Information Letter No. 18-07 - Addressed to Nursing Providers. Nursing Facility (NF) providers MUST ensure that a designated resident has a valid Daily Care service authorization reflected on the Medicaid Eligibility Service Authorization Verification (MESAV) at the significant steps in the submission and approval process for NF Specialized Services. The letter addresses how to minimize billing issues. NF staff must ensure all appropriate and necessary forms and assessment submissions have … [Read more...] about Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
Preparing for the Upcoming Fiscal Year 2018 Fee-for-Service Claims Billing Closeout
Information Letter No. 18-06 : This letter addresses preparation for the August 31, 2018, end of fiscal year closeout. Providers must promptly submit claims to be paid by the Health and Human Services Commission (HHSC) for any unbilled services. Any problems associated with the claims are resolved within the 12-month filing limitation. The letter directly addresses the following: Adult Foster Care Providers Assisted Living Facilities Community Attendant Services Providers Community … [Read more...] about Preparing for the Upcoming Fiscal Year 2018 Fee-for-Service Claims Billing Closeout
Guidelines Regarding Plans of Correction Associated with a PASRR Violation
Provider Letter 18-09 (NF) - This letter addressed Long-Term Care Regulations by HHSC. Nursing facilities (NFs) must comply with both state and federal requirements related to Preadmission Screening and Resident Review (PASRR). This includes coordinating Level I screening and Level II evaluation assessments, participating in interdisciplinary team meetings (IDTs), and providing necessary specialized services for individuals with intellectual disabilities (ID), developmental disabilities (DD) or … [Read more...] about Guidelines Regarding Plans of Correction Associated with a PASRR Violation
Nursing Providers – Designation of Disability Rights Texas as Protection and Advocacy System in Texas
Provider Letter - PL 18-08 (NF) - Nursing providers have been issued a new provider letter regarding Disability Rights Texas (DRTx). Prior to March 2011, Disability Rights Texas was known as Advocacy, Inc. As a part of recent rules amendments, HHSC Long-term Care Regulatory has elected to use a generic description of the protection and advocacy system rather than the name of the entity. The letter details that when Nursing Facility (NF) rules refer to the designated protection and advocacy … [Read more...] about Nursing Providers – Designation of Disability Rights Texas as Protection and Advocacy System in Texas
Healthcare concerns looms as Nursing provider shortage facing country intensifies
News reports have indicated that the Texas's large population of older residents, healthcare systems and assisted living facilities (ALF) could be impacted due to a nursing provider (NP) shortage facing the entire country. Central Texas and the Texas Panhandle are largely affected by the shortage of nurses. According to a Nursing Shortage Factsheet : The U.S. is projected to experience a shortage of Registered Nurses (RNs) that is expected to intensify as Baby Boomers age and the need for … [Read more...] about Healthcare concerns looms as Nursing provider shortage facing country intensifies
Amended Nursing Peer Review Committee (NPRC) Requirements and a State Agency’s Duty to Report
PL 18-06 - Long-Term Care Regulatory Provider Letter (PL) The Texas Health and Human Services Commission released the provider letter to nursing providers (ALF, DAHS, HCSSA, ICF/IID, and Nursing Facilities) the letter details that House Bill (HB) 3296, 85th Legislature, Regular Session, 2017, amended Texas Occupations Code §303.0015, regarding the establishment of a NPRC. Additionally, this letter clarifies the process a surveyor from the Texas Health and Human Services Commission (HHSC) … [Read more...] about Amended Nursing Peer Review Committee (NPRC) Requirements and a State Agency’s Duty to Report
American Health Care Association/National Center for Assisted Living Announce Quality Improvement Goals for Nursing Providers
The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) issued quality improvement goals for skilled nursing providers in long term and post-acute care. The goals, aligned with the priorities of the Centers for Medicare & Medicaid Services and federal mandates, were identified to improve care delivery during the next three years. According to reports: The goals outlined by the AHCA and NCAL include: --Safely reduce long- and short-stay hospitalizations by … [Read more...] about American Health Care Association/National Center for Assisted Living Announce Quality Improvement Goals for Nursing Providers
Elderly patients at risk at Nursing homes that overmedicate
National reports by Human rights advocates say that nursing homes are overprescribing antipsychotics to patients. According to the latest data from the federal Centers for Medicare & Medicaid Services, known as CMS, the percentage of long-term nursing home residents being given antipsychotic drugs dropped from about 24 percent in late 2011 to under 16 percent last year. Yet advocacy groups reveal that misuse of drugs remains a major problem in nursing facilities. The findings outlined in a … [Read more...] about Elderly patients at risk at Nursing homes that overmedicate
New Hospice Care Law allows Physician Assistants to manage Hospice care for Medicare Patients
Beginning on Jan. 1, 2019, physician assistants can now supervise cardiac and pulmonary rehabilitation programs under the Medicare program as well as provide and manage Hospice care for terminally ill Medicare patients. The extended medical privileges for physicians assistants could benefit Medicare beneficiaries who live in medically underserved and rural communities, where a PA might be the only available medical professional to provide some services, according to news reports. According to … [Read more...] about New Hospice Care Law allows Physician Assistants to manage Hospice care for Medicare Patients
CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.
CMS is adding flexibility to their expansion of benefits by redefining health-related supplemental benefits to include services that increase health and improve quality of life, including coverage of non-skilled in-home supports and more. Hospice care and palliative care are considered as well as supplemental benefits down the road. Benefits will only be available to some of the participants of Medicare Advantage plans. These benefits will not be extended to original Medicare. Supplemental … [Read more...] about CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.
