Post-Acute Advisor

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CMS to conduct pilot audit process for PBJ

CMS has announced in a letter addressed to skilled nursing facility administration that their PBJ staffing audit team will begin conducting audits of PBJ data submitted to CMS. The letter states that the PBJ audit team will examine payroll records and other auditable data along with PBJ submission data to identify if staffing is being reported accurately based on hours staff are paid to work.

Change to Advanced Beneficiary Notice of Noncoverage

Providers should be using the updated Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131, beginning June 21, 2017 (but may begin using the new forms prior to this date). There are no changes to the form itself, however, providers should take note of the new expiration date of March 2020.

Louisiana Nursing Home Association seeks to limit competition from assisted living facilities

In Louisiana, assisted living facilities do not follow the typical structure of senior living. While these facilities typically offer more independence than traditional nursing homes, they are not approved by the Centers for Medicare & Medicaid Services and therefore cannot accept Medicaid residents.

Examine CASPER outcome reports before your agency launches a QAPI program

If your agency still has a long way to go to prepare for CMS’ new Home Health Conditions of Participation (CoP) involving Quality Assessment and Performance Improvement (QAPI), a good way to start is to review your agency’s CASPER outcome reports.

CMS welcomes feedback on proposed case-mix rule, extends comment deadline

The Centers for Medicare & Medicaid Services (CMS) has extended the comment deadline for the advance notice of proposed revisions to case-mix methodology rule from June 26, 2017 to August 25, 2017.

Is your facility prepared for an active shooter event?

In today’s rapidly changing environment, no organization is immune from violence. It’s an unfortunate truth, but one that facilities should keep in mind as they revise their emergency preparedness plans to be compliant with the Centers for Medicare & Medicaid Services’ (CMS) new standard before surveys begin in November. Those plans likely include policies and procedures for natural disasters, cyberattacks, and disease outbreaks—but what about an active shooter event?

CMS offers guidance on A1400 of HIS

The new Hospice Item Set (HIS), effective in April 2017, left a confusing piece – Item 1400, regarding the patient’s payer information at time of admission–for hospices to ponder. The National Association of Home Care & Hospice (NAHC) stated in a June 9 statement that the association has been fielding “numerous questions” regarding the item. As a result, NAHC submitted questions to CMS and received clarifying guidance.

5 ways for healthcare providers to get ready for new Medicare cards

Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft and protect essential program funding and the private healthcare and financial information of our Medicare beneficiaries.

New House bill would change face-to-face documentation requirement

A new bill filed in the U.S. House would require CMS to consider a patient’s entire patient — including the home health agency’s medical record — when determining whether a patient is eligible to receive home health care.

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Other Post-Acute News

New in the June issue of PPS Alert for Long-Term Care: Reducing readmissions from the post-acute setting

With skilled nursing facilities spread thin and under value-based performance pressure, hospital systems are testing new approaches to prevent readmissions.

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

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!

Upcoming CMS Events

Tuesday, June 20, 1:00pm - 2:00pm ET - Special Door Forum: The IMPACT Act and Improving Care Coordination

Thursday, June 22 (date subject to change) - Skilled Nursing Facilities/Long Term Care Open Door Forum

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

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