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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Every April a Proposed PPS Final Rule is put forth by CMS. The proposed rule this year (2020) would update the SNF prospective payment rates for fiscal year (FY)2021 as required under the Social Security Act. CMS recognizes that the entire healthcare system is focused on responding to the COVID-19 public health emergency. As a…

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The COVID-19 pandemic has highlighted the need for skilled nursing facilities to have an effective Emergency Preparedness Plan – one that includes sheltering-in-place. The Centers for Medicare and Medicaid Final Rule requires that participating providers have an active Emergency Preparedness Plan. With reimbursement payments, accreditation status, and liability exposures all on the line, long-term care…

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COVID-19 (coronavirus) Tools In this difficult time, MDS Consultants is here for you with reimbursement guidance and can help with MDS completions when needed. Our team keeps an up-to-date list of links and resources at https://mds-consultants.com/helpful-cms-info/  COVID-19 (coronavirus) Updates Novel Coronavirus 2019, or COVID-19, is causing a crisis in our healthcare system. Do not let…

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Baseline care plans have been required since late November 2017, but nurse assessment coordinators (NACs) and other interdisciplinary team (IDT) members are still navigating through a lot of misinformation to learn the rules of the road for F655 (Baseline Care Plans) as detailed in Appendix PP of the State Operations Manual. Here are seven common…

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When it comes to the Minimum Data Set, accuracy can be the defining factor in whether a facility keeps its doors open, thrives or ends up facing federal indictment. Whether providers are looking to ensure they can afford to provide the proper care their residents need or to maintain a five-star quality rating, the information…

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The conventional wisdom for improving Activities for Daily Living is to educate and re-educate and then educate again. This is important, but I look at ADL capture as a process that requires audits and examining systems. Every process has gaps that can be narrowed or even closed. Usually 80% of ADL capturing problems are caused…

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While this autumn won’t bring nearly as many MDS changes as last year, documentation and coding due-diligence remains crucial. And despite coordinators’ knowledge and leadership role in the MDS process, they shouldn’t be shouldering the responsibility alone, experts say. “Any discipline that contributes to the MDS should understand the ‘tell me more’ about the MDS…

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