Operators head to Hill to brief Congress

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U.S. Capitol
U.S. Capitol

Quality, regulation and Medicaid will be three of the big themes as assisted living operators gather Monday and Tuesday in the nation's capital to meet with legislators and their staffs as part of this year's American Health Care Association / National Center for Assisted Living Congressional Briefing.

The organizations are expecting that more than 400 people representing assisted living communities and skilled nursing facilities will attend.

For NCAL members, NCAL Executive Director Scott Tittle told McKnight's Senior Living, “It's a great opportunity for them to tell their story in Washington about what they do and how they do it and the important role that assisted living plays in the continuum of care.”

Members will spend some of the time discussing the NCAL Quality Initiative and their progress in meeting its goals, he said.

“The good news is, we've got a lot of great stories to tell through members about high-quality assisted living providers,” Tittle said. “We've asked members to talk about where they are in improving staff stability and reducing turnover, where they are on customer satisfaction scores and reducing hospital admissions, and then the really important topic of reducing the off-label use of antipsychotics.”

Assisted living isn't experiencing any direct threats related to regulation, he said, but regulation will be implicit among the talking points for the event. “Assisted living is doing a great job at the state level, and states should continue to be incubators for the growth of assisted living in the future,” Tittle said.

Although providers haven't seen direct threats related to Medicaid since last year's attempts by Congress to repeal the Affordable Care Act, he said, “it's important for members of Congress to understand the important role that Medicaid plays in this growing continuum of assisted living.”

Many members of Congress and their staffs “will be surprised” to learn that 15% to 17% of assisted living residents are beneficiaries of a Medicaid waiver or state plan reimbursement system, Tittle predicted. Forty-four states and Washington, D.C., use Medicaid to cover services in assisted living, according to NCAL.

As part of the Medicaid discussion, operators will talk about the home- and community-based settings final rule — “where their states are in terms of implementing the rule and interpreting it and what it means for them going forward, whether that means it will provide more opportunity or less for low-resource residents in the future,” he said.

The final rule, issued in January 2014, established new reimbursement criteria for home- and community-based settings with the goal of enabling Medicaid beneficiaries to receive services in settings that are integrated into the community rather than in skilled nursing facilities. Many assisted living communities have provided HCBS to their residents through Medicaid waivers. Under the rule, however, certain settings — including locations in buildings in which inpatient institutional treatment is provided, settings in buildings on the grounds of or adjacent to a public institution, or settings that isolate individuals from the broader community — are presumed ineligible for the waiver program unless they meet a heightened standard of proof.

Members also will be encouraged to invite their senators and congresspeople to tour their communities, Tittle said. “To me, there's no better advocacy and education opportunity than to get a sitting member of Congress, a candidate or a member of their staff to actually come into the building and see what our members do,” he added.

Attendees of the Congressional Briefing also will hear from Health and Human Services​ Secretary Alex M. Azar II and journalist and author Carl Bernstein, perhaps best known for his original news reporting on Watergate with Bob Woodward in the 1970s when they worked for the Washington Post.

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