The clinical and technical eligibility requirements for skilled care coverage in a SNF are unchanged under the proposed RCS-1 system—and frankly, those are just about the only things that are unchanged.

New in the October issue of PPS Alert for Long-Term Care:

Understanding C.diff infection and prevention methods

Clostridium difficile, also known as C. difficile or C. diff, is a spore-forming bacterium that can cause an infection whose primary symptom is severe diarrhea. Over the years, C. diff infection has become more prevalent and severe in long-term care settings, and management of its symptoms has likewise become more complex. However, by understanding what C. diff infection is and how it can be spread, long-term care providers can better incorporate practices into their care routines to prevent cross-contamination and reduce their residents’ risk of contracting the infection.

Survey: Education and Training Tools

Is your antibiotic stewardship program survey ready? Deadline November 28

In the past two years, federal agencies have taken a hard look at infection control practices in long-term care facilities and demanded improvement. CMS requires that facilities have an antibiotic stewardship program in place by November 28. Long-term care facilities traditionally lack the specialized infection control training of hospitals, with infection control violations making up one of the most common LTC survey deficiencies. In other words, these facilities have their work cut out for them.

Quality: Five-star ratings and performance improvement

As quality and value take a front row seat in the reimbursement world, more emphasis will need to be placed on monitoring and improving your facility’s standings. The best way to achieve this is by monitoring for trends and changes to the five-star rating reports.

Billing: Reduce your facility’s audit risk

Facilities can reduce their audit risk and the potential for nonpayment by ensuring claims are complete and accurate. In order to do this, administrators need to identify risk areas and analyze providers’ information so that billers can review their own data before submission and ensure compliance.

Customer service: Managing risk through person-centered care

According to a recent report published by the OIG, nursing home complaints increased from 47,279 complaints in 2011 to 62,790 complaints in 2015. More than half of the complaints were related to quality of care, treatment, or neglect. It’s essential that facilities understand the components of an effective customer service program, realize the importance of risk management, and master several methods of reducing the potential for litigation.

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, November 9, 2:00pm-3:00pm, ET - New Medicare Card Project Special Open Door Forum

Thursday, November 16, 1:30pm-3:00pm, ET - SNF Value-Based Purchasing Program FY2018 Final Rule Call