FAQs

Q&A: How long does a pressure injury stay on Quality Measures (QMs)? It was captured several months ago and is now resolved. When it will come off our QMs?
Q&A: When a long-term care resident tests positive for COVID-19, can we skill the resident under Medicare Part A for nursing skilled services?
Q&A: A resident started a new benefit period using the benefit period waiver. Daily skilled care is now ending. Do I need to issue any of the beneficiary notices to take the resident off Medicare?
Q&A: We recently completed a Significant Change in Status Assessment (SCSA) for a resident with a prognosis of less than six months. Is another SCSA required with a hospice election today?
Q&A: Is the Part A PPS Discharge Assessment (NPE) or Interim Payment Assessment (IPA) required for insurance companies?
Q&A: All therapy is ending for a Medicare Part A resident. What assessments are needed to continue to skill for direct nursing services?
Q&A: A resident had a fall with a fracture and delayed healing. Can I code aftercare in I8000?
Q&A: Will a Fall with Major Injury remain on the Quality Measures (QMS) for 275 days even though the resident has been discharged?
Q&A: Can a resident ask for both an expedited appeal and a demand bill?
Q&A: In section I, do we need a physician’s diagnosis for “risk of malnutrition,” or can we use the dietitian's assessment to code in section I?
Q&A: A resident uses two half-siderails when in bed but is not able to remove the siderails once they are up. Should the siderails be coded as a restraint in section P?
Q&A: A resident on Medicare Part A discharged home on Oct. 7 and readmitted back to our facility on Oct. 9. Is this an interrupted stay? Should I do a 5-Day or an IPA?
Q&A: Our state is requiring PDPM data on OBRA assessments. Is section GG collected on only Medicaid residents or for all payer types?
Q&A: Are the Quality Measures (QMs) still frozen? If so, does anyone know how long they will remain frozen?
Q&A: A resident already had their Medicare benefit extended related to COVID-19. Can this same beneficiary receive another 100 days using the waivers?

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