• At-a-Glance Updates to the RAI User's Manual Effective Oct. 1, 2018 Tool

    By AANAC - August 28, 2018
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  • Scanning the Horizon: The Latest Updates to the RAI User’s Manual Effective October 1, 2018

    By Jane Belt, MS, RN, RAC-MT, QCP - August 28, 2018

    Just in time to help celebrate Labor Day, CMS has provided us with many pages to “labor” over in the few weeks that remain before October 1, 2018. Since August 22, we have had the opportunity to review the draft item sets and the technical specifications, but what our hearts most desired was to get the manual. And that we did—even a bit earlier than CMS had originally projected for its release. The good news: we have more time to absorb the changes that we have long been anticipating due to the SNF Quality Reporting Program. Let’s cover a high-level review of the chapter 3 updates and changes so that the horizon to October 1 will be clear.

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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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  • RAI Manual v1.16 Arrives In September, But Start Training Now

    By Caralyn Davis, Staff Writer - August 07, 2018
    On July 31 – August 1, the Centers for Medicare & Medicaid Services (CMS) held a two-day train-the-trainer seminar to jumpstart provider preparations for the MDS item changes, as well as the updates to the Skilled Nursing Facility Quality Reporting Program (SNF QRP), that will implement this Oct. 1, 2018. The revisions will be wide-ranging. On the MDS side, there will be key item changes in these seven MDS sections:
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  • Goodbye RUG-IV: PDPM Will Implement On Oct. 1, 2019

    By Caralyn Davis, Staff Writer - August 02, 2018
    On July 31, the Centers for Medicare & Medicaid Services (CMS) released the Fiscal Year (FY) 2019 Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule, ushering in a new payment era for traditional fee-for-service Medicare Part A that will be unlike anything SNFs have seen before. The Patient-Driven Payment Model (PDPM) will go into effect on Oct. 1, 2019 (i.e., starting with FY 2020), replacing the RUG-IV case-mix classification model that has been the hallmark of SNF PPS for years.
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  • New Section GG Items Coming Soon

    By Mark McDavid, PT - July 23, 2018
    With the CMS QRP training just around the corner, it’s important to be familiar with the draft items being added to the MDS.  Section GG is being updated for FY 2019, taking effect October 1, 2018, to include over 20 new items and a new Activity Did Not Occur code. In addition, four new Quality Reporting Program (QRP) outcome measures will be introduced this October that will use this data. However, before skilled nursing facility (SNF) leaders can focus on the new outcome measures, they must develop a strong process for completing the functional assessment for section GG. Here is what you need to know about these changes from a therapy perspective.[1]

    [1] The section GG discussion in this article is based on draft language for FY 2019 that is subject to change. We expect to see finalized language when the new RAI User’s Manual is published in August or September of this year.
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  • AANAC Responds to FY 2019 SNF PPS Proposed Rule: Is Now the Time for PDPM?

    By Jessie McGill, RN, RAC-MT - July 10, 2018
    CMS took the long-term care profession by surprise in April when the SNF PPS Proposed Rule revealed the Patient-Driven Payment Model (PDPM). With a proposed implementation date of October 1, 2019, PDPM would replace RUG-IV without a phase-in or blended transition. CMS provided a 60-day comment period for the public to express concerns, support, and other feedback on the proposed rule, and AANAC responded. Following weeks of collaboration with our sister organization, AADNS, and with the Expert Advisory Panel members from both organizations, members, and other stakeholder groups, AANAC and AADNS jointly submitted 25 pages of comments to CMS. (For purposes of brevity in this article, the issuer of those comments is referred to as AANAC, but the collaborative effort should be understood.)
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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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  • SNF/LTC ODF News: Section GG Takes Center Stage

    By Caralyn Davis, Staff Writer - May 03, 2018
    The functional scores used to classify patients under the proposed Patient-Driven Payment Model (PDPM) are based on Section GG of the MDS, pointed out officials with the Centers for Medicare & Medicaid Services (CMS) in a review of key aspects of the Fiscal Year (FY) 2019 Skilled Nursing Facility Prospective Payment System (SNF PPS) Proposed Rule during the May 1 Skilled Nursing Facility/Long-term Care Open Door Forum. This would mark a significant change for providers because the current RUG-IV model uses Section G, as did the Resident Classification System, Version I (RCS-I) model when CMS presented it last year as an initial possibility for revamping the case-mix classification system used in the SNF PPS.
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  • SNF PPS: CMS Proposes Big Changes for Oct. 1, 2019

    By Caralyn Davis, Staff Writer - May 01, 2018

    On April 27, 2018, the Centers for Medicare & Medicaid Services (CMS) proposed to launch a revised case-mix classification model called the Patient-Driven Payment Model (PDPM) effective Oct. 1, 2019, (i.e., starting with FY 2020) that could radically re-imagine the job of the nurse assessment coordinator (NAC). The PDPM makes the use of therapy minutes to classify a resident for payment purposes obsolete, significantly alters the PPS assessment schedule, and institutes a variable per-diem payment adjustment schedule for the first time in SNF PPS history, according to the Fiscal Year (FY) 2019 Skilled Nursing Facility Prospective Payment System (SNF PPS) Proposed Rule.

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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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  • Section GG Overhaul Coming This Oct. 1 In Conjunction With New QMs

    By Caralyn Davis, Staff Writer - February 28, 2018
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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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  • FY 2017 SNF PPS Final Rule: CMS Adopts Drug Regimen Review SNF QRP QM

    By Caralyn Davis, Staff Writer - August 03, 2016
    It’s official: On Oct. 1, 2018, providers will begin data collection on three new standardized MDS items for the MDS-based quality measure (QM), Drug Regimen Review Conducted With Follow-Up for Identified Issues -- Post-acute Care (PAC) Skilled Nursing Facility Quality Reporting Program (SNF QRP) measure, for fiscal year (FY) 2020 payment determinations. CMS made the announcement in the FY 2017 SNF PPS final rule, which went on display on July 31 and will be published in the Federal Register on Aug. 5. 
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