• Senate Healthcare Bill: Read the Text for Yourself (6/17)

    By Kaiser Health Network - June 26, 2017

    The text of the Senate healthcare bill under consideration in June/July 2017.

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  • New Long-term Care Survey Process – Slide Deck and Speaker Notes (6/17)

    By CMS - June 26, 2017
    CMS has released a slide deck and speaker notes previewing the upcoming changes to the long-term care survey process.
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  • SNF QRP Quarterly Deadlines Impact Payment and Public Reporting

    By Caralyn Davis, Staff Writer - June 20, 2017

    The next upcoming data reporting deadline for the Skilled Nursing Facility Quality Reporting Program (SNF QRP) is Aug. 15, 2017, for the data collection period of Jan. 1, 2017 – March 31, 2017. The SNF QRP quarterly data submission/correction deadlines are critical in two key ways, revealed the May 2 Review and Correct Reports Provider Training webinar held by the Centers for Medicare & Medicaid Services (CMS). (Access the recorded webcast here, the webcast slides here, and the participant Q&A document here.) The quarterly reporting deadlines occur 4.5 months after the end of each quarter, freezing the data for the following purposes:

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  • How to Lead Effective Meetings

    By Jessica Kunkler, MA, Staff Writer - June 20, 2017
    With new regulations and a constantly growing list of demands, nurse assessment coordinators are busier than ever. To accomplish everything (or everything possible) on their lists, NACs need to find new efficiencies. Scheduling and executing effective and efficient meetings is one way that NACs and their interdisciplinary teams can make more time in the day. Linda Shell, DNP, MA, RN, principal of lindashell.com, suggests taking a look at all of the upcoming meetings on your calendar, especially long-standing ones, and considering these best practices:
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  • The Importance of Documentation in Long-Term Care for Chronic Medical Conditions

    By Sophie Campbell, MSN, RN, CRRN, RAC-CT, CNDLTC - June 20, 2017

    Medical record documentation has always been a critical component of the post-acute care environment, for nursing in particular. In skilled resident care, documentation is required to support MDS coding, reimbursement, and the need for skilled services on an inpatient basis. There are other uses for medical record documentation, however, that shouldn’t be overlooked.

    In the post-acute environment, the focus of documentation has been on providing rationales for (1) the resident’s hospitalization during the qualifying acute-care stay and then (2) for the referral to the post-acute care facility for continued services such as, most commonly, rehabilitation. In the past, documentation from nursing team members and ancillary departments has focused on supporting the need for rehabilitation services. As reported in sections G and GG of the MDS, this includes the quality and quantity of functional and self-care tasks and the resident’s capacity to achieve discharge goals. It has been rare, and is especially so with the current trend toward reduced lengths of stay, for the documentation to address chronic medical conditions—the comorbidities to the acute medical need that initially led to the hospitalization and post-acute referral. 

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  • SNF QRP Review and Correct Reports Available (6/17)

    By QTSO - June 19, 2017

    The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Review and Correct reports are now available on demand in the CMS Certification and Survey Provider Enhanced Reporting (CASPER) application. Providers can access these reports by selecting the CASPER Reporting link on the “Welcome to the CMS QIES Systems for Providers” webpage. NOTE: You must log into the CMS Network using your CMSNet user ID and password in order to access the “Welcome to the CMS QIES Systems for Providers” webpage.

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  • Five Star Preview Reports Avail. June 20, Help Line Open June 26 - 30

    By QTSO - June 19, 2017

    The Five Star (5 Star) Preview Reports will be available on June 20th. Nursing Home Compare will update with May's Five Star data on June 28, 2017. The 5 Star Help line (800-839-9290) will be available June 26, 2017 through June 30, 2017.

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  • MedPAC June 2017 Report to Congress Looks at Postacute Care Payment (6/17)

    By MedPAC - June 19, 2017

    The Medicare Payment Advisory Commission (MedPAC) releases its June 2017 Report to the Congress: Medicare and the Health Care Delivery System. The Commission’s report examines a variety of Medicare payment system issues, including implementing a unified payment system for post-acute care, as well as hospital and skilled nursing facility use by Medicare beneficiaries who reside in nursing facilities.

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  • 2018 ICD-10-CM Code Files Available (6/17)

    By CMS - June 19, 2017
    The 2018 ICD-10-CM code files are now available on the 2018 ICD-10 CM and GEMs webpage. This includes the 2018 tabular and index, code descriptions, and addendum files:
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  • CMS Extends Comment Period for Case Mix Revisions Advance Notice (6/17)

    By CMS - June 14, 2017

    Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-mix Methodology; Extension of Comment Period AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

    SUMMARY: This document extends the comment period for the advance notice of proposed rulemaking with comment entitled “Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-mix Methodology” that appeared in the May 4, 2017 Federal Register (82 FR 20980) (the ANPRM). The comment period for the ANPRM, which would end on June 26, 2017, is extended until August 25, 2017.

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  • Emergency Preparedness / Appendix Z, State Operations Manual Update (6/17)

    By CMS - June 12, 2017

    Appendix Z, Emergency Preparedness Final Rule Interpretive Guidelines and Survey Procedures: Interpretive Guidelines. The Centers for Medicare & Medicaid Services (CMS) is releasing a new Appendix Z of the State Operations Manual (SOM), which contains the interpretive guidelines and survey procedures for the Emergency Preparedness Final Rule.

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  • October Section N Changes: How to Prepare

    By Caralyn Davis, Staff Writer - June 06, 2017
    This fall, the alignment between the MDS and the survey process will become a little stronger. The Centers for Medicare & Medicaid Services (CMS) plans to add six new items to section N (Medications) that largely correspond with some of the new medication requirements in the revised Medicare/Medicaid conditions of participation (aka the Mega Rule), notes Carol Maher, RN, BC, RAC-CT, director of education for Hansen, Hunter & Co. PC based in Vancouver, WA.
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  • MDS/Billing Hot Spots Part 2: Are You In Sync on These Two Issues?

    By Caralyn Davis, Staff Writer - June 06, 2017
    Two critical areas don’t receive nearly enough attention during communications between the billing office and nurse assessment coordinators (NACs) at most skilled nursing facilities (SNFs), says Colleen Toebe, RN-MSN, RAC-MT, a senior nurse consultant with Lake Elmo, MN-based Pathway Health Services. “Many providers just haven’t made these issues a priority, but they can have a significant impact on provider billing and liability.”
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  • Consolidated Billing: Major Categories II – V

    By Caralyn Davis, Staff Writer - June 06, 2017
    The annual update of HCPCS codes used for consolidated billing enforcement of institutional claims submitted to Medicare administrative contractors covers five Major Categories of services. Skilled nursing facilities (SNFs) use the HCPCS code file, in conjunction with the General Explanation of the Major Categories for SNF Consolidated Billing, to determine whether specific services are included in or excluded from consolidated billing.
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  • CASPER Reporting User’s Guide for MDS Providers UPDATED (6/17)

    By QTSO - June 06, 2017
    Provides information and instructions pertaining to CASPER Reporting, including accessing Final Validation Reports.
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