Tag: regulations

RCS-1 draft model calculation worksheet

SNF providers are on the edge of their seats as they anticipate CMS’ consideration of a replacement for the Resource Utilization Group (RUG) system, which will change the way facilities are reimbursed for SNF Medicare Part A residents beginning as early as FY2019. The Resident Classification System, Version 1 (RCS-1) will be the most significant […]

New CMS policy could change inpatient rehab denial trend

In the past, Medicare contractors have been allowed to deny a claim for inpatient rehab if the required three-hour minimum of direct care mark was missed by mere minutes, even if the additional minutes were made up on a subsequent day. Now, however, due to new guidance released by CMS, this denial trend could change. […]

Tune into CMS’ next SNF/LTC open door forum March 8

The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for: Thursday, March 8, 2018, 2:00 PM – 3:00 PM Eastern Time (ET). Announcements and updates will include: Low Volume Appeals Opportunity Announcement SNF QRP Update Payroll-Based Journal (PBJ) Update Click here for call-in information.

Survey preparation experts will share their top tips on Wednesday, March 7

It’s important that providers understand how the new survey process differs from prior survey cycles and what to expect from surveyors before they arrive at the facility. On Wednesday, March 7, from 1:00-2:00pm, ET survey preparation experts Reginald M. Hislop III, PhD, and Diane R. Hislop, RN, will help providers prepare for the new QIS-driven […]

CMS announces disaster exceptions/exemptions for providers affected by California wildfires

CMS is granting exceptions under certain Medicare quality reporting and value-based purchasing programs to skilled nursing facilities, home health agencies, and hospices. These healthcare providers and suppliers will be granted exceptions without having to submit a request if they are located in Santa Barbara county or Ventura county. The scope and duration of the exception […]

How will ADL scoring change under RCS-1?

RCS-1 was introduced in an Advance Notice of Proposed Rulemaking [CMS-1686-ANPRM]. While providers are awaiting an implementation date, HCPro is dedicated to helping you understand the changes from RUG-IV and navigate the shift every step of the way! An important change introduced by RCS-1 affects capturing of ADLs and a reduction in the number of assessments required. “With […]

Ethical principles for long-term care billers

The following post is an excerpt from Medicare Guide for SNF Billing and Reimbursement by Janet Potter, CPA, MAS, and Frosini Rubertino, RN-CNE, CDONA/LTC, CPRA. The following ethical principles are based on the core values of The Billers’ Association for Long-Term Care. They apply to all members. Long-term care billing professionals shall do the following: […]

Understanding phase 2 requirements for survey readiness

A thorough review and update of the implementation of Phase 2 requirements, as well as preparation tactics for survey readiness, will help long-term care providers mitigate citation risks. This review will also help providers understand what to expect as surveys transition throughout the year to the new outcome-oriented survey format. During HCPro’s 60-minute webinar on […]

Who needs to prepare for RCS-1?

On July 31, 2016, CMS announced that the payment levels currently used in the prospective payment system (PPS), resource utilization group (RUG) IV, will be replaced in FY2019 by the resident classification system (RCS-1). This replacement is currently scheduled to be implemented by October 2018. This will be a complicated and significant change for providers. […]

Two-year budget deal repeals therapy caps, cuts skilled nursing spending by $1.96 billion

Last week, President Donald Trump signed a two-year federal budget deal that left long-term care providers sighing with relief at the repeal of therapy caps for Medicare Part B beneficiaries retroactive to January 1, followed by a sigh of disappointment with a $1.96 billion cut to skilled nursing facility (SNF) spending. The cuts include a payment […]