Issue: May 8, 2014

Published on May 7, 2014

Articles in this issue:

National Nursing Home Week- Next Week, May 11-17


Mother’s Day Opens Week to Honor Residents & Workers
National Nursing Home Week® celebrated since 1967

Washington, D.C. – National Nursing Home Week® (NNHW), which begins on Mother’s Day Sunday, May 11 and runs through Saturday, May 17, honors the residents and patients currently in skilled nursing and rehabilitation care centers across the nation with special activities and events.

Sponsored each year since 1967 by the American Health Care Association (AHCA), this year’s NNHW theme is “Living the Aloha Spirit.” In Hawaii, by “Living the Aloha Spirit,” a person shows love and respect to others and joyfully shares life to create a better world.

“Skilled nursing care centers strive daily to attain the ideal expressed in this year’s theme for all patients by focusing on person-centered care and continuous improvement,” said Mark Parkinson, President and CEO of AHCA. “This special week is also about honoring the staff in skilled nursing care centers. These dedicated individuals often form meaningful, enduring relationships with residents and families that are beneficial to everyone.”

National Nursing Home Week can be a time to reflect on the many challenges that society faces in ensuring access to the quality services available in a skilled nursing care center. Some of the national issues that potentially threaten such access include: federal reductions in Medicare payments; limitations on therapy services, such as physical therapy; and government Medicaid payments that are $7.7 billion below the cost of providing care nationwide.

Most importantly, NNHW week is a great time to visit a loved one, friend, acquaintance, or veteran in a skilled nursing care center or other setting. This special attention will help someone catch that “Aloha Spirit.”

National Nurses Week- Special Thanks To All Nurses!

Author: Hayden Parker

This week is National Nurses Week!  More than three million strong in America, registered nurses are leaders in healthcare. They are working on multidisciplinary teams of healthcare professionals to elevate patient care, advancing their education, serving in key leadership roles and providing individualized care to improve healthcare outcomes for patients. National Nurses Week is a time to recognize and celebrate the incredible contributions of nurses and nurse educators to advance patient care and transform healthcare. There are many ways employers can say “thank you.” Here are just a few:

1. Workplace awards: Present special awards at hospital events and ceremonies. Peers and leaders offering recognition for a job well done can be highly motivating and a concrete way to show appreciation.

2. Extra assignments: Yes, really! Extraordinary nurses feel valued when given assignments that bring them outside of their daily routine and help them grow. Offering nurses special assignments in their areas of interest illustrates an employer’s awareness of their nurses’ potential and ability to meet their professional needs.

3. Development opportunities: Providing education and career options, such as tuition reimbursement and group tuition rates for certifications and advanced degree programs, will help demonstrate the appreciation you have for your nurses and their future leadership in healthcare. Some employers may offer “career ladders”—educational cohorts with online and other convenient educational options. These present opportunities for advancement based on work experience, certifications and advanced degrees.

4. Provide independence: Give nurses the authority to fulfill their responsibilities in ways they deem best for their patients and themselves. Trust they are committed to high quality work and provide them with the necessary resources to accomplish it.

5. Listen: Honor nurses by listening to them. Allow nurses a voice and a seat at the table where decisions are made. One way to provide nurses a voice in your hospital is through shared governance structures where nurses are governed by their own committees and by having nurse representatives on all policy-making decision boards. For example, create nurse-led committees and task forces to make decisions about processes and policies. Additionally, don’t forget to ask nurses for their opinions in workplace and industry surveys.

National Nurses Week is a time for all of us to show our appreciation for nurses, the care they provide and the passion for others they exhibit every day. Please join me in honoring nurses everywhere—our heroes of health care—and celebrating their extraordinary contributions during National Nurses Week.

Health Care Stabilization Fund News

Author: Hayden Parker

Did you know providers will be considered “health care providers” after January 1, 2015?  You as providers will benefit from this designation in several ways.  KHCA, Leading Age, and Chip Wheelen with the Health Care Stabilization Fund will be offering a provider webinar on June 18th.  Look out for the announcement from the Associations. 

Please read the following news article to familiarize yourself with the Kansas Health Care Stabilization Fund written by Chip Wheelen.

Health Care Stabilization Fund Article

ICD-10 KHCA/KCAL Education Still Available



KHCA/KCAL will be holding an ICD-10 Training, May 20-21, 2014 in Topeka, KS Register Online Today

The changes are still coming.  Will you be ready?

The Senate approved a bill H.R. 4302 "Protecting Access to Medicare Act of 2014" which included a delay for ICD-10 implementation until 2015. The bill was signed into law on Tuesday following a 64 to 35 vote in the Democratic-led Senate on Monday, after the Republican-led House had approved the bill late last week. 

The inclusion of the ICD-10 delay in the bill came as a surprise to the industry because CMS Administrator Marilyn Tavenner stated one month ago that there would be no extension. The ICD-10 delay was only one paragraph of a larger bill mostly focused on postponing cuts in Medicare reimbursement to doctors that would otherwise be required under the Sustainable Growth Rate (SGR) formula. 

A one-year delay provides welcome breathing room for some organizations to further prepare for the ICD-10 transition. Numerous provider associations are encouraging operators to continue with their current ICD 10 training plans as the transition to this far reaching initiative has significant financial, clinical, quality and operational effects.

Many providers are asking, what is next?

Continue to improve clinical documentation processes, while building a strong foundation for process improvement knowing that ICD-10 is a measure of quality and will be critical to the new quality measures included in the H.R. 4302 bill.

Big Changes Coming to The KHCA/KCAL Website


BIG changes are coming to the KHCA/KCAL website!  Can you guess what is going to happen?  We are expanding to better serve all of our members.  Be sure to check out our current website, and utilize the beneficial information. 

Visit KHCA/KCAL right now!

2014 SNF PEPPER Reports Available in May Via Electronic Portal


2014 SNF PEPPERs Available in May Via Electronic Portal

TMF Health Quality Institute, the Centers for Medicare & Medicaid Services (CMS) contractor responsible to produce and distribute the Program for Evaluating Payment Patterns Electronic Report (PEPPER) for various professional groups, including skilled nursing facilities (SNFs), has just announced a WebEX entitled The SNF Program for Evaluating Payment Patterns Electronic Report (PEPPER) on May 8, 2014, at 2:00PM, Central Daylight Time.  The WebEX will focus on:  1) Updates for the new SNF PEPPER, summarizing statistics for FYs 2011-2013; and 2)  the new method for accessing the 2014 SNF PEPPER via the Secure PEPPER Access portal on  Registration is not required to join the event.  Simply click on about 15 minutes prior to the start time of the WebEX. The event number is: 924 457 628 and the event password is: flower.  AHCA has advocated strongly for this process and is pleased that CMS is making this change.

Currently, the SNF PEPPERs are scheduled for release on May 5, 2014; however, TMF will send an email to announce the formal release when the SNF PEPPERs are available to access. To receive this email, join the email list at  SNFs do not have to register to receive a PEPPER report; however, TMF has asked us to share the following specific information:

Note: If providers use only letters in both of these fields they must contact TMF to request assistance. Patient names cannot be entered due to patient privacy laws.

If you have individual or specific questions regarding the 2014 PEPPER reports, please visit to submit questions.

Emergency Preparedness Checklist- Are you ready?

Author: Hayden Parker

Is your center or home prepared for natural disasters and other emergencies?  Evaluate your preparedness with this useful checklist from CMS.

Emergency Preparedness Checklist

Also be sure to check out AHCA/NCAL for more tips on staying ahead of the storm

CMS Propose Rule for SNF Prospective Payment System

Author: Hayden Parker

CMS released the proposed rule for the SNF Prospective Payment System, indicating our Medicare rates for the coming fiscal year. CMS is proposing a 2.0% increase, estimated to be $750 million for the profession. There are several aspects to this proposed rule that look positive. (Find the fact sheet on CMS' website.)

This reflects the third year in a row of market basket increases, and an increase from last year's 1.3% market basket update. I believe this is a direct result of the proactive approach we have implemented over the past few years to work with CMS before the rule is ever written.

Below is a short summary of the key provisions in the SNF PPS proposed rule that could have a direct impact on the long term and post-acute care profession.

Market Basket Update

Other Key Provisions

AHCA will conduct a more detailed review and analysis of the SNF PPS NPRM in the coming days and provide a thorough summary next week.

Comments are due to CMS by June 30, 2014. AHCA will be submitting comments.  If members wish to provide comments to AHCA, we ask that they be provided by COB on June 1, 2014. Comments can be emailed to Elise Smith (, AHCA's Senior Fellow of Health Policy & Post-Acute Care.

CMS SC Regarding CPR

Author: Hayden Parker

In October 2013, CMS issued a Survey & Certification letter on the topic of CPR. KDADS survey team are looking closely at the policies and procedures within skilled nursing homes during their inspection process. Please review the following summary from CMS as well as the Survey & Cert letter to make sure your home is in compliance. Additionally, homes must be sure they are aware of a resident’s “code status” at all time so that the appropriate interventions can occur that are in line with the resident’s wish. Recent surveys have resulted in IJ situations based on this issue.

Initiation of CPR - Prior to the arrival of emergency medical services (EMS), nursing homes must provide basic life support, including initiation of CPR, to a resident who experiences cardiac arrest (cessation of respirations and/or pulse) in accordance with that resident’s advance directives or in the absence of advance directives or a Do Not Resuscitate (DNR) order. CPR-certified staff must be available at all times. • Facility CPR Policy –Some nursing homes have implemented facility-wide no CPR policies. Facilities must not establish and implement facility-wide no CPR policies. • Surveyor Implications - Surveyors should ascertain that facility policies related to emergency response require staff to initiate CPR as appropriate and that records do not reflect instances where CPR was not initiated by staff even though the resident requested CPR or had not formulated advance directives.

CMS S&C CPR Letter


CMS SC Long Term Care Provider Update 14-05

Author: Hayden Parker

Nursing Homes


Mark Dykstra of Region V let us know there will be a national call titled “National Partnership to Improve Dementia Care in Nursing Homes” on Tuesday, May 20; 1:30-3:00 pm ET.

To Register: Visit MLN Connects™ Upcoming Calls. Space may be limited, register early.

The CMS National Partnership to Improve Dementia Care in Nursing homes was developed to improve dementia care through the use of individualized, comprehensive care approaches. The partnership promotes a systematic process to evaluate each person and identify approaches that are most likely to benefit that individual. The goal of the partnership is to continue to reduce the use of unnecessary antipsychotic medications, as well as other potentially harmful medications in nursing homes and eventually other care settings as well.

During this MLN Connects™ National Provider Call, a CMS subject matter expert will provide National Partnership updates, discuss efforts to monitor enforcement rates, and track surveyor training completion.  Additional speakers will be presenting on the critical role that activity professionals play in the mission to improve dementia care and the reduction of antipsychotic medications through person-centered, nonpharmacologic care approaches. A question and answer session will follow the presentation.


•   Partnership updates

•   Role of activity professionals

•   Nonpharmacologic approaches to care

•   Next steps

Target Audience: Consumer and advocacy groups, nursing home providers, surveyor community, prescribers, professional associations, and other interested stakeholders


Continuing education credit may be awarded for participation in certain MLN Connects Calls. Visit the continuing education credit informationweb page to learn more.

5 Star Kansas Gracious Dining Award for 2014 Winner- Sandpiper Healthcare and Rehab LLC

Author: Hayden Parker

5 Star Kansas Gracious Dining Award for 2014 Winner is:

Sandpiper Healthcare & Rehab LLC.

The 5 Star Kansas Gracious Dining Award for 2014 is sponsored by the Practice Group of Dietetics in Health Care Communities (DHCC) and was awarded to SandpiperHealthcare & Rehab of Wichita Kansas.  The award was presented at the Kansas Dietetic Association Spring Conference Luncheon on Friday April 25th in Manhattan.  Karlyn Hake, R.D.L.D., chair of DHCC, presented the award to Donna Ashenfelter, CDM, CFFP, Flo Berry, Assistant CDM and Susan Sader, ADM.  Per Donna they have been on a journey of Person Centered Care. Meal-service is a team effort from the elders to all staff in every department. It is a journey that has a beginning but will not end due to the commitment of the staff and the unlimited possibilities.  Lisa Friesen, R.D.,L.D. is the Consultant Dietitian.   Sandpiper Healthcare & Rehab has been a dietary deficiency free facility since 2009.


Congratulations to Sandpiper Healthcare & Rehab LLC the 2014 - 5 Star Gracious Dining Award recipient.