Stark Law tagged as barrier, CMS to perform top-to-bottom review

May 02, 2019
 | 
The Bottom Line

During her speech at the National Association of Accountable Care Organizations Spring 2019 Conference, CMS Administrator Seema Verma referred to the Stark Law as an outdated regulation that “addressed real issues regarding the potential for financial incentives to inappropriately influence how physicians make decisions” when it was enacted 30 years ago, but that serves little purpose under a value-based system.

PBJ and SNF QRP submissions due May 15

Apr 25, 2019
 | 
The Bottom Line

Staffing data from Jan 1 through March 31 must be submitted no later than 45 days from the end of the quarter. The final submission deadline for this quarter is May 15, 2019. On a SNF open door forum held earlier this week, officials instructed facilities to review their monthly provider preview reports in their CASPER folder for feedback on their most recent submission.

Q&A: Therapy will still tie into your bottom line under PDPM

Apr 25, 2019
 | 
Billing Alert for Long-Term Care

Q. Should therapy treatment practices change under the Patient-Driven Payment Model (PDPM)?

A. Even though therapy minutes are no longer relevant to the provision and payment for therapy, CMS has assumed that most therapy will continue to be provided one-on-one. SNFs with contract providers need to take great care to ensure that the contractor does not automatically ramp up inpatient therapy on a group and concurrent basis to the 25% threshold!

Unless the facility has experienced a significant change in overall case mix from when under resource utilization groups (RUG) to PDPM (fewer therapy-qualified residents), there would be no logical clinical reason to change treatment practices.

New white paper available: Customer service for the business office

Apr 05, 2019
 | 
The Bottom Line

One of the most important staff members in the facility is the person who informs the family that they owe money, making the business office the most important stop during the admissions process. Download this white paper to ensure your staff understand best practices for providing customer service to residents and family members, especially when discussing complicated financial matter by

CMS to lift freeze on health inspection star ratings, assign one-star for no RN onsite

Mar 08, 2019
 | 
The Bottom Line

CMS announced several updates to Nursing Home Compare (NHC) that will take place this April, including a removal of the freeze placed on health inspection star ratings instituted in February 2018. The freeze was placed to give all facilities a chance to be surveyed at least once under the new process. Beginning in April, consumers will be able to see the most up-to-date status of a facility’s compliance on NHC.

Connecting the dots between competency development and your bottom line

Mar 08, 2019
 | 
Billing Alert for Long-Term Care

CMS regulations require that a facility assessment be completed annually to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies. These assessment findings can then be used to make decisions about direct care staff needs and capabilities needed to care for each resident. If current needs aren’t being met, nurse leadership may need to implement new competency development. This task doesn’t involve the billing department directly; however, billers, business office managers, and the finance department can support other departments through changes in the facility’s expenses that will help contribute to a healthier bottom line.

Updates to QIES won’t change the way providers submit data

Mar 01, 2019
 | 
The Bottom Line

CMS announces that starting in March, the Quality Improvement and Evaluation System (QIES), Certification and Survey Provider Enhanced Reports (CASPER) and Automated Survey Processing Environment (ASPEN) will undergo a series of modernizing enhancements. The agency clarified that once updated, the new system, Internet Quality Improvement and Evaluation System (iQIES), will not change how providers currently submit data to CMS.

OIG highlights from 2018

Feb 15, 2019
 | 
Billing Alert for Long-Term Care

The Office of Inspector General’s (OIG) studies can serve as a good alert system for long-term care facilities as well as the regulators who monitor them. We’ve compiled a list of relevant reports and recommendations published by the OIG in 2018 to help you prioritize your quality and compliance goals for this year.

Pages

Members-only webcasts

Enjoy past webcast events with your AMBR Membership! Click here!

Free Resources

Access sample white papers, tools, analysis, and resources.