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RAC-CT Certification Program Materials:
MDS 3.0 Coding for OBRA and PPS with Accurately Assessing Function
Status
Content/Slides for Workshop
Handout; Medicare Stay End Date Algorithm (A2400C); MDS 3.0 Cue Cards; ADL
Self-Performance Algorithm (G0110); NAC-EAP Resolution
OBRA Timing and Scheduling for the MDS 3.0
Content/Slides for Workshop
Handout; Entry, Discharge, and Reentry Algorithms
PPS Timing and Scheduling for the MDS 3.0
Content/Slides for Workshop
Handout; COT OMRA Example 1; Medicare PPS Assessment Schedule
Resource Utilization Groups IV (RUG
Content/Slides for Workshop
Handout; Resource Utilization Groups Version IV – Rural 66 Group PPS Model; Resource
Utilization Groups Version IV – Urban 66 Group PPS Model; Medicare Short Stay
Assessment Algorithm; The Hierarchy of RUG-IV 66 Classification Eight Major
Groups; RUG-IV 66 Group Classification Category Qualifiers; Medicare Short Stay
Assessment Algorithm
Introduction to Medicare Part A
Content/Slides for Workshop
Handout; SNF Medicare Benefit Period Flow Chart; Benefit Period Examples;
Skilled Rehabilitation Examples; SNF Denial Letter Examples 1 -5; Health
Insurance PPS (HIPPS) Codes; Additional Development Request Checklist; Perils
and Pitfalls of the MDS/PPS Process Billing
Care Area Assessments and Care Planning and the MDS 3.0
Content/Slides for Workshop
Handout; Ruth Abrams Case Study; Assessment Care Planning Flow Chart; Critical
Thinking Case Study; Care Plan Example 1; Interventions Case Study;
Communication Case Study; Interdisciplinary Care Plan Conference Record; Time
Frames Case Study; Sample “I-Format” Care Plan; Skin Integrity- Before ECP Care
Plan, Standard of Care, and After ECP
Quality Measures and the MDS 3.0
Content/Slides for Workshop
Handout; Chapter 1- QM Sample and Record Selection Methodology; Sample Casper
Reports: MDS 3.0 Facility Characteristics Report, MDS 3.0 Facility Level
Quality Measure Report, MDS 3.0 Resident Level Quality Measure Report
The Five-Star Quality Rating System
Content/Slides for Workshop
Handout; Five-Star Rating Quality Measure Scoring Chart; Quality Improvement
Plan
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RAC-CT Recertification Program Materials:
Content/Slides for Workshop
Handout; Medicare Stay End Date Algorithm A2400C; Medicare Short Stay
Assessment Algorithm; COT OMRA Example 1 and 2; Case Study 1-21; Chapter 1: QM
Sample and Record Selection Methodology; Sample Casper Reports: MDS 3.0
Facility Characteristics Report, MDS 3.0 Facility Level Quality Measure Report,
MDS 3.0 Resident Level Quality Measure Report; Case Studies
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Medicare University Program Materials:
Medicare in a Skilled Nursing Facility
Content/Slides for Workshop
Handout; Analysis of Common MSP Coverage Situations; SNF Medicare Benefit Period
Flow Charts; Benefit Period Scenarios
The Prospective Payment System for Skilled Nursing Facilities
Content/Slides for Workshop
Handout; Entry Tracking Record; Medicare PPS Assessment Schedule
Resource Utilization Groups: Version IV
Content/Slides for Workshop
Handout; Rural 66 Group PPS Model; Urban 66 Group PPS Model; Medicare PPS
Assessment Schedule; The Hierarchy of RUG-IV 66 Classification Eight Major
Groups; RUG-IV 66 Group Classification Category Qualifiers; Medicare Short Stay
Assessment Algorithm
Medicare Part B Rehabilitation Services in a Skilled Nursing Facility
Content/Slides for Workshop
Handout; Common Reasons for Referring Residents for Therapy in a Nursing
Facility; Functional Reporting Severity Modifiers
Medical Review in a Skilled Nursing Facility
Content/Slides for Workshop
Handout; PCA Flow Chart; Original Medicare Flow Chart; A/B MAC Jurisdictions;
RAC Audit Flow Chart; Recovery Audit Program Improvements
Documentation to Support the Daily Skilled Need
Content/Slides for Workshop
Handout; When Nursing and Therapy Notes Collide; SNF Documentation Case Study:
Mrs. Johnson; SNF Document Guidelines
SNF Management Strategies: Putting it all Together
Content/Slides
for Workshop Handout
Skilled Nursing Facility Consolidated Billing
Content/Slides for Workshop
Handout; Major Category Explanations; Transportation Billing Guide;
Consolidated Billing Claims Processing Instructions; UB-04 Elements
The Beneficiary Notification Initiative for Skilled Nursing Facilities
Content/Slides for Workshop
Handout; Key Concepts Regarding Liability notices and Resident Appeals Rights; SNF
Beneficiary Notice Requirements
CMS Current Initiatives and Preview of Upcoming Events
Content/Slides for Workshop
Handout; 2012-2013 Work Plan; Five-Star Rating Quality Measure Scoring Chart
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Director of Nursing Services-Certified (DNS-CT)
Prep Workshop Program Materials:
Leadership & Management for the Nurse Leader
Content/Slides for Workshop
Handout
Risk Management for the Nurse Leader
Content/Slides for Workshop
Handout
Quality Assurance and Performance Improvement for the Nurse Leader
Content/Slides
for Workshop Handout
Human Resource Management for the Nurse Leader
Content/Slides for Workshop Handout
Survey Readiness 24/7/365 for the Nurse Leader
Content/Slides for Workshop Handout
Survey Management and Enforcement for the Nurse Leader
Content/Slides
for Workshop Handout
Quality Indicator Survey Essentials for the Nurse Leader
Content/Slides
for Workshop Handout
Essential Business Skills for the Nurse Leader
Content/Slides
for Workshop Handout
MDS and Medicare Process Essentials for the Nurse Leader
Content/Slides
for Workshop Handout
Care Management and Surveillance Systems for the Nurse Leader
Content/Slides
for Workshop Handout
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QAPI Certified Professional (QCP) Prep
Workshop Program Materials:
Design and Scope for Skilled Nursing Facilities
Content/Slides
for Workshop Handout
Governance and Leadership for Skilled Nursing Facilities
Content/Slides
for Workshop Handout
Feedback, Data Systems, and Monitoring for Skilled Nursing Facilities
Content/Slides
for Workshop Handout
QAPI Performance Improvement Projects for Skilled Nursing Facilities
Content/Slides
for Workshop Handout
Systematic Analysis and Systemic Action for Skilled Nursing Facilities
Content/Slides for Workshop Handout
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