Issue: October 3, 2013

Published on October 3, 2013

Articles in this issue:

Reminder: DOH Issues Final Sandy Reconciliation Notice - October 7, 2013 Deadline

Author: Carl Pucci* Published in Finance & Reimbursement

Facilities will have one final opportunity to reconcile their survey data in order to be properly reimbursed for residents affected by Hurricane Sandy.  The deadline for final submission is October 7, 2013.  Please see attached DAL with specific filing requirements.

Director, Finance & Reimbursement
518-462-4800 x36



OMIG Audits

Author: Nancy Leveille and Carl Pucci* Published in Finance & Reimbursement


OMIG is actively pursuing MDS audits for facilities that had not been selected for phase one last spring.  NYSHFA is interested in collecting information from SNF in this second phase so we can track top issues being highlighted.  If you have been recently audited, we would appreciate a call or email noting how the process went and any problematic issues identified.  We will share aggregate information with all members. Thank you.

Sr. Director, Member Operational Support
518-462-4800 x20
  Carl J. Pucci
Director, Finance & Reimbursement
518-462-4800 x36


Flu Mask Requirement FAQs Updated

Author: Karen Morris and Nancy Leveille* Published in Clinical & Quality

The FAQs related to the flu mask requirement have been revised and posted. They are dated September 24, 2013.  Use link to access.

NYSHFA contacts: 

Nancy Leveille
Sr. Director, Member Operational Support Services
518-462-4800 ext 20 


Karen Morris
Director, Clinical & Quality Services
518-462-4800 ext 15 


AHCA Memo Related to RAI Manual Updates Effective October 1, 2013

Author: Karen Morris and Nancy Leveille* Published in Clinical & Quality

AHCA has published the following memo regarding the changes published in the revised MDS RAI manual which goes into effect on October 1st. Please forward to your MDS coordinators and related staff.
CMS recently posted the fall updates to the RAI User’s Manual, which take effect on October 1. Among the important changes providers need to be familiar with are new items in Section K (swallowing/nutritional status) and Section O (special treatments, procedures and programs).  Additional clarification is also provided in Section G (activities of daily living) and on setting the assessment reference date (ARD) for Discharge assessments.  These changes will impact classification of residents into RUGs for payment purposes and should be reviewed carefully by center staff involved in care documentation and MDS assessments and coding.
In Section K, a new item is added to capture information about caloric and fluid intake via parenteral feeding, tube feeding or intravenously.  
In Section O, two new pieces of information are being captured.  First, centers will be required to report co-treatment minutes by entering the total number of minutes each discipline of therapy was administered to the resident in co-treatment sessions in the last 7 days. Second, centers will now be required to report the number of distinct calendar days on which at least 15 minutes of therapy services were provided in the past 7 days.
In Section G, item G0110, Activities of Daily Living (ADL), the manual updates relate to the “rule of three” and the use of the ADL Self-Performance Algorithm. Over the past several months, CMS has commented in a number of different venues regarding the intended application of the rule of three described in the RAI manual.  In these new updates, CMS clarifies the instruction that as the first step to determining the appropriate coding for this section, “When an activity occurs three or more times at any one level, code that level.” If this step applies to the situation, providers are instructed not to go on to apply the algorithm. New examples are included in this section to illustrate correct coding.
Finally, with regard to discharge assessments, CMS clarifies  that the ARD for a discharge assessment is always the date of discharge.

CMS also released a separate memorandum describing the transition process for implementation of these new items, effective October 1.  The transition policies will apply to determination of RUGs for individuals with assessment reference dates between October 1 and October 13. 

NYSHFA contacts: 

Nancy Leveille
Sr. Director, Member Operational Support Services
518-462-4800 ext 20 


Karen Morris
Director, Clinical & Quality Services
518-462-4800 ext 15 

DOH/Provider Meeting September 2013

Author: Nancy Leveille* Published in Clinical & Quality


The following is a synopsis of our most recent meeting:

Electronic Plans Of Correction:

DOH noted that SNF have provided a lot of valuable input to DOH on this new system which has helped to make it work better for all parties. SNF generally are reporting quicker receipt of the approval of the POC through this process. NYSHFA is identifying some inconsistencies in area offices with the timeliness of SOD and now EPOC’s.  We will continue to track for any trends and further discuss at the next meeting. Many SNF feel using this technology is improving the system.

Sprinkler Regulation

The Smoking Regulation was enacted in August and the surveyors are checking on the implementation during survey.  A memo was sent to all New York City SNFs last week to provide guidance on the elevator and machine rooms specific to this NYC area due to a conflict with FDNY, NYC Building Code and CMS regulations.  This was a three year effort from NYSHFA to get this group to agree and finalize this guidance .If any NYC facilities have not received this guidance, please contact us.

Smoking Law

NYSHFA has identified the issues that negatively affect SNFs once this law goes into effect across NYS.  We have provided input to DOH as they develop the guidance and are setting plans to meet with the legislator who initiated this law. NYSHFA will keep you posted on our activities.


E-cigarettes can be used in SNF but they should follow the guidance of using electrical equipment near oxygen and like any new equipment be cleared by your maintenance department.

QIS Update

The QIS process is being taught to all new surveyors and is continuing to evolve across the state. The average # of deficiencies is almost the same for QIS and traditional surveys, 4.9 and 5.1 deficiencies per survey respectively.

Medical Director/Physician Guidance

DOH has approved a grant using CMP dollars to implement these guidelines.  NYSHFA will be working with NYMDA, DOH and HANYS on this project.

CMS 13-57 Applicability of CMP’s Escrow IIDR

Only one to two IIDR’s have occurred using this new process. Nothing significant to report except that SNFs are not using this process.  Civil Money Penalty dollars are currently being targeted to be used in NYS SNF as evidenced by newly released grants for dementia care, customer satisfaction and medical director guidance.

Hurricane Sandy Reimbursement:

They noted the DOH’s 9/13/13 DAL outlined the final recommendations for reimbursements. DOH remitted approximately $7million to SNF who had no reconciliation discrepancies via Medicaid payment cycle 1883. The last 14% of SNF had until Oct 7, 2013 to get the additional data to DOH for final reconciliation. Payment will occur once that process is complete.

Medicaid Managed Care Update:

DOH gave an update the similar to what NYSHFA reported to members in our Member Mailing of September 19, 2013.  Please refer to that memo for full information.

NYSHFA CONTACT: Nancy Leveille, RN, MS
Sr. Director, Member Operational Support
518-462-4800 x20

Save The Date: NYSHFA/NYSCAL 65th Annual Convention

Author: CMP Scott Jackson* Published in Education, Convention


NYSHFA/NYSCAL 65th Annual Convention
The Hilton Westchester
Rye Brook, NY

The Hilton Westchester

June 29 - July 2, 2014


Greater New York Health Care Facilities Association
New York Chapter American College of Health Care Administrators
Southern New York Association

NYSHFA Website Credentials - Reminder

Author: Ellen Bagley* Published in Communication, Information Services

Since NYSHFA has launched the latest version of its web site, we’ve instituted a global login for members.

Username: mynyshfa
Pwd: stitches33


[This password will change periodically.  Watch NYSHFA Now emails for updates.]

Hang on to your previous login [email address] and [password].  You’ll need these when you register for events or purchase products from NYSHFA.

Feel free to leave comments on the web site or to contact Ellen Bagley directly with any issues.

eMedNY Training Schedule Oct-Dec 2013

Author: Ellen Bagley* Published in eMedNY

Attached for your convenience is the eMedNY training schedule for ePACES and other items.  If the item is listed as a webinar, click on the word "webinar" for a link to the training session.

NYSHFA Contact:  Ellen Bagley