Post-Acute Advisor

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Some information on new survey process shared, more guidance to be released soon

Several aspects of the new survey process being rolled out in Phase 2 of the revision to Requirements of Participation were discussed this week at the American Association of Directors of Nursing Services conference in Leesburg, VA.

Prepare for dozens of new and deleted codes not previewed in the proposed set

Starting Oct. 1, 2017, you’ll be able to capture the severity of non-pressure chronic ulcers that have penetrated muscle and bone tissue but haven’t caused necrosis, thanks to the addition of 72 new codes in the L97.

CMS proposes quality program updates to ease clinician burdens

On Tuesday, June 20, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make changes in the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The agency states that their goal is to simplify the program, especially for small, independent, and rural practices, while ensuring fiscal sustainability and high-quality care within Medicare.

Leaving hospital, older patients resist home help at their peril

Editorial Note: The article has been republished with permission by the author, Judith Graham, Kaiser Health News

The 84-year-old man who had suffered a mini-stroke was insistent as he spoke to a social worker about being discharged from the hospital: He didn’t want anyone coming into his home, and he didn’t think he needed any help.

Flu vaccine proved ineffective for seniors last winter, data shows

Data show that the flu vaccine did a poor job of protecting older adults, ages 65 and older, from the illness last winter. Results were presented by the Advisory Committee on Immunization Practicesa group of health experts that provide recommendations regarding the use of vaccines in the United Statesand showed that the vaccine was only 42% effective in preventing individuals from being affected enough by the flu to need to go to the doctor.

MedPAC’s June report is in: Summary here

The Medicare Payment Advisory Commission (MedPAC) published their June Report to the Congress: Medicare and the Health Care Delivery System, in which they evaluate several Medicare payment issues in order to make recommendations to Congress.

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Other Post-Acute News

New in the June issue of PPS Alert for Long-Term Care: Activities in long-term care: Serving the baby boomer generation

Individuals born between the years 1943 to 1960 are referred to as the “baby boomer” generation. As this group ages and begins to fill long-term care facilities, baby boomers will perhaps be one of activity professionals’ greatest challenges.

De-stressing distressed long-term care facilities: Challenges they currently face and solutions to help them thrive

External pressures such as lower reimbursement rates and an overall shift in policy by the Centers for Medicare and Medicaid Services (CMS) and state Medicaid agencies, and internal pressures including higher acuity residents, operational decisions, and a competitive environment for residents and employees, have put significant financial and operational pressures on long-term care facility operators.

Pressing “refresh” on your activities program

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 residents active and engaged, is a major challenge for long-term care professionals.

SNF therapy contracts: Your risks and what you need to know

The use of contracted therapists in your SNF immediately increases your citation and criminal risk in terms of billing and liability. These facilities must understand how to limit such risk under Medicare due to improper treatment and coding of your therapy contractor, including how to implement a shared risk arrangement with your therapy contractor while outlining a strategic way to monitor such risk within your SNF.

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.

Product Spotlight

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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

Monday, June 26, 1:00 pm – 2:30 pm, ET - Medicare Quality Payment Program Year 2 Proposed Rule Overview

Wednesday, June 28, 12:00 - 1:30 ET - Diagnosis and Treatment of Parkinson’s Disease Webinar

Thursday, June 29, 1:00 – 3:00 ET - Improvements to the Medicare Claims Appeal Process and Statistical Sampling Call

Wednesday, July 2, 3:30 pm, ET - Quality Payment Program Year 2 Proposed Rule Listening Session

Wednesday, July 5 - Home Health, Hospice, and Durable Medical Equipment Open Door Forum

Wednesday, July 12, 2:00 pm – 3:30 pm, ET - Creating and Verifying Your National Provider Identifier Call

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