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Looking for a tool to make your job easier? PPS Alert for Long-Term Care, exclusively for the RN or MDS coordinator, is your survival guide for complying with PPS.
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Issue 12, December 1, 2007 - VIEW THE FULL ISSUE
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Learn how the CPS can help your interdisciplinary team
Editor's note: This article is the first in a two-part series about the CPS. Part two will examine... -
CMS offers insights for coding MDS Sections P and T
Scenario: A therapist provides a physical therapy service such as electrical stimulation (E-Stim... -
Long-awaited MDS 3.0 rollout information trickles in
Nursing homes have been waiting for information about the next version of the MDS for several...
Issue 11, November 1, 2007 - VIEW THE FULL ISSUE
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Changing the ARD of a PPS assessment
The assessment reference date (ARD) is the last day-the common end point-of every MDS item's... -
Leave of absence past midnight means consolidated billing doesn't apply
CMS has established that certain events trigger the end of a Medicare beneficiary's status as a... -
PPS Q&A
The QIES Technical Support Office, which supports the submission and use of MDS data, recently...
Issue 10, October 1, 2007 - VIEW THE FULL ISSUE
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New ICD-9-CM codes: Key changes could affect your diagnosis coding
Editor's note: Part one of this two-part series examined processes that need to be put in place to... -
Physical restraints: Learn what surveyors will evaluate
In August, CMS held a series of Webcasts, "Physical Restraints in Nursing Homes: The Exception Not... -
Improve the coding accuracy of MDS item P4
The two incarnations of the Data Assessment and VErification project (i.e., DAVE 1 and DAVE 2) have... -
Case study: What your restraint QM can-and can't-do
The quality indicator/quality measure (QI/QM) reports that derive from MDS assessment data give a... -
PPS Q&A
The QIES Technical Support Office, which supports the submission and use of MDS data, recently...
Issue 9, September 1, 2007 - VIEW THE FULL ISSUE
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Use new F-tag #323 guidance to fine-tune your accidents and supervision processes
The new guidance combines F-tag #323 (accidents) and F-tag #324 (supervision) into one revised... -
ICD-9 update: Take steps to improve your coding accuracy
Editor's note: Part one of this two-part series examines processes that need to be put in place to... -
OIG targets Medicare Part A rehab claims for audits and recoupment of reimbursement
The Office of Inspector General (OIG) examined 100 sampled Medicare Part A claims from the skilled... -
PPS Q&A
Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...
Issue 8, August 1, 2007 - VIEW THE FULL ISSUE
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CMS to SNFs: You've got default billing all wrong
You know the general rule: If you miss an MDS assessment, you must bill the default rate. However... -
Demo projects abound at Open Door Forum
While some MDS coordinators patiently wait for the MDS Version 3.0, others wonder whether a new... -
Use PPS schedule for MSP residents who qualify as Part A
Medicare as a Second Payer (MSP) is primarily dealt with by billing and admissions departments in... -
PPS Q&A
Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...
Issue 7, July 1, 2007 - VIEW THE FULL ISSUE
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Breaking down ADL coding
Why do nursing homes continue to struggle with coding accuracy in MDS item G1, activities of daily... -
SCSAs: Learn how to get them 'just right'
In the popular fairytale Goldilocks and the Three Bears, Goldilocks was seeking balance at the... -
Billing default for missed PPS assessments under fire
As if there weren't enough MDS auditing tools out there, the government introduced a new one this... -
PPS Q&A
The QIES Technical Support Office, which supports the submission and use of MDS data, recently...
Issue 6, June 1, 2007 - VIEW THE FULL ISSUE
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Surveyors showing up early?
Some nursing home professionals across the country have recently been surprised by state surveyors... -
How the RUG-III system works with index maximizing
Understanding the nuts and bolts of how facilities get paid under Medicare Part A SNF PPS is... -
Hone assessment skills to capture respiratory therapy on the MDS
MDS coordinators often fail to code respiratory therapy services in MDS item P1bd, respiratory... -
PPS Q&A
The QIES Technical Support Office recently posted an MDS test on its Web site. Test your knowledge...
Issue 5, May 1, 2007 - VIEW THE FULL ISSUE
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MDS 3.0 resident self-report items
CMS has yet to set an implementation date for the MDS Version 3.0, noted agency officials during... -
Part A therapy requirements: Look to your payment source for answers
In late March, CMS rescinded Transmittal 65, which would have applied some of the current Medi-care... -
New surveyor guidance slated for summer
CMS has backpedaled on its earlier promise that there would be no more F-tags in fiscal year 2007... -
PPS Q&A
Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...
Issue 4, April 1, 2007 - VIEW THE FULL ISSUE
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Changes to RAI User's Manual update fall short of expectations
The next update to the RAI User's Manual was expected to roar in like a lion with some significant... -
Not all chemotherapy is excluded under consolidated billing
Consolidated billing is simple enough in theory. Basically, the consolidated billing provision... -
Learn to calculate an ADL index score
For most MDS coordinators, it's a no-brainer that the activities of daily living (ADL) affect the... -
PPS Q&A
Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...
Issue 3, March 1, 2007 - VIEW THE FULL ISSUE
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Part A eligibility: CMS clarifies limits on qualifying hospital stay
One of the so-called "technical" benefit eligibility criteria for Medicare Part A skilled nursing... -
Benefits exhaust and no-pay bills: Clinical team plays key role
In April 2006, CMS issued Transmittal 930 (CR 4292) to establish a new process for submitting... -
Compliance with medication regulations requires a holistic review
New surveyor protocols and guidance for unnecessary medications and pharmacy services took effect... -
PPS Q&A
Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...
Issue 2, February 1, 2007 - VIEW THE FULL ISSUE
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Section M: Coding boggy skin vs. ecrotic eschar or slough
A common question that MDS coordinators have about coding MDS item M1, ulcers, involves at what... -
Prepare for additional pressures on the MDS/PPS process in 2007
Predicting the path of the MDS/PPS process isn't an exact science. CMS recently laid out its basic... -
2007 to-do list: Take a stand with the administrative team
There is overwhelming evidence of the core role the MDS plays in both the provision of resident... -
PPS Q&A
Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-CT, founding chair...
Issue 1, January 1, 2007 - VIEW THE FULL ISSUE
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Restorative nursing and Part A
Editor's note: This is part two of a two-part series. Last month's PPSA helped you fine-tune your... -
Are you cutting MDS coding corners?
MDS coordinators today are struggling to balance increasingly nu-anced MDS coding requirements with... -
RAI process plays key role in activities compliance: Identifying crucial MDS
MDS coordinators may find themselves playing a new role under F-Tag #248, Activities. Not only are... -
PPS Q&A
Editor's note: "PPS Q&A" is written by Rena R. Shephard, MHA, RN, FACDONA, RAC-C, founding chair...