Jul 12, 2019
The Bottom Line

This book with downloadable tools helps you navigate recent changes to the RAI and includes more than 100 customizable care plan templates, as well as the most up-to-date care area assessment (CAA) worksheets from CMS. With many updated regulations already in effect, this timely book covers Section GG, discharge planning, QAPI, person-centered care, and survey changes, as well as the changes resulting from the ICD-10 transition.

May 16, 2019
The Bottom Line

SNF Provider Preview Reports are available during a 30-calendar day preview period beginning from the date on which providers can access the report. SNF providers have until May 30, 2019 to review reports that contain data submitted between 2017 Quarter 4 and 2018 Quarter 3 for assessment-based quality measures, and between 2017 Quarter 1 to 2017 Quarter 4 for claims-based quality measures.

Apr 25, 2019
The Bottom Line

Staffing data from Jan 1 through March 31 must be submitted no later than 45 days from the end of the quarter. The final submission deadline for this quarter is May 15, 2019. On a SNF open door forum held earlier this week, officials instructed facilities to review their monthly provider preview reports in their CASPER folder for feedback on their most recent submission.

Jan 25, 2019
The Bottom Line

Once you come to understand how reimbursement will be calculated under the new skilled nursing facility (SNF) prospective payment system (PPS) model, Patient Driven Payment Model (PDPM), you may wonder why it wasn’t named the Primary Diagnosis Driven Payment Model, but that’s a conversation for another day. What we should be focusing on is the fact that under PDPM, each resident’s primary diagnosis code entered into line I0020B of the minimum data set (MDS) (a new MDS field that will be added effective 10/1/2019) will be used to place the patient into one of ten PDPM clinical categories. These clinical categories are then used as part of the patient’s classification under the physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) components. A resident’s primary diagnosis code is essentially the hinge for that resident’s clinical documentation and reimbursement path, so getting it right is essential in order to achieve accurate reimbursement under PDPM.

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Tuesday, October 15, 2019 - 07:00

2019 Revenue Integrity Symposium

The 2019 Revenue Integrity Symposium covers topics essential to revenue integrity, Medicare compliance, and the revenue cycle in acute care and long-term care settings.

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Karen A. Thomas
Victorine Courtois