• Pressure Ulcer Coding Algorithm

    By AANAC - July 26, 2017
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  • Baseline Care Plans: How NACs Can Prepare

    By Caralyn Davis, Staff Writer - July 26, 2017
    Effective Nov. 28, 2017, nursing homes that participate in the Medicare and/or Medicaid programs have to complete and implement a baseline care plan within 48 hours of a resident’s admission, as well as provide a baseline care plan summary to the resident (and representative if necessary) by the completion of the comprehensive care plan. On June 30, the Centers for Medicare & Medicaid Services released an advance copy of Appendix PP, “Guidance to Surveyors for Long-term Care Facilities,” of the State Operations Manual, offering some important details about the baseline care plan implementation requirements in F-tag 655. (See excerpt at the end of this article.)
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  • Best Practices for Reporting Wounds

    By Jessica Kunkler, Staff Writer - July 26, 2017

    There’s a lot on the line when it comes to accurately reporting wounds. Not only will the Quality Measure (QM) NQF #0678, “New or Worsened Pressure Ulcers,” negatively impact public reporting and payment, dashing M0300 B, C, and D could also negatively impact payment as part of the Quality Reporting Program (QRP) for Medicare stays.

    NQF #0678 looks strictly at the number of worsened pressure ulcers at M0800. The QRP measure will look at the Part A PPS Discharge assessment to determine whether a higher number of pressure ulcers are reported than were coded as present on admission, indicating new pressure ulcers developed at the facility or pressure ulcers that have worsened to a deeper anatomical stage since admission. Pressure ulcers are notoriously misreported, according to Jessie McGill, RN, RAC-MT, AANAC curriculum development specialist. She advises properly training staff to avoid the following pitfalls and ensure correct data reporting.

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  • Section H: Best Practices for an Individualized Toileting Program

    By Jessica Kunkler, Staff Writer - July 26, 2017
    Urinary incontinence frequently or always affects over 50% of nursing home residents, according to the 2017 first quarter MDS frequency reports. Given the prevalence of incontinence in nursing homes, “it’s important to remember that incontinence is not a normal part of aging,” stresses Jane Belt, MS, RN, RAC-MT, QCP, curriculum development specialist for AANAC. Here are the basic steps to follow and best practices to keep in mind when designing a resident’s urinary toileting program.
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  • SNF PPS Advance Notice of Proposed Rulemaking Building-by-Building impact Analysis (7/17)

    By CMS - July 21, 2017
    To aid stakeholders in commenting on the SNF PPS Advance Notice of Proposed Rulemaking, we have posted a building-by-building impact analysis, which provides the estimated Medicare Part A payment impact of the RCS-I model currently under consideration for each SNF. 
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  • Five Star Help Line Open July 24 - 28

    By QTSO - July 21, 2017

    The Five Star (5 Star)  Preview Reports are available as of July 18, 2017. Nursing Home Compare will update with June's Five Star data on July 26, 2017. The 5 Star Help line (800-839-9290) will be available July 24, 2017 through July 28, 2017.

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  • SNF QRP Requests for Reconsideration for Calendar Q4 2016 Due Aug. 13

    By CMS - July 19, 2017

    CMS provided notifications to facilities that were determined to be non-compliant with Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) requirements for Quarter 4 of CY 2016, which will affect their FY 2018 annual payment update (APU). Notifications of non-compliance were placed into facilities’ Quality Improvement and Evaluation Systems (QIES) - Certification and Survey Provider Enhanced Reporting (CASPER) system on July 14, 2017 and also mailed directly to providers. Providers that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59pm PST, August 13, 2017. 

     

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  • Medicare / Medicaid Reform of Requirements for LTC Facilities: CMS Final Rule UPDATED (7/17)

    By CMS - July 18, 2017

    In October 2016, CMS finalized improvements in care, safety, and consumer protections for long-term care facility residents. Revisions mark first major rewrite of the conditions of participation (CoP) for long-term care facilities since 1991. In July 2017, the agency published some corrections.

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  • Fiscal Year 2017 HHS OIG Work Plan UPDATED

    By CMS - July 18, 2017
    The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Work Plan for fiscal year (FY) 2017 summarizes new and ongoing reviews and activities that OIG plans to pursue with respect to HHS programs and operations during the current fiscal year and beyond. Work planning is an ongoing and evolving process, and the Work Plan is updated throughout the year.
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  • Proposed CY 2018 Medicare Physician Fee Schedule (7/17)

    By CMS - July 18, 2017
    Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program
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  • CMS SNF QRP Transmittal Explains Payment Reduction Reconsideration Process (7/17)

    By CMS - July 18, 2017

    Fiscal Year 2018 and After Payments to Skilled Nursing Facilities That Do Not Submit Required Quality Data. SUMMARY OF CHANGES: This is a new Change Request (CR) to pub. 100-22, Medicare Quality Reporting Incentive Programs, Chapter 80, to reflect changes to the payment reduction reconsideration process.

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  • SNF QRP Deadline: MDS 3.0 Submission, Submission Status, and Final Validation Reports Helpful Hints (7/17)

    By QTSO - July 18, 2017
    The submission deadline for the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) is approaching. Minimum Data Set (MDS) assessment data for January-March (Q1) of calendar year (CY) 2017 are due with this submission deadline. All data must be submitted no later than 11:59 p.m. Pacific Standard Time on August 15, 2017. This document is an overview for MDS providers of the steps required to submit an MDS 3.0 file, verify its submission status, and obtain a Final Validation report. It is strongly recommended that providers access and review the MDS 3.0 Provider User’s Guide and the CASPER Reporting User’s Manual from the MDS 3.0 Welcome page, which is accessed from your state’s MDS Welcome page.
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  • Mega-Rule Appendix PP Survey Resources From CMS - Revised (7/17)

    By CMS - July 14, 2017
    CMS has released an Advance Copy of Appendix PP of the State Operations Manual with updated Interpretive Guidance for multiple F-tags, a list of revised F-tags by regulatory grouping, a crosswalk between old and new F-tags, and a survey-and-certification memo explaining upcoming changes, training opportunities, and enforcement issues.
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  • SNF QRP Review and Correct Reports: The Basics

    By Caralyn Davis, Staff Writer - July 11, 2017
    After a misfire, the first Skilled Nursing Facility Quality Reporting Program (SNF QRP) Review and Correct Reports for the data collection period of Jan. 1, 2017 – March 31, 2017, are now available to SNFs. (See the notice here.) This data collection period will remain open so that providers can continue to make relevant MDS submissions or corrections until the data correction deadline 4.5 months later on Aug. 15, 2017. As of that date, the MDS data for that quarter will be frozen for the purposes of meeting the SNF QRP data submission threshold for the MDS-based SNF QRP quality measures (QMs), as well as for the upcoming SNF QRP public reporting.
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  • Don’t Skip a Beat When Dealing With Skip Days

    By Emily Royalty-Bachelor, Staff Writer - July 11, 2017

    There can be quite a bit of confusion around Medicare skip days. What exactly constitutes a skip day? How does it affect your Medicare billable days? How does it affect scheduled and unscheduled assessments, assessment reference date (ARD) windows, and observation periods? What happens if you don’t track it correctly?

     

    Not to worry. We’re here to help with this complete guide to skip days—what exactly they are, how to adjust for them, and how to plan your assessments when your resident has one. So without skipping a beat, let’s get started.

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