular Dementia Care Certificate Program, recently updated, streamlined and retooled for 2019. This three-part program is designed for efficient learning and meets the requirements outlined in the Elder Care and Vulnerable Adult Protection Act of 2019.

You can earn the certificate by completing two webinars and a two-day workshop that focuses on the most critical topics in caring for persons with dementia. The webinars are open for registration now; and workshop information and registration will be available soon.

• Module 1: Overview and Early Dementia (Aug. 29 webinar)
• Module 2: Related Dementias (Sept. 4 webinar)
• Module 3: Person-Centered Care and Strategies to Avert Challenging Behaviors (Sept. 24-25 or Oct. 22-23)