The interrupted-stay policy in the Patient-Driven Payment Model (PDPM) of the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS) governs when multiple SNF stays are combined into a single interrupted stay (i.e., one continued stay that includes one or more interruption windows) vs. when they are treated …
In the ever-evolving realm of healthcare data management, the transition of the Minimum Data Set (MDS) submission process to the Internet Quality Improvement and Evaluation System (iQIES) in April 2023 marked a significant milestone for skilled nursing facilities (SNFs). Replacing the outdated Quality Improvement and Evaluation System Assessment and Submission …
Pressure-related deep tissue injury (DTI) coded in M0300G (Unstageable Pressure Injuries Related to Deep Tissue Injury) does not play a role in Medicare payment under the Patient-Driven Payment Model (PDPM). While DTI is an unstageable pressure ulcer/injury, only ulcers that are unstageable due to slough and/or eschar (MDS item M0300F1) …
Staff turnover is a nationwide problem for nursing homes and it may be worse than previous reports have suggested, according to a study of newly available Payroll-Based Journal data published in the National Library of Medicine. The study also noted a possible negative relationship between a facility’s overall Five-Star rating …
In calendar year (CY) 2023, F880 (Infection Prevention and Control) was the third most frequently cited F-tag in nursing homes nationwide, as well as the fifth most common at the immediate jeopardy (IJ) level, according to QCOR data accessed on Jan. 16, 2024. That is an improvement over CY 2022, …
With the influenza season in full swing plus the ongoing peaks and valleys of COVID-19 and respiratory syncytial virus (RSV) outbreaks across the United States, nurse assessment coordinators (NACs) should take steps both to protect the MDS process and to capture relevant clinical events on MDS assessments when a respiratory …
The year 2024 brings a plethora of updates to the Medicare program, several significantly impacting skilled nursing facilities (SNFs). SNF staff must stay well informed about these updates to ensure proper billing and adequate coverage for a beneficiary’s skilled stay. This comprehensive article delves into key updates, encompassing changes in …
Like in-house hospital readmissions, post-discharge hospital readmissions can affect provider performance in the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP), says Carol Hill, MSN, RN, LNHA, RAC-MT, RAC-MTA, DNS-MT, QCP-MT, CPC, president of Hill Educational Services in Warrior, AL. “With the Skilled Nursing Facility 30 Day All-Cause Readmission Measure …
The expedited determination beneficiary notification process covers a lot of ground in skilled nursing facilities (SNFs), affecting residents in the fee-for-service (FFS) Medicare Part A program and Medicare Advantage plans, as well as residents who receive Part B rehabilitation therapies under consolidated billing, says Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, …
The Centers for Medicare & Medicaid Services (CMS) announced on the Dec. 7 Skilling Nursing Facilities/Long-Term Care Open Door Forum that the drug classification of anticonvulsants will be added to the Minimum Data Set (MDS) item set starting Oct. 1, 2024. The new item will be added to N0415, High-risk …
