Tag: admission

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 proposes initiative to address improper SNF discharges

According to a memo published by the Centers for Medicare & Medicaid Services (CMS) on December 22, 2017, post-acute care discharges that violate Federal regulations continue to be one of the most frequent nursing home complaints made to State Long Term Care Ombudsman Programs. The memo, addressed to state survey agency directors, announces CMS’ consideration […]

25 national organizations join AHCA in letter to CMS regarding observation stays

On June 20, 2017, a broad coalition of beneficiary and provider advocacy groups submitted a comment letter to the Centers for Medicare & Medicaid Services (CMS) in response to the matter of observation stays in hospitals, an ongoing issue that prevents thousands of beneficiaries from being able to access their skilled nursing benefit because of […]

Evidence-based criteria for determining whether services are skilled

Editorial Note: This post is an excerpt from HCPro’s title Long-Term Care Skilled Services: How to Document for Proper Medicare Reimbursement by Elizabeth McLaren. Chapter 8 of the Medicare Benefit Policy Manual, Section 30.2.2 (“Principles for Determining Whether a Service is Skilled”) starts to look more closely at the criteria for assessing a skilled need. […]

49 states have reduced avoidable hospital readmissions

On September 13th, CMS released data showing that 49 states (all but Vermont) have reduced avoidable hospital readmission rates since 2010. To address the problem of avoidable readmissions, the Affordable Care Act created the Hospital Readmissions Reduction Program, which adjusts payments for hospitals with higher than expected 30-day readmission rates for targeted clinical conditions such as: […]

Physicians and health care providers continue to improve quality of care, lower costs

Affordable Care Act Accountable Care Organization initiatives put patients at the center of their care while generating more than $1.29 billion in total Medicare savings since 2012. The Centers for Medicare & Medicaid Services (CMS) announced on August 25, 2016, the 2015 performance year results for the Medicare Shared Savings Program and the Pioneer Accountable […]

Digital Standards and Operating Rules adopted by HHS under HIPAA

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required HHS to establish digital standards for business-related tasks like submitting claims and getting paid. The goal is to reduce paperwork and streamline business processes across the health care system. Standards allow information to be shared digitally in consistent ways. With common standards for content […]

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Take our book survey! We’re constantly striving to deliver the tools you need to make your job easier and more efficient but we can’t do it without hearing from you. Please take a few minutes to fill out our short survey so we can determine what books we should be offering. To take the survey […]

Centers for Medicare & Medicaid Services Special Open Door Forum May 12

CCSQ will host a Special Open Door Forum (SODF) to allow patients, families, caregivers, patient advocacy groups, disabled groups, low-income health patients, other consumers and interested parties to ask questions on The Improving Medicare Post-Acute Care Transformation Act (commonly called the IMPACT Act) and standardizing the assessment of patients across post-acute care settings of Skilled […]

CMS announces initiative to transform primary care

On April 14, 2016, the Centers for Medicare & Medicaid Services (CMS)  announced its largest-ever initiative to transform and improve how primary care is delivered and paid for in America. The effort, the Comprehensive Primary Care Plus (CPC+) model, will be implemented in up to 20 regions and can accommodate up to 5,000 practices, which […]