1:30 – 3:30pm
The Changing SNF Part A Payment Model - An Afternoon with RCS-1
This session will feature a slide presentation to educate on the Resident Classification System, Version 1 (RCS-1) model under consideration by CMS, followed by a facilitated discussion on patient and provider concerns and key aspects of the model with a panel of NASL therapy and health IT members who have studied the RCS-1 model.
Presenter and Moderator:
Principal, Mason Advisors LLC
Sherill Mason is currently a Principal of Mason Advisors, where she provides strategic planning, program development and operations analysis for post-acute care providers including senior living and nursing home facilities, home health, hospice, long term acute care hospitals, in-patient rehabilitation facilities, and long term care pharmacy. Previously, Sherill she served as a Vice President to the Marwood Group, a healthcare industry consultant, as Senior Vice President at Sunrise Senior Living and as a Director at KPMG. Among other current professional activities Sherill currently is a Guest Lecturer at the University of Pennsylvania School of Nursing. She received her RN diploma and training at the Englewood Hospital School Nursing and a BA in American Studies from Eckerd College.
Director of Clinical Operations,
Zimmet Healthcare Services Group, LLC
Sheryl joined Zimmet Healthcare in 1996, and has been the partner in charge of the firm’s growing clinical consulting team for nearly 20 years. As a Board Certified Registered Nurse, Sheryl has devoted her career to serving the post-acute care community, remaining at the forefront of regulatory and payment changes for over 40 years. She has been a trainer of the MDS since 1990 and is among the nation’s leading resident-assessment experts.
Sheryl has longstanding relationships with many State and Federal agencies, having worked with CMS and various Medicaid agencies on multiple projects. She was appointed to the Technical Expert Panel established to evaluate the impact of the Medicare Prospective Payment System on provider operations and finances. She was a member of the clinical standards and training team for the Federal DAVE project and a Data Monitor for the Federal STRIVE initiative. She also served as an MDS 2.0/3.0 Manual reviewer, and remains highly engaged in improving the resident assessment process and empowering post-acute nurse managers.
Robert L. Choi, Chief Strategy Officer and Founding Partner, Collain Healthcare, LG CNS Healthcare Solutions
Robert Choi has founded and managed several population health management and technology companies. He is a co-founder and Chief Strategy Officer for Collain Healthcare, an LG CNS Company, and exclusive commercialization and innovation partner for LG CNS Healthcare Solutions. His focus includes development and commercialization of next-generation health information platforms and connectivity solutions for the long term post-acute care industry and digital health apps for consumer-connected care including the LG Interactive Virtual CareTM framework. He has extensive experience in healthcare provider operations across long term, post-acute, community-based care and population health initiatives. He previously served as a Vice President at Harden Healthcare, a provider to 34,000 patients daily. He is an active investor and advisor of several healthcare provider organizations, technology startups and investment groups involved in population health, long term post-acute care, concierge medicine and senior housing real estate. He is a graduate of Emory University in Atlanta.
Leigh Ann Frick
President, Care Navigation Consulting
Leigh Ann Frick has spent her entire 24-year career in the post-acute space, working to ensure clinical integration with compassionate care and compliance at the core of the delivery of rehabilitative services to support operational initiatives. She started as a treating therapist splitting her time between acute care and skilled nursing facilities. She quickly realized her passion was teaching and training clinicians about best practices, regulatory compliance, documentation and billing. She moved through various operational and clinical positions, eventually becoming the Executive Vice President of Rehabilitative Services and then the Chief Clinical Officer for a large therapy provider. Seeing the opportunity to help a variety of providers handle the need for clinical integration in the changing world of healthcare reform initiatives, she decided to start a consulting practice, with a goal of helping providers along the continuum be successful in this everchanging landscape.
Chief Operating Officer, Reliant Rehabilitation
Peggy Gourgues is Chief Operating Officer of Reliant Post-Acute Care Solutions, where she manages operations for the company’s growing PACN, Reliant Rehabilitation and Reliant Medical Management divisions. Peggy holds an M.A. in Speech Pathology, a Certificate of Clinical Competency in Speech Language Pathology, and has practiced in home health, private practice, skilled nursing and acute care hospital settings. She is a certified member of the American Speech-Language-Hearing Association, a member of the Healthcare Compliance Association, and a 2014 Board Member of the National Association for the Support of Long Term Care. Peggy has worked in healthcare management for the past 11 years and joined Reliant in 2004.
Vice President for Regulation and Compliance,
Genesis Rehab ServicesJoanne serves as Vice President-Legislative Advocacy for Genesis Rehab Services/Respiratory Health Services following six years as GRS Vice President-Regulation and Compliance. As a speech-language pathologist who has worked in all post-acute settings, as a clinical and operational manager and a health care administrator, Joanne has been actively engaged in clinical service improvements, financial stewardship, statutory compliance and legislation development for over 40 years. Joanne was inducted as 2017 Public Policy Distinguished Fellow for the National Academies of Practice, is a Life Member of the American-Speech-Language-Hearing Association and currently serves as the State Advocate for Medicare Policy on behalf of the Pennsylvania Speech-Language Hearing Association. Through participation on CMS Technical Expert Panels (TEPs), CMS Focus Groups and industry work groups, areas of expertise include the Development of Outpatient Therapy Payment Alternative (DOTPA) Project, the Short Term Alternative Therapy Payment System (STATS) Project, CARE Tool Development, Medicare Spending Per Beneficiary in Post-Acute Care, IMPACT Act of 2014, Post- Acute Standardized Assessment, Rehabilitation Therapy Cap Legislation and Skilled Nursing Facility Payment Models. Joanne was an invited member of the MedPAC Technical Expert Panel addressing Medicare Part B Payment and has represented stakeholder interests through Congressional work groups and committee member collaboration.
4:00 – 5:00pm
Data Breaches, Hackers & Ransomware:
Cybersecurity Concerns for LTPAC
As care coordination gains in importance, so does the need for connected health. Providers need speedy access to patient data, and share an increasing responsibility for securing their systems, medical devices and patient data. Healthcare cybersecurity is an immediate concern that needs aggressive attention.
Get the latest information on best practices to safeguard against the modern threats of data breaches, hackers and ransomware.
Chief Executive Officer, Blue Orange Compliance
John is the co-founder and CEO of Blue Orange Compliance, which provides privacy and security solutions, assessments, remediation, training and guidance that simplifies the complexities around HIPAA and focuses on practical, scalable solutions. A commissioner with LeadingAge’s Center for Aging Services Technologies (CAST), he has worked as CIO at NCS Healthcare and Omnicare. DiMaggio holds an MBA in Finance from Katz Graduate School of Business and a BS in Computer Science from the University of Pittsburgh.
5:00 – 6:00pm
NASL Policy Counsel
President, Sims Strategies, LLC
For over twenty years, in both the public and private sectors, Michaela Sims has developed and implemented successful strategies that achieve desired policy and political results. Though she has worked in numerous policy areas, Michaela’s main area of expertise is working on health and tax policies overseen by the powerful Senate Finance and Health, Education, Labor and Pensions (HELP) Committees, and related federal agencies. Named one of The Hill’s Top Lobbyists in 2016, Sims has provided critical insight and strategic advice during the development, implementation, and now the dismantling of the Affordable Care Act to many health care industry clients, including hospitals, physicians, long-term care providers, and pharmaceutical and insurance companies. Drawing on her strong ties to Senate centrists, she has developed a reputation as an honest broker with credibility on both sides of the aisle.
Cynthia K. Morton, MPA
Executive Vice President
National Association for the Support of Long Term Care (NASL)
Cynthia Morton is a national expert on Medicaid, Medicare and other public policy affecting the long term and post-acute care sector. Currently, she serves as the Executive Vice President of NASL, where she advocates for her members’ interests. Prior to joining NASL, Cynthia served as the Vice President for Political Affairs for the American Health Care Association/National Center for Assisted Living (AHCA/NCAL). In more than a decade with AHCA/NCAL, she represented the long term care profession before Congress, the Washington health care community, and the media. In 2005 and 2006, Roll Call magazine named Cynthia as one of the leading long term care lobbyists.
9:00 – 11:30am
NASL Medical Services Committee Meeting
Scott A. Wandstrat, Esq.
Partner, Arnall Golden Gregory LLP
Scott Wandstrat is a partner in AGG’s Litigation, Healthcare, and Governmental Investigations and Special Matters Practices, chair of the firm’s Electronic Discovery Practice, and serves as the firm’s Technology Partner.
Scott focuses his practice on handling complex business disputes and governmental investigations. An unapologetic nerd, Scott enjoys a well-earned, national reputation as a “go-to” lawyer for electronic discovery issues. His clients and colleagues praise his practical, cost-effective guidance on even the most frustrating aspects of e-discovery. When asked, Scott has attributed his success, in part, to his fluency in Techspeak, Legalese, and (thankfully) plain English. In addition to his work on e-discovery matters, Scott maintains an active government investigation and business litigation practice. He has particular experience in handling commercial disputes, insurance coverage matters, and defending healthcare companies involved in False Claims Act and Anti-Kickback Statute investigations.
3:00 – 4:30pm
LTPAC’s Value in Bundled Care
Learn from two experts what accountable care organizations (ACOs) and other value-based arrangements value in their post-acute care partners such as nursing facilities and home health providers, and how what is valued differs per program. Speakers Dr. David Muhlestein, who conducts research on what the marketplace prioritizes in partnerships with PAC providers, and Michelle Templin, will provide more specific insight on what ACOs value with post-acute care providers and their rehab therapy partners.
David Muhlestein, PhD, JD, Chief Research Officer, Leavitt Partners
Dr. Muhlestein directs the study of accountable care organizations through the LP Center for Accountable Care Intelligence and leads the firm’s quantitative evaluation of health care markets. He is an expert in using policy analysis, predictive modeling, and applied analytics to understand the evolving health care landscape.
David also serves as Adjunct Assistant Professor of The Dartmouth Institute (TDI) at the Geisel School of Medicine at Dartmouth College and is a visiting fellow at the Accountable Care Learning Collaborative. In both of these roles he conducts research to translate learnings of high-performing organizations for the benefit of the broader health care system.
Michelle L. Templin, Vice President of Legislative Affairs and Business Development, Managed Health Care Associates, Inc.
In her capacity as VP of Legislative Affairs and Business Development, Michelle Templin oversees all the legislative and grass roots advocacy work that touches MHA’s diverse post-acute care (PAC) membership including: long term care (LTC), home infusion and specialty pharmacies, DME and respiratory providers, and skilled nursing, assisted living and rehabilitation facilities. Her team helps PAC providers navigate the legislative landscape to identify, analyze and advocate on the issues that matter most to their business.
Additionally, Michelle has led the strategy and management of the MHA ACO Network since its formation in 2013. Working with ACOs, Medicare Advantage Plans and other payers, the MHA ACO Network assists in defining local Payer/PAC engagement strategies and analyzes the value of appropriate PAC utilization across the care continuum.