Melanie Tribe-Scott, BSN, RN, RAC-MT, RAC-MTA, QCP, Author at MDS Consultants

It’s a dreary Monday morning, and the state surveyors walk into your facility to conduct a Focused Infection Control survey. You and your team have been trying your hardest to comply with infection control procedures throughout the pandemic. At the end of the survey, you are issued several citations and the state is requiring the…

The Centers for Medicare & Medicaid Services (CMS) recently released the October 2020 version of the Five-Star Quality Measure System Technical Users’ Guide. It includes several revisions and updates for the Staffing, Quality Measure, and Health Inspection ratings in response to the Public Health Emergency (PHE). Health Inspection Since the Nursing Home Compare (NHC) refresh…

Is your facility using the proper ABN form? The Centers for Medicare & Medicaid Services (CMS) recently updated the Advanced Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131. The new ABN will be mandatory for use on 1/1/2021, but the new form can be implemented now. CMS debuted an updated ABN for use this summer but…

With the beginning of fiscal year 2021 October 1, there will be the expected changes to our MDS and billing processes. This year the number of changes is limited due to the unprecedented public health emergency we are experiencing with COVID-19. Despite that, we can expect updates to the PDPM ICD-10 Mapping Tool this year.…

The Centers for Medicare & Medicaid Services (CMS) states in an FAQ for COVID-19 Medicare Fee-For-Service (FFS) that: “A COVID-19 diagnosis would not in and of itself automatically serve to qualify a beneficiary for coverage under the Medicare Part A SNF benefit.” Yet Skilled Nursing Facilities remained confused on this issue. Providers argue that a…

Some skilled nursing facilities (SNFs) are concerned about accurate payment when a resident unexpectedly discharges and the Brief Interview for Mental Status (BIMS) has not yet been completed. However, they should be just as concerned about the PHQ-9. The PHQ-9 identifies depressive symptoms to be captured on the MDS. The interview follows the same basic…

In late June, CMS addressed two issues and posted MDS 3.0 Final Item Sets (V1.17.2). The two edits were changes to facilitate the calculation of Patient-Driven Payment Model payment codes on OBRA assessments for states that wish to have this calculation performed. These two edits will be revised and go into production on October 1,…

By Caralyn Davis, Staff Writer – July 07, 2020 Full article available to Members at https://www.aanac.org/ The Centers for Medicare & Medicaid Services (CMS) makes clear in the title of MDS section GG (Usual Performance and Goals) that the assessment subitems in items GG0130 (Self-Care) and GG0170 (Mobility) are designed to capture a resident’s usual ability or…

Many providers have have cohorted residents in the same isolation room – applying recent CMS and CDC guidance during the COVID-19 emergency. This cohorting leaves many providers with the question: Can we code isolation on the MDS for cohorted residents? These facilities recognize that coding isolation will result in higher reimbursement in the PDPM, State…

When the President and HHS Secretary declared a national health emergency in response to the COVID-19 pandemic, they triggered section 1135 of the Social Security Act. Section 1135 allows the Secretary to temporarily waive or modify certain Medicare and Medicaid requirements to ensure sufficient health care for enrollees. Skilled Nursing Facilities (SNFs) were issued multiple…

Posts by Melanie Tribe-Scott, BSN, RN, RAC-MT, RAC-MTA, QCP

Focused Infection Control Surveys and Directed Plan of Correction

Five Star Updates

New Advanced Beneficiary Notice

PDPM ICD-10 Mapping Changes Effective Oct 1, 2020

Covid-19 and Skilled Status

Mind Your PHQs

Medicaid Changes Coming in October 2020

Section GG: Assessing Usual Performance During the COVID-19 Pandemic

Isolation and COVID

Section 1135 Waivers