1:30 - 3 pm

Connect with members of the AANAC Board of Directors during this intimate and informal session. Leading small-group discussion at individual tables, members of the AANAC Board of Directors will briefly introduce various topics and then you and other participants in your group will share your views and experiences on what’s next in the field. Past topics have included new regulatory tools and resources in development at AANAC, best practices in the RAI process, and implementing resident-centered care.

Seating is limited, so make sure to add this session to your conference registration.

3 - 3:45 pm

Are you a new AANAC member or first-time conference attendee? Be sure to attend this kick-off event to begin networking and to make some new friends. This fun and relaxed get-together happens just before the opening keynote and is a wonderful place for new conference attendees to meet other first-timers, rub elbows with AANAC experts and board members, and put faces to the names of the AANAC staff. We look forward to meeting you there!

4:30 - 6:00 pm

Allison Massari

“The power of what you do goes far beyond the technical part of your job. You are healing the places medicine cannot touch. In fact, YOU are the medicine.”

Allison Massari knows that you have the power to transform lives. As the survivor of two life-threatening car accidents, one where she was severely burned and suffered second and third degree burns on more than 50% of her body, Allison has a deep understanding of what it takes to heal. With sensitivity and compassion born from her experience, Allison shines light on the provider’s immense value to a patient who is suffering, reinvigorating healthcare providers and helping heal burnout in the workplace. Her unforgettable keynote stories reveal the potent impact that each healthcare provider had upon her journey and how some of the most dramatic healing occurred in a matter of seconds. Those moments are vital to recovery.

In this breathtaking and thought-provoking keynote, Allison will take you on a journey and offer a sincere and direct approach to transcending life’s difficulties. Her experiences and her extensive time in recovery give her compelling authority to energize your healthcare teams and to galvanize your commitment to this noble profession. Packed with tools to manage change and adversity, Allison’s life-changing message will mobilize you to always find a way to be the healer in the room.

• Identify that compassionate care is not dependent upon direct patient contact and that being an expert at your job, no matter the role, is a part of compassionate care
• Transform burnout into passion and a self-generating desire to give
• Master the art of expressing kindness in just three seconds, regardless of professional challenges and pressures and learn how those simple acts can be profoundly memorable to a resident

8:30 - 10 am

Moderators:

Judi Kulus, MSN, MAT, RN, NHA, DNS-CT, RAC-MT, AANAC VP of Curriculum Development

Jennifer LaBay, RN, RAC-MT, NAC-EAP Chair

Carol Maher, RN-BC, RAC-MT, CPC, NAC-EAP Vice-Chair

CMS Representatives invited:

Evan Shulman, Deputy Director, Division of Nursing Homes, Survey and Certification Group, CMS

Mary Pratt, Director of Chronic and Post-Acute Care, CMS

Join CMS representatives as they share valuable information about the current national initiatives that impact the everyday care of nursing home residents and the staff that care for them. CMS will cover topics such as MDS assessment, Medicare payment initiatives, the Quality Reporting Program, and the federal survey processes. Don’t miss this eagerly anticipated AANAC conference highlight!

10:30 am - Noon

Jessie McGill, RN, RAC-MT

A big change requires even bigger preparation. Abraham Lincoln said, “Give me six hours to chop down a tree, and I will spend the first four sharpening the axe.” The proposed Resident Classification System, Version 1 (RCS-I), which is proposed to replace the current RUG-IV Medicare payment model, is no small matter. This session will help you gain knowledge of the components of the RCS-I rate, take a deep dive into the MDS items that impact each of the case-mix adjusted components, and apply your understanding with case studies.

• Explore Medicare innovation payment models
• Summarize programs impacting Medicare Reimbursement
• Define the five components of the RCS-I payment model
• Describe the vision of a unified post-acute care payment

10:30 am - Noon

Maureen McCarthy, RN, BS, RAC-MT, QCP-MT

During this session, you will learn how routine, federally reported data, along with data monitored in day-to-day operations in the nursing home, can aid you in your QAPI implementation program. Because CMS required facilities to have a fully implemented QAPI program by Nov. 28, 2019, you needed to take QAPI plans from paper into practice. As the NAC, you have a lot to contribute to the process. This session will assist you in achieving your goal to meaningfully assist in your facility’s vibrant QAPI program.

• Learn how to use four CASPER reports to develop performance improvement projects to improve quality ratings
• Utilize the most effective timetables to review the data
• Review two strategies to monitor performance in real time
• Gain ability to incorporate performance improvement projects into overall QAPI plan

10:30 am - Noon

Colleen Toebe, RN-MSN, CWCN, RAC-MT, MU-MT

New MDS items for October 2017 required an understanding of the Drug Regimen Review (DRR) process. The revised regulations and MDS items for DRR bring the MDS coordinator into a new area of clinical operations. During this session, you will review the revised regulations and discuss ways to obtain information about each resident’s DRR. You will leave with an understanding of your role in this important clinical process.

• Understand the DRR requirements and MDS coordinator’s role
• Identify how to communicate with the director of nursing to obtain DRR status for MDS coding
• Monitor the effectiveness of the DRR process to support successful clinical operations

10:30 am - Noon

Kris Mastrangelo, OTR/L, LNHA, MBA

In response to several OIG investigations and reports that skilled nursing homes are overbilling Medicare, the healthcare industry is experiencing a surge of probe reviews per CMS mandates. Multiple contracted agencies are out in full force investigating Medicare and Medicaid billing practices of nursing home providers across the country. Skilled nursing and rehabilitation documentation, coupled with MDS 3.0 accuracy, is critical to ensuring accurate reimbursement for Medicare claims under the scrutiny of review. In this session, you will learn techniques to prepare for these legal situations, as well as strategies for appealing denied claims. The presentation will include recommended tactics to manage and guide you and the interdisciplinary team toward compliance.

• Gain a toolkit of techniques for educating staff in relationship to Medicare Probe Reviews and preparation of legal documentation
• Be aware of the most common documentation errors that lead to fraudulent claims and place the facility at risk for legal ramifications
• Understand the key elements of managing patient care with associated medical record audits

1:30 - 3 pm

Barbara Bates, RN, MSN, RAC-CT, DNS-MT, QCP-MT and Linda J. Winston, RN, BS, MSN, RAC-CT, DNS-MT, QCP-MT

Care plans are expected to be the voice and choice of the person and direct care to meet the needs, goals, and preferences of each individual. Current care planning systems are lengthy, repetitive, and frequently contain the same information from resident to resident, appearing as a “cookie cutter” process to addressing the person’s problems or needs with canned goals or interventions. New federal regulations, in all three phases, are driving a change in care plan development through enhanced involvement of the resident and/or representative, recognizing the resident’s rights related to care, and focusing on designing person-centered care plans. In addition, the new baseline care plan must include the resident goals for his or her care. Care planning with the resident as the focal point during the entire stay is a tall order. During this session, you’ll gain needed clarity on how to meet these important goals.

• Learn 3-5 requirements in developing person-centered care plans
• Review 3-5 residents’ rights that must be supported as part of the care plan process
• Describe 2-3 federal requirements to be applied to person-centered care plans
• Understand how the MDS 3.0 CAA tools assist you and the interdisciplinary team in exploring care issues and how they can be used as the foundation for person-centered care plans
• Define how to implement the baseline care plan using resident-specific goals

1:30 - 3 pm

Mark McDavid, OTR/L, RAC-CT

With the potential for the Resident Classification System, Version 1 (RCS-I) to take effect in coming years, some may think that providing less therapy is the best way to support the bottom line. At face value, that may be true. However, CMS’s implementation of the Quality Reporting Program and Quality Measures may cause you to re-think that prospect. This presentation will focus on therapy’s role in supporting outcome measures. We will discuss the current state of RCS-I and where it appears to be headed. You will learn about the updates to section GG and therapy’s and nursing’s role as well as therapy’s role and impact on various items in the Quality Reporting Program (QRP).

• Understand the current state of RCS-I and where it appears to be headed
• Gain a practical understanding of who should be completing the various items on section GG, including discussion about new items coming Oct. 1, 2018
• Understand how therapy can impact your QRP items and Quality Measures

1:30 - 3 pm

Nikki Poropat, RN, MSN, RAC-CT, DNS-CT

The MDS is an often misunderstood tool that, if properly utilized, can benefit almost every department within a skilled nursing facility setting. The MDS coordinator, with awareness of how much of an impact accurate and timely MDS completion and submission impacts the overall health of a SNF, can educate IDT members on the importance of his/her role within the facility and non-MDS members of the IDT with limited knowledge of what the MDS is and why it is important. The MDS coordinator can help other staff understand how the MDS impacts areas such as Department of Health surveys; publicly reported information accessed by potential residents, hospital clinical managers, and health plan clinical managers; financial reimbursement for Medicare and Medicaid in case-mix states; and how accurate scheduling can assist many other departments in a building.

• Understand how the MDS impacts the Department of Health survey
• Grasp how the MDS impacts publicly reported information and who can access that information
• Learn how accurate scheduling of OBRA assessments can help other departments in the SNF

1:30 - 3 pm

Carol Maher, RN-BC, RAC-MT, CPC

New SNF QRPs have been approved that will require additional MDS items to accomplish the data collection and risk adjustment. This session will explain the new SNF QRP measures and the MDS items that will be answered on MDS assessments beginning Oct. 1, 2018. As the MDS coordinator, you will need to understand these new items and begin to plan how the information will be collected in your SNF.

• Identify the new SNF QRP Measures that will begin data collection in 2018
• Understand when the new MDS items will be required
• Determine how these new measures could impact the SNF reimbursement process
• Know why the cross-setting measures were developed

3:30 - 5 pm

Eugenia J. White, RN, MHA, RAC-CT, C-RNAC, CDP, CQRMS, C-DON, DNS-CT, SWC

By Nov. 28, 2019, all nursing homes will be required to have an infection prevention and control officer and an antibiotic stewardship program in place. Infections in the nursing home can result in readmissions to the hospital, which can have negative effects on the facility. These affects can range from loss of census to loss of revenue and referrals.

Antibiotic use in long-term care facilities is an issue that most experts agree needs to be addressed as part of the nationwide effort to slow the emergence of antibiotic-resistant bacteria. According to the Centers for Disease Control and Infection (CDC), an estimated 70% of nursing home residents receive one or more courses of antibiotics during a year. In this session, you will learn the basics for how to plan for and implement an antibiotic stewardship program in your facility.

• Examine the CMS regulation for antibiotic stewardship program
• Prepare for implementation to meet the CMS regulation
• Compare where you should be now, one year out, to where you are

3:30 - 5 pm

Julie Bilyeu and Sherri Robbins, BSN, RN, LNHA, CLNC, RAC-CT

In the current environment of decreasing reimbursement, it’s more important than ever to understand consolidated billing requirements to avoid unnecessary costs. Consolidated billing begins prior to admission, and to be successful, hinges on the knowledge and communication led by the clinical team. This presentation will focus on understanding provider responsibilities including provider agreements, provider notices, and payment responsibilities. You will also learn the CMS major category exclusions, the impact of place of service and tools available to providers to assist in determining excluded and included items, and Medicare fee schedules. This presentation will include case studies and best practices.

• Understand provider responsibilities under Medicare consolidated billing
• Be aware of the tools and resources available to providers to help determine excluded and included items
• Learn best practices under consolidated billing
• Determine Medicare fee schedules

3:30 - 5 pm

Jane Belt, MS, RN, RAC-MT, QCP

Imagine you’re sound asleep when the phone rings, a loud car pass, or the dog barks. How do you feel the next day? Perhaps a bit edgy, a normal sign of a sleep that was disturbed. Now, imagine how a resident in the nursing home feels when a personal alarm sounds -- or maybe five or six alarms ring out in intervals. We can all empathize with a resident’s discomfort from lack of sleep and loss of dignity.

To improve resident quality of life, the latest October 2017 MDS 3.0 updates (v.1.15) are now correlated to the November 2017 revised Requirements of Participation (otherwise known as the Mega Rule), and therefore, SNFs are required to reduce and eliminate personal alarms when possible. For some facilities, this is a seemingly impossible task. We think, “The residents will fall, the surveyors will give us citations, the families will be so upset.” The good news is that these challenges can be mitigated, while making our facilities quieter and more homelike for residents. This session will focus on the change in thinking, brought about by the increased scrutiny of alarms, by the cultural transition in facilities to person-centered care and a homelike environment, and what a facility can do to eliminate the noise makers.

• Understand pertinent revised F-Tags related to falls, accidents, restraints, alarms, dignity, choice, home-like environment, and sound
• Recognize the impact of the use of personal alarms and the link to restraints and alarms in section P
• Implement strategies and interventions to reduce the use of alarms

3:30 - 5 pm

John Sheridan, BS, MHSA, FACHE, MACHCA

The new Requirements of Participation are stretching your profession. The declining Medicare length of stays, growth of Medicare Advantage, ACOs, and other payment processes are stretching facility budgets. The new survey process, PBJ, and QM updates are changing your Five-Star ratings and stretching your understanding of how you are doing as a facility. In this session, you will learn five strategies for using the Facility Assessment to help you plan for better surveys, optimal reimbursement, and shining stars.

• Understand the Facility Assessment process and demands
• Learn five strategies to improve the Facility Assessment and make it part of QAPI
• Review and question the proposed RCS-I payment, QRP, and readmission penalties, and know their place in the Facility Assessment

5:15 - 6:45 pm

Enlighten us, but make it quick! In this fast-paced speaker series, each presenter has five minutes and 20 auto-advancing slides to share their stories, lessons, and experiences. From care plans to family vacations, the topics can be inspiring, educational, and funny. Come by and enjoy light appetizers, a cash bar, and enlightening presentations.

8 - 9:30 am

• Moderator: Judy Wilhide Brandt, DNS-CT, RAC-MT, QCP
• Expert Panelists:
• Jane Belt, MS, RN, RAC-MT, QCP
• Maureen McCarthy, RN, BS, RAC-MT, QCP-MT
• Carol Maher, RN-BC, RAC-MT, CPC

The MDS assessment rules and coding guidance is supposed to be objective, but sometimes it seems to very subjective. Back by popular demand, the Expert Panel, packed with nationally recognized MDS and Medicare experts, will answer your questions and discuss some of the most current MDS coding dilemmas. In this session, you’ll have the opportunity to ask any MDS or Medicare questions you may have. You’ll be able to better understand challenging coding situations and clear up misconceptions that may exist. Come learn how you can be more accurate and confident when coding the MDS.

9:45 - 11:15 am

Amy Stewart, RN, RAC-MT, DNS-MT, QCP- MT

Are you thriving or merely surviving in the new regulatory environment? With 70% of the pre-selected resident survey sample based off of submitted MDSs, your role as a NAC has become the hub of efficiency and quality. Come explore the top ten RAI citations since the implementation of the new survey process and how to avoid the trap of burdensome deficiencies. The role of the NAC in the survey process is critical in mitigating scope and severity through the RAI and care planning process. You’ll discover how to set a path for successful MDS compliance, with the added bonus of unforgettable participant interactions.

• Identify which critical element pathways, mandatory and triggered facility tasks, affect the RAI process
• Understand the elements of the newly required CMS matrix, beneficiary forms, and other mandatory forms that the NAC tracks and the surveyors review
• Know the difference between a RAI outcome measure and a process measure for quality assessment and assurance committee activities

9:45 - 11:15 am

Rosanna L. Benbow, RN, CCM, CIC, DNS-CT, RAC-CT

In this ever-changing field, Managed Care is becoming one of the biggest challenges. This session will summarize how to partner with your managed care plans to meet clinical goals timely for optimal outcomes for our elders. The Triple Aim of the Affordable Care Act (ACA) is right time, right place, right cost. Find out in this session how to integrate this aim into your clinical plan of care for great results for both you and your residents.

• Learn three barriers to managing clinical outcomes for Managed Care residents and ways to overcome those barriers
• Identify options for clinical management of length of stay
• Discover three ways to limit costs of clinical care for your residents during treatment

9:45 - 11:15 am

Tracy Burger Montag, BSN, RN, RAC-CT and Stephanie Kessler, RAC-CT

Facilities lose thousands of dollars every year when the components needed for admitting, providing services, and then discontinuing Medicare Part A benefits are not followed. This session will address the basics of traditional Medicare Part A coverage in a skilled nursing facility, including the required technical and clinical components, skilled care criteria, benefit periods, physician certification, and beneficiary notices.

• Learn the technical, administrative, and clinical criterion for determining Medicare Part A benefit eligibility
• Be able to identify the beginning and end of a Medicare Part A benefit period
• Become familiar with the regulatory components of the Physician Certification for skilled care
• Recognize the appropriate beneficiary notice to be issued at the discontinuation of Medicare Part A benefits

9:45 - 11:15 am

Scott Heichel, RN, RAC-MT, DNS-CT, CIC

MDS coding is the driver behind many care delivery and governmental programs, including care plans, Five-Star ratings, CASPER Quality Measures, Value-Based Purchasing programs, survey process, and it is tied to Medicare/insurance reimbursement, and some state Medicaid reimbursement programs. With over 350 questions on the MDS and an RAI manual that is in excess of 1,300 pages, the likelihood that errors are happening in coding is 100%. This presentation will review the most common coding misunderstandings, confusions, and inaccuracies that our profession faces every day. With the multitude of areas the MDS impacts, your ability to navigate the process accurately is critical to both your residents and your organization.

• Understand the top coding errors within the MDS
• Share the information you have learned and educate your organizations
• Identify strategies for accurate reimbursement and Quality Measures

11:15 am

AANAC Awards, Grants, and Scholarships Celebration Honor your profession and your peers at the 2018 AANAC Awards, Grants, and Scholarships Celebration. Hosted during lunch before the closing keynote, this event is not to be missed. Each fall, we open applications for individuals to be nominated for their work in long-term care. A committee of peer volunteers reviews the applications and selects the winners that are most deserving. We’ll celebrate the following 2018 winners together at this special celebration:

• Nurse Assessment Coordinator of the Year
• Best Practice of the Year
• Outstanding Contributor of the Year
• President’s Professional Development Grant recipient
• Founder’s Professional Development Grant recipient
• Rena R. Shephard Professional Development Grant recipient
• Carter-Elmblad Family Scholarship recipient

As we recognize these outstanding individuals that are always a step ahead and preparing for the future, you will be inspired by their stories and leave feeling the impact you and others have on the future of long-term care.

After the Awards Celebration - 2 pm

Judi Kulus, MSN, MAT, RN, NHA, RAC-MT, DNS-CT

With new payment systems on the horizon, many are asking, “What does the future hold for the nurse assessment coordinator?” We can confidently say that the NAC has a huge role to play in the new survey process, QRPs, VBPs, and the potential RCS-I system! The MDS has already taken on new significance in the new survey process, and this will only increase as the IMPACT Act and other CMS initiatives continue to roll out. AANAC has been on the cutting edge of supporting the NAC to drive MDS accuracy, care planning, and quality resident care. The role of the MDS nurse goes way beyond paperwork and reimbursement. If RCS-I is iimplemented, the complex PPS scheduled and unscheduled assessments may go away, but new responsibilities and career opportunities are presenting themselves for the NAC. Are you ready to face your MDS career with confidence? This session will inspire you to embrace your NAC role to become the champion you were meant to be for your residents!

• Understand how the proposed RCS-I will tax and change the role of the MDS nurse
• Review how the NAC can influence positive care outcomes through the RAI process
• Explain career opportunities for the NAC during these changing times
• Describe how the NAC can be a formal and informal leader to improve resident care and survey outcomes