As a screening tool to identify potential weight problems for adults, body mass index (BMI) has always been important to document, but it gained new importance as a reimbursement factor for Medicare Part A residents under the Patient-Driven Payment Model (PDPM). Here’s what nurse assessment coordinators (NACs) need to know …
The nurse assessment coordinator and team members can easily convert the case-mix groups achieved under the Patient-Driven Payment Model (PDPM) to the five-digit Medicare billing code by using the PDPM Case-Mix Group Conversion to HIPPS Characters tool. For permission to use or reproduce this tool in full or in …
New Episode of CMS: Beyond The Policy is Available: Episode 5: Nursing Home Strategy Part 1 – Strengthening Oversight The Centers for Medicare and Medicaid Services (CMS) posted the 5th episode of the CMS: Beyond the Policy podcast which focuses on the first of the CMS’s 5-pronged strategy on strengthening …
Question: Does the primary diagnosis that physical therapy and occupational therapy use need to match the primary ICD-10 code used by nursing? Answer: Often confusion stems from the terms used across different disciplines. Therapists use medical and treatment diagnoses, while the SNF uses other terms, such as admission diagnosis, …
Question: Under RUG-IV PPS, if the resident returns to a skilled level of care within 30 days the reason for skilled care would have to be something that was present/treated during the first qualifying hospital stay or developed during the skilled period. How does that work with PDPM and the Interrupted …
Trends in Deficiencies at Nursing Homes Show That Improvements Are Needed To Ensure the Health and Safety of Residents (A-09-18-02010) In this data brief, we analyze nursing home deficiencies that were identified by State survey agencies (State agencies) across the Nation for calendar years 2013 through 2017 (review period). This …
An Additional Development Request or Additional Documentation Request letter can cause a lot of stress in the SNF if there’s not a process in place to respond to it. Use this Responding to ADRs Tool to help your team more confidently approach medical reviews. For permission to use or reproduce this …
In today’s fast-paced world, we often try to solve problems by simply “googling” the answer. However, when it comes to ICD-10-CM coding, using the Internet or a cheat sheet to determine diagnosis codes can be detrimental to the process and result in selecting the wrong codes. As we begin preparing …
When completing section GG the interdisciplinary team is required to complete an assessment of every day activity function and device use prior to the current illness or injury. The team will also need to work with the resident, family, and direct care staff to determine the resident’s usual performance in …
Jeri Lundgren, RN, BSN, PHN, CWS, CWCN, CPT, president of Senior Providers Resource, LLC, recalls being a new nurse and noticing that while facility staff do everything they can to make the environment safe and prevent falls, they often don’t do enough to prevent the real reason for the falls: …
