This March, Congress will re-introduce legislation with bipartisan support to allow Medicare beneficiaries that are hospitalized in observation to qualify for SNF coverage following their hospital stay. Currently, under the three-midnight rule, beneficiaries mThis March, Congress will re-introduce legislation with bipartisan support to allow Medicare beneficiaries that are hospitalized in observation to qualify for SNF coverage following their hospital stay. Currently, under the three-midnight rule, beneficiaries must have been categorized as being an inpatient in a hospital for three midnights in order to qualify for a Medicare Part A SNF stay.
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.
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.
Readmission occurs when the beneficiary is discharged and then readmitted to the SNF, needing skilled care, within 30 days after the day of discharge. Such a beneficiary can then resume using any available SNF benefit days, without the need for another qualifying hospital stay. The same is true if the beneficiary remains in the SNF for custodial care after a covered stay and then develops a new need for skilled care within 30 consecutive days after the first day of noncoverage.
NAHRI is currently seeking speakers to present at the 2019 Revenue Integrity Symposium (RIS), to be held October 15–16, 2019, at the Renaissance Orlando at SeaWorld in Orlando, Florida. We seek speakers to present on all aspects of revenue integrity, Medicare compliance, and the revenue cycle in acute care and long-term care settings. NAHRI will waive admission fees to the 2019 Revenue Integrity Symposium for all selected speakers and co-speakers. Click here to learn more and complete the call for speakers application. Contact NAHRI Director Jaclyn Fitzgerald at firstname.lastname@example.org with questions.
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.
The Centers for Medicare & Medicaid Services (CMS) released several proposals in a blog post dated February 8, 2019, to help increase interoperability between hospitals and LTC facilities and remove silos that prevent SNFs and nursing homes from getting the information they need to care for patients. The agency is accepting comments on the requests for information and proposed rule until early April (exact date to be announced).
We’re conducting a brief survey to better understand your PDPM training needs. The first five participants who take the survey will receive a free, on-demand webinar of your choice. This is a quick survey and we greatly appreciate your feedback.
Did you know that as a member of the Billers’ Association for Long-Term Care, you get a discount on HCPro boot camps? Our instructors bring best-in-class compliance education to your facility so your entire team can benefit.
After speaking with a few subject matter experts about the new tax laws, Billing Alert for Long-Term Care has the good, the bad, and the salvageable for 2019 tax reform. For some long-term care (LTC) facilities, these changes will have significant dollar impacts on 2018 tax returns, while other facilities will slip through the IRS’ narrow cracks mostly unaffected. Just as the care plan for each resident should be individualized to his or her care needs, each facility’s approach to taxes this year should be customized to its unique situation. Here are a few changes to keep in mind and discuss with your certified public accountant (CPA) before submitting this year’s tax return.