Welcome to the HealthPRO Heritage Blog

MDS coding experts must remain vigilant! Beware coding pitfalls when it comes to Section G versus Section GG.

November 14, 2018. HealthPRO Heritage (“HealthPRO”) completed the acquisition of the long-term care division of Agility Health (“Agility Health”) from Alliance Physical Therapy Management (“Alliance”), on August 31, 2018.

CMS released the much anticipated Home Health Final Rule October 31. Much of the content from the Proposed Rule and the Final Rule will remain the same, with significant changes highlighted below.

Step one to ensuring your facility delivers positive patient outcomes, maintains regulatory compliance, and achieves financial viability in the New PDPM World is to perform a RUGs-to-PDPM Crosswalk on all your patients.

In the recently updated Conditions of Participation, CMS spells out what they expect from a QAPI program. Additionally, the final draft of the interpretive guidelines (IG) for the Home Health Agency Conditions of Participation (CoP) was released last month.

How can agencies use this already mandatory requirement to help prepare them for the expected changes coming in 2020 with the proposed Patient Driven Groupings Model (PDGM)?

Success or failure for SNFs will hinge directly on hospital readmission rates (& other performance metrics, too!)

What’s This About 2% of My Revenue?

One Very Important, Creative Solution for Forward-Thinking Senior Living Communities

YOUR GOAL is to attract new residents and to preserve occupancy keeping them happy & healthy and aging in place.

YOUR CHALLENGE is executing on unique, tangible initiatives that differentiate your community from market competitors.

How Will the Recent Home Health Proposed Rule Affect the PAC Industry?

NOW WHAT?
PDGM (Patient-Driven Groupings Model) was recently announced in July as part of the Proposed Rule published by CMS and is anticipated to be THE biggest change in home health reimbursement 20+ years!

Hear Ye, Hear Ye! The new Long Stay Quality Measure for hospitalizations are to be posted on Nursing Home Compare in October 2018. The formal name for this measure is Number of Hospitalizations per 1,000 Long-Stay Resident Days.

If the 2019 proposed rule is finalized, which we anticipate is likely, it will cement the shift in Medicare’s payment system from a prospective payment system to value based purchasing model.  With these mega changes it can feel like a daunting task to provide clinical excellence while maintaining a profit, thus it will be paramount that detailed analysis and strategies be developed to ensure that we keep patient care as our number one priority.

Following a thorough review of the 599-page “Proposed Rule”, HealthPRO Heritage experts offer the following highlights on the PDGM section of the rule: