The strict coding criteria for O0110M1, Isolation or quarantine for active infectious disease, requires precise documentation to support the MDS. AAPACN’s new Documentation Template: Isolation for Active Infectious Disease tool can help nurse assessment coordinators (NACs) educate nurses on the key areas of required documentation for residents in isolation. Want …
The Centers for Medicare & Medicaid Services (CMS) announced corrections to the Patient-Driven Payment Model (PDPM) mapping files for I0020B, the primary diagnosis representing the reason for the skilled nursing home stay, which is also used to determine a resident’s clinical category assignment under PDPM. CMS released an update to …
The “PDPM Grouper JAR Package V2.2002.zip” is now available. This release was updated to support corrections to the Fiscal Year (FY) 2024 Patient Driven Payment Model (PDPM) International Classification of Diseases (ICD)-10 code mapping for the purposes of resident classification under the PDPM for Medicare Part A Skilled Nursing Facility …
From https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/list-federal-regulations/cms-1779-f2 Note: Typically, this file is posted at https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/patient-driven-model
The Microsoft Access database containing the International Classification of Diseases (ICD)-10 codes allowed for item I0020B has been updated to reflect changes occurring soon with PDPM V2.2002. The new tables added should be treated as retroactive for FY2024. Please review the README.TXT included in the ZIP file From https://www.cms.gov/medicare/quality/nursing-home-improvement/minimum-data-set-technical-information
See the section “Enhance Enrollees’ Rights to Appeal a Medicare Advantage Plan’s Decision to Terminate Coverage for Non-Hospital Provider Services” for details on expedited determination changes for Medicare Advantage residents. Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) On April 4, 2024, the Centers for Medicare & …
Update: April, 2024 CMS consistently strives to improve the effectiveness and efficiency of our nursing home oversight and compliance programs to protect residents’ health and safety. In 2017, CMS implemented a new nursing home survey process across all states, in conjunction with the implementation of revised Requirements for Participation for …
This ZIP file contains resources for surveyors conducting initial surveys under the Long-term Care Survey Process (LTCSP). It is a one-stop shop containing a multitude of reference materials that are provided to the surveyors going into facilities, including, for example, a document detailing their principles of documentation, a document showing …
A survey finding of noncompliance with the Medicare and Medicaid requirements of participation may soon be a little more difficult for nursing homes to navigate without significant financial burden. In the March 28, 2024 Fiscal Year (FY) 2025 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule, the Centers …
In the March 28, 2024 Fiscal Year (FY) 2025 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule, the Centers for Medicare & Medicaid Services (CMS) doesn’t propose the dizzying number of changes that ended up in the FY 2024 SNF PPS final rule. However, nurse assessment coordinators (NACs) …
