New final rule makes changes to requirements for LTC facilities; hospice services

A final rule, released on Thursday, June 27, will revise the requirements that an institution will have to meet in order to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility (NF) in the Medicaid program.
These requirements will ensure that long-term care (LTC) facilities (SNFs and NFs) that choose to arrange for the provision of hospice care through an agreement with one or more Medicare-certified hospice providers will have in place …

CMS issues ICD-10 split claims billing instructions

CMS issued a MLN Matters article that offers instructions that clarify the policy for processing claims for certain institutional encounters that span the ICD-10 implementation date of October 1, 2014.
Skilled Nursing Facilities (Inpatient Part B):

Bill type: 22X
Use FROM date
Require providers split the claim so all ICD-9 codes remain on one claim with Dates of Service (DOS) through 9/30/2014 and all ICD-10 codes placed on the other claim with DOS beginning 10/1/2014 and later.

Skilled Nursing …

CMS releases new QAPI resources

On June 7, the Centers for Medicare & Medicaid Services (CMS) released a memo sent to state survey agency directors that announced the rollout of introductory materials to help nursing homes establish a foundation to implement and sustain the Quality Assurance and Performance Improvement (QAPI) transition.
The introductory materials include:

QAPI at a Glance: A guide for understanding and implementing QAPI in nursing homes
QAPI Tools: Process tools, within QAPI at a Glance, to help providers establish a …

Diving In Deeper: MDS 3.0 RAI User’s Manual Update

The Centers for Medicare & Medicaid Services (CMS) recently released a revised version of the MDS 3.0 Resident Assessment Instrument (RAI) User’s Manual.
Let’s take an in-depth look at the changes, which were fairly minimal, according to Diane Brown, BA, director of postacute education at HCPro, Inc. The changes (which are underlined) were mostly clarifications and include:

Chapter 2

ADDED: If a resident goes from Medicare Advantage to Medicare Part A, the Medicare PPS schedule must start over …