Directions Spring 2019 edition will be bigger and better than ever!
A message from John Damgaard, President and Chief Executive Officer
It’s time to start planning for your attendance at Directions 2019 in Nashville, Tennessee, April 24-26, 2019, at the Gaylord Opryland Resort – Early Bird Registration opens November 2018!
At your popular request, we shifted the timeframe for our annual user conference from its traditional early fall timeslot to the springtime. We believe that the extra planning time associated with this transition will pay valuable dividends for those looking to understand the impact of regulatory changes on their business, successfully manage risk, and increase performance under value-based care.
Whether you’re a MatrixCare Certified Professional or just beginning to discover what MatrixCare has to offer, Directions 2019 will have something for you. Multiple session tracks will cover everything from basic how-tos to advanced tips and tricks for getting the most from your MatrixCare solution.
In addition, you’ll have opportunities to see demos of our products, spend time with our product experts in the Genius Lab, network with other LTPAC colleagues and explore our Partner Pavilion to learn about other helpful solutions that integrate seamlessly with MatrixCare. Something new this year will be a dedicated Technology Leadership Forum day for CTOs/CIOs, where we will address opportunities and concerns for this key audience.
But don’t worry…although our format is evolving, we’re still including time to party! We’re planning to blow the roof off the world-famous Wildhorse Saloon with a country-themed party that combines MatrixCare’s famous hospitality with some boot-stompin’ fun.
As you head into budget planning for next year, make sure that attendance at Directions 2019 is at the top of the list for you and your staff!
See you in Nashville! #HappinessMatters
Don’t Miss Our Roadmap for the Future Town Hall
MatrixCare is committed to extending the value of our platform by continuing to equip clients like yourself with industry-leading technology that helps you deliver on your mission to residents and families.
If you have not had an opportunity to participate in one of our previous Town Hall Webinars, we invite you and your executive staff to join us. Additional sessions will be offered October 11, and October 18 at 3:00 PM EDT.
We also encourage you to download our white paper titled “Forward Together: The Roadmap to a Successful Future.” This document provides you with detailed information about how MatrixCare is continuing to evolve our SigmaCare by MatrixCare solutions and guidance on how you can take advantage of these exciting innovations as a provider using these products. The document also details the Solution Expansionstrategy and the Platform Modernization strategy.
Zimmet Conference Highlights and PDPM
A message from Amy Ostrem, Senior Product Manager
Recently, I had the pleasure of attending several excellent educational sessions at the Zimmet Conference held in Atlantic City, NJ August 8th-9th. The expert insights and presentations were superior. Over 1,200 people with a passion for LTPAC were in attendance. The learnings on the new Patient Driven Payment Model (PDPM) effective 10/1/2019 were enlightening, informative, and provided some great networking discussion topics.
To highlight some of the key takeaways around PDPM from the Zimmet conference, I will focus on 3 major areas:
- What is PDPM
- What are the key differences between RUGS-IV and PDPM
- What actions can you take now in preparation for PDPM
WHAT is PDPM?
To begin with the WHAT, in the what is PDPM, there are a couple of key components to remember:
- PDPM is a revised case-mix classification methodology
- PDPM is Budget Neutral. Reimbursement is being shifted away from its ties to therapy to more appropriately reimburse for conditions requiring nursing time and medical expense.
- PDPM is NOT a change of benefits
Key differences between RUGS-IV and PDPM
|2 case-mix components||5 case-mix components|
|5 scheduled PPS assessments||1 scheduled PPS assessment|
|Constant reimbursement rates for the entire length of stay||Declining reimbursement rates over the length of stay|
|Maximum therapy incentivized||Minimum therapy incentivized|
To begin to prepare for PDPM, there were many suggestions based on the key impacts and details of what is coming with PDPM. Here are some key items to consider and examples that were shared:
- Form a PDPM task force in your organization.
- Educate, educate, educate! Read, attend industry seminars, vendor seminars, and other events on PDPM.
- Network with other providers and consultants to brainstorm success factors.
- Be sure you are documenting the reasons for skilled care on a daily basis.
- Make a plan to improve coding and how it relates to PDPM. The ICD-10 codes used will be extremely critical and could equate to a gain of $30 per day just by coding the correct, most specific code! And, just as you are selecting the proper ICD-10 codes, be sure to resolve those no longer relevant (for example, you cannot have pneumonia for 6 years).
- Pay attention to morbid obesity and a BMI over 40 as this also adds up to more $ per day.
- With fewer MDSs, consider revising your MDS coordinator’s job description. Think of ways to be even more diligent on the 5 day MDS. Since there is no 14, 30, 60, or 90; the 5 day is even more critical to your success!
- With the twist on therapy with PDPM, consider enhancing your therapy team’s responsibilities. Perhaps the therapists, with their expert knowledge, could complete section GG?
Here at MatrixCare, we ensure regulatory changes are completed for you on time. We participate in industry events such as Zimmet, we analyze CMS documentation, we go straight to CMS with questions, concerns, and additional suggestions, and most importantly, we have a strong Research and Development team that is already up to speed on PDPM. Client education is also critical at MatrixCare, so you will continue to receive invites for PDPM webinars, documentation, and short blogs such as this. Stay tuned for more updates, and let’s work together on PDPM success!
MatrixCare is celebrating Customer Service Month in October!
Customer Service Employee Appreciation Month is a series of events we schedule to recognize and honor employees who have provided excellent customer service. We value our customers and believe an important part of delivering excellent customer service is recognizing employees that go above and beyond to support our goals and values!
We’d like to ask for your feedback on individuals that have provided you service in the past. We are recognizing employees who provide support/helpdesk, training, implementation, sales, tech services, finance, development or product management.
2018 R3 Release is Coming Soon! Are You Ready?
SigmaCare by MatrixCare Care Management 2018 R3 release is right around the corner. A key to taking advantage of all the new enhancements and functions in your SigmaCare by MatrixCare solution is being educated about their use and organizational impacts. We encourage you to leverage the Release Tool Box in Customer Connect to aid you in your readiness efforts.
Highlights of the 2018 R3 release:
- MDS Regulatory Updates
- SigmaCare by MatrixCare Care Management has been updated to ensure compliance with MDS 3.0 changes effective October 1, 2018, for assessments with an ARD of 10/01/2018 or later.
- Updates have been made to the Standard Content Library to include the new and updated MDS data population.
- Questions related to MDS changes effective October 1, 2018, have been set to pre-populate date from Clinical Assessments entered
- Redacted Medication Administrations
- Users can remove medication administrations from a resident’s medical record to protect confidential or privileged information from being disclosed inappropriately.
- Page View and Resident Auditing
- The system will capture the pages within the Resident Summary page that a user views in the Resident Audit Log and System Audit Log.
Access the 2018 R3 Release Tool Box in Customer Connect to download the Release Notes and learn about all of the new features that will be included in the release. We also encourage you to register for an upcoming Release Overview Webinar; we will review MDS changes, pre-population updates, and current workflow impacts.
Superior Interoperability with Best in KLAS Revenue Cycle Management Software
The MatrixCare platform allows for the sharing of information between your SigmaCare by MatrixCare Care Management (CM) and MatrixCare Revenue Cycle Management (MC RCM) solutions. At MatrixCare, we understand that the efficiencies provided by interoperability are no longer a luxury, time savings and information sharing are critical drivers of the quality of care delivered and the success of your business. The SC CM and the MC RCM solutions, when used together, can maximize your organization’s workflow and minimize data entry between your clinical, admissions, and billing staff, ensuring consistent information across the platform.
Preadmission information that is entered in CM, or generated from ReferralConnect, will create a face sheet for a resident in MC RCM. When the resident is admitted in CM, the attending physician will be automatically assigned, and the admission census event added in MC RCM.
To ensure the utmost synchronization of your census, the following events are managed in CM and will be reflected in MC RCM:
- Room changes
- Attending Physician changes
- Hospital Transfers and returns in CM will create Hospital Leave and Return events in MC RCM
- Leave of Absence Start and Returns entered in CM can also be configured to create Therapeutic Leave and Return events in MC RCM
The hospital transfer turned discharge workflow is designed to support billing and clinical needs. When the resident is first sent to the hospital, the hospital transfer entered in SigmaCare will be reflected in MC RCM. Once the clinical staff learns of the admission to the hospital, a discharge with bed hold request is entered in CM but will not impact MC RCM. This gives billing the flexibility, based on payer and state bed payment policies, to leave the resident on Hospital transfer if the bed is being paid for, or to discharge the resident if or when the bed is no longer being paid for. If the bed is not being paid for and biller has entered a discharge in MC RCM, that discharge will release the bed hold in CM.
The seamless integration of these transactions ensures that the census in SigmaCare and MatrixCare match and the events in each resident’s history are the same, down to the minute, without any duplicate entry.
Sharing of Resident Information
Resident payer information is the primary focus of the billing team and plays a significant role in clinical workflows as well. A resident’s payer drives their drug formulary and MDS scheduling, to support these workflows, resident payer information entered by billing in MC will be automatically reflected in CM.
Resident diagnoses are initially assessed by the Provider and entered in the EHR, but billing needs a comprehensive record of the of the diagnoses to ensure the correct codes are applied to the claims. Resident diagnoses are managed in CM and will populate in MC RCM automatically. The sequencing of diagnoses is managed in each application separately to support accurate billing and clinical prioritization.
Resident demographics and contact updates can be made in both MC RCM and CM and will update the other application in real time.
MDS information, specifically the RUG scores, are critical to reimbursement. Manually importing the MDS assessments is time-consuming and could lead to files being missed which puts reimbursement at risk. With the CM/MC RCM bidirectional integration, the MDS files automatically transmit from CM to MC during normal submission workflows, so there is no manual upload required.
Overall, information managed by the clinical team will be entered in CM and flow to MC RCM. Similarly, the information supplied by the billing team will be entered in MC RCM and flow to CM. You will find that the SC CM and the MC RCM solutions, when used together, will optimize your billing and clinical resources, avoid duplicate entry, and ensure consistency across a resident’s record.
Discover all the ways that Matrixcare Revenue Cycle Management can save time, increase revenue, and provide you with data to make sound, timely decisions. Learn about the business rules and regulations built into the system to give you improved results and reporting that allows you to dive into your data to analyze it from all angles.
Join us for a 30-minute webinar to learn more!
Support Frequently Asked Questions and Helpful Tips
Managing Flu Vaccine Library Orders
It’s that time of the year again, time to create or update your existing library order for the 2018-2019 Flu vaccine. Library orders can aid users in entering orders for residents by including pre-determined information such as SIG or Schedule.
Below are the steps to guide your facility through creating a new library order or editing an existing one. These steps will need to be completed by a user with access to the necessary areas of Setup; typically this is a Nursing Supervisor or System Administrator.
Steps to Create a Library Order:
- Navigate to Setup > Physician Order Setup > Physician Order Library Setup.
- Click the library name.
- Click Add Medication Order.
- Select the desired medication.
- Enter the desired description (include medication name and years of use).
- Click Save.
- Enter any additional information.
- Click Save.
Note: If editing an existing library order, you simply need to select the desired order from the library menu, update the medication selected and click save.
Complimentary Teleforum: Staff Recruitment & Retention in LTPAC
People are at the core of Long-Term and Post-Acute Care whether you’re in Independent Living, Assisted Living, or Skilled Nursing. You can have a pretty new building, but if you don’t have great staff, it shows up in your quality outcomes, your census, and lack of referrals.
So how do you attract and keep great staff and leaders?
During this 60-minute MatrixCare/Conduit Coaching teleforum we discussed the points below plus field your specific questions:
- How much of a problem is recruitment & retention in Long-Term and Post-Acute Care? And why is it happening?
- What can organizations do to attract the best people? And how can leaders help new hires succeed in their first 90 days?
- What are the 3 crucial cornerstones to holding onto great people once you hire them so that they’re engaged, happy, and they stay?
This session was led by Bonnie Schultz, Director of Human Resources Operations at MatrixCare and Senior Care Leadership expert, Mary Ellen Sanajko of Conduit Coaching, for a 60-minute, complimentary thought-leadership teleforum.
If you missed this informative session on September 19, 2018, at 12:00 PM EDT, you can still register to access a recording of the teleforum.
Upcoming Live Webinars
MatrixCare offers complimentary monthly training webinars to ensure clients are optimizing their use of the software. A variety of topics are covered, including recent release updates and regulatory items.
- Prepare for the Upcoming MDS 3.0 Changes
Thursday, September 27, 2018 1:00-2:00 PM EDT
During this instructor-led webinar, we will review the upcoming MDS changes, as well as how to update your pre-population, and how that affects your SigmaCare by MatrixCare workflow. Additional features included in the SigmaCare by MatrixCare Care Management 2018 R3 Release, will also be reviewed during this session.
Access Customer Connect to register for an upcoming live webinar.
Missed a live webinar? View a recording on-demand. Check out the latest:
Get Ready for the Patient Driven Payment Model (PDPM)
Presented on Thursday, September 6, 2018
In late July, CMS released the Final Rule for FY 2019 which “replaces the existing case-mix classification methodology, the Resource Utilization Groups, Version IV (RUG-IV) model, with a revised case-mix methodology called the Patient-Driven Payment Model (PDPM) beginning on October 1, 2019”. In this session, you will learn how PDPM differs from RUGS-IV and what you need to do to be ready for the proposed October 1, 2019 implementation date.
Access Customer Connect to view this on-demand webinar.
Readmissions Penalties Are Near: Avoid Them by Leveraging Your Data
Presented on August 28, 2018
Value-based purchasing (VBP) penalties and incentives for skilled nursing facilities begin October 1, so the need for a comprehensive approach to managing hospital readmissions is more important than ever. During this session, attendees will learn the regulatory and legislative path to value-based payment; how to identify and incorporate data into QAPI processes to effectively manage hospital readmissions; and how to use analytics to manage readmissions and strategies for building a data-driven culture.
This session co-hosted with McKnight’s is available on-demand, click to view this webinar.
Maximize Your MatrixCare Solution with Training Assurance Plus
MatrixCare Training Assurance Plus (TAP) gives you options to secure training and consulting throughout the year, guaranteeing you will have the education necessary to stay on top of industry changes, product updates, and staffing needs.
With MatrixCare TAP, you will have access to the following:
- Annual Product Optimization: Yearly MatrixCare audit done by our staff results in a customized agenda focused on recommended areas for improvement.
- New Hire Training: Let us know your staff turnover situation and we’ll customize an agenda to ensure you have the same level of expertise always on board.
- Advanced Training & Consulting: This option is designed to assist your experienced staff with implementing newly released features of MatrixCare on an ongoing basis.
- Personalized Plan: Consult with MatrixCare to determine a PLUS solution that works for you.
To learn more, download the MatrixCare Training Assurance Plus (TAP) brochure or contact your MatrixCare representative for more information.
Boosting Your MatrixCare Investment with Clinical Product Partners Webinar Now Available On-Demand
In August, MatrixCare hosted the first of several upcoming sessions that focus on partner integrations and ways to enhance your existing MatrixCare solution. The Clinical Product Partner Webinar held on August 16, 2018, was led by a panel of our certified partners as they presented on products and solutions that improve clinical outcomes, financial performance, staff efficiency and more.
Attendees learned about tools and resources available from Relias, Constant Care Technology, Pioneer Solution and eKare to optimize their MatrixCare investment. Interested in learning more about a specific partner’s technology? View the webinar today!
Stay tuned for our next partner webinar which will be Thursday, October 25th.
MDS 3.0 RAI Manual Updates Effective October 1, 2018
The MDS 3.0 RAI Manual v.1.16 is effective October 1, 2018. This version of the RAI manual incorporates clarifications to existing coding and transmission policy; it also addresses clarifications and scenarios concerning complex areas.
CMS has posted the MDS 3.0 RAI Manual v 1.16, change tables, and replacement manual pages to help you prepare for the upcoming changes.
Access the CMS website to download the updated RAI manual and associated files.
Upon upgrade, the updated RAI manual will be available in MatrixCare.
Medicare Part A Rate Changes Effective October 1, 2018
Effective Oct 1st, 2018 Medicare Part A rates are now facility specific and calculated in the following order:
- 2.4% Market Basket/Labor to Arrive at Current FY Rates
- QRP Penalties (if applicable)
- VBP Adjustments
- Sequestration (applied to subtotal after all coinsurance and deductible payments)
QRP Penalties: Skilled Nursing Facilities who were identified as not meeting the 80% reporting threshold under the SNF Quality Reporting Program (QRP) for fiscal 2019 were notified in early July of their noncompliance and opportunity to request reconsideration by August 7. SNFs that did not request reconsideration or whose requests were denied will be subject to a 2% reduction on their FY2019 Medicare fee-for-service rates beginning October 1, 2018.
Noncompliance letters were distributed to SNFs in one or more of the following ways: through U.S. mail, from the Medicare Audit Contractor (MAC) and posted in the CASPER system. Noncompliance letters from the MAC appeared generic, providing no explanation of which measure(s) the SNF failed to meet the 80% reporting threshold. SNFs who received these MAC letters can download a more-specific FY2019 noncompliance notification letter from the CASPER reporting which will identify the measure(s) for which they are being considered noncompliant and the steps for requesting reconsideration.
To ensure future compliance, SNFs who provide their CCN and email address(es) to QRPHelp@cormac-corp.com (a CMS contractor) will receive quarterly submission deadline reminders if they are under-reporting. These emails are only sent to SNFs if they are not meeting all required reporting thresholds ahead of the submission deadline.
VBP Adjustments: The Centers for Medicare & Medicaid Services (CMS) has released the Skilled Nursing Facility (SNF) Value-Based Purchasing (VBP) Confidential Performance Score Reports, which contains each SNFs payment adjustment for FY 2019 along with information on rehospitalization rates and scores used to calculate payment adjustments beginning October 1, 2018. Details on how to access your reports via the Quality Improvement Evaluation System (QIES) and the CASPER reporting application can be found here.
On tab 3 of the Value-Based Purchasing (VBP) Confidential Performance Score Report, named 3 – Facility Performance, you will see your facilities “Incentive Payment Multiplier” for example.
New Medicare Card Mailing Update: Wave 5 Begins, Wave 3 Ends
CMS started mailing new Medicare cards to people with Medicare who live in Wave 5 states: Alabama, Florida, Georgia, North Carolina, and South Carolina. CMS will continue to mail new cards to people who live in Wave 4 states, as well as nationwide to people who are new to Medicare.
CMS finished mailing cards to people with Medicare who live in Wave 1, 2 and 3 states and territories. If your Medicare patients say they did not get a card, instruct them to:
• Sign into MyMedicare.gov to see if we mailed their card. If so, they can print an official card. They must create an account if they do not already have one.
• Call 1-800-MEDICARE (1-800-633-4227). There might be something that needs to be corrected, such as updating their mailing address.
To ensure your Medicare patients continue to get care, you can use either the former Social Security number-based Health Insurance Claim Number or the new alpha-numeric Medicare Beneficiary Identifier (MBI) for all Medicare transactions through December 31, 2019.
Check this website as the mailings progress. Continue to direct your Medicare patients to Medicare.gov/NewCard for information about the mailings and to sign up to get an email about the status of card mailings in their state.
Information on the transition to the new MBI:
Celebrating National Senior Citizen’s Day
In 1988, President Ronald Reagan declared August 21st as National Senior Citizen’s Day. This observance was established to honor the many contributions senior citizens in the US have made and continue to make in their communities. The day was also created to bring awareness of social, health, and economic issues that affect senior citizens.
At MatrixCare, we appreciate and value the contributions of the elderly and feel lucky to serve America’s aging population today and every day. This year we had the pleasure of visiting and with residents in the community as they recalled their days past. A special thank you to St. Gertrude’s Health & Rehabilitation Center of Benedictine Health System for allowing us to meet and chat with your residents!
We look forward to seeing you at the upcoming events. Be sure to stop by our booth and learn more about all the MatrixCare solutions available to you.
- LeadingAge WI | October 3-4, 2018
- NAHC Home Care and Hospice Conference and Expo | October 7-9, 2018
- AHCA/NCAL Annual Convention & Expo | October 7-10, 2018
Visit us at Booth 1405 or for more information: matrixcare.com/expo
- Empire State Association of Assisted Living- ALR Conference | October 17-18, 2018
- HCANJ Annual Conference | October 23, 2018
- LeadingAge Annual Meeting & Expo | October 28-31, 2018
Visit us at Booth 1227 or for more information: matrixcare.com/leadingage