CMS new Patient-Driven Payment Model (PDPM) will be implemented on Oct. 1, 2019. CMS finalized the Patient-Driven Payment Model for skilled nursing facilities (SNF), which will link Medicare payments to value and care, rather than volume/ fee-for-service care. The rule according to news reports “would reduce documentation standards around patient assessments, saving facilities approximately $2 billion over 10 years," and would "give a $975 million collective raise next year to post-acute care … [Read more...] about New CMS payment system for skilled nursing facilities reimburses providers for care not volume
Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
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
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
Nursing Facilities – Immediate Threat Violations
PL 18-03-NF - This guidance for Nursing providers was issued by HHSC to address licensure violations and when violations counts as one of the three violations forming the basis for the license revocation that is required by §19.2107 in 40 Texas Administrative Code Chapter 19. b) Except as provided by subsection (d) of this section, the executive commissioner revokes a license if DADS finds that: (1) the license holder has committed three violations in §19.601(b) or (c) of this chapter … [Read more...] about Nursing Facilities – Immediate Threat Violations
New Requirements for Rehabilitative Services and Nursing Facility Specialized Services
PL 18-01 (NF) -Last September 10, 2017, the Health and Human Services Commission (HHSC) added new rules and amended and deleted rules in Texas Administrative Code (TAC), Title 40, Part 1, Chapter 19, Nursing Facility Requirements for Licensure and Medicaid Certification. The Provider letter describes new requirements related to rehabilitative services and nursing facility (NF) specialized services and the provider responsibilities that arise from the new rules. Among many new rules and for … [Read more...] about New Requirements for Rehabilitative Services and Nursing Facility Specialized Services
Nursing Providers: Avoiding Common Errors that Result in Nursing Facility Specialized Services Denial
Information Letter No. 18-02 -Nursing Facility providers often make two common mistakes that usually result in denial of authorization requests or Health and Human Services Commission (HHSC) Preadmission Screening and Resident Review (PASRR) NF specialized services or assessments. To avoid this error, DADS has published this letter to help avoid these errors. The two most common reasons HHSC denies authorization requests for PASRR specialized services and assessments are: 1. NF staff … [Read more...] about Nursing Providers: Avoiding Common Errors that Result in Nursing Facility Specialized Services Denial
Report: Forecasting the growth prospect of the global long-term care market
There are more than 1,200 long-term care centers in Texas and according to the Administration on Aging, over 70 percent of people turning age 65 can expect to use some form of Long term care in their lives. Long-term care in the US has been based on but not limited to nursing homes, and facility-based long-term care that includes services such as continuing care retirement communities, assisted living, and board-and-care home. Long term care is not medical care but serves the purpose of … [Read more...] about Report: Forecasting the growth prospect of the global long-term care market
Procedural Requirements for Requesting Additional Medicaid Beds through an Exemption
Provider Letter 2017-30 Addressed to Nursing facilities. DADS reports that to qualify for a high occupancy rate exemption and receive an allocation of additional Medicaid beds when it has high occupancy rates, a NF must demonstrate that it has had an occupancy rate of at least 90 percent for nine of the 12 months prior to the application. A NF may not rely on data for any month before a previous increase. See the provider letter for more details. Medicaid Bed Allocation Requirements for high … [Read more...] about Procedural Requirements for Requesting Additional Medicaid Beds through an Exemption
