TIP: BFCC-QIO’s Updated Notification Process for New Appeals Started January 17

Starting on Jan. 17, 2023, post-acute care facilities and Medicare health plans will no longer receive phone calls for appeal notifications. The initial notification, medical record requests, and case outcomes for post-acute care facilities and Medicare health plans will be communicated via fax only. Notifications will be faxed to the …

TIP: CMS Releases QSO Memo with Updates to Care Compare and Quality Measure Ratings

The Centers for Medicare & Medicaid Services (CMS) released a memo last week containing updates to Care Compare and Quality Measure ratings. These changes include: CMS will consider a lesser action to the star ratings for facilities that admit miscoding prior to the survey such as suppression of the QM …

TIP: Audit for Accurate Schizophrenia Diagnosis Coding

CMS recently released a memo stating they will begin conducting an off-site audit of MDS coding of residents with a diagnosis of schizophrenia to ensure accuracy, and based upon the results, the quality measure (QM) star rating will be adjusted. Facilities selected for the off-site audit will receive a letter …

TIP: ICD-10 Coding Convention “with”

When using the Alphabetical Index in the ICD-10-CM Official Guidelines for Coding and Reporting, generally the main terms and subterms are alphabetical. However, when the word “with” is immediately after a main term or subterm, there is a specific coding convention that must be followed. The words “with” or “in” …

TIP: CMS Releases Draft Minimum Data Set 3.0 Item Sets

The Centers for Medicare & Medicaid Services (CMS) released an updated draft of the new MDS 3.0 Item Sets on Dec. 23, 2022. This newest draft includes changes to the following: Because there are multiple changes to the discharge assessment (NPE), leadership may wish to review the facility’s current discharge …

TIP: CDC’s Core Practices Now Available on Infection Control Webpage

The Centers for Disease Control and Prevention’s (CDC) Core Infection Prevention and Control Practices for Safe Healthcare Delivery in All Settings, also known as Core Practices, are now available on CDC’s Infection Control webpage.  These core practices are intended to be standard references for basic and standard medical care. The …

TIP: OBRA Scheduling Tools Updated for 2023

AAPACN offers two great tools to assist nurse assessment coordinators (NACs) in scheduling OBRA assessments:• The Static OBRA Scheduling Tool is a 4-page tool that counts out day 92 for every calendar day – know when that next assessment is due.• The Interactive OBRA Scheduling Tool reacts to data entry to determine day 92 …

TIP: COVID-19 Vaccination and Therapeutics Toolkit Now Available

The Society for Post-Acute and Long-Term Care Medicine (AMDA) has developed a new toolkit with their partners. This free toolkit provides resources for clinicians to help them navigate challenging questions. This toolkit includes: For permission to use or reproduce this tip in full or in part, please complete a permissions form. 

TIP: Quality Improvement Organization Offers Training Library

For nursing facilities in 29 states, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO). Kepro provides education for healthcare providers to help ensure that appeals are performed quickly and that potential errors are avoided. Review the training videos below from Kepro. • Medical Record Submission ProcessVideo (YouTube) • …

TIP: IPRO QIN-QIO Hosts Free Streaming Nursing Home Education Summit

IPRO QIN-QIO will be having a free day of online learning on December 8 at 9 am – 3pm ET to share the latest updates on topics to advance quality and address needs such as: Clostridiodes difficile Sepsis Adverse Drug Events NJ DOH Hand Hygiene Demonstration Project Health Equity  For …