-- "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?
TX Register Updates: THTQIP, Hospital Waiver Payments
The following information was obtained from the June 7 issue of the Texas Register. Public Notice HHSC intends to submit to CMS a request to amend the Texas Healthcare Transformation Quality Improvement Program waiver program. An excerpt: Effective September 1, 2013, the expenditures for STAR+PLUS enrollees for elimination of the 30-day spell of illness limitation will no longer be authorized. Under this policy, after 30 days of inpatient care has been provided, additional inpatient care … [Read more...] about TX Register Updates: THTQIP, Hospital Waiver Payments
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
DRILLING DOWN TO ADL MDS ERRORS: THE HOW AND WHY MONEY IS WALKING OUT YOUR DOOR
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
