June 17, 2019 Edition of The Situation Report

EVV

MLTC UPDATES

LTC PLANNING PROJECT

IOC DRILL

A second Electronic Visit Verification (EVV) Listening Session has been added in NYC on July 9. HCA continues to urge provider input on EVV design.

DOH advisory meeting with MLTC representatives includes updates on: patients’ rights to HCBS information; one plan’s impending closure; EVV & CFCO readiness; and the future of NYS’s duals initiatives.

Second meeting of NYS’s Long Term Care Planning Project highlights innovative models; next meeting, on July 9, to examine family caregiver support.

Two DOH webinars are being held in July for background on an interoperable communications (IOC) drill coming for providers in August.

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Your Source for HOME CARE News, Policy and Advocacy

Vol. 4, Issue 24| June 17, 2019

Final Countdown, Last Chance to Prod Movement on HCA Priority Bills

July 11 (Suffern, NY)

State Legislature scheduled to adjourn on June 19

Blueprint for OASIS Accuracy – OASIS D Data Set

Leading up to this week’s final three scheduled days of the state legislative session, the Legislature continued to introduce and amend legislation, including program bills (at the “Request of the Governor”) throughout the weekend.

June 17-18 (Workshop); June 19 (Optional COS-C Exam) in Webster, NY (near Rochester) September 23-24 (Workshop); September 25 (Optional COS-C Exam) in NYC Editor's note: HCA will be resuming our schedule of biweekly newsletters in the summer. The next two editions will be as normal, but there will be no editions on July 8, July 22, August 5 and August 19. We will alert you, as always, by e-mail for breaking news.

Remaining legislative priorities expected to be voted on by Wednesday include the Driver’s License Access and Privacy Act, expanding the use of prevailing wage, farm worker rights, the Climate Community and Protection Act, as well as vacating records and modifying the definition of smoking to include “marijuana,” among others.

See BILLS p. 8

HCA’s ‘Stop Sepsis at Home’ Initiative to Receive 2019 National Sepsis Hero Award HCA is receiving one of five national Sepsis Heroes awards from Sepsis Alliance in recognition of our “Stop Sepsis at Home” initiative. See https://www.sepsis.org/sepsis-heroes/.

The award honors “Sepsis Heroes who have made a significant contribution to sepsis awareness and education among both the general public and health care professionals.”

INSIDE Final Countdown, Last Chance to Prod Movement on HCA Priority Bills............1 HCA’s ‘Stop Sepsis at Home’ to Receive 2019 Sepsis Hero Award......................1 Additional EVV Listening Session Added.........................................................2 DOH Updates on MLTC Policy Issues...............................................................3 A Message from HCA Sponsor TSG Financial....................................................5

See SEPSIS p. 2 MFP RFA Released...................................................................................6 HCA Participates in Second Meeting of DOH LTC Planning Project.............6 Interoperable Communications Drill Coming in August............................7 Meetings and Deadlines........................................................................9 Update on Last Week’s Emergency Drill..................................................10 Webinar on Gaining a Full APU/Market Basket Update.............................10 Health Resources.................................................................................11

The Situation Report: the Home Care Association of New York State SEPSIS from p. 1 Awards are presented at an annual gala in New York City on September 12 during Sepsis Awareness Month. Learn more about the event at the link on page 1.

HCA’s Stop Sepsis at Home initiative (http:// stopsepsisathomeny.org/) has been adopted in 55 of New York’s counties where nurses are using the screening tool to potentially identify life-threatening cases of sepsis and help triage follow-up protocols. It is being replicated in sites across the country, including by entire state associations, establishing a new primary level of sepsis intervention through home and community-based health.

We hope this award elevates the importance of this initiative for sepsis cases that originate in the home and community-based setting – 80 percent of all cases. We congratulate our partners, including the project’s clinical leader and HCA Board Member Amy Bowerman, as well as IPRO’s Sara Butterfield, for their pioneering work with us.

Additional EVV Listening Session Added

Volume 4, No. 24 June 17, 2019 

The Situation Report is a weekly publication of the Home Care Association of New York State (HCA).

Unless otherwise noted, all articles appearing in The Situation Report are the property of the Home Care Association of New York State. Reuse of any content within this newsletter requires permission from HCA. Al Cardillo President and CEO acardillo@hcanys.org Roger L. Noyes Director of Communications, Editor of The Situation Report rnoyes@hcanys.org Rebecca Fuller Gray Executive V ice President for Clinical and Program Affairs rgray@hcanys.org Patrick Conole Vice President, Finance & Management pconole@hcanys.org Andrew Koski Vice President, Program, Policy & Services akoski@hcanys.org

The state has added an additional listening session on Electronic Visit Verification (EVV) in New York City on July 9, from 1 to 4 p.m.

Alyssa Lovelace Director for Policy and Advocacy alovelace@hcanys.org

Registration is at https://www.eventbrite.com/e/nyc-electronicvisit-verification-evv-regional-listening-session-registration63108415971.

Lauren Ford Director of Program Research, Development and Policy lford@hcanys.org

A list of other sessions and EVV information are at https:// www.health.ny.gov/health_care/medicaid/redesign/evv/ index.htm.

We understand that DOH will be adding another webinar format of the Listening Sessions, now that the June 24 webinar has been filled, and this date should be announced soon.

DOH’s handouts from the June 5 Albany session are at https:// www.health.ny.gov/health_care/medicaid/redesign/evv/201905_reg_listening.htm.

HCA intends to submit feedback on the upcoming requirement that home care providers implement an EVV system for personal Home Care Association of New York State (HCA) 388 Broadway, 4th Floor, Albany, NY 12207 Tele: 518-426-8764; Fax: 518-426-8788; Website www.hcanys.org

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Laura Constable Senior Director, Membership & Operations lconstable@hcanys.org Celisia Street Director of Education cstreet@hcanys.org Mercedes Teague Finance Manager mteague@hcanys.org Jenny Kerbein Director of Governance & Graphic Design jkerbein@hcanys.org Billi Wilson Manager, Meetings & Events bwilson@hcanys.org Teresa Brown Administrative Assistant tbrown@hcanys.org

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Volume 4, No. 24 June 17, 2019 

care services starting January 1, 2020. (We have been advised that New York will request a one-year delay in this mandate by demonstrating that it has made a “good-faith” effort to implement EVV.) Members are asked to send us any concerns, questions or issues they may have with the EVV requirement so we can incorporate them into our comments. These should be sent to Andrew Koski at akoski@hcanys.org.

Any interested stakeholders may also submit written comments to the state at EVVHelp@health.ny.gov (please copy Andrew Koski).

For updates on EVV, join the listserv at listserv@listserv.health.state.ny.us and include only the following in the body of your e-mail request: SUBSCRIBE EVV-L YourFirstName YourLastName.

The U.S. Centers for Medicare and Medicaid Services also has a website on EVV at https://www.medicaid.gov/medicaid/hcbs/guidance/electronic-visit-verification/index.html.

DOH Updates on MLTC Policy Issues Last week, the state Department of Health (DOH) briefed managed long term care (MLTC) plans and MLTC member associations on a variety of policy issues. The following are highlights from the meeting, which HCA attended.

Proposed Regulation on Right to HCBS Information On May 29, the Department issued a new proposed regulation in the State Register that will codify the roles and responsibilities of nursing home facilities to ensure that individuals know their right to receive services in the least restrictive setting. As part of the proposed regulation, the nursing home shall ensure that all residents are provided with information on home and community-based services (HCBS) and community transitions programs that support the resident in returning to the community. The regulation also ensures that all residents can exercise their right to live in an integrated setting and that all nursing homes must work with “Money Follows The Person” program transition specialists to assist individuals that wish to return to the community.

United Healthcare MLTC Closure Update United Healthcare Personal Assist MLTC Plan has given the Department notice of its intent to close its MLTC plan. The target date for closure is September 1, 2019. The closure impacts the MLTC program and recipients only; this does not include United’s Mainstream Managed Care Organization (MCO) or other managed care products.

Approximately 3,000 enrollees are affected in the following counties: the Bronx, Kings, New York, Queens, and Richmond.

Enrollees will be provided plan choice information and may elect to transfer to any other MLTC in their county within a 60-day selection period or otherwise be auto-enrolled into a new plan if no election is made

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by that time. Enrollees will receive 120 days of continuity of care as indicated in DOH’s MLTC Policy 17.02 at: https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/mltc_policy/17-02.htm.

Notification on Eligibility Renewal Packets A technical issue has impacted the May mailing of New York City Welfare Management System (WMS) eligibility renewal packets. DOH anticipates that consumers will receive their renewal packets in June and that no consumer will lose coverage based on this delay. Individual consumers affected by the deferred mailing will have their coverage extended to ensure appropriate time to complete the recertification process.

This issue does not affect renewal cases in Manhattan for the WMS transition to the Modified Adjusted Gross Income (MAGI) eligibility group. New applications should not be submitted on behalf of individuals in this renewal cycle. Additionally, to maximize resources at the Human Resources Administration (HRA), DOH requests that plans not make any inquires to HRA on this issue.

Electronic Visit Verification (EVV) System Update DOH also provided an EVV update (see related p. 2 story), additionally reporting at the meeting that it is compiling an EVV Readiness Survey to assess current EVV utilization for providers and plans covering or providing personal care and home care services.

CFCO Plan Readiness Review Priorities and Reporting Template For Community First Choice Option (CFCO) readiness, MCOs are required to demonstrate the following: 

Enough staff have been hired and trained, including any subcontractor/vendor staff.

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Detailed member communication/education plans are developed and implemented.

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Plans are compliant with network adequacy requirements.

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Completion of provider contracting and credentialing.

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Readiness to process and pay new CFCO claims upon carve-in date.

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Training and assistance to providers who are new to managed care (billing, guidance, and service authorization are in place).

DOH is also developing an Excel template that MLTC plans will use to communicate the names of the specific files submitted to the Department, including but not limited to: 

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Required information/documents to demonstrate the plan is “ready” to perform under the terms https://hca-nys.org/events-education/upcoming-events of the agreement provided.

Continued on next page

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Continued from previous page 

Standardized exhibits.

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An organized document submission, by content area as described in the Requirements and Standards document (organizational capacity, personnel, member services, network, etc.).

DOH reviewers will use the tool to summarize their findings. The tool may not be altered or modified. DOH expects to issue the tool by July 12, and plans will have three months to provide the requested information to the Department.

Contract Updates MLTC Partial Cap model contract and Partial Medicaid Advantage (MAP) amendments have recently been approved by the U.S. Centers for Medicare and Medicaid Services (CMS).

DOH asks that plans submit documents upon request including: Workers’ Compensation and Disability forms; DOH Lobbying form; Contractor Conflict of Interest Attestation form; and others.

Duals Initiatives The Department is reviewing potential adjustments to CMS data exchanges and systems to implement default enrollment. The developing process will allow DOH to receive CMS confirmation on which Medicaid MCO enrollees are about to

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become eligible for Medicare in time for plans to meet default notification requirements (60 days prior to enrollment date).

Statewide Enrollment The following are enrollment numbers and the percentage changes in enrollments from April 2018 to April 2019:      

MLTC Partial Cap Plans – 229,711 members, up 12.59 percent.

PACE – 5,802 members, up 2.62 percent.

MAP – 15,345 members, up 50.97 percent.

FIDA – 2,890 members, down 27.19 percent.

FIDA IDD – 1,236 members, up 51.10 percent.

Total – 260,277 members, up 12.50 percent.

MFP RFA Released The state has posted a Request for Applications (RFA) to provide Money Follows the Person (MFP) Nursing Home Transition Assistance, Support and Education.

The intent is for a single vendor to administer a statewide Transition Center infrastructure. It will provide education about community living options, transition assistance, peer outreach and support, and education and outreach to nursing homes to support the transition of individuals from institutional to community-based settings.

The MFP program supports a number of activities to rebalance long term care, including a statewide network of regionally based Transition Centers that identifies potential participants in long-term care facilities, provides them with education on return-to-community options, and facilitates their transition from institutional to community-based care.

The RFA is at https://www.health.ny.gov/funding/.

Questions must be submitted to OHIPcontracts@health.ny.gov by June 20, 2019; proposals are due July 25, 2019.

HCA Participates in Second Meeting of DOH Long Term Care Planning Project Registration open for third meeting on July 9 HCA last week participated in the second of five installments dedicated to New York State’s Long Term Care Planning Project (LTCPP).

Approximately 120 individuals representing long term care services organizations were in attendance.

Hosted by the state’s Department of Health and Office for Aging, the goal of the LTCPP is to create a path for New York State to follow as it works to support its aging population for the next ten years. The first

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meeting, held in February, focused on questions that were designed to promote conversation and recommendations about improvements in coordination, communication, and the consumer experience.

The second meeting addressed specific evidence-based programs and innovative models in aging and long term care. Fourteen presentations were given by different organizations, which included: home care agencies, skilled nursing facilities, universities, consumer advocacy organizations, community-based providers and others. These included detailed summaries of their innovative programs and how they were able to improve patient outcomes, decrease hospitalizations and emergency department visits, while providing a valuable return on investment. Many of these models represented intriguing and often inexpensive opportunities for home care, hospice, and managed long term care providers alike.

The next LTCPP will be on July 9 in Meeting Room 6 on the Concourse of the Empire State Plaza in Albany from 1 to 4 p.m. The meeting topic will be Family Caregiver Support.

To register, please visit https://ltcppmeeting3.eventbrite.com. Registration must be completed by July 5, 2019, as seating is limited.

More information on the LTCPP can be found at: https://www.health.ny.gov/facilities/long_term_care/ planning_project/. Presentations from last week’s meeting can be viewed at: https://www.health.ny.gov/facilities/long_term_care/planning_project/docs/2019-05-13_presentations.htm.

Questions about the LTCPP can be directed to Lauren Ford at lford@hcanys.org.

Interoperable Communications Drill Coming in August The state Department of Health (DOH) will be holding an Interoperable Communications (IOC) emergency response drill on an unspecified date in August. The drill, on a date which will not be announced in advance, will involve home care and hospice agencies providing services outside of New York City.

In order to brief agencies on what to expect, DOH will be holding two webinars with repeat information on July 23 and 30, from 2 to 3 p.m. (Interested agencies should pick only one session.)

The IOC drill tests agencies’ ability to use a primary and back-up communication system to communicate with coalition partners. It will also test provider response to a survey on the Health Commerce System (HCS) within the timeframe outlined in an HCS alert.

On the day of the drill, agencies will receive an Integrated Health Alerting and Notification System (IHANS) message that outlines the emergency scenario and requirements to complete a Health Electronic Response Data System (HERDS) survey.

Registration for the webinars is at https://meetny.webex.com/meetny/ j.php?MTID=m723113b30ca6e58d5355e043d4e40cdf (July 23) and https://meetny.webex.com/meetny/ j.php?MTID=mde10f4cb2c8638945550a240a130549c (July 30).

For more information, contact Andrew Koski at (518) 810-0662 or akoski@hcanys.org; or Alyssa Lovelace at (518) 810-0658 or alovelace@hcanys.org.

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BILLS from p. 1 If packaged together with other measures affecting home care, these bills need to be carefully watched: such measures often involve a settled give-and-take of major, final-negotiated priorities among the two houses and the Governor’s offices, advanced in the political pressure cooker of the final week before adjournment, with little time – or appetite – for amendments.

For home care, hospice and managed long term care services providers, a number of priority bills still remain in the Assembly. HCA outlined many of these in a press release last week (https://hca-nys.org/ press-releases/hca-presses-bills-for-home-care-hospice-mltc-rate-stability-workforce-support-cost-saverprograms).

This week is your last opportunity to use HCA’s Legislative Action Center on priority bills that we have targeted for grassroots advocacy. All of our campaigns are at one link (https://p2a.co/CrvM1NC) with individual action-item links below. 

Home Care Worker Annual In-service: This legislation, S.5605 (Senator G. Rivera)/A.7854 (Assembly Member R. Gottfried), would ease agency administration and compliance by the submission and tracking of mandatory annual in-service hours for home health aides and personal care aides in the Home Care Worker Registry. It has already passed in the Senate and is on the Assembly Floor Calendar. Send a letter to your Assembly Member, urging him or her to pass this important legislation, using HCA’s Legislative Action Center campaign at https://p2a.co/abwLkof.

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Health Care Transformation Fund: This legislation, S.6376 (Senator G. Rivera)/A.7977-A (Assembly Member R. Gottfried), would require the allocation of at least 25 percent of Health Care Transformation Fund (HCTF) amounts to the community-based sector on an annual basis. Home care and hospice providers are included within the definition of “community-based health care provider.” Last week, HCA and the New York State Council for Community Behavioral Healthcare coordinated an advocacy campaign with a coalition of over 20 providers and stakeholder groups who’ve been working to advance this bill. Using HCA’s Legislative Action Center, the groups have sent more than 1,025 letters to legislators on this one bill alone. If you have not done so already, please contact your lawmaker today and urge them to set aside funding for community-based health care providers at https://p2a.co/LyNzmvj. The bill remains in the Assembly Ways and Means Committee and Senate Rules Committee.



Sepsis Prevention: This legislation, S.1817 (Senator G. Rivera)/A.3839 (Assembly Member J. McDonald), would authorize the state Department of Health to support statewide home care sepsis-related efforts. The bill has already passed in the Senate, and it has advanced to the Assembly Rules Committee where it needs your support.

HCA will alert members throughout the week as these bills gain traction. During this time, it is very important for providers to engage with their elected officials to let them know how these bills would benefit their communities. Please visit HCA’s Legislative Action Center to view all of the Association’s grassroots advocacy initiatives.

For questions or concerns about HCA’s priorities, which are also available in this easy-to-read chart (https:/ /tinyurl.com/yyxet48h), please contact Alyssa Lovelace at alovelace@hcanys.org.

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MEETINGS & DEADLINES

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Requirement/Change/Meeting

Effective/Due Date

More Information

Electronic Visit Verification (EVV) Public Listening Session in New York City

June 18, 2019, 1 to 4 p.m.

https://www.eventbrite.com/e/nycͲelectronicͲvisitͲverificationͲevvͲregionalͲ listeningͲsessionͲregistrationͲ61173885739

Fiscal Intermediary Workgroup meeting

June 26, 2019, 11 a.m. to 2 p.m.

akoski@hcanys.org

Nassau County Health & Medical MultiͲAgency Coordinating Group (Emergency Preparedness) meeting

June 27, 2 to 4:30 p.m.

nfischer@nassaucounty.ny.gov

EVV Public Listening Session in Lake Placid

June 27, 2019, 1 to 4 p.m.

https://www.eventbrite.com/e/lakeͲplacidͲelectronicͲvisitͲverificationͲevvͲ regionalͲlisteningͲsessionͲregistrationͲ61174344110

Revised Home Health Change of Care Notice (HHCCN)

July 1, 2019

https://www.cms.gov/Medicare/MedicareͲGeneralͲ Information/BNI/HHCCN.html

EVV Public Listening Session in NYC

July 9, 2019, 1 to 4 p.m.

https://www.eventbrite.com/e/nycͲelectronicͲvisitͲverificationͲevvͲregionalͲ listeningͲsessionͲregistrationͲ63108415971

Fiscal Intermediary (FI) Workgroup meeting

July 10, 2019, 11 a.m. to 2 p.m.

akoski@hcanys.org

Interoperable Communications Drill Webinar

July 23, 2019, 1 to 2 p.m.

https://meetny.webex.com/meetny/j.php?MTID=m723113b30ca6e58d5355e 043d4e40cdf

EVV Public Listening Session via webinar

July 24, 2019, 9 a.m. to 12 p.m.

https://www.eventbrite.com/e/electronicͲvisitͲverificationͲevvͲregionalͲ listeningͲsessionͲwebinarͲregistrationͲ62614410387

CHHA Cost Report Due

July 29, 2019

https://commerce.health.state.ny.us/public/hcs_login.html CHHAͲRates@health.ny.gov

Interoperable Communications Drill Webinar

July 30, 2019, 1 to 2 p.m.

https://meetny.webex.com/meetny/j.php?MTID=mde10f4cb2c8638945550a2 40a130549c

FI Workgroup meeting

August 7, 2019, 11 a.m. to 2 p.m.

akoski@hcanys.org

Emergency Preparedness Coalition of Manhattan (EPCOM) meeting

August 7, 2019, 12 to 1:30 p.m.

Caitlin.Flynn@nyulangone.org

Comments due on CMS Request for Information on Regulatory Relief

August 12, 2019

https://www.cms.gov/newsroom/pressͲreleases/cmsͲseeksͲpublicͲinputͲ patientsͲoverͲpaperworkͲinitiativeͲfurtherͲreduceͲadministrativeͲregulatory

Personal Care Cost Report

August 27, 2019

https://commerce.health.state.ny.us/public/hcs_login.html; PersonalCareͲ Rates@health.ny.gov

Transition Period for Using Health Insurance Claim Number (HICN) or new Medicare Beneficiary Identifier (MBI)

April 1, 2018 to December 31, 2019

https://www.cms.gov/Medicare/NewͲMedicareͲCard/index.html

Changes in MLTCͲLHCSA Contracting Limits

October 1, 2019

https://www.health.ny.gov/health_care/medicaid/redesign/mrt90/mltc_polic y/lhsca_contract_guidance.htm

Medicare will only accept claims submitted with the Medicare Beneficiary Identifier (MBI)

January 1, 2020

https://www.cms.gov/Medicare/NewͲMedicareͲCard/index.html

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Volume 4, No. 24 June 17, 2019 

Update on Last Week’s Emergency Response Drill During last week’s required emergency response drill for home care and hospice, HCA fielded many questions from members and nonmembers on such issues as: how to access the survey process being tested during the drill; how many surveys had to be completed by agencies with multiple offices; clarification on specific survey questions; who specifically an agency needed to document as a community partner in their simulated outreach activities; and other issues.

HCA has requested that DOH hold a follow-up conference call with the associations to discuss the survey experience, including successes and any issues that DOH identified for redress.

Member feedback on the drill can be directed to Andrew Koski at (518) 810-0662 or akoski@hcanys.org; or Alyssa Lovelace at (518) 810-0658 or alovelace@hcanys.org.

HCA reminds Certified Home Health Agencies and hospices that they are required to complete an After Action Report (AAR) in order to meet one of their federal exercise requirements. An ARR template is at https://hca-nys.org/wp-content/uploads/2019/05/AAR-IP_Template-BLANK-for-CMS-EP-exercises.docx.

HCA will be holding an Emergency Preparedness conference on September 17, 2019 in the Albany area and will send out information shortly.

Learn Criteria for Gaining a Full APU/Market Basket Increase on June 19 CMS Webinar The U.S. Centers for Medicare and Medicaid Services (CMS) will be hosting a webinar on Achieving a Full Annual Payment Update (APU)/Market Basket Increase for home health providers on June 19 from 2 to 3 p.m. It will cover:   

The relationship between the APU and the Home Health Quality Reporting Program.

Data submission requirements.

The reconsideration process for providers who are identified as being noncompliant.

Registration is limited to 1,000 people on a first-come, first-served basis. CMS requests that you only register if you know you will be able to attend the webinar.

Registration is at: https://events-na2.adobeconnect.com/content/connect/c1/1411885136/en/events/ event/shared/default_template/event_landing.html?connect-session=na2breezp24q6d3mfui6hmir&scoid=1596475547&_charset_=utf-8.

You can join an e-mail list for getting an alert when an archive is posted. Go here: https:// docs.google.com/forms/d/e/1FAIpQLSfZKFbFoft34JqMLTxC297hGuml4hFSmqLm8Bs2U_q_6HXweg/ viewform?vc=0&c=0&w=1.

Questions or further information requests can be sent to PACTraining@econometricainc.com.

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Health Resources

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“Electronic Health Record Adoption and Interoperability among U.S. Skilled Nursing Facilities and Home Health Agencies in 2017,” by the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology https://www.healthit.gov/sites/default/files/page/2018-11/Electronic-Health-Record-Adoption-andInteroperability-among-U.S.-Skilled-Nursing-Facilities-and-Home-Health-Agencies-in-2017.pdf

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“CMS Could Use Medicare Data To Identify Instances of Potential Abuse or Neglect,” by the Office of Inspector General https://oig.hhs.gov/oas/reports/region1/11700513.asp