The Medicare Benefit Policy Manual Chapter 16, Section 220 Refers to Coverage of Outpatient Rehabilitation Therapy Services (Physical Therapy, Occupational Therapy, and Speech-Language Pathology Services) Under Medical Insurance. In addition to the requirements described in this chapter, the services must
Month: August 2012
Fall Prevention and Safety
Falls in the long term care setting account for nearly 25% of hospitalizations of the elderly and 40% of all nursing home admissions. Declining strength, cognition, balance and poor safety awareness related disease processes can negatively impact a resident’s ability
MEDICAL REVIEW CLAIMS ABOVE $3700 THRESHOLD
Phase information is now available!! CMS has developed a tool which will allow providers to search by their NPI (National Provider Number) to determinae their phase. Providers can now identify which Phase they are in for rollout of the manual medical review
Prevent Readmissions of Residents With the Risk for Developing Acute Change of Condition
An acute change of condition is a sudden, clinically important deviation from a resident’s baseline in physical, cognitive, behavioral, or functional status. It is essential to notice and report change in a resident’s condition, and it is everyone’s responsibility to
ALERT UPDATE: MEDICARE PART B
Latest news regarding Medicare Part B Outpatient Therapy Cap and Exceptions Process: CMS held a conference on Tuesday August 7th to announce the “manual review process” for Part B therapy claims above the $3700 threshold. The $3700 threshold for PT and
Medicare Updates
On Aug. 2, 2012 the U.S. Centers for Medicare and Medicaid Services (CMS) published a notice in the Federal Register setting the Medicare SNF payment rates for Federal Fiscal Year for Skilled Nursing Facilities. CMS chose to publish a notice
ACO’s ARE HERE: LET THE CONVERSATIONS BEGIN.
Unless you have been living under a rock lately then you are well aware of the advent of Accountable Care Organizations (ACO’s). What you may not be aware of is that the time is NOW to begin positioning yourself. Positioning
The Time Is Now To Shore Up Readmission Rates
Hospital readmissions have been a hot topic in the healthcare industry for some time now. Everyone agrees that hospitalizing nursing facility residents can disrupt continuity of care, diminish quality of life and consume a sizeable portion of Medicare spending. Readmission
CMS Issues 2013 Proposed Rules
The Centers for Medicare and Medicaid Services (CMS) released the FY 2013 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Notice on July 27, 2012 which updates the Part A payment rates used under the PPS for SNFs for FY
Preventing Re-Hospitalization
Is your patient ready to go home? Comprehensive discharge planning has become a key component of care planning in long term care settings as increased scrutiny and pending financial sanctions loom for both hospital and nursing home health care providers.