State Home Per Diem (SHPD) National Association State Veteran Home (NASVH) Summer Conference July 27-August 2, 2014.

State Home Per Diem (SHPD)

National Association State Veteran Home (NASVH) Summer ConferenceJuly 27-August 2, 2014

VETERANS HEALTH ADMINISTRATION

SHPD Dictionary

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ADHC Adult Day Health CareBMS Business System ManagementCBO Chief Business OfficeCBOPC Chief Business Office Purchased CareDOM DomiciliaryHIPAA Health Insurance Portability and

Accountability ActIPERIA Improper Payments Elimination and Recovery Improvement ActOMB Office of Management and BudgetNASVH National Association of State Veterans HomeNHC Nursing Home CarePDF Portable Document FormatPII Personally Identification Information

PKI Public Key InfrastructureSHPD State Home Per Diem ProgramSME Subject Matter ExpertSVH State Veteran HomeVA Veterans AffairsVAMC Veterans Affairs Medical CenterVISN Veterans Integrated Service Network10-10EZ Application for Health Benefits10-10EZR Health Benefits Renewal Application10-10SH State Home Program Application for

Veteran Care Medical Certificate

July 28, 2014

IMPROPER PAYMENTS ELIMINATION ANDRECOVERY IMPROVEMENT ACT (IPERIA) OF 2012

PUBLIC LAW 112–248JAN. 10, 2013

Presenter: Colette Alvarez

VETERANS HEALTH ADMINISTRATION

FY2014 IPERIA

• FY2014 Results have been releasedo SHPD rate 3.02% (Goal 1.5%)

• Duplicate Payments• 10-10EZs were missing or not signed• 10-10SHs were missing or not signed• Inaccurate tracking in tracking tool

– Incorrect per diem rates being used– Incorrect bed hold methodology– Incorrect leave methodology

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Presenter: Colette Alvarez

10-10SH AutomationVISN 12 Pilot

VETERANS HEALTH ADMINISTRATION

Purpose of Pilot

• Provide the capacity for the SHPD Program to design, launch, support and evaluate automated 10-10 SH pilot between VISN 12 Great Lakes/VAMC and SVH (Marquette) with support of CBOPC and CBO Systems Management.

• The VISN 12 pilot will serve as Phase I and the remaining facilities will serve as Phase II, based on the outcomes and recommendations from the Phase I pilot.

• When implemented nationwide, it will improve program efficiency and significantly reduce improper payments.

• Required to use current 10-10SH form (May 2009) until OMB approves new

form with improved clarification and functionalities.

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VETERANS HEALTH ADMINISTRATION

Goals of Phase I

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• Convert the current 10-10SH PDF form into a web-based, fillable form that can be electronically submitted to VHA State Home Per Diem Care Program.

• Include validation on the form that precludes the 10-10SH from being submitted electronically unless all of the required fields/information have information in them.

• Require an electronic signature or equivalent prior to submission. • Provide a date/time stamp upon receipt at the VA facility to assist with

the 10 day rule determination. • Determine if the 10-10SH should be paired with a 10-10EZ for initial

admission to a State Veterans Home (SVH) and for per diem payments for domiciliaries.

• The VA portion of the application should allow the VA representative to return incomplete applications to the SVH along with a notification to them and record the receipt of a “completed” application.

VETERANS HEALTH ADMINISTRATION

10-10SH Pilot Screen Snapshot

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VETERANS HEALTH ADMINISTRATION

10-10SH Pilot Screen Snapshot

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The automated 10-10SH is made up of a series of panels devoted to specific areas of the 10-10SH form. Filling out the panels populates the actual form. It also makes it possible to populate multiple fields from one entry.

The panels are divided between the two sections of the form. There is one set for the SVH, one for purchased care, and another for the clinical reviewer.

The fields on the panels are also tied to the business rules for SVH.

VETERANS HEALTH ADMINISTRATION

Where We Are Today

• Guided version of the 10-10SH completed and vetted within VA

• SVH and VA pilot sites selected and contacted • SVH personnel obtained PKI and have secure email• VA site setting up email account for receipt of SVH

submissions• Training package for both groups ready• Practice data selected and formatted• Dates for pilot being coordinated among participants• Incorporate lessons learned and feedback from the SVH

and VAMC into the form

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VETERANS HEALTH ADMINISTRATION 11

VISN 12 PILOT CONTACTS• Colette Alvarez, VA Program Manager, State Home Per Diem Program (SHPD) [email protected] (775) 326-5721

• Brad Radichel, VA Project Manager [email protected] (404) 828-5622

• Brenda Wiggins, VA Project Manager/COR Brenda.Wiggins3@va (202) 382-2529

July 28, 2014

CBOPC State Home Per Diem Program (SHPD) Pilot

Organization PilotImproving Veterans

Access to Care

Presented to: National Association of State Veterans Home AdministratorsPresenter: Jeanne Crook

VETERANS HEALTH ADMINISTRATION

Why an Organizational and Process Pilot?

• Gathered and reviewed data

• Determined training alone would not solve root cause

• Based on Interviews and feedback from SME’s in the field

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VETERANS HEALTH ADMINISTRATION 14

Overall Benefits

What SVH Will See• Dedicated Staff

• Standardized forms

• Consistent processes and procedures

• Clear escalation path

Resulting In …• Reduced length of time

for application and invoice approvals

• Improved visibility and communications

• Decreased requests to you for redundant documentation

VETERANS HEALTH ADMINISTRATION 15

Next Steps• Hire and Train Lead Contact Representative

and 2-Contact Representatives• Implement requirements for State Veterans

Homes Access• Develop Metrics and Analysis for the Pilot

• October 1st Launch

• Continue Monthly Briefings with NASVH Leadership

VETERANS HEALTH ADMINISTRATION 16

VISN 19 PILOT CONTACTS• Colette Alvarez, VA Program Manager, State Home Per Diem Program (SHPD) [email protected] (775) 326-5721

• Andre’ Bynum, VA Project Manager/COR [email protected] (303) 372-4659

• Martin Ottenbrite, Pilot Project Manager [email protected]

(720) 470-4025

July 28, 2014

2015 Per Diem Rates

Presenter: Jeanne Crook

VETERANS HEALTH ADMINISTRATION

FY2015 Basic Rates

• 2015 Per Diem Rates will increase by 2% for the following:– ADHC $81.56 – DOM $44.19– NHC Basic $102.38

• Source of the increase is the Center for Medicare and Medicaid Services’ for Skilled Nursing Facilities for FY 2015, as printed in the 5/6/2014 Federal Register.

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VETERANS HEALTH ADMINISTRATION 19

State Home Per Diem Program Contacts

Colette AlvarezState Home Per Diem Program Manager

[email protected](775) 842-2529 or (775) 326-5721

Brenda WigginsProgram Analyst

[email protected](202) 382-2529

Jeanne CrookProgram Specialist

[email protected](303) 398-5224

Andre’ BynumProgram Analyst/[email protected]

(303) 372-4659

Stephanie HaddockProgram Specialist

[email protected](303) 331-7504

Gloria J. SanfordDeputy Program [email protected]

(303) 331-7856

Vacant/New HireLead Contact EEV Representative

(Projected August 2014)

Isabel SaundersProgram Specialist

[email protected](303) 372-6209

Stephen PellicerProgram Specialist

[email protected](386) 623-5534

Monica Scott-CarterAdministrative Specialist

Monica [email protected](303) 780-4733

Gloria TestaBudget Analyst

[email protected](303) 398-5573

Vacant/New HireContact EEV Representative

(Projected August 2014)

Vacant/New HireContact EEV Representative

(Projected August 2014)

VETERANS HEALTH ADMINISTRATION

State Home Per Diem VISN Liaisons

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SHPD Staff VISNs AssignedAndre’ Bynum [email protected] 19Jeanne Crook [email protected] 1, 22, & 23Stephanie Haddock [email protected] 6, 9, 18, & 20Steve Pellicer [email protected] 7, 8, & 15Gloria Sanford [email protected] 3 & 10Isabel Saunders [email protected] 4, 5, 16, & 21Gloria Testa [email protected] 2, 11, & 17Brenda Wiggins [email protected] 12

VETERANS HEALTH ADMINISTRATION 21

QUESTIONS

VETERANS HEALTH ADMINISTRATION 22

THANK YOU!