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Sep 26, 2019
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Billing Alert for Long-Term Care

CMS announced proposed changes to the Medicare long-term care requirements that would reform “unnecessary, obsolete, or excessively burdensome” requirements for SNFs on July 17. The proposed rule, “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency” (CMS-3347-P), fueled by the Trump administration, aims to reduce red tape surrounding SNF compliance and regulations.

Sep 13, 2019
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Billing Alert for Long-Term Care

When it comes to knowing the difference between inclusions and exclusions in Consolidated Billing (CB), it can be extremely confusing for SNFs. Let’s first break it down by the basics. Included refers to items or services that are included in CB and for which the SNF must pay the outside vendor for specific services they provide. Excluded refers to items or services that are excluded from CB and may be billed by the outside vendor directly to Medicare Part B. Sometimes these items or services are also referred to as carve-outs.

Aug 16, 2019
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Billing Alert for Long-Term Care

With the October 1, 2019 go-live date for the Patient Driven Payment Model (PDPM) just months away, providers are anxious to learn of any updates or clarifications CMS will make prior to the new model taking effect. As such, many providers were relieved when CMS released the mid-year draft of the MDS 3.0 Resident Assessment Instrument (RAI) Manual v1.17 on May 20.

Aug 16, 2019
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Billing Alert for Long-Term Care

Understaffing has become a major issue in SNFs. A study published in the July issue of Health Affairs, Daily Nursing Home Staffing Levels Highly Variable, Often Below CMS Expectations,” found that 75% of SNFs are rarely in compliance with staffing levels. According to the Institute of Medicine’s Committee on the Adequacy of Nurse Staffing in Hospitals and Nursing Homes, the number of RNs in a facility has been directly linked to that facility’s quality of care. When a facility is understaffed, it can be detrimental to the residents and cause headaches for administration—not to mention the possibility of fines and lower star ratings.

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jku369@comcast.net
jku369@comcast.net