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…

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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…

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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…

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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…

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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…

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