Revised RAI Manual Effective October 1

The most recent revisions to the Resident Assessment Instrument (“RAI”) User’s Manual became effective yesterday for all assessments with an assessment date on or after October 1.  The significant portion of the revisions addresses changes to therapy coding and swallowing and nutrition.  ... Continue Reading →

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CMS Clarifies Requirements for Minimum Data Set Discharge Assessments

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On August 23, 2013, the Centers for Medicare & Medicaid Services (“CMS”) published a memorandum that addressed issues arising from incomplete, inaccurate and missing Minimum Data Set (“MDS”) Discharge Assessments that adversely affect Skilled Nursing Facilities (“SNFs”) and Nursing Facilities (“NFs”).  Under 42 C.F.R. §§ 483.20(g) and (f)(1), SNFs and... Continue Reading →

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CMS Releases FY 2014 SNF PPS Rates, Updates Therapy Day Reporting Requirements

The Centers for Medicare & Medicaid Services (“CMS”) recently released the final rule for fiscal year (“FY”) 2014 skilled nursing facility (“SNF”) prospective payment system (“PPS”) rates.  These rates will take effect October 1, the start of FY 2014.  ... Continue Reading →

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CMS Issues Advance Copy of Long-Term Care Survey Protocol

On September 27, 2012, CMS issued an advance copy of the State Operations Manual (“SOM”) revisions to Appendix P of the SOM, which addresses Long-Term Care Facility survey protocol. The SOM guidance also makes changes to various survey forms resulting from the new quality measures reports.... Continue Reading →

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Providers Face Greater Risk of Claim Denial Under New PPS Rules

Effective October 1, new PPS rules for fiscal year 2012 require nursing homes to diligently review claims prior to submission.  As previosly discussed, significant cuts in SNF reimbursement are aimed mostly at therapy services.   SNFs submitting claims under the previous rules can expect high rates of denials and rejections.  Even facilities... Continue Reading →

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CMS to Host Conference Call Related to MDS 3.0, PPS

CMS will host their monthly Skilled Nursing/LTC Open Door Forum on Thursday, October 20, from 2-3pm EST.  This call was originally scheduled on October 13.  The information to participate in the call is available here. The recent changes to MDS 3.0 and PPS are likely to be heavily discussed topics.    Should you have any questions,... Continue Reading →

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