Tag: regulations

CMS releases FAQ document on functional reporting for therapy services

On June 19, the Centers for Medicare & Medicaid Services (CMS) released a new Frequently Asked Questions (FAQ) document on functional reporting for PT, OT, and SLP services. The document includes FAQs on: Providers, plans, and payers subject to functional reporting How to report functional information Assessment tools Claims requirements Click here to access this […]

New final rule makes changes to requirements for LTC facilities; hospice services

A final rule, released on Thursday, June 27, will revise the requirements that an institution will have to meet in order to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility (NF) in the Medicaid program. These requirements will ensure that long-term care (LTC) facilities (SNFs and […]

Ask the expert: Medicare coverage

Q: A resident in a SNF has not used her Medicare benefit since 2005. She was receiving rehab therapy 5x week prior to qualifying for a hospital stay. Are we allowed to skill her upon re-admission? A: Your question cannot be answered without more information.  Did the beneficiary ever go 60 days without receiving skilled […]

CMS releases fact sheet on Jimmo v. Sebelius settlement

As MDS 3.0 Insider previously reported, a settlement in the Medicare Improvement Standard case, Jimmo v. Sebelius, was approved on January 24, 2013. Now CMS has released fact sheet that gives an overview of the settlement and some background information. Glenda Jimmo of Lincoln, Vt., was the lead plaintiff in a class-action suit filed after […]

Digging in deeper: MedPAC report’s SNF findings

On March 15, the Medicare Payment Advisory Commission (MedPAC) issued its annual report to Congress. In the report, MedPAC addresses the SNF PPS in Chapter 8. MedPAC states that most indicators of payment adequacy for SNFs are positive. Here are some findings published in the report: Access to SNF services remains stable for most beneficiaries. […]

Ask the expert: Care plans

Q: We are having a large debate about care planning in our facility. Some people believe the basis of the care plan is to identify the resident’s care problems and plan actions, implement steps to care for those problems, and establish assessment dates, and then put MDS into the care plan. On the other side […]