Every time Jacque Pearson tried to devise a plan to move her 81-year-old dad, who has Alzheimer’s, from his home in Boise, Idaho, to hers in Denver, she felt stuck. Then, two weeks ago, she had a breakthrough. A program for people with dementia cannot be thrown together overnight. Caring for a group of people who have different histories, tastes, interests, personalities, physical abilities, cultures, and beliefs is complex. Given this reality, it should come as no surprise that creating a program that meets the distinct, sometimes disparate needs of these individuals and aims to help each one stay independent is also complex. The agency’s policies and procedures will include a discipline and discharge policy. It is important for the administrator/HR professional to follow the policy as written. Discipline is an important tool for managing agency personnel. Discipline can address poorly performing employees, resulting in improved performance, which benefits the employee and the agency. Following the discipline and discharge policies can also protect the agency against wrongful discharge claims. However, for discipline and discharge policies to have the appropriate effect, the agency must follow the policy as written. Provider Preview Reports are now available and hospice providers are encouraged to preview their quality measure results based on Quarter 1-2016 to Quarter 4-2016 data, prior to the November 2017 Hospice Compare refresh. Providers have 30 days to preview their quality measure results (August 29, 2017 through September 28, 2017). CMS reports that in a September 2015 report, the Office of the Inspector General (OIG) released results of a study of Medicare Part B ambulance claims. According to the report, almost 20 percent of ambulance suppliers had inappropriate and questionable billing for ambulance transport, creating vulnerabilities to Medicare program integrity. The CMS Innovation Center is seeking feedback from stakeholders through an informal Request for Information (RFI) to determine a new direction for healthcare systems that promotes patient-centered care and tests market-driven reforms that empower beneficiaries as consumers, provides price transparency, increases choices and competition to drive quality, reduces costs, and improves outcomes. A delay in the application process for Medicaid can have serious financial implications for the nursing facility. It is key to speak early with new residents and family members who might have a need to apply for Medicaid coverage. If the referring hospital hasn’t already discussed eligibility with the resident, it should be discussed during the inquiry and admission process. New in the September issue of PPS Alert for Long-Term Care: In long-term care credentialing, be rigorous yet realistic Increasingly, mergers and acquisitions are making strange bedfellows of acute, ambulatory, and postacute care facilities. As these newly aligned entities share practitioners and best practices, formalized credentialing is catching on across the care continuum. New Survey Process Training Tools Phase 2 of the new survey process is coming…are you ready? CMS delayed financial penalties for facilities found to be in noncompliance with Phase 2 regulations, but surveys will still begin November 28, 2017. Developing an effective survey compliance program now in line with the new requirements will keep your facility citation free, so you can focus on resident care. Know your survey, prepare for your survey, and be survey ready! Activities: Create a compliant activities program for your facility The Centers for Medicare & Medicaid Services’ latest revised Conditions of Participation place a stronger emphasis on person-centered care and resident preferences, a realm where activities serve as a core concept. However, current residents are more discerning than ever before and have different interests than they used to. Planning and designing new activities that fit diverse resident needs, all while keeping them active and engaged, is a major challenge for long-term care professionals. Billing: Comply with claims submissions to avoid common billing errors Rising healthcare costs and quickly depleting Medicare funds have put federal agencies up against a red hot timeline to rein in costs by uncovering instances of waste, fraud, and abuse, leaving some facilities with large settlement fines and in some extreme cases, jail sentences. With value-based purchasing transforming the long-term care billing landscape, billers need to bill appropriately to avoid submitting inaccurate claims and ensure that they are not leaving money on the table. Staff competencies: Leading change with enthusiasm When challenges arise in a facility, nurse leaders are often called upon to lead change with adaptability, empowerment, innovation, and critical thinking. To ensure your staff are encouraged to be the best they can be, they need positive supervision and the skills, tools, and momentum to meet new staff competency requirements. | | Product Spotlight 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! |
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