The Academy of Senior Health Sciences, Inc. (formerly The Ohio Academy of Nursing Homes, Inc.) seeks to provide public education and awareness initiatives to the long-term care community in Ohio. Our membership represents a true cross-section of the skilled nursing facility profession, from small sole proprietorships to larger Ohio-based multi-facility companies, as well as those businesses that service our industry. Through our public education and awareness efforts, the Academy brings the collective influences of the members together into a single voice on vital issues affecting our profession.
Founded in 1966, the Academy then identified one of its core purposes as "To foster a spirit of goodwill among those persons engaged in the nursing home industry, to promote ethical practices in their relationships with each other, their employees, and the general public to the end that all interests may be served fairly..." Though the organization has undergone several transformations over the years, most notably in 2011, its dedication and commitment to Ohio's most frail and elderly remains the same.
| The Academy Weekly Headlines from 2 Weeks Ago|
ODM to use Provider Gateway for 9401s
The Ohio Department of Medicaid announced this week that they will be contracting to use Provider Gateway to facilitate the processing of Form 9401. Provider Gateway is software that allows nursing home providers and County Jobs and Family Services to communicate about the form. It is currently in use in about a dozen counties and by about 350 nursing homes, including the larger metropolitan areas. ODM anticipates moving to Provider Gateway will reduce delays in the processing of 9401s and create a documentation trail for the form's submission and subsequent communications. The move to Provider Gateway will not impact the current PL situation as 9401s are no longer used to communicate those amounts. ODM anticipates implementing the move to Provider Gateway in January of 2019.
Notes from the ODM provider meeting
The Academy, along with other LTC associations, meet monthly with the Ohio Department of Medicaid. Below are notes from this month's meeting:
Rules update: The vent weaning rules are still in the rule making process. ODM anticipates filing them soon for an effective date of early January 2019. The related forms for the vent weaning program are waiting final approval. A rule package with various NF changes is still under CSI review. The most significant change in that rule package is language clarifying how an entering operator's rate is to be determined after a CHOP. ODM is also opening the rules for the cost report chart of accounts and both SNF and ICF/IID cost reports. It was noted in the meeting that the cost report itself does not need a rule to be changed. ODM is willing to consider changes to the cost report such as how MA days are reported.
Prior authorization: A DME Medicaid prior authorization presentation was given to the group. The presentation covered how the process worked, denial codes, and exceptions for Medicaid individuals under 18 years of age. Mark Rogers from ODM stressed the importance of telling a story. He suggested that in many cases the information given on the CME forms does not provide a full enough picture for the authorization. It was also noted that the most up to date supply lists are found on ODMs website. These lists should be viewed carefully as a code may be listed more than once and just because there is a "N/A" for maximum payment does not necessarily mean it is not available for Medicaid recipients. It was also noted that custom wheelchairs are not part of the NH Medicaid per diem. Furthermore, repairs are possible for custom wheelchairs even if it is within the normal lifespan of the product. Mr. Rodgers stressed again relaying the importance of the repair in the PA request. You can download the presentation by clicking here.
Exception reviews: ODM is a few weeks into the next round of exception reviews. There is only one reviewer, so it will be at a much slower pace. Early results suggest similar trends to the last round of reviews. The Quadriplegia issue was raised again and it was noted that the change in the RAI manual did not take place until October 1, 2018 and the current review is for records dating before that time.
NF billing training update: ODM provided an update on the recent billing training. About 33 facilities were represented by 54 in person attendees and 72 via the web. Providers are reminded that the training materials are available on ODM's website.
If you have a question or issue you would like addressed at the provider meeting, please contact The Academy.
Free Eden training opportunity to reduce antipsychotic use
From the State Long-Term Care Ombudsman Office: "Ohio nursing home employees have the opportunity to transform quality of care and quality of life for people living with dementia. A grant-funded partnership between The Eden Alternative® and the Ohio Office of the State Long-Term Care Ombudsman seeks to help reduce antipsychotic use through non-pharmacological, person-directed practices. Funds will support the delivery of a unique educational package, including Dementia Beyond Drugs, an Eden Alternative training co-developed with award-winning author and geriatrician Dr. Al Power. The goal of this 2-day educational event is to shift the focus of dementia care from managing so-called “difficult behaviors” to, instead, identifying and responding to the unmet needs that are typically their underlying cause. Gone unchecked, unmet needs can lead to distress and the subsequent overuse of antipsychotic medications for those who live with dementia.
Up to 100 nursing homes in Ohio will combine Dementia Beyond Drugs training with two other educational offerings. The second, Reframing Dementia: Train the Change Agent, involves the provision of a turnkey training kit that participants can use over time back in their organizations. Participants also learn training and facilitation skills that prepare them to deliver the training with confidence. The third educational experience is the Care Partner Workshop, an online training also developed by The Eden Alternative. This interactive, team-based training will engage family members, side-by-side with nursing home employees, to strengthen care partnerships and overall well-being on the team, as a way to collaboratively respond to the needs of people living with dementia. According to 2017 data from the National Partnership to Improve Dementia Care in Nursing Homes, Ohio currently ranks as #33 in the country in terms of reducing antipsychotic medications. To receive fully-funded registration privileges, you must be an employee of a Medicare and/or Medicaid participating nursing home. This project will meet the licensure requirement that Ohio nursing homes must participate in at least one nursing home quality improvement project approved by the Ohio Department of Aging every two years.
To learn more and to register, click here: https://2dff35.campgn4.com/Creating-a-Culture-of-PersonDirected-Dementia-Care-in-Ohio
Join a FREE 1-hour informational webinar about the project on November 1. Register by clicking here: https://edenalt.zoom.us/meeting/register/9e15eb31ecb5971e34538d7d4481ef37
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