The Centers for Medicare & Medicaid Services (CMS) has identified an issue related to missing discharge assessments for inactive residents. On August 23, 2013, CMS issued a survey and certification memorandum
Hospitals and physicians are increasingly working to form strategic alliances that can help both parties survive the increasingly complex health care environment. There are many goals for such alliances, but for every alliance that works out well, there are at least as many that come to grief. Here are some of the common issues that—when addressed properly—can help pave the way for success
On August 2, 2013, the Centers for Medicare & Medicaid Services (CMS) released the 2014 IPPS Final Rule. In the final rule, CMS made a few revisions from the proposed rule related to the Disproportionate Share Hospital (DSH) calculation
The Texas Nursing Home Upper Payment Limit (UPL) could result in significant financial benefits for nursing home operators and many Texas governmental hospitals. Here is an update on the program’s status and key action steps. In October 2012, the Centers for Medicare & Medicaid Services (CMS) approved a Texas State Plan Amendment allowing for a nursing home Intergovernmental Transfer (IGT)/UPL program
On May 9, 2013, the Skilled Nursing Facility (SNF) Open Door Forum announced upcoming updates to the Resident Assessment Instrument (RAI) manual. The Centers for Medicare & Medicaid Services (CMS) posted the new RAI manual version 1.10 and change tables on May 20
Effective May 19, 2013, skilled nursing facility (SNF) providers will have more leeway in the minimum data set (MDS) 3.0 assessment correction policy. The Centers for Medicare & Medicaid Services (CMS) announced the revision to Chapter 5 of the Resident Assessment Instrument (RAI) User’s Manua l for the MDS 3.0 during the May 2, 2013, Open Door Forum. The current correction policy in Chapter 5 of the RAI manual, “Submission and Correction of the MDS Assessments,” will only allow facilities to inactivate an assessment if an error is discovered in the following items: A0200 – Type of Provider A0310 – Type of Assessment A1600 – Entry Date (on an entry tracking record) A2000 – Discharge Date (on a discharge/death in facility record) A2300 – Assessment Reference Date (ARD) For SNFs completing Medicare prospective payment system (PPS) assessments, the current policy results in default billing, as the ARD of the new assessment must be no earlier than the date the error was identified
The Centers for Medicare & Medicaid Services (CMS) released the 2014 IPPS Proposed Rule on April 26, 2013, proposing several payment revisions as a result of the Patient Protection and Affordable Care Act (PPACA).
The long-term care (LTC) mergers and acquisitions (M&A) market had an outstanding year in 2012, generating 189 deals worth $9.2 billion. The high transaction volume for the year makes 2012 the most active year in LTC M&A since the late 1990s, with approximately 60 percent more transactions than the annual average over the previous four years.
The results of recent recovery audit contractor (RAC) automated reviews of hospital services were outlined in the January 2013 Medicare Quarterly Provider Compliance Newsletter, Volume 3, Issue 2 . Among the hot topics discussed was a significant issue for physician providers: the RACs identified that inappropriate current procedural terminology (CPT) codes were being assigned for related professional evaluation and management (E/M) services “rendered in swing bed facilities (with nursing facility levels of care)” in the same episode of care as an acute inpatient stay, when the patient was not “on a leave of absence from the hospital.” Specifically, inpatient hospital CPT codes, i.e
The last day of the 90-day reporting period for the 2012 program year for an Eligible Professional (EP) was December 31, 2012. The EP’s payment year runs on a calendar year instead of the federal fiscal year like the Eligible Hospital’s (EH) payment year. The last day of the EH’s 90-day reporting period for the 2013 program year will be September 30, 2013.