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Nursing Home Alert - January 27, 2012
CMS 5-Star Update
Allowing Physician Assistants to Perform Skilled Nursing Facility (SNF) Level of Care Certifications and Recertifications
Oscar Reports for the Fourth Quarter of 2011 Now Available
LeadingAge’s OSCAR Reports for quarter four of 2011 are now available for download.
Announcement from CMS
CMS has posted a video slideshow presentation from the Nov. 3, 2011, National Provider Call on the “Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Minimum Data Set (MDS) 3.0 and Resource Utilization Group-Version 4 (RUG-IV) Policies and Clarifications” to the CMS YouTube Channel.
CMS National Provider Call: Register Now for Medicare FFS Implementation of HIPAA Version 5010 and D.0 Transactions
CMS will be hosting another National Provider Call regarding the Medicare FFS implementation of HIPAA Version 5010 on Wednesday, Jan. 25, from 2-3:30 p.m. EST.
Click here to read more about each issue in Nursing Home Alert 12-04
Nursing Home Alert - January 20, 2012
Updated S&C Memo Regarding Reporting Reasonable Suspicion of a Crime
CMS has just revised Memo 11-30-NH regarding Reporting Reasonable Suspicion of a Crime in a Long Term Care (LTC) Facility: Section 1150B of the Social Security Act.
CMS: Version 5010 and ICD-10 Rule Resources
Upgrading to Version 5010 is an important step to take before transitioning to ICD-10, which is quickly approaching.
AHCA Provider Training: Verifying Medicaid Recipient Eligibility
Verifying Medicaid Recipient Eligibility training will be held Wednesday, Feb. 8, from 9:00 - 10:00 a.m., EST. Medicaid providers are invited to participate.
AoA Webinar on Transitions and Long-Term Care: A Look at the Minimum Data Set 3.0 Section Q and Money Follows the Person
On Monday, Jan. 30, 3:00 – 4:40 p.m. EST, the Administration on Aging (AoA) will continue its series of webinars focused on the Patient Protection and Affordable Care Act of 2010 (also known as the Affordable Care Act, or ACA) and its impact on the aging network, beginning a multi-webinar series on transitions and long-term supports and services.
Click here to read more about each issue in Nursing Home Alert 12-04
Nursing Home Alert - January 13, 2012
CMS Issues Guidance on Survey and Certification Responsibilities: Provider Enrollment Revocations (12/23/11)
Please see webite listed in alert.
Temporary Workaround for the ARD Reason Code 31742 for Skilled Nursing Facility and Swing Bed Claims
CMS has developed a workaround for SNF and Swing Bed (SB) claims incorrectly returned to the provider for assessment reference date (ARD) reason code 31742 to allow these claims to process.
AHCA Announces Provider Training: Verifying Medicaid Recipient Eligibility
Verifying Medicaid Recipient Eligibility training will be held Thursday, Jan. 19, from 1:30 - 2:30 p.m., EST. Medicaid providers are invited to participate.
Click here to read more about each issue in Nursing Home Alert 12-02
Nursing Home Alert - January 6, 2012
Jan. 1 Nursing Home Rates
By the time you read this article, AHCA should have posted the Jan. 1, 2012, nursing home rates on its website.
CMS Video Slideshow Presentation and Podcasts of the Nov. 17 National Provider Call on "ICD-10 Implementation Strategies and Planning"
The Centers for Medicare & Medicaid Services (CMS) released a YouTube video slideshow presentation and multiple podcasts from the Nov. 17, 2011, National Provider Call on “ICD-10 Implementation Strategies and Planning.”
CMS Survey and Certification Letter: Use of Federally Imposed CMP Funds by States Update
Following is the link to a new Centers for Medicare and Medicaid Services (CMS) Survey and Certification Letter: Use of Federally Imposed Civil Money Penalty (CMP) Funds by States – Update; Supersedes S&C: 11-42-NH (12/16/11) [Replaces: Use of Civil Money Penalty (CMP) Funds by States (9/30/11)].
Reminder from CMS: Version 5010 Benefits and Resources
The Version 5010 compliance deadline was Jan. 1, 2012. Upgrading from Version 4010/4010A standards to Version 5010 is a critical step necessary for the ICD-10 transition, and must be implemented before ICD-10 implementation is possible.
Click here to read more about each issue in Nursing Home Alert 12-01
Nursing Home Alert - December 23, 2011
Attention Health Professionals: Information Regarding the Holding of 2012 Date-of-Service Claims for Services Paid Under the 2012 Medicare Physician Fee Schedule
From CMS: Information Regarding the Holding of 2012 Date-of-Service Claims for Services Paid Under the 2012 Medicare Physician Fee Schedule
Georgetown University Researchers Study Florida’s Medicaid Reform Efforts
On Dec. 8, Co-principal Investigators Joan Alker and Jack Hoadley from Georgetown University’s Health Policy Institute held an audio conference on Florida’s Medicaid Program: Looking Ahead to 2012. Four Florida Medicare Fee-For-Service (FFS) Policy Regarding 90-Day Discretionary Enforcement Period for Non-Compliant HIPAA Covered Entities
A CMS notice was issued regarding billing and 90-Day enforcement period for non-compliant HIPAA requirements (i.e. Version 5010).
Multaq (dronedarone): Drug Safety Communication - Increased Risk of Death or Serious Cardiovascular Events
[Updated Dec. 19, 2011] FDA completed a safety review of Multaq (dronedarone).
Click here to read more about each issue in Nursing Home Alert 11-49
Nursing Home Alert - December 16, 2011
New CMS S&C Letters: Initiatives for FY2012; National Background Check Program
Please see the alert for the links to two new Centers for Medicare and Medicaid Services (CMS) Survey and Certification Letters.
CDC Issues New Recommendations for Treating Latent TB
The Centers for Disease Control and Prevention (CDC) have published new guidance on how to administer a new 12-dose regimen for TB preventive therapy that will significantly shorten and simplify the course of treatment from about nine months to 12 weeks.
Four Florida Nursing Homes Participate in National Demonstration Project to Transform Quality in Nursing Homes
As part of a project led by the University of Minnesota and Stratis Health, four Florida nursing homes are participating in a national demonstration project to develop and test prototypes of a national Quality Assurance Performance Improvement (QAPI) program.
CMS 2012 Minimum Data Set (MDS) 3.0 National Conference
The CMS 2012 MDS National Conference is a two-day conference that will be held twice. The conference will be held on March 6-7, 2012 and repeated on March 8-9, 2012, at the Hyatt Regency St. Louis at the Arch in St. Louis, Missouri.
Click here to read more about each issue in Nursing Home Alert 11-48
Nursing Home Alert - December 9, 2011
News from the Board of Nursing Home Administrators
The Board of Nursing Home Administrators (Board) met on Friday, Nov. 18, in Tampa and elected a new board. Patricia (Pat) Freeman was elected as Chair and Robert (Bobby) Rosenthal as Vice-Chair.
Deadline for License Renewals is Sept. 2012: Be Prepared!
Sept. 30, 2012, is the end of the nursing home administrator biennium and it is the deadline for license renewals. Be sure to have your CEUS!!
NYU Study: Medical Error Reporting for Nurses in Nursing Home Settings Found Difficult
According to a new study from the New York University College of Nursing, most registered nurses have a difficult time disclosing and responding to errors in the work place. In the article, researchers found that multiple barriers exist that might inhibit disclosure.
New PASRR Forms
This week, AHCA mailed a letter to all Florida Medicaid hospital and nursing facility providers informing them about the revised Pre-Admission Screening and Resident Review (PASSR) Level I Screen and Determination form (AHCA MedServ Form 004, Part A), and the Level II Request for Evaluation and Determination or Resident Review form (AHCA MedServ Form 004, Part B).
Announcement from CMS: Part B Services for Skilled Nursing Facility (SNF) Patients Medicare Claims Erroneously Denied
A claims processing issue was identified that has affected payment of some Part B claims for SNF patients for dates of service from Saturday, Oct. 1, 2011 through Monday, Nov. 21, 2011. Some Part B claims for SNF patients submitted to Medicare during Oct. and Nov. 2011 have been erroneously denied by Medicare’s claims processing system. In other instances, the claims processing system has paid and then identified a Medicare “overpayment” on these claims in error.
CMS Survey and Cert Letter: Updated IDDR Requirements
Advanced SOM Guidance
An opportunity for IIDR must be provided within 30 calendar days of the notice of imposition of a CMP that is subject to collection and placement in escrow.
Click here to read more about each issue in Nursing Home Alert 11-47
Nursing Home Alert - December 2, 2011
Long-Term Care Providers Receive Disparate Treatment from the Florida Supreme Court
On the Wednesday before Thanksgiving, the Florida Supreme Court issued two decisions that significantly impact the validity of arbitration agreements utilized by long-term care facilities. In Shotts v. OP Winter Haven, Case No. SC 08-1774, and Gessa v. Manor Care of Florida, Inc., Case No. SC 09-768, the Court singled out nursing home and assisted living providers for unequal treatment from other businesses in the State of Florida. Essentially, the Supreme Court overturned precedent in the Second District Court of Appeals and held that Florida courts may consider and invalidate arbitration agreements entered into by residents of these long-term care facilities under certain conditions.
Question on Dual Eligibility and Payment for Part D Drugs
AHCA Provider Training: Verifying Medicaid Recipient Eligibility Training
Verifying Medicaid Recipient Eligibility training via teleconference will be held Wednesday, Dec. 14, 2011 from 2:00 p.m. - 3:00 p.m., EST. Medicaid providers are invited to participate. To join the teleconference training, please dial 1 (888) 808-6959 and at the prompt enter the conference code: 3054466900. You don’t need to register or reserve space. Just call at the designated time.
Therapy Caps Values for CY 2012
CMS released MLN Matters article MM7529, which describes the CMS policy for outpatient therapy caps for Calendar Year (CY) 2012 and announces the therapy caps for 2012 to be $1880.00. Be sure your billing staff is aware of the update.
Click here to read more about each issue in Nursing Home Alert 11-46
Nursing Home Alert - November 23, 2011
From CMS: Medicare Fee-for-Service Statement Regarding Versions 5010 and D.0
On Nov. 17, the Centers for Medicare & Medicaid Services’ Office of E-Health Standards and Services (OESS) announced that it would not initiate enforcement with respect to any HIPAA-covered entity that is not in compliance on Sunday, Jan. 1, 2012 with the ASC X12 Version 5010 (Version 5010), NCPDP Telecom D.0 (NCPDP D.0) and NCPDP Medicaid Subrogation 3.0 (NCPDP 3.0) standards until March 31, 2012.
CMS to Focus on Reducing Inappropriate Use of Antipsychotics in Nursing Homes
LeadingAge wants to bring to your attention some developments regarding the inappropriate use of antipsychotics in the nursing home setting. This is a topic which recently garnered significant attention on Capitol Hill, as well from CMS. At an Oct. 26 meeting with key stakeholders - including LeadingAge - CMS Administrator Dr. Donald Berwick and several CMS quality leaders called for improvement in how antipsychotics are used in the treatment of nursing home residents with dementia.
Click here to read more about each issue in Nursing Home Alert 11-45
Nursing Home Alert - November 18, 2011
Menorah Manor Names New Chief Executive Officer
This week, the Menorah Manor board of trustees (St. Petersburg) announced Seth D. Levy, LNHA, MSW, ACSW, will be assuming the executive leadership of Menorah Manor, Menorah Manor Senior Living and Menorah Manor Foundation effective Thursday, Dec. 1. Levy will succeed Marshall Seiden, who joined Menorah Manor in 1988 as chief executive officer.
CMS Revisits LTC Smoking Safety
The Centers for Medicare & Medicaid Services (CMS) is revisiting smoking safety in long-term care facilities in response to the recent report of a nursing home resident’s smoking-related death.
NH Top Health Deficiency Citations Statewide (July 2011)
Patricia McIntire, BSN, RNC, AHCA Bureau of Field Operations Divisions of Health Quality Assurance, recently presented at the FAHSA Infection Control Symposium on the nursing home top health deficiency citations statewide. See the alert for the list of deficiencies.
SNF Billing Issue: Notice from CMS
CMS recently developed a new Change of Therapy (COT) Other Medicare Required Assessment (OMRA) for the SNF PPS and developed a mechanism to allow providers to report a Resumption of Therapy on an End of Therapy (EOT) OMRA.
Click here to read more about each issue in Nursing Home Alert 11-44
Nursing Home Alert - November 10, 2011
1. FAHSA Meets with AHCA Secretary
2. CMS Notice: Medicare Provider Enrollment Fee for 2012
3. Next Skilled Nursing Facility (SNF) Open Door Forum Scheduled for Dec. 1
4. Memo From the Department of Health: Electronic Death Registration System (EDRS) Implementation
5. Reminder: Don’t Forget to Post the Nursing Home Guide and Watch List Nov. 15
6. Trilipix (fenofibric acid): Drug Safety Communication - Label Change
Click here to read more about each issue in Nursing Home Alert 11-43
Nursing Home Alert - November 4, 2011
Proposed Child Labor Regulation on Use of Electronic Devices
The U.S. Department of Labor (DOL) has published a proposed rule that would prohibit the use of electronic devices by minors, including communication devices, while operating or assisting to operate power-driven equipment. The definition of power-driven equipment would include patient lifts powered by a source other than human power.
Updated MLN Articles on Revalidation of Provider Enrollment
The alert contains links to updated CMS Medicare Learning Network (MLN) articles regarding the Revalidation of Medicare Provider Enrollment:
AHCA: Medicaid Recipient Eligibility Training
Verifying Medicaid Recipient Eligibility training will be held on Tuesday, Nov. 8. All Medicaid providers are invited to participate. The training will be performed via teleconference.
Click here to read more about each issue in Nursing Home Alert 11-42
- Important Notice to Level 1 Screening and Level II Request for Evaluation Forms
- CMS Survey and Cert Letters: Federal Requirements for IIDR; Retraction of Revised Guidance for Feeding Tubes
- CMS-Proposed Rule Regarding Consultant Pharmacists in LTC Facilities
- Skilled Nursing Facility Claims Hold -- CMS Announcement
- 2011-2012 Summary of Medicaid Services Available
Announcements & Resources
- Register Now for National Provider Call: Revalidation of Medicare Provider Enrollment
- AHCA Issues Letter to Provider About Reporting Reasonable Suspicion of Crime
- Registration Now Open for the Skilled Nursing Facility Prospective Payment System Minimum Data Set 3.0 and Resource Utilization Group-Version 4 Policies and Clarifications National Provider Call
- CMS Follow-up Information from Aug. 23 Provider Training and Sept. 1 Open Door Forum
- OSCAR Reports for Q3 2011 Now Available
- Medicaid Provider Compliance Program & Provider Self Audits Video
- Make Sure You Know How to Meet Version 5010 Level II Compliance
- FHA-FMQAI Care Transitions Webinar Approaches
- New CMS Survey and Cert Letter: Consumer Oriented Websites; Use of CMP Funds
- 2011 Payment Error Rate Measurement (PERM) Provider Webinars and Conference Calls
- National Provider Call: Revalidation of Medicare Provider Enrollment
Announcements & Resources