In order to better quantify the fiscal challenges facing nursing facilities in the State of Maryland, LifeSpan is requesting nursing facilities to complete a survey regarding costs associated with Medicaid eligibility delays and bad debt.  LifeSpan does appreciate your staff taking the time to complete it.  Download survey HERE. 

STATE AGENCIES SUBMIT PROPOSED REGULATORY CHANGES

• Last month, the Department of Health and Mental Hygiene proposed regulations changing the circumstances for requesting a fair hearing under the Medicaid program. As a result of comments submitting by LifeSpan and other groups, the Department will be making changes to the regulations and resubmitting them for publication in early 2010.
• The Board of Pharmacy is circulating for informal comment regulations concerning pharmacy services in a comprehensive care facility; and
• The Board of Examiners for Nursing Home Administrators has submitted proposed regulations affecting fees, continuing education and carry over hours, requirements of a preceptor and the AIT program.

All regulations can be viewed by clicking HERE.

• FINANCIAL ELIGIBILITY UPDATES: 
  • With HFAM, LifeSpan held a second eligibility meeting to discuss provider concerns regarding the new Bureau of Long-Term Care Eligibility.  Adrienne Warren, Director, and Patrice King, Assistant Director, were in attendance. 
  • At the meeting, an updated phone directory was distributed, which contains the case assignments by applicant's last name for each case worker. 
  • The Stuck Case process was again discussed and emphasized.  If an application or redetermination was submitted to the department and all supporting documentation was provided and 30 days have passed with no response from the department, a provider should initiate the Stuck Case process.  AT09-33 describes in detail the process for handling a Stuck Case, as well as the appropriate form for filing a Stuck Case review.   The Bureau requests that providers not send inquiry lists without first requesting a Stuck Case review.   
  • The issue regarding redeterminations that have fallen off-line was also discussed.  LifeSpan brought this issue to the attention of the Secretaries of Human Resources and Health and Mental Hygiene last week.  The Secretaries are meeting this week to discuss the issue and expedite correcting this problem.  If a redetermination was submitted to the Bureau and has fallen off-line, send an email to VEvans@dhr.state.md.us or PKing@dhr.state.md.us with the following information:  case name, case identifier (client # or social security number), date MA was to continue, date MA redetermination was delivered, and brief comment if it would be helpful to the reviewer. 
  • Providers also brought up the issue of what to do when information was submitted but the caseworker states that it is "lost" or not in the file.  Ms. Warren stated that the Bureau will honor those applications or other materials that were submitted to the locals/Bureau and now cannot be located provided that the provider/resident can show verification (e.g., receipt) that the items were submitted.

*** All information regarding the new Bureau as well as copies of transmittals can be downloaded on the LifeSpan website by clicking HERE. 

• TRANSMITTALS AND MEMOS:
  • Correction memos have been released for both the new rates effective December 1, 2009 as well as the Annual Wage Survey, which must be completed by January 20, 2009.  The corrected rates memo will actually see nursing facility rates increase.  Please make sure that your rate memo has the term "Corrected" on it.  The wage survey correction memo instructs facilities not to use the pay period that falls within Labor Day.  Rather, use the very next pay period, which will include a few October days.  Click HERE for the wage survey corrected memo. 
  • Please remember Medicaid released several transmittals - all of which can be found on the LifeSpan website. Click HERE.
    • Transmittal No. 224 revises instructions for the use of Form 259.
    • Transmittal No. 225 mandates the use of iExchange when seeking a Medicaid eligibility determination for long-term care facility or home or community based services when a nursing home or chronic care level is mandated. This new mandate goes into effect March 1, 2010 rather than the earlier February 1^st date. There is a training session on December 17^th at 11:00 AM on the use of iExchange. To register, contact Janis Grady at jgrady@kepro.org.

    • In addition, please note that as of December 1^st, KePro will no longer be sending fax confirmations on MERs submitted via iExchange. To check the status, you will need to examine the notes section of iExchange.

• CLINICAL ALERT: OHCQ has issued a Clinical Alert on HealthCare Acquired Pressure Ulcers. Click HERE for the Alert.
• MDS 3.0: On December 17th, the CMS will sponsor a live satellite broadcast and webcast entitled "MDS 3.0: Part I - An Introduction." This program will be the first of a three-part series focused on providing information on the Minimum Data Set Version 3.0 (MDS 3.0) due to be implemented on October 1, 2010 by nursing homes across the nation. This program will focus on providing information regarding the major areas of change to, & impacts as a result of implementation of, the MDS, as well as plans and resources for the implementation of the instrument in October, 2010. The target audiences consist of the Regional & State Survey and Medicaid agencies, including the Regional & State LTC surveyors and RAI/MDS Coordinators, and nursing home providers.

• • Satellite Technical Specifications.  This broadcast will be available only on CMS's digital network. Specific satellite technical specifications are available at http://surveyortraining.cms.hhs.gov/ or can be obtained by calling 1-800-401-9387.

  • Webcast Information
    This program will also have a live webcast, and will be available as an archived webcast for viewing after December 17, 2010, at http://surveyortraining.cms.hhs.gov/.

  • Handouts Handouts for this broadcast are available at http://surveyortraining.cms.hhs.gov/.

• QIS UPDATE: OHCQ has reported that it plans to delay QIS training for the remaining survey teams on the Eastern Shore and Montgomery County until September of 2010. OHCQ states that CMS has informed them that an upgrade to the software is to occur next year, which will hopefully solve the software glitches that are being experienced. Team Four recently completed the training and is now conducting QIS - Western Maryland and Prince George's County.

• FIVE STAR RATING SYSTEM - December News:

  1. The Five-Star provider preview reports became available beginning Tuesday, December 15, 2009. Providers can access the report from the Minimum Data Set (MDS) State Welcome pages available at the State servers for submission of Minimum Data Set data.

  Provider Preview access information:

  � Visit the MDS State Welcome page available on the State servers where you submit MDS data to review your results.

  � To access these reports, select the Certification and Survey Provider Enhanced Reports (CASPER) Reporting link located at the bottom of the login page.

  � Once in the CASPER Reporting system,

  i. Click on the 'Folders' button and access the Five-Star Report in your 'st LTC facid' folder,

  ii. Where st is the 2-digit postal code of the state in which your facility is located, and

  iii. Facid is the state assigned facid of your facility.

  2. BetterCare@cms.hhs.gov is available to address any questions and concerns about the December's data. The helpline will reopen in January 2010.

  3. Nursing Home Compare will update with December's Five-Star data on Thursday, December 24, 2009.

  4. Please visit http://wwwwww.cms.hhs.gov/CertificationandCompliancCertificationandComplianc/13_FSQRS.asp for the latest Five-Star Quality Rating system information.

SAVE-THE-DATE

THURSDAY, FEBRUARY 11, 2009

LIFESPAN'S ANNUAL LEGISLATIVE DAY

IN ANNAPOLIS

3:30 PM - 8:00 PM

Contact Danna Kauffman at dkauffman@lifespan-network.org.