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Proposed rule: CMS moving forward with PDGM in 2020

CMS is staying true to plans to implement a new payment model. The 2020 PPS proposed rule, which was posted to the Federal Register July 11, reinforces the plan to implement the Patient-Driven Groupings Model (PDGM) beginning on or after Jan. 1, 2020. The model will move from 60-day episodes to 30-day payment periods. While […]

Medicare Part A SNF PPS Pricer Update FY 2020

A new MLN Matters Article MM11347 on Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2020 is available. Learn updates to payment rates beginning October 1.

Correlations found between home care for dementia patients and higher risks of hospitalization

A new study published July 1 in the journal Health Affairs found that seniors with dementia who use home care have suffered more severe outcomes stemming from medical emergencies than those in skilled nursing facilities. According to study author Rebecca Gorges, “While Medicaid’s trend to shift long-term care from institutions to the community is intuitively […]

CMS to hold two-day Quality Reporting training

Registration is open for CMS’ SNF QRP Provider In-Person Training Event, August 13 and 14, 2019. The training is a two-day in-person ‘Train the Trainer’ event for providers at the Four Seasons Hotel, 200 International Drive, Baltimore, MD 21202. This event will be open to all SNF providers, associations, and organizations. Like the May 2019 […]

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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 […]

Intake and output monitoring

You should monitor residents who have fluid imbalances or are at high risk of dehydration by calculating intake and output (I&O) each shift.

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% […]

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 […]

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 […]