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Provider Groups Urge Congress to Extend Relief From Medicare Sequester Cuts Into 2021<p>The American Health Care Association, American Hospital Association, American Medical Association, and National Association for Homecare and Hospice wrote congressional leaders on Oct. 21 urging them to extend the congressionally enacted moratorium on the application of the Medicare sequester cuts into 2021 and through the duration of the public health emergency (PHE) caused by the COVID-19 pandemic. </p><p>In total, these organizations provide health care to more than 62 million Medicare patients, and the persistently high COVID-19 rates across the country are stressing the health care system, they said. </p><p>The letter to House Speaker Nancy Pelosi (D-Calif.) and Senate Majority Leader Mitch McConnell (R-Ky.) urges extension of the relief from the 2 percent sequester cut enacted in the CARES Act that afforded critical relief during the pandemic to all providers who participate in the Medicare program through the end of 2020.</p><p>“Physicians, nurses, hospitals, health systems, long term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, home health agencies, and hospices have been hit hard by the pandemic, incurring significant expenses to treat the sick, but experiencing historic financial losses due to the decrease in inpatient and outpatient services,” the letter said.</p><p>Relief from the 2 percent sequester cut by way of the CARES Act afforded critical relief during the PHE to all providers who participate in the Medicare program through the end of 2020, it continued. </p><p>“Clearly Congress recognized the importance of this relief for the duration of the PHE. Given that the PHE is certain to continue into 2021, it is a safe assumption that America’s health care providers will continue to face the overwhelming financial challenges and pressures<br>associated with higher overhead costs due to personal protective equipment and other safeguards, lost revenue due to delayed elective procedures and/or forgone routine visits, and hazard pay to staff.”</p><p>The organizations said they are grateful that Congress has provided a much-needed reprieve from the Medicare sequestration since May. Without future sequestration relief, however, America’s health care safety net could be at risk of collapse, they said.<br></p>2020-10-22T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/mask_4.jpg" style="BORDER&#58;0px solid;" />PolicyPatrick ConnoleGiven that the public health emergency is certain to continue, it is safe to assume that America’s health care providers will continue to face the overwhelming financial challenges associated with higher overhead costs, the groups said.
AHCA, NCAL Gold Quality Award Achievers Talk Strategy, Sacrifice<blockquote><h4><span class="ms-rteThemeForeColor-6-4 ms-rteFontSize-2">National Quality Awards Ceremony </span></h4><h4><span class="ms-rteThemeForeColor-6-4 ms-rteFontSize-2"><strong>Don’t miss the Live National Quality Awards Ceremony, which begins at 2&#58;00 p.m. ET Thursday, Oct. 22, in the General Session and Special Events Theater in conjunction with AHCA/NCAL’s 70th Virtual Convention &amp; Expo. </strong></span></h4><h4><span class="ms-rteThemeForeColor-6-4 ms-rteFontSize-2"><strong>All 719 Bronze, 147 Silver, and 4 Gold recipients will be honored. Attendees are invited to join in the chat function to share congratulatory messages and shout out to other 2020 recipients. </strong></span></h4><h4><span class="ms-rteThemeForeColor-6-4"><strong class="ms-rteFontSize-2"> Registration for the convention closes Friday, Oct. 23. Not signed up?</strong><span class="ms-rteFontSize-2"> </span><a href="https&#58;//www.eventscribe.com/2020/AHCANCAL/aaStatic.asp?SFP=WURZVUdSWVlAMzk3NA%29"><strong class="ms-rteThemeForeColor-6-4 ms-rteFontSize-2">Register now.</strong></a> </span></h4></blockquote><p></p> <style> p.MsoNormal, li.MsoNormal, div.MsoNormal { margin:0in; font-size:11.0pt; font-family:"Calibri",sans-serif; } a:link, span.MsoHyperlink { color:#0563C1; text-decoration:underline; } span.MsoHyperlinkFollowed { color:#954F72; text-decoration:underline; } .MsoChpDefault { font-size:11.0pt; font-family:"Calibri",sans-serif; } .MsoPapDefault { margin-bottom:8.0pt; line-height:107%; } div.WordSection1 { } </style> <p>A quartet of providers has received the preeminent Gold National Quality Award designation from the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) for 2020 and is being honored for their achievement during the association’s annual convention that runs on a virtual basis through the month of October.</p><p>Jane Martin, RN, director of nursing, Treutlen Health and Rehabilitation, Soperton, Ga., says for her 50-bed facility in rural Georgia the latest attempt to achieve Gold started five years back when the organization earned Bronze from AHCA/NCAL, then Silver in 2017.</p><p>“That is when we decided to go for the Gold,” she says. “We [earned] a site visit last year and then this year got the Gold award.”</p><p>Going for the top honor and going for the Bronze or Silver are worlds apart, Martin notes. “The Gold is so much different, and you really need to dedicate time to it.” This work includes copious writing down to report quality-based outcomes for residents, since getting positive results is what the award process is all about, she says.</p><p>“Probably the most difficult things is collecting the data. Everything has a different measurement time frame, so I really rely on LTC Trend Tracker [from AHCA/NCAL], NursingHome Compare…You need to know all of these data today on a regular basis.”</p><p>Once all the hard work resulted in the Gold, Martin says sharing the good news, in a COVID-sensitive manner, was a great feeling for staff and residents alike.</p><p>“We were in a huge open area when we told them, and it was a lot of yelling through masks,” she says. “It was kind of sad that we could not hug or have family there, but we did our best.”</p><p>As for what she would tell fellow providers about the award program, Martin says facilities should do it; even though it is not easy, it is well worth it. “We all learned so much through the process, and there were so many little things along the way, it has changed the way we live and work here.”</p><p>Kristin Thrun, administrator, Burgess Square Healthcare and Rehab Centre, Westmont, Ill., says her nursing home got into the quality award world because back in 2012 when accountable care organizations and other value-based care entities emerged in her area, it became imperative for her facility to set itself apart.</p><p>“The focus became even more pronounced on overall performance outcomes and quality measures, and becoming part of the AHCA award process helped us to do this in a systematic way,” she says.</p><p>After receiving some local awards for their work with residents, the facility earned Bronze from AHCA/NCAL in 2017 and then eyed going for Gold after that. </p><p>“I think the biggest challenge is continuing to push forward in terms of meeting the criteria and putting our programs in place and sustaining them despite the external challenges brought on by things like changes in payment models [person-directed payment model] and keeping pace with those,” Thrun says.</p><p>An example she gives is the challenge it was to make the systemic change on medication reconciliation when a resident moved from the hospital to the nursing home. “We worked with the hospital to change the process and reduce errors tied to these transitions of care and created a pharmacy position that just does admission reviews for new patients coming in,” she says. </p><p>The third achieving group says its journey to Gold began 18 years ago, according to Gail Cushing, RN, executive director, Applewood Center, Winchester, N.H.</p><p>“It has been a long journey for sure, but we continued to forge on throughout the time, but it did not prevent us from getting to where we wanted to go,” she says.</p><p>The greatest thing about the Gold process, Cushing says, is that it gave Applewood Center and its staff new skill sets to be able to adapt to new demands. “We can take new problems and adapt very quickly. An example is with COVID-19; I have said handling the pandemic was made more manageable because we went through a dress rehearsal with the Gold awards.”</p><p>For her, the award application has taught her and her people to communicate better, get feedback, educate, teach, and fix pitfalls. One example is that during the pandemic, her staff came up with a way to clean their goggles when there was no water source in an area where people were working.</p><p>“The whole Gold process is a concept really that provides a facility&#160;with new means to achieve success, and the more you practice, the better you become and the more ingrained it all becomes,” Cushing says.</p><p>Katie Frederick, administrator, Heritage of Bel-Air, Norfolk, Neb., started out talking about the end game of achieving Gold, which was the joy she, her 160-strong staff, and residents felt at accomplishing so much. Even though the pandemic has made a true celebration difficult, she says the pride all in the community feel about making Gold is real.</p><p>For her, making changes to be more efficient and better at evaluating results and outcomes is the lasting impact going through the award process will have. </p><p>“Evaluating and learning is what this has all been about. And, really getting better at communicating, listening to each other, and putting ideas into practice. That has all worked for us,” Frederick says.</p><p>Looking ahead to 2021, AHCA/NCAL said the deadline to submit an Intent to Apply for a 2021 National Quality Award is Nov. 12 by 8 p.m. (ET). For more information, visit the Quality Award <a href="https&#58;//www.ahcancal.org/Quality/National-Quality-Award-Program/Pages/default.aspx">website</a>.</p>2020-10-21T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/0220_News2.jpg" style="BORDER&#58;0px solid;" />Quality AwardsPatrick ConnoleAll Quality Award recipients are being honored Oct. 22 at the association’s 70th Virtual Convention & Expo going on this month and live on Thursday the 22nd.
AHCA, NCAL Say Even with COVID Restrictions, Residents Have Right to Vote<p>​As Election Day nears, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) said residents of long term care (LTC) facilities have a right to have their voices heard, even if the communities in which they live are operating with COVID-19 restrictions.</p><p>“With the election less than a month away and a pandemic that uniquely targets the LTC population still rampant, providers have an opportunity to play a larger role in helping residents exercise their right to vote in 2020,” AHCA/NCAL said.</p><p>“As the prevalence of COVID-19 continues to require targeted restrictions and precautions for indoor visiting, previous strategies to facilitate voting for residents, such as making facilities polling places on Election Day, have likely shifted to reduce the risk to residents and staff. Nonetheless, our seniors and other residents have a right to make their voice heard, and providers should make every effort to assist them in doing so.”</p><p>To learn more, go to <a href="https&#58;//www.ahcancal.org/News-and-Communications/Blog/Pages/Helping-Residents-Vote-in-2020.aspx">https&#58;//www.ahcancal.org/News-and-Communications/Blog/Pages/Helping-Residents-Vote-in-2020.aspx</a>.</p><p>In other developments, the Centers for Disease Control and Prevention (CDC) is releasing a new pathway through its National Healthcare Safety Network (NHSN) LTCF COVID-19 Module that will allow providers to report the results of their Point of Care (POC) COVID-19 testing. <a href="https&#58;//www.ahcancal.org/News-and-Communications/Blog/Pages/Point-of-Care-Laboratory-Reporting-Pathway-in-NHSN.aspx">Read More.</a><br></p>2020-10-21T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/senior_man_nurse.jpg" style="BORDER&#58;0px solid;" />ManagementPatrick ConnoleLTC residents have a right to have their voices heard, even if the facilities in which they live are operating with COVID-19 restrictions.
Occupancy Will Evolve as Owners, Operators Look for Recovery, Says NIC Expert<p><em>Below is the first of a two-part interview. Keep your eyes out for the second part coming to you next week in another Provider News Alert.</em></p><p><em>Provider </em>posed a series of questions to Beth Burnham Mace, chief economist and director of outreach at the National Investment Center for Seniors Housing &amp; Care (NIC), on issues tied to the COVID-19 pandemic and occupancy levels across the seniors housing sector.</p><p><em>Provider</em>&#58; What is the current trend for occupancy, and which of the market segments is showing the most negative impact from the pandemic?</p><p>Mace&#58; The distinction between nursing care/skilled nursing and seniors housing is especially important to consider in discussing occupancy performance because the frailest elderly are often patients of skilled nursing’s higher acuity setting with around-the-clock nursing attention. And, it has been these elderly patients with significant pre-existing conditions that have seen the highest rates of COVID-19 incidence and fatalities.</p><p>Partially as a result, according to data from the NIC MAP® Data Service, the occupancy rate for skilled nursing properties fell more than other segment types with a 6.5 percentage point decline from the first quarter to 80.2 percent in the second quarter of 2020.</p><p>This was significantly more than the 2.8 percentage point drop in seniors housing properties to 84.9 percent, and, when the aggregated seniors housing category is broken down into its subcategories, there was a 3.2 percentage point decline seen in assisted living properties to 82.1 percent and a 2.4 percentage point decline in independent living properties to 87.4 percent from the first to second quarters.</p><p>This placed the occupancy rate for assisted living at its lowest level since NIC began reporting the data in late 2005. In general, residents in independent living tend to be healthier than those in assisted living and nursing care, and hence the lesser decline.</p><p>NIC MAP’s Intra-Quarterly data show further declines in occupancy beyond the second quarter. In the August report period, defined as the three-month rolling average June, July, and August, the assisted living occupancy rate was 79.5 percent, independent living was 85.6 percent, and nursing care was 76.5 percent.</p><p><em>Provider</em>&#58; A big if, but if the pandemic is under control and vaccines available to all, what do you expect the occupancy outlook to be once this terrible time abates?</p><p>Mace&#58; As you point out, the pandemic holds the cards. At this point, the outlook for the sector is tied to the path of the pandemic, its infection and penetration rate within properties, and the impact of the pandemic on broad economic growth. The seniors housing and nursing care industry as well as the broader national economy will be negatively affected by the COVID-19 virus until a vaccine is available and widely distributed. And, whenever that happens, I do not believe that we will go back to business-as-usual (BAU).</p><p><em>Provider</em>&#58; What do you mean by not going back to BAU?</p><p>Mace&#58; The new normal will not revert to the old normal, and the new normal is here now and will continue to evolve. Flexibility, responsiveness, and readiness are new standards for successful operators.</p><p>To answer your question directly, I believe that there is a transformational change in the seniors housing and care industry and that the change will continue to evolve. Occupancy will eventually return to pre-pandemic levels, but the industry will be changed.</p><p><em>Provider</em>&#58; And, we have the demographics to consider?</p><p>Mace&#58; Yes, more broadly, the underlying fundamentals and drivers of seniors housing remain in place. First, the demographics alone support the growing need for care and housing for seniors. Today, there are seven adult children aged 45 to 64 to care for every senior over the age of 80. By 2030, this ratio shrinks to 4&#58;1, and, by 2050, it becomes 3&#58;1. Fewer caregivers suggest that community-based congregate settings will be needed more than ever.</p><p>Second, with nearly two of every three properties built before 2000, the inventory of seniors housing properties is relatively old, and often a property refresh is needed for design, functionality, and efficiency. And, as obsolescence increases, new supply is needed at least in some markets. Moreover, COVID may have accelerated obsolescence, as building design is moving front and center for improved safety and health outcomes.</p><p>Third, seniors housing is increasingly recognized as a critical part of the solution for population health management and health care cost containment—a growing social, economic, and political reality.</p><p><em>Provider</em>&#58; Any other factors in play for occupancy recovery and trends post-pandemic?</p><p>Mace&#58; The need for care and housing is especially acute for middle-income seniors. NIC’s Forgotten Middle study highlights that point, with only 46 percent of middle-income seniors capable of affording seniors housing and care by 2029. It’s likely that, as a result of the pandemic and the secondary impact it has had on the economy, more Americans than ever will slip into the Forgotten Middle-income cohort, making the need for affordable care and housing ever more pressing.<br></p>2020-10-20T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/0920_News1.jpg" style="BORDER&#58;0px solid;" />COVID-19Patrick ConnoleProvider poses a series of questions to NIC’s Beth Burnham Mace on issues tied to the COVID-19 pandemic and occupancy levels across the seniors housing sector.