On January 1, 2015, the Centers for Medicare & Medicaid Services (CMS) required home health agencies (HHAs) to obtain documentation from the certifying physician's and/or the acute/post-acute care facility's medical record for the patient. This served as the basis for the certification and eliminated the face-to-face encounter narrative as part of the certification of patient eligibility for the benefit.
Topics: Home Health & Hospice
Did you know that in 2016, 20% of Medicare residents are hospitalized within 30 days of discharge? Nearly 90% of these hospitalizations were classified as unplanned. Early identification of a resident’s change in condition is paramount to managing and preventing unnecessary transfers. The eINTERACT™ program is a PointClickCare® module that was developed to help decrease hospital readmissions and improve quality of care. It consists of several parts including:
The Level of Care (LOC) in the PointClickCare® Census and Rates resident tab is used for the management of No Pay and Exhaust claim billing for residents, after a Medicare Part A skilled stay. The LOC has no other function but to drive this process. Skilled Nursing Facilities (SNFs) are required to submit claims to Medicare for residents to report the benefit period even though no benefits may be payable. The Centers for Medicare & Medicaid Services (CMS) maintains a record of all inpatient services for each beneficiary, whether those services are covered by Medicare or not.
The Phase 2 roll out of the Mega Rule Requirements of Participation is quickly approaching. One of the requirements of Phase 2 is the Facility Assessment. The Facility Assessment is a written report that includes items such as patient population, resources and risk assessments.
Skilled nursing facilities will be required to complete the Facility Assessment by November 28, 2017, and annually thereafter. The Facility Assessment should also be updated with any significant changes in census or services.
The three sections of the Facility Assessment are outlined below. We have also assembled a template for use by the facility when completing the Facility Assessment.Click here to download your Mega Rule Facility Assessment Tool.
Topics: Clinical Consulting