Department of Labor proposes changes to overtime rules

Apr 12, 2019
 | 
The Bottom Line

The Department of Labor has published three Notices of Proposed Rulemaking (NPRM) regarding the minimum salary requirement for an employee to qualify for overtime, which forms of payment can be included and excluded in the “time and one-half” calculation when determining workers’ overtime rates, and clarifications of and revisions to the responsibilities of employers and joint employers to employees in joint employer arrangements.

Get your compliance and ethics program up and running by the November deadline

Apr 01, 2019
 | 
AMBR Journal

As of November 28, 2019, CMS will require SNFs to have a compliance and ethics program in place that meets one of CMS’ regulations in the Conditions of Participation (CoP).

Many SNFs have compliance and ethics programs in place, but November marks the first time that facilities can be subject to a survey tag or cited for not meeting the specific elements outlined in the CoPs, says Stefanie Corbett, DHA, postacute regulatory specialist for HCPro.

MedPAC makes recommendations for FFS payment updates in annual report

Mar 22, 2019
 | 
The Bottom Line

In their annual report to Congress, the Medicare Payment Advisory Commission (MedPAC) made policy recommendations for nine provider sectors in fee-for-service (FFS) Medicare, including recommendations against raising payment rates for both skilled nursing facilities (SNFs) and home health agencies. MedPAC recommends that Congress not increase base payment rates for SNFs in 2020 and suggests that Congress reduce base payment rates for home health agencies by 5 percent for 2020.

Congress makes another attempt to eliminate three-midnight rule barriers to SNF coverage

Mar 15, 2019
 | 
The Bottom Line

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 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.

You sent a discharge claim prior to readmission, now what?

Mar 01, 2019
 | 
The 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.

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