ASSISTED LIVING

Washington Post article spurs Senate scrutiny

Sen. Bob Casey (D-Pa.), chairman of the Senate Special Committee on Aging, is launching a new review of safety within the assisted living sector in light of the newspaper’s reporting last month. Casey told the Post that he was focused on “a set of cascading crises” related to staffing, oversight, how operators inform families and quality of care.

The Senate review provides an opportunity for the industry to engage with and educate the public on the benefits of senior living services and the overall safety record of senior living operators.

ASSISTED LIVING

U.S. Senate Special Committee on Aging held hearing on assisted living for first time in 20 years

On January 25, 2024, a hearing entitled, “Assisted Living Facilities: Understanding Long-Term Care Options for Older Adults.” was the first hearing on assisted living held by the Committee in twenty years. It followed a series of letters sent by the Committee’s Chairman, U.S. Senator Bob Casey (D-PA), to Atria Senior Living, Brookdale Senior Living, and Sunrise Senior Living.

Hearing testimony, like Senator Casey’s letters, focused on present areas of concern in the long-term care space: workforce shortages and staff compensation, the cost of care to the consumer, and the adequacy of care in assisted living facilities.

CMS CHANGES

CMS changes to the Minimum Data Set October 2023 implementation challenges

Providers have experienced many technical issues with submitting data to Centers for Medicare & Medicaid Services (CMS) with uncertainties about the impact on Care Compare data which will start to be released in April 2024. Proactive measures such as continuing education of staff and ongoing documentation audits will ensure compliance with the new requirements.

Industry experts note that in addition to the quality reporting, the changes from G to GG will also have a huge impact on reimbursement, care planning, and staffing metrics.  The removal of Section G changes the staffing calculations for reporting on Care Compare.  The Staffing Rating will now be calculated using the SNF payment Patient-Driven Payment Model (PDPM).  Staffing rating reporting will begin in July 2024.  CMS is also instituting a penalty for providers that fail to submit or submit erroneous staffing data so that they will receive the lowest score possible for corresponding staffing turnover measures.

INTERNAL AUDIT

Supporting Enterprise Risk Management (ERM) in long-term care

Enterprise Risk Management (ERM) is simply assessing how risks affect an organization and devising plans on how to approach different risks.  ERM is an organization-wide strategy, both top-down and bottom-up, to identify and prepare for hazards and mitigate operational, financial, compliance, legal, and other risks.

When you want to verify how well your facility is complying with regulatory standards, an internal audit may be in order. Excelas can objectively review a sample of your records—no matter how big or small—to assess the criteria you specify. Common areas of focus include skilled nursing facility and therapy documentation, hospice compliance with Medicare requirements, Medicare and Medicaid fraud and waste, and necessity for prolonged services in acute settings.

ENTERPRISE RISK MANAGEMENT