Monthly tips, tools, information & special offers
May 2021 | Issue 4
Solutions Spotlight
Developing Awareness Training Programs for Healthcare Professionals
The strongest endpoint protection, encryption, and firewalls might make you think your ePHI is safe, but your staff’s behavior is just as important, if not more! 95% of cybersecurity breaches are caused by human error, not by technology failures.
 
Join Brian Murphy, CISA, CRISC of GreyCastle Security for a webinar on 5/25, to learn how to train doctors and nurses on cybersecurity best practices. Even if your calendar is full, all registrants receive the slides and recording to review at your leisure! 
Innovation in Senior Care Models: What’s Next?

Recently, there has been a provisional decline in ADR and denial activity related to the onset of Covid-19 and the pandemic, but Medicare and other regulatory agencies are once again shifting their focus. Claim denials from Medicare, Medicare Advantage, and Medicaid plans are on the rise. Knowing industry trends and taking a proactive approach can reduce loss of revenue for healthcare providers and SNFs across the country. The best way to manage a denial is to be versed in the claims process and to stay vigilant with documentation in order to prevent claim arbitration.
CORE Analytics Releases Medicare Advantage Platform 

The Medicare Advantage Post-Acute eXchange (MAPAX) delivers the industry’s first claims-based intelligence on current SNF-MA reimbursement, outcomes and value proposition. This data does not exist elsewhere, despite Medicare Advantage enrollment exceeding 40% of all beneficiaries nationally. Learn more here!
How to Build Equity Into Your Employee's Health Benefits

The converging crises in 2020 shed light on the lack of access to affordable healthcare for Black and Brown peoples and persons from economically marginalized communities. We all witnessed the crippling compound effect of health inequity shouldered by economically distressed communities - many New York nonprofits responded in turn.
Employee Health Benefits in a Pandemic
One major area where health inequities still exist in the workplace is in employer-sponsored health benefits plan design. Traditional insurance plans—premiums, copayments, deductibles and coinsurance—frequently create barriers to care. They also can exacerbate inequities in healthcare by inhibiting the use of services - such as primary care - that benefit health and wellbeing.
Special Savings from Value First!

Germ free is the way to be - save on COVID related costs!
Bouncing Back From COVID-19: The Role of Rehabilitation in Recovery

We have learned over the last year how COVID-19 attacks the body and mind leaving an individual debilitated, weak, and possibly with cognitive decline. The good news, though, is that rehabilitation efforts including physical, occupational, and speech therapies seek to restore the whole person and help individuals resume previous quality of life.
Holy Smokes - Marijuana Legalization
New Yorkers are abuzz with the news that the state has legalized recreational adult use of marijuana effective September 2022. Under the Compassionate Care Act, skilled nursing facilities (SNFs) and assisted living facilities (ALFs) have supported the use of medical marijuana for residents with qualifying conditions since the Act was passed in 2014. With legalized adult use of marijuana, how will health care facilities and their residents be impacted?
Quality Measures for Optimal Performance

This past January, CMS released their updated Long-Term Care Survey Process Materials. In addition to a focus on infection control policies and procedures, CMS surveyors will now investigate any concerns related to residents who have experienced a significant decline in their condition during the Public Health Emergency. The COVID-19 impact on the elderly population has been significant. There is an increase in isolation, decreased socialization, and limited interaction with caregivers. Understanding the surveyor’s guidance is the first step to a successful survey. Proactive measures, as well as accuracy in baseline data for all residents, will improve the survey process, and enhance the quality of care provided. 
Health Care Items in American Rescue Act of 2021

New legislation includes numerous provisions for health care, with billions of dollars allocated to vaccines, contact tracing, rural development, mental health and substance abuse, and the health care workforce.
Nursing Homes Save Money with Community Solar

Nursing homes are typically master metered, meaning one electricity account encompasses the electricity usage for all residents in a building, rather than each resident having their own account. Community solar subscriptions are usually capped at a specific amount of demand (kW) per account. However, master metering allows a customer to circumvent this cap. A common cap for a direct metered account is 30kW. If the account is master metered, the customer can exceed this cap and be granted a subscription several times this amount, depending on the number of residents. With a larger subscription, the customer will see greater savings.
Curious Case of Consent
At the Leading Age New York Conference on May 20, 2021, Cona Elder Law is presenting an in-depth panel discussion from 3:00-4:00 PM of the realities of sexual activity in residential health care facilities and the balance facilities must maintain between preserving the rights to privacy and respect for the sexual fulfillment of residents. The presentation will also cover tips for navigating liability and regulatory compliance concerning the protection of residents from sexual harm. We hope you will join us for this thought-provoking virtual presentation which will include a live “Question & Answer” feature where attendees can interact with the presenters and ask questions.
Insurance Marketplace Continues to Harden
For 2021, the insurance market continues to harden with significantly higher pricing. After approximately 20 years of a soft, buyer-friendly insurance market, the past few years have seen a firming or hardening market—one that is less friendly to insurance buyers.

While the effects of this hardening insurance market on long term care will depend on a variety of factors, most facilities will see premium increases for their insurance coverage overall. In fact, most facilities may see double-digit rate increases at their renewal.
CYBERSECURITY &
BUSINESS GROWTH:
Turn Your Program Into a Profit Center
When most companies think about
cybersecurity, they’re considering things
like regulatory compliance, loss prevention,
and qualitative risk reduction – all valuable
facets of a well-rounded program. But with
the right strategies and implementation,
a well-managed cybersecurity program
has a major impact on driving revenue,
reputation, and company growth.

Companies of all sizes are exploring digital
technologies more than ever to build
better-connected audiences, increase
operational agility, and create web-based
ecosystems that offer new revenue
streams. With such a prevalence of digital
services and solutions, opportunities
to extract more value from your
cybersecurity program are ever-growing.
Help Your Employees Be Financially
Prepared for the Unexpected
Today’s workforce is complex, which makes voluntary benefits especially important. While auto and home insurance may not be top of mind for your benefits program, these coverages provide more options for your employees to improve their financial wellness.
Time to consider?

Just like medical, premiums and out-of-pocket expenses for auto and home insurance are going
up. From auto accidents to natural disasters, there has been an increase in the severity and
frequency of incidents. And without the right coverage, an accident or storm can be devastating
to your employees’ financial wellbeing. With MetLife Auto & Home®, you can give your employees
access to the protection they need to stay prepared for the unexpected. And the support they
need to get back on track.
Does Your Facility Struggle with Denied Medicaid Applications Resulting in Uncollectible Debt?
Studies show that a vast portion of Nursing Facility uncollectible debt nationwide is a result of inefficient Medicaid planning for residents who are in need of Medicaid for long term care - and subsequent denied Medicaid applications as a result. The solution to this problem is for Providers to have a healthy Medicaid planning structure in place to proactively mitigate risks and identify eligibility issues. This will ensure that providers have ample time to plan and strategize in advance, thus limiting surprises that arise after the application is submitted.