• Balancing Sections G and GG Requirements

    By Jessie McGill, RN, RAC-MT, RAC-MTA - July 10, 2019

    With the enormous focus on the transition from RUG-IV to PDPM, some may consider abandoning their section G Activities of Daily Living (ADLs) training materials, audits, and tools— but wait just a moment! Although section GG is stepping into the Medicare reimbursement spotlight, section G still plays a big role in other types of reimbursement and Quality Measures. To ensure success, the nurse assessment coordinator (NAC) must have a full understanding of the coding instructions, documentation requirements, impact on Quality Measures, and reimbursement for both section G and GG. Here are four key differences between the two sections and tips for successfully managing both.

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  • August 13 - 14 CMS SNF QRP Training Event: Register to Attend Online or In-person

    By CMS - July 04, 2019

    REGISTRATION OPEN – SNF QRP Provider In-Person Training Event, August 13 and 14, 2019

    The Centers for Medicare & Medicaid Services (CMS) will be hosting a 2-day Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) in-person ‘Train the Trainer’ event for providers on August 13 and 14, 2019, at the Four Seasons Hotel, 200 International Drive, Baltimore, MD 21202. This event will be open to all SNF providers, associations, and organizations.

    Like the May 2019 SNF QRP Provider Training, the primary focus of this 'Train-the-Trainer’ event will be to provide those responsible for training staff at SNFs with information about:

    ·        The transition to the Patient Driven Payment Model (PDPM) which becomes effective on October 1, 2019.

    ·        A review of SNF QRP changes and updates to the Minimum Data Set (MDS) 3.0 Version 1.16.0, which became effective October 1, 2018.

    ·        An overview of the eleven SNF QRP Quality Measures.

    An interactive session on the use of reports to identify opportunities for process improvement and utilize information contained in reports available via the Certification And Survey Provider Enhanced Reports (CASPER) system to develop quality improvement plans.

    During this event, presenters will incorporate additional information into their presentations based on questions received from participants during the May training.

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  • Section GG Web-based Training Module UPDATED (6/19)

    By CMS - June 27, 2019

    The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training course on how to properly code of Section GG. This 45-minute course is intended for providers in the following care settings: Skilled Nursing Facilities (SNFs), Long-Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), and Home Health Agencies (HHAs); and is designed to be used on demand anywhere you can access a browser. The course is divided into the following four lessons and includes interactive exercises that allow you to test your knowledge in real life scenarios:

    • Lesson 1: Importance of Section GG for Post-Acute Care

    • Lesson 2: Section GG Assessment and Coding Principles

    • Lesson 3: Coding GG0130.Self-Care Items

    • Lesson 4: Coding GG0170.Mobility Items

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  • CMS Section GG Training Videos: GG0110, GG0170C, GG0130B, Decision Tree for GG0130/GG0170 (6/19)

    By CMS - June 10, 2019

    These apply to all four QRP programs, including the SNF QRP:

    • GG0110 Prior Device Use with Information From Multiple Sources. This 4-minute video demonstrates how a caregiver can utilize information collected from multiple scenarios to accurately code GG0110. Prior Device Use. 
    • Decision Tree for Coding Section GG0130. Self-Care and GG0170. Mobility. This 12-minute video demonstrates how to apply the six-point coding scale to GG0130. Self-Care and GG0170. Mobility using GG0170D. Sit to stand as an example.
    • Coding GG0170C. Lying to sitting on side of bed This 4-minute video demonstrates how to distinguish between Code 02, Substantial/maximal assistance and Code 03, Partial/moderate assistance when coding GG0170C. Lying to sitting on side of bed.
    • Coding GG0130B. Oral HygieneThis 4-minute video demonstrates how to distinguish between Code 05, Set-up or clean-up assistance and Code 04, Supervision or touching assistance when coding GG0130B. Oral Hygiene. 
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  • TIP: New Section GG Training Videos

    By AANAC - June 05, 2019
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  • Q&A: Can therapy code section GG based on their clinical judgment of what the resident is capable of doing?

    By Carol Maher, RN-BC, CPC, RAC-MT - June 05, 2019
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  • May 7 - 8 SNF QRP Training Materials Available

    By CMS - May 02, 2019
    May 7 - 8 SNF QRP Training Materials Available
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  • SNF QRP Q&A Document Targets Section N and Other issues (4/19)

    By CMS - April 05, 2019

    A new Question and Answer (Q+A) document is now available. The Q+A document reflects frequently asked questions that were received by the SNF QRP Help Desk during the fourth quarter (Oct - Dec) of 2018.

    ·        SNF QRP Quarterly FAQ Update Q4 2018 [PDF, 268KB]

     

    From https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-FAQs-.html

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  • IPAs: Basic Rules of the Road

    By Caralyn Davis, Staff Writer - March 06, 2019

    With the next version of the RAI User’s Manual not slated to be released until late spring, there are still some unknowns about the new Interim Payment assessment (IPA), but the Centers for Medicare & Medicaid Services (CMS) has established the basic rules of the road. Here’s a handy summary of the information CMS has provided thus far.

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  • Q&A: We had to dash a few GG items on the PPS Discharge assessment, is this going to count against us for SNF QRP?

    By Carol Maher, RN-BC, CPC, RAC-MT - March 06, 2019
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  • No. 1 Sign of GG Dysfunction? Therapy Runs the Show Alone

    By Caralyn Davis - February 20, 2019

    Providers have been collecting data for MDS section GG (Functional Abilities and Goals) since October 2016, largely to meet the data submission threshold for the Skilled Nursing Facility Quality Reporting Program (SNF QRP). “In many SNFs, nursing has generally abdicated responsibility for section GG to the therapy department because there is no payment attached to section GG under the RUG-IV case-mix classification system,” says Joel VanEaton, BSN, RN, RAC-MT, vice president of compliance and regulatory affairs for Broad River Rehab in Asheville, NC.

     

    “That’s a big mistake when it comes to the Patient-Driven Payment Model (PDPM), which implements on Oct. 1,” says VanEaton. “To correctly define the resident’s functional profile in section GG, you have to figure out how to shift from that therapy-only paradigm to a paradigm of true collaboration, particularly among the MDS department, nursing, and rehab.”

     

    “The most significant problem with section GG is that coding often isn’t interdisciplinary,” agrees Tracy Montag, BSN, RN, RAC-MT, clinical consultant with the Senior Living Services Consulting Group at RKL LLP in York, PA. “There are still a lot of facilities that don’t look at usual performance over three days because coding is so therapy-driven. For example, for the 5-day PPS MDS, they input information directly into section GG from the documentation the therapist completes during the therapy evaluation. Sometimes facilities don’t even have information collected for some components of section GG because therapy is not seeing the resident for those components.”

     

    To improve section GG coding accuracy, nurse assessment coordinators (NACs) should consider the following steps:

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  • TIP: PDPM Resources Updated

    By AANAC - February 20, 2019
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  • SNF QRP 3Q 2018 Help Desk Q+A Doc Includes 2 GG Coding Q&As (2/19)

    By CMS - February 19, 2019
    A new Question and Answer (Q+A) document is now available from the SNF Quality Reporting Program FAQs webpage. The Q+A document reflects frequently asked questions that were received by the SNF QRP Help Desk during the third quarter (July - September) of 2018. It includes information about the SNF QRP program, as well as two section GG coding questions (related to GG0170N and GG0170O).
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  • TIP: CMS Releases GG Tool

    By AANAC - February 06, 2019
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  • Section GG’s Role in PDPM: The Basics

    By Caralyn Davis, Staff Writer - February 06, 2019
    MDS section GG (Functional Abilities and Goals) will replace section G (Functional Status) as a key payment driver for fee-for-service Medicare Part A residents paid under the Skilled Nursing Facility Prospective Payment System (SNF PPS) when the Patient-Driven Payment Model (PDPM) implements on Oct. 1, 2019. Using items from section GG instead of section G “advances CMS’s goal of using more standardized assessment items across payment settings,” said officials with the Centers for Medicare & Medicaid Services during the Dec. 11, 2018, SNF PPS: PDPM National Provider Call (NPC).
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