In lieu of recent changes inherent in FY 2012 PPS, many Skilled Nursing Facilities are searching for ways to improve clinical outcomes, staffing, and profitability. One way you can improve your facility’s outcomes and profitability is by incorporating updated, sophisticated software into your system. Nursing home software plays a crucial role in your facility’s success and is something you cannot overlook.
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In today’s environment of heightened fraud and abuse scrutiny, the compliance implications for providers, often focused on therapy, increase the risks of practice. Solid, consistent documentation that supports medical necessity and ongoing education for clinical staff is critical to ensure that providers protect their billed revenue. Below are some highlights that emphasize the plan for increased scrutiny.
The House Republicans today released their bill that includes a payroll tax holiday, unemployment benefits, and a measure to speed up work on the Keystone XL oil pipeline among other issues. This bill contains a two year "doc fix" and a two year extension of the therapy cap exceptions process. The House intends to vote on the bill next week.
Heritage Healthcare continues positive growth in 2012 by providing therapy management solutions to senior care facilities.
Independently owned Heritage Healthcare is an industry leader guided by an experienced executive team since its inception in 1999. Based on a core philosophy of Compassionate Care that applies to their Associates and customers, Heritage Healthcare has continued to expand into 12 states as it approaches its 13th Anniversary this June.Read More
Why it’s important
In response RUG IV refinements stemming from the SNF PPS FY2012 Final Rule, many Skilled Nursing Facilities are taking a close look at the processes and systems they have in place. With downward reimbursement pressure at both state and Federal levels, it’s increasingly important to have an efficient, streamlined operational plan. The best way to equip your facility for these changes is to identify broken processes, uncover inefficient systems and put a realistic plan into place for improvement. Your staff needs efficient, modern tools to perform their jobs effectively, which is why identifying inefficient processes and systems should be a priority.
Recent RUG IV refinements stemming from the SNF PPS FY2012 Final Rule are now in effect and could impact your facility negatively if your staff does not fully understand how to manage the new changes. It’s also increasingly important that your staff has access to efficient, modern tools that allow them to track care, documentation, and results prospectively. As a whole, your approach needs to be informed and effective in order to remain viable in this increasingly complex operating environment. Therapy is a crucial area of focus and many of the new rules inherent in FY 2012 PPS will challenge your facility’s ability to operate efficiently, achieve compliance and capture credit for the care you provide.
When CMS (Center for Medicare & Medicaid) issued its 2012 Final SNF PPS Rule, it created the new Change of Therapy Other Medicare Required Assessment, referred to as the COT OMRA. In doing so, CMS also developed a process to allow providers to report a Resumption of Therapy OMRA following an End of Therapy (EOT) OMRA, referred to as an EOT-R OMRA. The result of the above new OMRAs meant CMS had to create several new Assessment Indicators (AIs) to identify when a COT OMRA was completed, and when an EOT OMRA was completed, accounting for both scenarios of with and without a resumption of therapy. These new AIs are described in the revised RAI Manual, Chapter 6, Section 6.4 – Relationship Between the Assessment and the Claim (pages 5-21).
by Geralyn Magan. Published in Senior Housing News on: Jan 18, 2012Read More
As a result of the recent changes inherent in FY 2012 PPS, many Skilled Nursing Facilities are feeling the strain of short-staffed therapy programs. Due to the downward reimbursement pressure at both state and federal levels, it might be a good idea to have a professional staffing assessment performed. A detailed assessment of how your therapy program is staffed in the context of patient acuity, length of stay, and the volume and intensity of therapy will give you the chance to identify staffing inefficiencies. Your program may in fact be short-staffed, or you might identify ways to create more efficient processes in order to achieve better results.