Skilled nursing facility (SNF) providers are on the edge of their seats as they anticipate the Centers for Medicare and Medicare Services' (CMS) consideration of a replacement for the Resource Utilization Group (RUG) system to change the pay for SNF Medicare Part A residents beginning FY2019. The Resident Classification System, Version 1 (RCS-1), will be the most significant change in the current reimbursement model, which has been in place for nearly two decades. Since being published in the Federal Register on April 27, 2017, providers and advocacy groups have submitted public comments and recommendations on the SNF prospective payment system (PPS) payment methodology proposed in the Summary of Advance Notice. Many concerns have been raised, especially regarding the reimbursement methodology for therapy services.
Providers should anticipate a new computer-based process for surveys to begin after November 28, 2017. The new survey process is intended to blend best practices from the traditional and QIS survey processes to improve efficiency and effectiveness, as well as to balance structure and surveyor autonomy. It will include resident/staff observations, resident/family/staff interviews, medical record reviews, documentation reviews, and policy/procedure reviews.
While there is no specific way to prepare or immunize the facility to/for an MDS survey, there are ways to be prepared that are especially important today for operational issues. The best practice methodologies for MDS survey preparation include reviewing:
If a facility prepares itself appropriately for an audit, then the post-audit processes will be minimal. Unfortunately, that is not always the case or perhaps your facility has already undergone one and you need to know what to do now. Most audits will find some issues that will require immediate action and attention as well as long-term resolutions.
The temperatures are dropping and all of a sudden winter is here! With the transition of the seasons, long-term care facilities must focus on prevention methods to reduce residents’ risk of contracting the influenza (flu) virus.
Prevention methods are particularly important for long-term care providers to recognize and implement due to the greater severity of the flu in seniors age 65 and older, such as increased risk for heart attack, stroke, and bacterial lung infection (i.e., bronchitis or pneumonia), as well as a negative impact on ability to function independently. Due to these increased risks, it is unlikely that a senior infected with the flu will regain his or her level of health prior to infection. The illness may even prove fatal; the CDC warns that more than 90% of flu deaths occur in people over 65.