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Mid-Winter Conference CFO Break out Session February 13, 2019

Mid-Winter Conference CFO Break out Session February 13, 2019. Discussion Topics. Prevailing Rate Calculation – Step by Step Medicare PDPM and the impact on future Prevailing Rates Surety Bond requirements and resident trust accounts.

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Mid-Winter Conference CFO Break out Session February 13, 2019

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  1. Mid-Winter Conference CFO Breakout Session February 13, 2019

  2. Discussion Topics • Prevailing Rate Calculation – Step by Step • Medicare PDPM and the impact on future Prevailing Rates • Surety Bond requirements and resident trust accounts. • Direct / Indirect Costs for the calculation of per diem payment on the 5588. • Provider agreements – update • Construction Program - update

  3. Prevailing Rate Calculation • The VA has provided a presentation explaining the steps taken to calculate the nursing home prevailing rate. This document has been posted to the NASVH web-site.

  4. Medicare PDPM and the Impact on the Prevailing Rate • Effective 10/1/19, Medicare will dramatically change its payment system from RUGS based payments to the Patient Driven Payment Model (PDPM). • Although we still do not have confirmation what information will be published in future Federal Registers, we are concerned that the RUGS information currently being utilized to calculate the Prevailing Rate, will no longer be available. • NASVH has sent a letter to the VA requesting that we jointly begin exploring solutions to define how prevailing rates will be calculated to ensure that future rates are announced timely and without delays in the normal payment cycle.

  5. Surety Bond Requirements38 CFR part 51.70 The VA has provided a detailed interpretation and procedure document to aide in State Veterans Homes understanding of the requirements for regulation 38 CFR 51.70 (c) (6) Assurance of financial security. This document has been posted to the NASVH web-site. • What does the federal regulations require in 51.70? • What is the VA Interpretation of 51.70? • What is the process to submit to VHA Under Secretary for Health? • What should I do next?

  6. Direct / Indirect Costs Reported on the 5588 • State Veterans Homes should be reviewing your direct and indirect costs to ensure that you are reporting correctly on the 5588. • Some homes have found in their review that past reporting of their costs were missing many allowable costs items and as a result, they were not receiving the full base per diem payment of $109.73 per day. • The VA has provided some additional resources that we have posted on the NASVH web-site to aide in your review of your direct / indirect costs.

  7. Other Updates from the VA • Provider agreements • Construction program • Other Topics?

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