• At A Glance QM, QRP, and VBP Tool

    By AANAC - November 10, 2020
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  • PDPM At-a-Glance Tool

    By AANAC - August 07, 2019
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  • FY 2019 SNF PPS Final Rule PLUS Correction, Updated Wage Index Tables (10/18)

    By CMS - October 01, 2018
    Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities Final Rule for FY 2019, SNF Value-Based Purchasing Program, and SNF Quality Reporting Program

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2019. This final rule also replaces the existing case-mix classification methodology, the Resource Utilization Groups, Version IV (RUG-IV) model, with a revised case-mix methodology called the Patient-Driven Payment Model (PDPM) beginning on October 1, 2019. The rule finalizes revisions to the regulation text that describes a beneficiary’s SNF “resident” status under the consolidated billing provision and the required content of the SNF level of care certification. The rule also finalizes updates to the SNF Quality Reporting Program (QRP) and the Skilled Nursing Facility ValueBased Purchasing (VBP) Program. 

    Correction Notice SUMMARY: This document corrects technical errors in the final rule that appeared in the August 8, 2018 Federal Register (83 FR 39162) entitled “Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNF) Final Rule for FY 2019, SNF Value-Based Purchasing Program, and SNF Quality Reporting Program.” DATES: The corrections in this document are effective October 1, 2018 .

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  • N0450: Finetune Your Antipsychotic GDR Coding

    By Caralyn Davis, Staff Writer - September 25, 2018

    Since the Oct. 1, 2017, implementation of MDS item N0450 (Antipsychotic Medication Review), some providers have experienced a few hiccups in the quest for accurate reporting despite the seemingly straightforward nature of the questions. The five-part item captures the following information:

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  • CMS Addresses Section GG Dashes for FY 2020 Data Collection

    By Caralyn Davis, Staff Writer - September 25, 2018

    Exactly when skilled nursing facilities are allowed to dash discharge goal items in Section GG (Functional Abilities and Goals) without imperiling their ability to meet the data submission threshold requirement for the Skilled Nursing Facility Quality Reporting Program (SNF QRP) remains a concern for many providers. Officials with the Centers for Medicare & Medicaid Services (CMS) offered the following responses to questions submitted by AANAC staff, providing some clarification about dash usage for Section GG goals for fiscal year (FY) 2020 data collection occurring in calendar 2018:

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  • Q&A: When would it be appropriate to dash “-“ an item on the MDS?

    By Jessie McGill RN, RAC-MT - September 25, 2018
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  • Pressure Ulcer Coding Algorithm

    By AANAC - September 18, 2018
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  • Section G Coding Tool

    By AANAC - September 14, 2018
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  • Section GG Prior Function and Admission Performance Tool

    By AANAC - September 12, 2018
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  • Section GG 3-Day Data Collection Tool

    By AANAC - September 12, 2018
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  • Guide to Successful Restorative Programs

    By AANAC - August 16, 2018
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  • B0700 and B1000: Two Items Worth Reviewing

    By Caralyn Davis, Staff Writer - August 13, 2018

    In MDS 3.0 Section B (Hearing, Speech, and Vision), nurse assessment coordinators (NACs) might be surprised by the importance of two items: B0700 (Makes Self Understood) and B1000 (Vision). Here’s why they should matter to interdisciplinary team members who code these items—and what NACs should check to ensure coding accuracy:

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  • CMS Touts SNF Cost Savings Under the New PDPM Payment Model

    By Caralyn Davis, Staff Writer - May 04, 2018

    Skilled nursing facilities should save approximately $2 billion in aggregate reduced administrative costs over the next 10 years ($12,000 and 183 hours in savings per provider annually), said officials with the Centers for Medicare & Medicaid Services (CMS) in a review of key aspects of the Fiscal Year (FY) 2019 SNF PPS Proposed Rule during the May 1 Skilled Nursing Facility/Long-term Care Open Door Forum. This estimate is based on the proposed changes to the skilled nursing facility prospective payment system (SNF PPS) assessment schedule associated with the Patient-Driven Payment Model (PDPM) if it’s implemented as proposed on Oct. 1, 2019.

     

    “While the current [RUG-IV] system requires substantial paperwork to track the volume of service utilization over time, PDPM eliminates the need of these frequent patient assessments and allows clinicians to focus more time on treating the patient,” noted officials. Note: PDPM is based on the Resident Classification System, Version I, or RCS-I, that CMS presented last year.

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  • Therapy and Nursing Collaboration on the Proposed Section GG Items

    By Mark McDavid, OTR, RAC-CT - April 04, 2018

    The anticipated October 1, 2018, changes to the MDS include a number of additions to section GG, according to technical specifications published in December by the Centers for Medicare & Medicaid Services (CMS). Additional data to be required in section GG will necessitate increased collaboration between nursing and therapy. As you may recall, section GG is a response to the IMPACT Act, and not collecting enough data may negatively impact your annual percentage update by as much as 2% of your reimbursement. Here is what you need to know.

     

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  • Opioids: Assessment and Care Planning Tips

    By Caralyn Davis, Staff Writer - November 14, 2017

    To be ready for the new survey process that implements on Nov. 28, 2017, nurse assessment coordinators (NACs) not only need to understand how to code N0410H (Opioid Medications Received), they also should make sure that the interdisciplinary team (IDT) understands how to assess and care plan for opioids as part of a resident’s pain management plan.

    Consider the following six tips to facilitate appropriate opioid use:

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