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

The Non-Therapy Ancillaries (NTA) component of PDPM can significantly increase revenue depending on MDS and ICD-10 coding. Just 1 NTA point can have an average worth of anywhere from $18 to $55 per day. (difference of NE-NF and NA-NB). The general method for calculation of any NTA category is as follows: Points (1-8) are assigned…

By Caralyn Davis, Staff Writer – March 2, 2021 Full article available to Members at https://www.aanac.org/ “CMS has been concerned about medication-related adverse events for many years. Identifying potential and actual clinically significant medication issues, communicating those issues to the physician, and then implementing physician-prescribed or physician-recommended interventions in a timely manner—at admission and throughout…

One of the requirements of payment is a valid Physicians Certification for Medicare part A services. If SNF certifications and re-certifications are not completed and signed following CMS regulations, then the facility is at risk of losing payment for an entire claim period. Is your facility compliant with Physicians’ certifications for Medicare services? According to…

The transition from Nursing Home Compare to Care Compare and unexpected Five Star Quality Rating updates brought disappointment to some Skilled Nursing Facilities. Due to the public health emergency (PHE), the rating system’s three domains had previously been held constant. Centers for Medicare and Medicaid Services (CMS) announced that the Five Star Quality Rating system…

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…

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

Non-Therapy Ancillaries: What are you missing?

Coding N2001 – N2005: Part A Drug Regimen Review

SNF Physician Certifications for Medical Review

Five-Star Preview: Not All Good News

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