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ADHC Update - May 12, 2017

ADHC Update - May 12, 2017

ADHC Update - May 12, 2017


Good morning ADHCC members,

Below are a few important updates for the end the work week:

·         CMS delays implementation of the federal Home and Community-based Services (HCBS) settings rule to March 2022.

·         Nursing home cost report due July 3.

·         ADHCC submits regulatory reform recommendations to DOH.

·         New York City and Westchester provider: please report your capacity and average census (percentage) for the past six months by COB today.

The Centers for Medicare and Medicaid Services (CMS) released an informational bulletin on May 9th announcing that the deadline for states to come into compliance with the federal Home and Community-based Services (HCBS) Settings Rule has been extended from March 17, 2019 to March 17, 2022. The informational bulletin states:

In recognition of the significance of the reform efforts underway, CMS intends to continue to work with states on their transition plans for settings that were operating before March 17, 2014 to enable states to achieve compliance with the settings criteria beyond 2019. Consistent with the preamble language, states should continue progress in assessing existing operations and identifying milestones for compliance that result in final Statewide Transition Plan approval by March 17, 2019. However, in light of the difficult and complex nature of this task, we will extend the transition period for states to demonstrate compliance with the home and community based settings criteria until March 17, 2022 for settings in which a transition period applies. We anticipate that this additional three years will be helpful to states to ensure compliance activities are collaborative, transparent and timely.

Over the years, the Adult Day Health Care Council (ADHCC) has expressed serious concerns with CMS guidance and how the rule may impact adult day health care providers. We are pleased that CMS has extended the timeline for New York to come into compliance; however, we will continue to emphasize the need for flexibility for residential and non-residential settings which serve older individuals with complex, chronic medical conditions.

ADHCC is meeting with DOH next week to discuss this new development as well as questions raised following DOH’s presentation on the HCBS settings rule at our annual conference.

The Department of Health (DOH) notified providers that the 2016 Nursing Home Medicaid Cost Report software has been posted on the Health Commerce System (HCS). Completed reports and associated certifications are due no later than July 3, 2017, earlier than in previous years. Because of the shortened timeframe, and since DOH has indicated that extension requests will not be considered, it is important for nursing homes to ensure that they are prepared to meet the deadline.

The cost report Dear Administrator Letter is available here. Please note that individuals required to certify the report must have or obtain appropriate HCS access well in advance of the report due date.

Last week, LeadingAge NY submitted a letter to the Department of Health (DOH) describing proposed regulatory reforms. The letter was sent in response to a request by the Department for proposals to improve the State’s regulatory framework for long-term/post/acute care, in order to support the efficient delivery of high quality care and new value-based payment arrangements. The letter included the following proposals from ADHCC:

·         Allow fee-for-service Medicaid, Mainstream Managed Care and private-pay to utilize unbundled services payment option;

·         Amend Part 425.4 (a)(1) to remove “other applicable statutes and regulations”;

·         Allow interdisciplinary care plan and UAS-NY to be completed during any day of the month it’s due; and,

·         Allow nursing home medical director to sign orders for continued stay.

Click here to read the entire letter and description of proposed ADHC reforms. If you have any other regulatory reform recommendations, please contact me.

Westchester and New York City ADHC providers: please email me today with your approved capacity and average census for the past six months. Five years deep into mandatory MLTC, ADHCC is collecting preliminary data on how Region 7 providers are performing. Some programs have adjusted and stabilized while others are still struggling. You submit weekly bed census data, but this information can be old or inaccurate.

To get an idea of how you are performing, please email me back with:

1.       Capacity (the total number of individuals you can admit per session)

2.       Average census or occupancy (percentage) for the past six months.

We may conduct a more in-depth survey in response to these numbers. For those who participate in the data request, I will email you back with your county/borough’s average capacity and average occupancy. If you operate more than one program, please include data on both or all programs. Program names and individual information will not be shared. Thank you to the programs who submitted data earlier this week.

If you have any questions regarding the contents of this email, please contact me at ahill@leadingageny.org or call 518-867-8836.