As discussed last week, ADL's are the major target for HHSC-OIG. ADL's are the source for most errors resulting in RUG write downs. Not only did the facility lose money on incorrectly charted ADL's they will also face large penalties after a RUG review. Charting ADL's For most MDS nurses, ADLS are pieces of paper the CNA's have scribbled some numbers on. Ideally this number reflects both the Plan of Care and what care was really given. Calculating an accurate ADL score for … [Read more...] about DRILLING DOWN TO ADL MDS ERRORS: THE HOW AND WHY MONEY IS WALKING OUT YOUR DOOR
IL/PLs: CMS Survey & Clarification
DADS released one PL and one IL/PL. All ICF/IID: DADS clarified the CMS Survey & Clarification Letter 13-11-ICF/IID, No Longer Certified Under Time-Limited Agreements, issued on February 8, 2013. An excerpt: CMS eliminated the requirement for TLAs on May 16, 2012. Since the ACC was tied to the TLA, the ACC has also been eliminated. DADS will survey an ICF/IID on an average of every 12 months and at least every 15 months. The provider agreement will not have a termination date and will … [Read more...] about IL/PLs: CMS Survey & Clarification
TX Register Update: CLASS Medicaid Waiver
The following information was obtained from the May 31 issue of the Texas Register. HHSC intends to submit to CMS a request to amend the CLASS Medicaid waiver to add the CDA services option for supported employment and a revision to the service definition of supported employment to clarify assistance available and specify integrated, competitive employment. See the Texas Register for more information. … [Read more...] about TX Register Update: CLASS Medicaid Waiver
DADS News Alerts: 6/14 HDM Waiver Deadline, 7/11 Webinar
-- DADS will host a webinar on Thursday, July 11, 2013, Implementing Consistent Assignment in a Long-Term Care Setting Using Evidence Based Strategies. You may reserve your seat now at: https://www1.gotomeeting.com/register/181006081 -- On May 29, 2013, CMS re-posted the RAI Manual V1.10. Effective May 20, the new version omits six sections: Chapter 3 Section F; Chapter 3 Section J; Chapter 3 Section S title page; Appendix D; Appendix F title page; and Appendix H title page. -- All … [Read more...] about DADS News Alerts: 6/14 HDM Waiver Deadline, 7/11 Webinar
RUG REVIEWS: HHSC-OIG reviewers are here – help!
Nursing Homes will be facing a RUG Utilization review in the near future. This review will cover the years from 2008 through 2010 for MDS 2.0 items. What it is and how it works Reviwers select a group of residents from predetermined RUG categories. We have all read how Medicare/Medicaid is going after the therapy RUGs claiming this is the most abused category. However, surveyors are also targeting the ADL RUGs. Any error found for one resident RUG causes the surveyors to … [Read more...] about RUG REVIEWS: HHSC-OIG reviewers are here – help!
TX Register Updates: Anesthesiologist Assistants
The following information was obtained from the May 24 issue of the Texas Register. Public Notice HHSC intends to submit an amendment to the Texas State Plan for Medical that would add Anesthesiologist Assistants to the fee schedules in the current state plan by adding fees for existing services. See the Texas Register for more information. Proposed Rule HHSC proposed new §355.8203, Waiver Payments to Other Performers, which would include a description of eligibility requirements, … [Read more...] about TX Register Updates: Anesthesiologist Assistants
Enrolled House and Senate Bills
-- The following recently enrolled bills affect certain long term care providers: HB 33: Relating to alternative methods of dispute resolution in certain disputes between the Department of Aging and Disability Services and an assisted living facility licensed by the department. HB 908: Relating to the assessment of an elderly or disabled person's psychological status for purposes of an emergency order authorizing protective services. HB 1358: Relating to procedures for certain audits … [Read more...] about Enrolled House and Senate Bills
IL and News Alert: 6/14 Meeting, HCS Service Delivery
DADS issued one information letter. ICF/IID: DADS provided guidance on the separation of oral and topical medication within an individual's medication box. An excerpt: 42 Code of Federal Regulations §483.460(l)(1) (W377) requires an ICF/IID to store drugs under proper conditions of sanitation. It is easy for topical ointments and creams to get on the outside of the tube or container when being dispensed. If an individual’s topical medications are stored in a box that also contains his … [Read more...] about IL and News Alert: 6/14 Meeting, HCS Service Delivery
CMS News and Texas Bills
-- CMS "could take a variety of steps to make audits less burdensome, healthcare providers stated in white papers submitted to members of the Senate Finance Committee. The committee released a report Thursday, summarizing stakeholders' input and recommendations for improving the audit process." – McKnight's -- CMS "has revised the provider certification manual for hospitals, giving more in-depth guidelines around discharge planning. The goal is for hospitals to reduce readmissions by … [Read more...] about CMS News and Texas Bills
IL/PL & News Alerts: Non-delegated Tasks, Admin Penalty
DADS released an information/provider letter. CAS, CBA, CLASS, CMPAS, DBMD, FC, HCSSA, MDCP, PHC, and SSPD: The letter provides direction for HCSSA on documenting non-delegated tasks delivered by unlicensed persons. (Letter) -- HHSC adopted new §98.105, Administrative Penalties, in Chapter 98, Adult Day Care and Day Activity and Health Services Requirements, which allows DADS to assess an administrative penalty against an adult day care facility that violates licensing … [Read more...] about IL/PL & News Alerts: Non-delegated Tasks, Admin Penalty
