ADR Successful Outcomes with Part B Therapy Audits

In nursing facilities, one of the primary regulatory requirements from Appendix PP of the State Operations Manual is that goods and services are provided to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident (§483.24 Quality of Life). One intervention frequently used is Medicare Part …

PDPM: Clearing Up NTA Confusion

At first glance, the methodology of the non-therapy ancillary (NTA) component of the Patient-Driven Payment Model (PDPM) seems simple: code qualifying items on the MDS to achieve points. Yet while the purpose of the NTA component is simple—to capture high expense medications and supplies—its calculation is more complex. Under PDPM, …

Recognizing Rejection of Care: MDS Coding Accuracy for E0800

Rejection of care can occur in many ways—Mr. Jones refuses to have his nails trimmed; Mrs. Abrahams clenches her mouth, refusing to take medications in the evening; or Mr. Martin discharges against medical advice. However, not all of these instances may be coded as rejection of care on the MDS. …

FY 2022 SNF PPS Proposed Rule Comments: AAPACN Highlights Impact of COVID-19 on SNFs

Jessie McGill, RN, RAC-MT, RAC-MTA Every spring, the Centers for Medicare & Medicaid Services (CMS) releases the notice of proposed rulemaking (NPRM) for the next fiscal year’s (FY’s) payment policies and rates. This provides an opportunity for stakeholders and providers to respond during the comment period. Each year, the American …

Pitfalls of Missing Shortness of Breath Documentation

Chronic conditions and comorbidities are common among both long-term residents and short-term patients in skilled nursing facilities (SNFs). However, when the symptoms from these chronic conditions become part of the resident’s normal routine, they may be under-charted—which could result in inaccuracies in MDS assessments, care plans, Quality Measures, and reimbursement. …