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Post-Acute Advisor

Palmetto’s top denial reasons for hospice include notice of election issue


Of the 26 hospice claims denied by Medicare Administrative Contractor (MAC) Palmetto GBA between April and June 2018, the majority were due to failing to supply medical records in response to Additional Documentation Requests (ADRs), Palmetto data show.

 

Does the home health episode have any effect on readmission?


Q: We have a patient that was in the hospital for one week. The patient went to another skilled nursing facility (SNF) for 25 days, then went home, but used home health services. The patient now wants to come back into our SNF. It is within 30 days of the previous SNF stay, so this should be ok, but the SNF wants to know if the home health episode has any effect on the readmission?

 

Post Acute Medical to pay anti-kickback fines


Post Acute Medical, LLC, (PAM) a Pennsylvania-based operator of long-term care and rehab nationwide, has agreed to pay the United States, Texas, and Louisianaafter violating the False Claims Act. PAM’s conduct allegedly resulted in false claims to Medicare as well as certain Medicaid programs. The latter are jointly funded by both the federal and state governments. Under the settlement, PAM will pay $13,031,502 to the United States, $114,016 to Texas, and $22,482 to Louisiana.

 

CMS to hold OASIS-D webinar about high-level changes


CMS will hold a webinar Aug. 28 on OASIS-D changes relevant to the Home Health Quality Reporting Program (HHQRP). The webinar is designed to help prepare home health providers for changes coming to the assessment and the program.

 


New in the August issue of PPS Alert for Long-Term Care...

 

Preparing your facility for an audit: Internal auditing and monitoring

 

Do not wait for Medicare contractors or government au-ditors to come into your facility and find a problem. Be proactive rather than reactive when it comes to compli-ance. For example, auditors can do an extrapolated over-payment, or they can place your facility on a prepayment review, which has a major impact on your cash flow. Also, if they find an issue and identify overpayments, you may choose to go through the appeals process, which is time-consuming, frustrating, and costly. Many facilities feel they don’t have the time, money, or resources to conduct regular internal audits, but they are much more cost-effective than Medicare determining you have issues. There is no way to avoid audits, especially in this current environment.

 

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Monthly In-Service: August issue of CNA Training Advisor

 

Replacing alarms with person-centered care approaches


Click here to receive a new lesson plan every month, including course materials, a 4-page in-service, and a quiz targeted to address the unique needs, interests, and concerns of CNAs.

 


Education and Training Tools

 

Consolidated Billing: How New Payment Reform Affects SNFs

 

Understand how PDPM differs from RUG classification system

 

Compliance Checkup With the Revised Home Health CoPs

 

Make Way for PDGM

 

Prepare for ICD-10 Code Changes and New Guidelines Coming October 1

 
 

Product Spotlight


New: PROPELAdvisory Services

 

At HCPro, we help your organization make faster, better decisions by connecting your challenges and questions to an unrivaled network of experts, resources, and solutions. With a shared-cost membership, you can expect world-class thinking and advice without having to worry about the meter running or expensive consulting fees.

 

An all-encompassing offering, PROPELAdvisory Services is available in six domains, with more on the way. Our growing family includes memberships in Medicare, long-term care, clinical documentation improvement, medical staff, coding, and revenue cycle management.

 

Click here to learn more, or contact us at: 615-724-7213 | advisoryservices@hcpro.com

 

 
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