A report from the Department of Health & Human Services (HHS) Office of Inspector General (OIG) recommends using Comprehensive Error Rate Testing Data (CERT) to identify “high-risk” home health agencies to help reduce improper payments and agency error rates. CMS didn’t agree with the recommendation, however. Instead CMS points to CMS’ fraud prevention system, targeted […]
October 15-16, 2019 | Orlando, FL The Revenue Integrity Symposium is the can’t-miss event for revenue integrity, revenue cycle, and Medicare compliance education and high-level networking for acute and long-term care professionals. Learn from trusted experts with cutting-edge regulatory insight that will arm you with the tools you need to take 2020 by storm. By […]
The new version of the MDS 3.0 RAI Manual, v1.17.1 are effective October 1, 2019 and incorporates clarifications to existing coding and transmission policy; it also addresses clarifications and scenarios concerning complex areas. This version of the MDS 3.0 RAI Manual incorporates clarifications to existing coding and transmission policy; it also addresses clarifications and scenarios […]
We are seeking speakers to present at the 2020 National Provider Enrollment Forum, to be held April 19-22 in New Orleans at the Sheraton New Orleans Hotel. Click here to view and complete the speaker application. Presenters must complete the application prior to the September 30 deadline. Accepted speakers and co-speakers receive free admission to […]
The following is an excerpt from Disaster Planning, Infection Control, and OSHA Compliance: A Toolkit for Senior Living written by Karen T. Stratoti, RN, BSN, LNHA, CALA.
The HHS Office of Inspector General (OIG) has released the “Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: Top Unimplemented Recommendations” which includes eight recommendations to CMS regarding Medicare Parts A and B: CMS should analyze the potential impacts of counting time spent as an outpatient toward the 3-night requirement for skilled nursing […]
CMS has released its FAQ sheet on PDPM: Q. What is PDPM? A. The Patient Driven Payment Model (PDPM) is a new case-mix classification system for classifying skilled nursing facility (SNF) patients in a Medicare Part A covered stay into payment groups under the SNF Prospective Payment System. Effective beginning October 1, 2019, PDPM will […]
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 […]
Source: The Bottom Line Most hospitals like for facilities to respond to referrals within 15 minutes, and that can be a very ambitious goal. It usually includes running insurance, speaking with the director of nursing, or calling the pharmacy to get an idea of drug costs. Facilities are used to relying on their admissions coordinator […]
You should monitor residents who have fluid imbalances or are at high risk of dehydration by calculating intake and output (I&O) each shift.