Post-Acute Advisor

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CBO predicts 32 million will be without health coverage in 2026 with new repeal-and-delay bill

After the Senate’s recommendation for repeal-and-replace of the Affordable Care Act (ACA) failed due to lack of support, Majority Leader Mitch McConnell is now suggesting a repeal-and-delay strategy that, if passed, is predicted will leave 32 million individuals without health coverage by 2026, and 17 million without coverage by next year. That’s 1 million more than were predicted to be without coverage under the initial repeal-and-replace tactic.

Evidence-based strategies for transitioning to an alarm-free facility

Change associated with alarm use doesn’t look the same for all residents or even all facilities. Several factors should be considered before implementing methods to eliminate alarms--and providers shouldn’t expect it to happen all at once. Root cause analysis and planning are essential to implement successful culture change that wins staff buy-in and delivers quality care.

CMS proposes changes to outpatient knee replacement coverage and three-day waiver rule

Two proposals published by the Centers for Medicare & Medicaid Services (CMS) last week suggest two potential changes affecting Medicare coverage and the three-day rule waiver.

New PEPPER available for home health agencies, updates to Home Health Compare

New Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) through CY 2016 are available for home health agencies (HHAs).

Hospice Quality Reporting Program: Noncompliance letters, new Q&A on HIS

CMS notified hospice providers that are noncompliant with Hospice Quality Reporting Program (HQRP) requirements for CY 2016.

Opportunities to participate in a Technical Expert Panel

A technical expert panel (TEP) is a group of stakeholders and experts who provide technical input to the measure contractor on the development, selection, and maintenance of measures for which CMS contractors are responsible. Convening the TEP is one important step in the measure development or reevaluation process that CMS contractors use to ensure transparency and it provides an opportunity to receive multi-stakeholders input early in the process.

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Nonprofit senior living organizations overtake post-acute care providers in EHR adoption

LeadingAge’s annual survey to rank and analyze the nation’s 150 largest nonprofit senior living providers found that EHR adoption in these facilities is taking the lead compared to other long-term and post-acute care (LTPAC) providers. The survey, released at the end of 2016, found an 80% adoption rate among survey participants, which is a 5% increase from the past two years.

Other Post-Acute News

New in the July issue of PPS Alert for Long-Term Care: What SNF providers should know about billing for pneumococcal pneumonia, influenza virus, and Hepatitis B vaccines

As residents age, their health needs become more complex and many find themselves coping with chronic conditions such as heart disease, lung disease, and diabetes. For all residents in a long-term care facility, but for residents with chronic conditions especially, vaccines are an important part of decreasing the risk for further health complications. While it is the job of nurses and CNAs to administer vaccines, it’s up to the billers to ensure your facility is being reimbursed appropriately for these common services.

Master OASIS-C2: Minimize productivity losses and comply with new guidance

OASIS-C2 is the single biggest regulatory change that is decreasing clinicians’ productivity in 2017, according to a recent DecisionHealth survey. New questions that were added for OASIS-C2 slow clinicians down, contributing to longer visits and documentation time; what’s more, incorrect OASIS answers also impact episode payments and outcome scores. Stop the productivity drain and ensure your outcome scores are accurate.

How do I build a partnership with a managed care organization?

Managed care organizations (MCO) are breaking new ground when it comes to controlling and reducing long-term healthcare costs, changing the way care is delivered in today’s skilled nursing facility (SNF). With the number of managed care beneficiaries increasing every year and continual changes in how care is administered and reimbursed, it’s essential that SNFs understand best practices for optimizing managed care partnerships to increase their revenue and avoid losing substantial sums of money.

Putting the pressure on pressure injury prevention

Pressure injuries and documentation are often among the most frequently cited survey deficiencies, and wound care is the subject of continuous research. Most recently, in April 2016, the National Pressure Ulcer Advisory Panel (NPUAP) approved revisions to its Pressure Injury Staging System.

Product Spotlight

Skilled Nursing Facility Billing Boot Camp

Skilled Nursing Facility Billing Boot Camp provides hands-on, how-to education focusing on billing for Medicare Part A and B, the ins and outs of consolidated billing, accurately completing the UB-04. Plus, guidance on understanding the SNF coverage criteria and a breakdown of the different beneficiary notices.

Attendees will be able to return to their facility with the tools they need to understand the latest billing and reimbursement regulations, plus how to navigate the many billing processes to ensure their SNF is receiving appropriate reimbursement for services provided.

Billers Association Members (BAM) save 10% off the registration fee!

Upcoming CMS Events

Tuesday, July 25, 1:30 pm to 3 pm, ET - Revised Interpretive Guidelines for Nursing Homes and New Survey Process Call

Wednesday, July 26 from 2 pm to 3 pm, ET - ESRD QIP: Proposed Rule for Payment Year 2021 Listening Session

Wednesday, August 16 from 1:30 pm to 3 pm, ET - Medicare Diabetes Prevention Program Model Expansion Listening Session

Thursday, August 17, 1:30 pm to 3:00 pm, ET - IMPACT Act: Drug Regimen Review Measure Overview for the Home Health Quality Reporting Program Call

Wednesday, August 23, 3:00 pm to 4:00 pm, ET - Comparative Billing Report on Drugs of Abuse Testing Webinar

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