Welcome to the HealthPRO Heritage Blog

Please read on for our latest input on coding support. Register to watch any of our pre-recorded PDPM webinars here. 

As we look to the future of skilled therapy under PDPM, it is important to remain focused on documentation that not only supports the provision of skilled therapy but the provision of skilled nursing services and accurate coding on the MDS. Case in point: during a recent review of documentation, a reviewer denied speech therapy services because of clear discrepancies between the speech pathologist’s documentation and nursing documentation. The reviewer argued that while the Speech Therapy Evaluation reported swallowing problems as evidenced by results from the MASA (Mann Assessment of Swallowing Ability), the 30-day MDS had not identified a swallowing disorder and according to the physician’s History and Physical, “the beneficiary had no problems with swallowing.” The reviewer’s conclusion? That skilled speech therapy was not medically necessary.

 With ~8 months to go, ask yourself: Are you on track for the transition to PDPM? Do you have the right therapy partner? This PDPM "To-Do" Checklist offers direction:

TODAY: PDPM “To-Do” Checklist

The more things change the more things stay the same.

CMS has been very clear that in order to receive Medicare Part A reimbursement under PDPM, the following will still hold true:  

Are you concerned about whether your EMR is equipped to handle the transition?  You’re not alone!

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?