Recent media coverage tells a sad story about inappropriate usage of social media in long-term care settings -- one that details not only severe legal repercussions for facilities, but also major violations of resident privacy and cases of mental abuse. While privacy and abuse are not black and white matters, the issue of photographs, videos, and identifying information of residents being published on social media is: Don’t do it.

Cardiac and orthopedic bundled payment models delayed to Jan 1, 2018

In a final rule published in the Federal Register today, May 19, the Department of Health and Human Services (HHS) finalized May 20, 2017 as the effective date of the bundled payment models and changes to the Comprehensive Care for Joint Replacement Model and delayed the implementation date of the final rule to January 1, 2018. This marks the third time the rule’s implementation date has been changed.

Attorneys General from 37 states request more power to investigate fraud in home care environment

On May 11, 2017, attorney generals from 37 states sent a letter to Secretary of the Department of Health and Human Services (HHS) Tom Price that requests policy changes to allow Medicaid funds to be used to investigate fraud and abuse in the home care environment.

Like hunger or thirst, loneliness in seniors can be eased

Editorial Note: This article has been republished with permission from the author, Judith Graham, Kaiser Health News.

Other Post-Acute News

*New in the May issue of PPS Alert for Long-Term Care* Defining maintenance therapy: A proactive approach to quality care

In February a federal judge accepted Medicare’s plans to better educate the public about individuals’ eligibility for coverage of physical and occupational therapy and speech-language pathology services. These updated plans came as a result of the Jimmo Settlement, a solution to the lengthy class action originally filed in 2011 by six individual Medicare beneficiaries and seven national organizations against the Secretary of Health and Human Services.

Ensuring an effective & efficient triple check process

The triple check process verifies claims for accuracy and compliance with Medicare regulations before billing. Since the Office of the Inspector General published a report that over a billion dollars of inappropriate payments were paid to skilled nursing facilities in 2009, many facilities have adopted the triple check process as a critical operational strategy to mitigate the risk of improper payments and triggering a Medicare audit.

Critical thinking in long-term care nursing is essential for success

Resident outcomes have come under growing scrutiny, both through new quality measures and the overall star rating. Nurses are the frontline staff who engage with residents daily, and it’s crucial for them to understand how to apply critical thinking. When caring for residents and creating documentation, critical thinking can improve facility and resident outcomes while reducing medical errors, which will ultimately lead to more accurate reimbursement.

SNF consolidated billing rule will seek public comment in July: Brush up on the five major categories here

A thorough understanding of how consolidated billing works will help billing and administrative staff determine which residents are subject to consolidated billing when there is a leave of absence, pay the correct vendor invoices, communicate efficiently with other vendors and physicians, and determine the Medicare allowable amount for services provided by outside vendors.

Put Your QAPI Plan Into Action, Prepare for CoPs, Achieve 5-Star Rating

CMS has granted home health agencies six additional months to prepare the Conditions of Participation—so don’t waste any more time. Implementing the CoPs is a huge time and cost burden so the sooner agencies begin to put policies and procedures into place, the better off they’ll be on Jan. 13, 2018.

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.

Upcoming CMS Events

Thursday, May 11, 9:30 am - 4:30pm ET - Medicare Advantage and Prescription Drug Plan Audit & Enforcement Conference & Webcast

Thursday, June 15, 1:30pm – 3:00pm ET - National Partnership to Improve Dementia Care and QAPI Call

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