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Need Necessitates Changes in Protocol<p>Signature HealthCARE, which operates 111 communities in 10 states, offers skilled nursing, home health, assisted living, and in-home care. The company employs approximately 15,000 individuals and delivers care to 9,000 residents and patients. <br></p><p>A great deal has changed since the COVID-19 pandemic hit in early March. Staff focused on being innovative and learning, as regulations and approaches to fighting the virus frequently changed, and leaders focused on protecting the spirit and vitality of residents and staff members during the daily challenges of COVID.<br></p><p>“There’s no doubt our staff have been personally and professionally challenged,” says Tracy Jansen, chief human resources officer at Signature. “With the needed adjustments and standards that came with the pandemic, many of our standard protocols had to be re-evaluated and modified in order to adapt.”<br></p><p><img src="/Monthly-Issue/2020/November/PublishingImages/1120_TracyJansen.jpg" alt="Tracy Jansen" class="ms-rtePosition-1" style="margin&#58;5px;width&#58;219px;height&#58;195px;" />These adaptations included an increased and evolving workload due to the demands of protecting residents from COVID-19, implementing mandated screening requirements, increased use of personal protective equipment, and taking the added responsibility of having no volunteers as communities had to close to nonessential workers. <br></p><h3>Staff Evolve</h3><p>Signature communities also had to close to residents’ family members. “That meant our staff, in addition to the responsibilities of medical care, had to take on a greater level of responsibility for the mental and psychosocial health and wellness of our residents,” says Jansen.<br></p><p>As restrictions were put into place, staff helped expand telehealth as a source of communication for families and residents and engaged them in new kinds of activities that were within the boundaries of infectious control guidelines.<br></p><p>In the meantime, while staff focused on these changes at work, they themselves faced challenges with their families at home due to the pandemic, and Signature stepped in to help. <br></p><h3>Supporting Staff Heroes</h3><p>As staff are supporting residents and patients, corporate leaders support staff in communities in need by setting up meal pantries with healthy snacks available to staff. Signature has provided more than 10,000 pounds of food to be distributed to various facilities for staff, plus free meals at work. <br></p><p>If a staff member tests positive, Signature has meals delivered to them at home during their quarantine. Additionally, in instances where COVID-19 has significantly affected a facility, Hero or COVID Pay is supplied. COVID Pay is supplemental pay for staff specifically treating COVID-positive patients, says Jansen. Hero Pay is also supplemental pay for being a hero during the pandemic and, while not directly working with COVID patients, working in a facility that has a significant number COVID patients.<br></p><p>Signature provides financial support programs as well. “Other support programs for staff include a loan program for employees that offers a low interest rate, access to child-care resources, flexible work scheduling for families, next-day payroll advances, and enrollment for child-care flexible spending accounts after the normal enrollment deadline,” says Jansen. <br></p><p>In an effort to provide funds as easily as possible, Signature restructured its Dependent Flex Care Program. </p><p>Traditionally, funds become available as employees contribute through payroll deduction. But for the past several months, the employee’s entire election will be front-loaded for immediate access for reimbursement up to $5,000, tax deferred.<br></p><p>Signature also partnered with TrueConnect, a voluntary employee-benefit program, to help assist staff with low-risk, easily accessible loans as a part of their benefits package. The service includes free financial counseling and planning for staff. Loans under $5,000 require no credit check and have a low annual percentage rate.<br>Signature employees also receive a PayActiv Benefit in which they can get up to a $500 advance loan that is paid back over two paychecks.<br></p><h3>Spiritual Help</h3><p>Spirituality plays a big role at Signature, and leaders help answer the call as requests come in. “In regard to the emotional and spiritual health of our staff, Signature offers a Spiritual Call Center where employees can seek counsel to find a listening ear, to connect in prayer, and find comfort and connect to community resources as the pandemic continues to increase difficulties, emotionally, physically, mentally, and financially,” says Jansen.<br></p><p>Signature’s corporate office has also adopted buildings to supply a steady flow of goody bags, cards, words of encouragement, and prayer, she says. The company-wide prayer chain also receives prayer requests and helps keep a continuous prayer chain going.<br></p><p>Every bit helps, as staff juggle the personal and professional challenges of COVID. “Our staff have to deal with family members who have lost employment and the related financial challenges that brings, they have children at home who are learning or preparing to return to school and have the need for child care, especially for some of our single-parent employees,” says Jansen.<br></p><p>“And this is not even mentioning the fact that, every day, they deal with the constant concern of bringing the virus home. But despite these challenges, our dedicated employees are relentless and have remained steadfast, vigilant, and committed. They are our true heroes.”​</p>2020-11-01T04:00:00ZWorkforceSignature HealthCARE offers skilled nursing, home health, assisted living, and in-home care.
HHS Makes Changes to COVID-19 Provider Relief Fund Requirements<p>The Department of Health and Human Services (HHS) has made changes to the reporting requirements and expanded the types of providers who could apply for COVID-19 Provider Relief Funds (PRFs), according to an update from the American Health Care Association/National Center for Assisted Living (AHCA/NCAL). </p><p>The association said the keys from the announcement include&#58;&#160;</p><ul style="list-style-type&#58;disc;"><li>HHS is returning to its previous definition of lost revenue, a decrease from 2019 revenue, rather than using the Sept. 19 version that would have capped funds to a facility's 2019 net revenue.&#160;</li><li>HHS has created new flexibility around reporting at the parent and subsidiary level.&#160;</li><li>HHS now is allowing private-pay assisted living communities to apply for Phase 3 awards.&#160;</li></ul><p>In its press release, HHS said, “In response to concerns raised, HHS is amending the reporting instructions to increase flexibility around how providers can apply PRF money toward lost revenue attributable to coronavirus.&quot;</p><p>The agency said after reimbursing health care-related expenses attributable to coronavirus that were unreimbursed by other sources, providers may use remaining PRF funds to cover any lost revenue, “measured as a negative change in year-over-year actual revenue from patient care related sources.&quot;&#160;</p><p>All Phase 3 applicants have until 11&#58;59 p.m. (ET) on Nov. 6 to submit their applications for payment consideration, AHCA/NCAL said. <br></p><ul style="list-style-type&#58;disc;"><li>Read the&#160;<a href="https&#58;//cl.exct.net/?qs=f7157b708618440f80788d4af76dd662e534573afa1d61a196ee22f41c53de8eeb3cae1ec5df10f018c6ed2c7eb83c7d16ebf65c544151c0">HHS Press Release</a>.</li><li>Download the&#160;<a href="https&#58;//cl.exct.net/?qs=f7157b708618440f14ade9af7bfc0748e1fca7a27959ef3203ab6cd27a38570f82d25f64827a9b8906e0ff41f52853cc569d7f298f1402b1">policy memorandum</a>&#160;on the reporting requirement decision.</li><li>Download the&#160;<a href="https&#58;//cl.exct.net/?qs=f7157b708618440f8b40d85f2acdf1370ccf83e7e0b4c7d8f6ffdfda72383919876083d80e06ad18323cba7ea7967a04bd90425920d359eb">amended reporting requirements guidance</a>.</li></ul><p>For updates and to learn more about the Provider Relief Program, visit&#58;&#160;<a href="https&#58;//cl.exct.net/?qs=f7157b708618440f18a0abe838b0efb71cedf8cf210d294e828141668c644ecd34c28cbb46fdde053e4f2586f9db3572ae77ea6d1ec4cfd9">hhs.gov/providerrelief</a>.&#160; </p><p>​</p>2020-10-23T04:00:00Z<img alt="" src="/Breaking-News/PublishingImages/740%20x%20740/mask_2.jpg" style="BORDER&#58;0px solid;" />COVID-19Patrick Connole​HHS says it is amending the reporting instructions to increase flexibility around how providers can apply PRF money toward lost revenue attributable to the coronavirus.
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.