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Richter ShareSource Blog

Tips on Choosing Diagnoses for the LTPAC Resident Stay

Posted by Celeste Rininger on Apr 5, 2019 11:42:51 AM

Trepidation, fear and confusion have all been experienced by minimum data set (MDS) coordinators and staff alike at various long-term post-acute care (LTPAC) facilities regarding selecting and/or having to code diagnosis for residents—especially upon admission. Some common questions include: “What do I choose?” “How do I know if it is the correct primary or admitting diagnosis?” “I’m not a coder—how do I know what diagnosis to choose?”

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Topics: Clinical Consulting, Financial Consulting

Understanding the CMS Requirements of Participation Past and Future

Note: This is the first blog in our multi-part blog series on the CMS Requirements of Participation.

Did you know that one in three long-term post-acute care (LTPAC) residents is harmed by an adverse event within 35 days of their stay? Indeed, it is true, and the statistics from the Office of Inspector General don’t stop there:

  • 59% of events are preventable
  • 37% of such events medication related (medication induced change in mental status, excessive bleeding)
  • 37% are resident related (fall, electrolyte imbalance, pressure injury)
  • 26% are infection related
  • 50% of those residents affected returned to the hospital
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Seeing the Connection Between Phase 3 Requirement of Participation and Quality Assurance and Performance Improvement (QAPI)

Note: This is the third blog in our multi-part blog series on the CMS Requirements of Participation.

Nov. 28, 2019 is quickly approaching, and with that will come Phase 3 of the Centers for Medicare and Medicaid Services’ (CMS’) Requirements of Participation. As part of this, a fully integrated QAPI program will be required on this date. This should come as no surprise since some of the QAPI components should have already been implemented by your long-term post-acute care (LTPAC) facility, as stated below. This requirement is not going away and should be implemented soon rather than later. 

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Topics: Qapi, QAPI Consulting

The Role of Trauma-Informed Care in Phase 3 Requirement of Participation

Note: This is the second blog in our multi-part blog series on the CMS Requirements of Participation.

Individual trauma is an experience (or series of circumstances, events or occurrences) that an individual considers emotionally, physically or socially threatening or harmful and that has a long-term negative impact on the individual’s emotional, physical and/or social well-being. An event becomes traumatic when the ability to cope is overwhelmed.

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CMS Phase 3 Requirement of Participation: Compliance and Ethics Program

Note: This is the fourth blog in our multi-part blog series on the CMS Requirements of Participation.

The Compliance and Ethics section of the Centers for Medicare and Medicaid Services’ (CMS’) Requirements of Participation is a new section developed in response to a mandate under the Affordable Care Act that requires the operating organizations of skilled nursing facilities to have a compliance and ethics program that is effective in preventing and detecting criminal, civil and administrative violations and in promoting quality of care consistent with current regulations.

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Topics: QAPI Consulting

Business Office Work Flow in LTPAC Settings – Is Yours Stop or Go?

Posted by Gina Toigo, MBA, Revenue Cycle Manager on Nov 30, 2018 1:46:58 PM

The life cycle of the business office in long-term post-acute care (LTPAC) settings is a science if you get it right—and a science experiment gone horribly awry if you don’t.

Process is the key word to success when it comes to managing your accounts receivable; but the wheel going round and round has to make sense and includes many moving parts outside of your control—hence the reason it is so important to have a work flow!

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Certifications and Recertifications – the Golden Ticket for Skilled Nursing Services

Posted by Celeste Rininger, RN RAC-CT on Nov 29, 2018 12:06:32 PM

Wouldn’t you hate to work hard all day, every day, only to have your employer tell you that you messed up and the paycheck you just received had to be turned back over to them? That is exactly what could happen to many long-term post-acute care (LTPAC) facilities in the case of an audit due to the status of the certification/recertification for skilled services. 

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Topics: Clinical Consulting

MDS Update – Section N and What You Need to Know

Posted by Jacklyn Brown, RN on Nov 29, 2018 10:51:52 AM

On Oct. 1, 2018 updates to Section N of the MDS were implemented by CMS. Two questions were added to Section N (N2001 and N2003) if the assessment type is coded as PPS 5-day, and one question was added to Section N (N2005) if the assessment type is coded as a SNF Part A PPS Discharge Assessment. These questions are related to reviewing the drug regimen for residents. Per the RAI Manual, the intent of the updated questions is to “document whether a drug regimen review was conducted upon the resident’s admission (start of Skilled Nursing Facility (SNF) Prospective Payment System [PPS] stay) and throughout the resident’s stay (through Part A PPS discharge) and whether any clinically significant medication issues identified were addressed in a timely manner.” 

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