MDS Alert
MDS & Billing News
It's here ...Medicare Part D drug coverage for all Medicare beneficiaries goes into effect on Jan 1. But what the federal payer giveth on the Medicare side, state Medicaid programs will be taking away. On Jan. 1, the Medicaid program will no longer offer drug coverage for full benefit dual eligibles (aka FBDEs) who qualify for both Medicare and Medicaid.
Two-thirds of residents in nursing homes fall into this category, according to information posted by the Centers for Medicare & Medicaid Services on the QIES technical support page.
Since Part D will have a major impact on nursing homes, CMS will use the MDS distribution system to keep nursing homes informed about the program.
Read "Message to Nursing Home Administrators on Medicare Prescription Drug Coverage" at www.qtso.com/download/LTC%20MDS1%20-%20060905.pdf.
Look for a new and improved Section W (flu and pneumococcal vaccinations) next year. Section W2 and W3 have created some confusion and controversy in the nursing home community. The questions in both sections currently have no option for a facility to explain that staff offered a resident the respective vaccinations but didn't have time to give them before the MDS assessment reference date. The Centers for Medicare & Medicaid Services plans to revisit and change the section in the spring when the flu season is over, according to a recent SNF Open Door Forum.
Watch for new ICD-9 triggers to the dehydration RAP, effective January 2006. Effective in January, CMS is adding newly available detailed dehydration or volume depletion ICD-9 diagnosis subcodes of 276.50, 276.51, or 276.52 to the ICD-9 trigger for the dehydration resident assessment protocol. Until CMS completes the conversion to its new website, the new dehydration RAP specs are posted on www.qtso.com/mdsdownload.html.
CMS has taken its first step toward the next prospective payment system refinements. The key to future changes will be the newly implemented national nursing home staff-time measurement study, which the agency has dubbed the STRIVE project, short for Staff Time and Resource Intensity Verification. The project aims to collect staffing and resident clinical data for updating the current Resource Utilization Group III payment system used by Medicare and some state Medicaid programs.
MDS Alert
- Medicare Payment:
Don't Pull The New RUGs Out From Your Bottom Line On The 14-Day MDS
Focus on the 5-day ARD only will leave your payment cup half full.
If you go [...] - Medicare Payment:
Running In Circles Trying To Set The Best ARD? Here's How To Cut To The Chase
Use a calendar to capture a resident's highest service utilization.
So many MDSs to do, so [...] - Practice Tip:
Capture The Big 3 For Rehab Plus Extensive Services
Triage MDS items that land a resident in one of the new RUGs.
To help the [...] - Clip 'N' Save:
Is Your Preadmission Screening Covering The Bases?
Check out this form for capturing RUG drivers.
Source: FR&R Healthcare Consulting. Copyrighted. Used by permission. - Survey Compliance:
Use The MDS To Red Flag Physician Care Shortfalls
That way you won't take a tumble under the revised F501 tag.
Are your attending physicians [...] - Case Study:
Quality Assurance and Survey Management--Streamline Physician Summary Forms To Tackle High QIs And F501 Noncompliance
Cue physicians to give the answers you need.
If you're looking for a way to ensure [...] - Coding Quizzer
A resident receives a physician exam during an unscheduled emergency room visit. Can you code the [...] - Quality Improvement:
The MDS Can Give Your End-Of-Life Care A Quality Reality Check
Research analysis flags gaps--make sure your facility isn't falling into them.
Your MDS assessments have a [...] - Medication Management:
Take A Close Look At Meds For Residents Near End Of Life
The total number will likely decline but the mix should change.
Palliative care is about promoting [...] - In The Spotlight:
Get In Step With Residents' Palliative Care Needs
Find out how this facility is thinking and care planning outside of the box.
Providing state-of-the-art [...] - MDS & Billing News
It's here ...Medicare Part D drug coverage for all Medicare beneficiaries goes into effect on [...] - What Do You Think?
Question: Should your facility do preadmission screening to determine whether to accept a resident whose [...] - Nursing CEU Offering:
Ready, Set--Earn Free Nursing CEUs From MDS Alert
We have great news for busy nursing professionals who want to earn continuing education credits.
MDS [...]
