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Study finds method to predict SNF admission from hosital admission profile

A June 2019 study in JAMA found that it’s possible to predict at the day of admission a patient’s risk of SNF discharge. Researcher’s noted strong indiciators for SNF admission included impaired mobility and impaired ability to bathe, as well as living alone. The study used a  retrospective cohort of 11,380 hospitalized patients. View the […]

CMS to hold webinar on APU/market basket increases

CMS announced it will hold a webinar 2 p.m. to 3:30 p.m. EST June 19 for home health agencies on “Achieving a Full Annual Payment Update (APU)/Market Basket Increase.” During the webinar, CMS plans to discuss: The relationship between the APU and quality reporting Data submission requirements. The reconsideration process for providers identified as noncompliant. […]

OIG report looks at abuse and neglect of Medicare beneficiaries

The Department of Health and Human Services Office of Inspector General issued two new reports that address the identification, reporting and investigation of incidents of potential abuse and neglect of our nation’s most vulnerable populations, including seniors and individuals with developmental disabilities. OIG issued an early alert in 2017 based on the preliminary findings of […]

Palmetto GBA posts info for next two RCD teleconferences

Agencies in Illinois, North Carolina, Ohio, Florida or Texas can get updates from Medicare Administrative Contractor (MAC) Palmetto GBA about the Review Choice Demonstration (RCD) by listening to Palmetto’s teleconferences in July and August. The July event will be held 10 a.m. to 11 a.m. EST July 3. Call (877) 789-3907 and use conference ID […]

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CMS posts much anticipated MDS 3.0 RAI Manual v1.17

On Monday, May 20, the Centers for Medicare & Medicaid Services (CMS) posted the MDS 3.0 RAI Manual, v1.17, containing many of the requirements that providers will need to follow to prepare for the Patient-Driven Payment Model (PDPM) effective October 1, 2019. New changes will be reflected in HCPro’s MDS 3.0 RAI User’s Manual. The […]

Proposed bill would innovate use of home health services

The Home Health Payment Innovation Act of 2019, H.R. 2573, would preserve Medicare recipients’ access to home health services and provide a pathway for innovative approaches to using these services. According to LeadingAge, which supports the bill, H.R. 2573 would prevent unwarranted payment rate cuts of Patient Driven Groupings Model (PDGM) by basing any behavioral […]

CMS releases tables detailing the 2019 quality measures for home health

Source: Home Health Line CMS has published updated details on potentially avoidable events, process and outcome measures for 2019. The updated tables also include details on star-ratings measures and quality measures new to Home Health Compare in 2019. Claims-based outcome measures “Medicare spending per beneficiary” and “Discharge to community” are joining the ranks of publicly […]

Educate clinicians about M1820, an item affecting functional points under PDGM

Source: Home Health Line Ensure clinicians have proper training about how to respond to the OASIS-D item involving patients’ ability to dress their lower body safely. M1820 (Ability to dress lower body) is one of six OASIS items that affect functional case-mix adjustment under the PPS, and it will be one of eight items that […]

Ask the expert: Medicare Part A coverage for a PEG tube

Q: I have a patient that has 100 days of Medicare Part A and a percutaneous endoscopic gastrostomy (PEG) tube—the primary source of nutrition—in place since 2008 due to laryngeal cancer. All rehab therapy is discontinuing in three days. Can I continue Medicare Part A, related to the PEG tube? A: As long as 26% […]