MDS Alert
Billing & Survey News to Use
SNFs will have their Part A claims readjusted but not by much. CMS recently reported in an e-news update that it found a mistake in the non-labor share percentage, which the agency used to calculate FY2011 SNF and swing bed PPS rates. "CMS is correcting this percentage in the SNF Pricer and, upon successful implementation, contractors will begin adjusting all previously adjudicated SNF and SB PPS claims with through dates on or after Fri Oct 1, 2010, to apply correct reimbursement," the agency states. The notice says the claims adjustment, which will only be a small payment change per claim, may require up to eight to 10 weeks. A new form could put SNF providers in the hot seat if residents don't like their care. A CMS proposed rule "would require most Medicare participating providers and suppliers to give Medicare beneficiaries written notice about their right to contact a Medicare Quality Improvement Organization (QIO) with concerns about the quality of care they receive under the Medicare program," the agency says in a release. "By requiring providers and suppliers to furnish QIO contact information to all beneficiaries, we are protecting beneficiaries' rights to bring their worries about quality of care to a third party for review," CMS administrator Donald Berwick says in the release. Evvie Munley, a regulatory analyst at LeadingAge, says the organization is just beginning to receive feedback on the proposed rule from its members. "We certainly respect residents' rights to file quality of care complaints to all appropriate authorities," Munley tells Eli. But the potential impact of the proposal in terms of "how it might impact facility relationships with and/or functions of the QIOs or present any undue burden, etc." is unclear, she says. Read the proposed rule starting on page 5755 at http://edocket.access.gpo.gov/2011/pdf/2011-2275.pdf.
MDS Alert
- MDS Management:
Home In On These 3 Problem Areas of the MDS 3.0
Clarity of Section O instructions for coding isolation is on the list. Facilities and residents [...] - Coding Instructions for Isolation at O0100M
Here's what CMS says to do. The RAI User's Manual provides the following instructions for [...] - MDS Assessments:
Efficiency Is Key When Dealing With Discharge Assessments
Make sure you're not doing more than required. Most people agree that discharge assessments have [...] - Quality of Care:
Preempt Aspiration With This Admission Checklist
There are more ways to detect swallowing problems than included in Section K. Completing Section [...] - Clinical Care:
Incorporate Speech Therapy Interventions and Recommendations in the Care Plan
Expert shares strategy for providing feeding and swallowing instructions in the dining room. An ongoing [...] - CODING QUIZZER:
How would you code the following scenario from the RAI User's Manual?
Calculation for Average Daily Fluid Intake Mrs. G. received 1 liter of IV fluids during [...] - WHAT DO YOU THINK?:
When Would the RUG Rate Change in This Scenario?
Question: When you combine a 5-day assessment with a significant change in status assessment, when [...] - WHAT DO YOU THINK?:
What Kind of Support Documentation Do You Need for This Service Coded on the MDS?
Question: When we have a resident who receives IV fluids to prevent dehydration in the [...] - WHAT DO YOU THINK?
Question: What support documentation would a nursing facility need to code IV fluids provided in [...] - Case Study:
Bringing On an MD + NP Hospitalist Team Proves to Be a Smart Move for This SNF Provider
The approach achieved several goals at once, including reducing rehospitalization. SNFs looking to reduce emergency [...] - Diagnosis Coding:
Most Organizations 'Surprised' By How All-Encompassing ICD-10 Transition Is
Best bet: Establish your initial plan for conversion immediately so you can project your facility's [...] - Tool:
Use This Form to Stay on Top of Community Referrals for Section Q
This way you can track where each resident is with the process. - Billing & Survey News to Use
SNFs will have their Part A claims readjusted but not by much. CMS recently reported [...]
