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.

What's New: May 17, 2013

Submit your quality data to ODJFS by May 31!  —  The deadline for SNF providers to submit the self-reported quality measures is May 31, 2013. These measures could impact your SFY 2014 Medicaid rates, including any bonus funds that may be distributed in part on the total number of points. Both the quality incentive payment and the quality bonus payment are awarded based on the measurement of provider performance on 20 quality indicators specified in statute. While much of the data for the quality measurement is automatically collected through the ODH survey process, the Medicaid Cost Report and the Ohio Department of Aging Consumer Satisfaction Survey, some measures are reported by providers. In order to collect the additional information needed to determine the quality points earned by each provider, ODJFS has developed a web based quality incentive payment survey tool. The survey tool can be found at http://www.odjfs.state.oh.us/NFSurvey/ and is designed to capture data for calendar 2012. If you have questions, you may submit an email to ODJFS or contact The Academy. Legal Update: DOJ files suit on Hospice provider; hearing begins on observation stay case  — The parent company of a national hospice chain, Vitas, is being accused of improperly billing Medicare, including upcoding and business practices that encouraged providers to upcode patients. The suit covers billings for many years and into the hundreds of millions of dollars. Wolters Kluwer Law & Business reports on a different case related to observation stays: "In November 2011, a group of Medicare beneficiaries who had been hospitalized and then later discharged to SNFs only to discover that their nursing home stays were not covered by Medicare because they were considered to be under observation, as opposed to admitted, by the hospital, filed suit in the district court of Connecticut. The seven plaintiffs in Bagnall v Sebelius all incurred unexpected Part B coinsurance charges as well as thousands of dollars each in nursing home costs. A hearing in the case was scheduled for May 10, 2013. The complaint notes that the beneficiaries were deprived of Part A coverage to which they were entitled, and thus forced to bear the financial responsibility for hospitalization and prescription drugs that are covered under Part A. They were then denied the right to coverage of their skilled nursing care, which in turn forced them either to pay the cost of that care or to be unable to obtain that care at all. Finally, the complaint notes that the beneficiaries did not receive notification of their observation status, and did not have any right under current Medicare law to appeal that status, depriving them of administrative review of their placement in observation status.The claimants are saying they were never notified of their status as an inpatient or outpatient while at the hospital and were therefore required to pay for services, including SNF services after being released from the hospital." This case is significant for SNFs as there has been an increase in observation stays recently, in part because of the penalties hospitals now face for readmissions and increased scrutiny in the RAC audits. The article does note that CMS is proposing to create a definitive definition for an inpatient stay (two midnights) that could potentially impact SNF payments. H.B. 59: Concerns raised over direct service worker certification at consortium meeting  —  H.B. 59 contains language that allows the director of agencies to develop certification of direct care workers around a core curriculum. The core curriculum is being developed under the guidance of the Ohio Direct Service Workforce Consortium. The objective is to develop a standardized method to determine if direct care workers have the fundamental skill set necessary to provide basic services. From there, each agency can develop additional curriculum related to that field of work (example, mental health) that a worker can show competency in. Should a department choose to have certification, it would be administered by the Department of Health. The STNA program will not be impacted by the changes because it already covers the core curriculum being discussed. Many members of the consortium raised concerns that DOH would be influencing the curriculum because they were running the certification program. Adminstrators insisited it was solely because DOH is currently running the STNA program and it would be more efficient to have them use those resources instead of each department requiring their own resources to run a certification program. Other members of the consortium expressed concerns that only those providers serving Medicaid recipients would be impacted by certification, thus making it more expensive for them to operate compared to those serving a private pay population. At this point in time, those issues will be handled through the budget process. Click Here to read The Academy Weekly in PDF format