-- "A compliance expert cautioned long-term care providers about CMS' new Fraud Prevention System in a recent McKnight's Super Tuesday webcast. While technology can catch bad actors, it's also a crucial way to maintain compliance, advised Alliance Training Center Executive Director Leah Klusch, RN, BSN, FACHCA. She advocated for programs that electronically compare Minimum Data Set and billing data so administrators can catch problems early." – McKnight's -- "[Nursing home management] … [Read more...] about From McKnight’s: CMS Crackdown, NF Management Agreements
CHARTING BY EXCEPTION–THE FAST TRACK TO RUG ERRORS?
Charting by exception is the single most problematic form of nursing charting. Charting by exception is a tool used for residents who require little to no nursing intervention or care. This type of charting, if not done correctly, will leave the facility subject to allegations of RUG review errors. Reviewers scrutinize nurse charting to determine if it supports flow sheets and checklists. Since MDS 3.0 requires clearly documented comments, charting by exception will be a basis for … [Read more...] about CHARTING BY EXCEPTION–THE FAST TRACK TO RUG ERRORS?
IL and News Alerts: RN Assessment, Workshop Registration
DADS released one information letter. TxHmL and Local Authority Service Coordinators: DADS informed TxHmL program providers of the requirement to complete a RN nursing assessment for all individuals in their program before a nurse or an unlicensed service provider can perform nursing tasks. (Letter) -- DADS contracted with the NACES Plus Foundation Inc. to collect data for the 2013 Nursing Facility Quality Review. For more information, see the 2012 Nursing Facility Quality … [Read more...] about IL and News Alerts: RN Assessment, Workshop Registration
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
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!
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
TX Register Updates: Board of Nursing, PASRR Changes
The following information was obtained from the May 17 issue of the Texas Register. Public Notice The Texas Board of Nursing proposed to amend 22 TAC §§213.27, 213.28, 213.29, 213.30, and 213.33, concerning Practice and Procedure: Disciplinary Guidelines for Criminal Conduct (PDF) Proposed Rules HHSC proposed to amend §355.8401, Case Management Reimbursement Methodology, which would update and clarify the methodology used to determine the Medicaid reimbursement rates for providers of … [Read more...] about TX Register Updates: Board of Nursing, PASRR Changes
ILs and PL: Ashtrays, ERS Services
DADS released two information letters and one provider letter. ADC, ALF, Freestanding Hospice Inpatient, ICF/IID, and NF: DADS reminds providers that if smoking is permitted in a facility, the facility must provide an ashtray of noncombustible material and safe design Tower and chimney-type ashtrays don't meet the requirement. (Letter) DBMD: DADS informed these providers of new service backup plan requirements, effective May 1, 2013. (Letter) Emergency Response Services: DADS … [Read more...] about ILs and PL: Ashtrays, ERS Services
LTC News: Convictions, Expansion, and Fraud
CMS recently released a report (PDF) on nursing homes, direct access employees, and criminal convictions. (McKnight's) Providers self-disclosing potential Medicare and Medicaid fraud. (McKnight's) Lawmaker proposes alternative to expanding Medicaid. (Texas Tribune) Hospitals and Medicaid expansion. (Pew) Providers push for whole-treatment payments. (USA Today) … [Read more...] about LTC News: Convictions, Expansion, and Fraud
IL/PL: Required Re-enrollment Process
DADS released an information and a provider letter. CBA HCSSA, CLASS, MDCP HCSSA, and PHC: DADS advises providers of a required contract re-enrollment process, which begins May 1, 2013, and to provide clarification about DADS' expectations for providers using the EVV system. (Letter) NF: DADS notified providers that the Nursing Facility Application, Form 3720-N, has been revised. (Letter) … [Read more...] about IL/PL: Required Re-enrollment Process
