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State Home Per Diem (SHPD)

State Home Per Diem (SHPD). National Association State Veteran Home (NASVH) Summer Conference July 27-August 2, 2014. SHPD Dictionary. PKI Public Key Infrastructure SHPD State Home Per Diem Program SME Subject Matter Expert

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State Home Per Diem (SHPD)

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

  2. SHPD Dictionary • PKI Public Key Infrastructure • SHPD State Home Per Diem Program • SME Subject Matter Expert • SVH State Veteran Home • VA Veterans Affairs • VAMC Veterans Affairs Medical Center • VISN Veterans Integrated Service Network • 10-10EZ Application for Health Benefits • 10-10EZR Health Benefits Renewal Application • 10-10SH State Home Program Application for Veteran Care Medical Certificate • ADHC Adult Day Health Care • BMS Business System Management • CBO Chief Business Office • CBOPC Chief Business Office Purchased Care • DOM Domiciliary • HIPAA Health Insurance Portability and Accountability Act • IPERIA Improper Payments Elimination and • Recovery Improvement Act • OMB Office of Management and Budget • NASVH National Association of State • Veterans Home • NHC Nursing Home Care • PDF Portable Document Format • PIIPersonally Identification Information

  3. PUBLIC LAW 112–248JAN. 10, 2013 IMPROPER PAYMENTS ELIMINATION AND RECOVERY IMPROVEMENT ACT (IPERIA) OF 2012 Presenter: Colette Alvarez July 28, 2014

  4. FY2014 IPERIA • FY2014 Results have been released • 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

  5. 10-10SH AutomationVISN 12 Pilot Presenter: Colette Alvarez

  6. 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.

  7. Goals of Phase I • 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.

  8. 10-10SH Pilot Screen Snapshot

  9. 10-10SH Pilot Screen Snapshot 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.

  10. 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

  11. VISN 12 PILOT CONTACTS • Colette Alvarez, VA Program Manager, • State Home Per Diem Program (SHPD) • Colette.Alvarez@va.gov • (775) 326-5721 • Brad Radichel, VA Project Manager • Richard.Radichel@va.gov • (404) 828-5622 • Brenda Wiggins, VA Project Manager/COR • Brenda.Wiggins3@va • (202) 382-2529

  12. Organization PilotImproving Veterans Access to Care CBOPC State Home Per Diem Program (SHPD) Pilot Presented to: National Association of State Veterans Home Administrators Presenter: Jeanne Crook July 28, 2014

  13. 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

  14. Overall Benefits Resulting In … • Reduced length of time for application and invoice approvals • Improved visibility and communications • Decreased requests to you for redundant documentation What SVH Will See • Dedicated Staff • Standardized forms • Consistent processes and procedures • Clear escalation path

  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

  16. VISN 19 PILOT CONTACTS • Colette Alvarez, VA Program Manager, • State Home Per Diem Program (SHPD) • Colette.Alvarez@va.gov • (775) 326-5721 • Andre’ Bynum, VA Project Manager/COR • Andre.Bynum@va.gov • (303) 372-4659 • Martin Ottenbrite, Pilot Project Manager raphael.ottenbriteII@va.gov • (720) 470-4025

  17. 2015 Per Diem Rates Presenter: Jeanne Crook July 28, 2014

  18. 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.

  19. State Home Per Diem Program Contacts Colette Alvarez State Home Per Diem Program Manager Colette.Alvarez@va.gov (775) 842-2529 or (775) 326-5721 Brenda Wiggins Program Analyst Brenda.Wiggins3@va.gov (202) 382-2529 Gloria J. Sanford Deputy Program Manager Gloria.Sanford@va.gov (303) 331-7856 Andre’ Bynum Program Analyst/COR Andre.Bynum@va.gov (303) 372-4659 Jeanne Crook Program Specialist Jeanne.Crook@va.gov (303) 398-5224 Gloria Testa Budget Analyst Gloria.Testa@va.gov (303) 398-5573 Vacant/New Hire Lead Contact EEV Representative (Projected August 2014) Stephanie Haddock Program Specialist Stephanie.Haddock@va.gov (303) 331-7504 Isabel Saunders Program Specialist Isabel.Saunders@va.gov (303) 372-6209 Vacant/New Hire Contact EEV Representative (Projected August 2014) Vacant/New Hire Contact EEV Representative (Projected August 2014) Stephen Pellicer Program Specialist Stephen.Pellicer@va.gov (386) 623-5534 Monica Scott-Carter Administrative Specialist Monica Scott-Carter@va.gov (303) 780-4733

  20. State Home Per Diem VISN Liaisons

  21. QUESTIONS

  22. THANK YOU!

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