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Post-Acute Advisor

USPSTF removes recommendation for falls prevention based on new evidence

 

Studies show that in 2014, approximately 2.8 million older adults sought treatment in emergency departments for falls; roughly 800,000 older adults who experienced a fall were hospitalized; and more than 27,000 older adults die as a result of a fall.

 

 

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HHGM draws widespread disdain: More than 1,300 commenters chime in on CMS proposal

 

Home health agencies spoke up in record numbers about their concerns with the proposed 2018 PPS rule. Many contend the Home Health Groupings Model (HHGM) hasn’t been properly tested, there’s not enough data or feedback available and the model is not ready for prime time in 2019.

 

 

CMS issues guidance on hospices seeking to correct RHC and SIA errors

 

CMS has now issued guidance permitting hospices seeking to correct their payments for RHC and SIA errors that are not related to transfers to submit a list instead of submitting individual claim adjustments. This guidance is included in MedLearn Matters Special Edition (SE) 17029. Use of this process will be permitted through October 20, 2017, and the MACs are expected to complete any related adjustments by January 19, 2018.

 

 

Senator McCain casts vote regarding Graham-Cassidy bill

 

In a press release published last week, Senator John McCain announced his lack of support for the Graham-Cassidy bill, a last-ditch attempt to repeal and replace the Affordable Care Act before the September 30 budget reconciliation deadline, explaining that he “would consider supporting legislation similar to that offered [by the bill] were it the product of extensive hearings, debate and amendment. But that has not been the case,” said McCain. “Instead, the specter of September 30th budget reconciliation deadline has hung over this entire process.”

 

 

64% of SNFs use EHRs, but far fewer have all four interoperability capabilities

 

Earlier this month, the HHS Office of the National Coordinator for Health Information Technology (ONC) released findings from a nationally representative survey on EHR adoption and health information exchange among U.S. SNFs.

 

 

CMS announces date for PBJ public use files to be made public

 

In 2015, the electronic submission of staffing data otherwise known as the payroll-based journal (PBJ) was established by CMS. The data submitted through the PBJ reflects the number of hours direct care staff are paid to work each day, auditable back to other verifiable information.

 

 

CMS announces start of national beta testing of standardized data elements

 

A Special Open Door Forum held this past Thursday, September 29, was hosted by officials from CMS and the RAND Corporation who discussed the goals of the IMPACT Act (signed in 2014) and provided an update for attendees regarding the RAND contract’s progress in item development, including pilot test results and plans for the upcoming national beta tests.

 

 

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

 

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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Tuesday, October 10, 2:00 pm to 3:00 pm, ET - Home Health Agencies: Quality of Patient Care Star Rating Algorithm Call

 
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