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Compliance Series - 7 Elements: Prevention and Response
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency As a continuation of the 7-Part Blog Series on Compliance, today we will explore Prevention and Response.

Harmony Healthcare International

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Compliance Series - 7 Elements: Education and Training
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency As a continuation of the 7 Blog Series on Compliance, today we will explore Education and Training.

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Compliance Series - 7 Elements: Reporting and Investigating
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency As a continuation of the 7 Part Blog Series on Compliance, today we will dive into Reporting and Investigating.

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Compliance Series - 7 Elements: Policies and Procedures
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency As a continuation of last week’s blog post, we are reviewing the seven elements of an effective Compliance Program. To reiterate, it is necessary to develop and implement a Compliance Program with the following key elements:

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Compliance Series: 7 Elements of An Effective Compliance Program
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency CMS revised paragraph §483.85(b) to accurately indicate that the operating organization for each Skilled Nursing Facility must have in operation a Compliance and Ethics program by November 28, 2019, (Phase 3). A technical error occurred on page 68869 of the October 4, 2016, Final Rule. CMS incor...

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New Long-Term Care Survey Process: Seven Parts
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency Long-term regulatory changes can be daunting at best and the New Long-term Care Survey Process is no different. Harmony Healthcare International (HHI) does its best to synthesize new information and present it in a manner that is easy to digest. With that in mind, let’s review the new survey pr...

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New Long-Term Care Survey Process: Implementation Grid and F-Tag Renumbering
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency As highlighted in our earlier blog posts, the New LTC Survey Process builds on the best of both survey processes. Various stakeholders provided input regarding the new process. Currently, both the survey process and software are in testing and development. Let us now review the Implementation...

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New Long-Term Care Survey Process: QIS vs New Survey Process
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency As promised in our previous post, the following tables compare the Quality Indicator Survey (QIS) to the New Survey Process for Automation, Sample Selection, Off-Site Survey Review, Information Needed Upon Entrance, Initial Entry to Facility, Survey Structure and Group Interviews.

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The Long-Term Care Survey Process: Refinements in the Making
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency The Centers for Medicare and Medicaid Services (CMS) is refining survey process and they are raising the bar! This seems to be a pattern with everything they are doing in the context of Regulatory Refinement. New standards and expectations will be effective November 28, 2017. The days of decade...

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Lower 14 RUG Days: What You Need to Know
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency Every month we arrive at our client sites to perform monthly audits. The Harmony HealthCARE Specialists review a litany of metrics invaluable to the integrity of the Compliance Auditing and Monitoring System established by Harmony Healthcare International (HHI). We work diligently prior to the v...

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Therapy Minutes Defined: Medicare Part A
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency The Harmony HealthCARE Specialist Team provides the following information on how CMS (Center for Medicare and Medicaid Services) defines billable therapy minutes under the Medicare Part A SNF Benefit. While analyzing the operations of a SNF Rehabilitation Department, it is often revealed that e...

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Combining OBRA and PPS MDS Assessments
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency It is common practice to combine the OBRA Admission Assessment with the PPS 5-Day or 14-Day Assessment when the time frames coincide for both required assessments. This is allowable to avoid unnecessary duplication of effort. In such cases, the most stringent requirement of the two assessments ...

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Isolation: Coding Requirements and Supporting Documentation
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency This week’s hot topic is a resurfacing of the definition of coding of isolation. We blogged about this in February, but it seems that questions continue to arise. Let’s dig a little deeper into the RAI Criteria for coding Isolation with a focus on supporting documentation. Per the MDS 3.0 RA...

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Requirement of Participation (RoP): Facility Assessment Tool
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency Of the many changes closing in with Phase 2 of the Requirements of Participation, there is the much-discussed Facility Assessment. This document is due November 28, 2017 and then annually thereafter. The intent of the Facility Assessment is for Skilled Nursing Facilities to define their facilit...

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Nursing Observations Necessary for Rehabilitation Screening, Evaluation and Intervention
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency While there is a great deal of focus on the management of Post-Acute patients in the SNF population, many of whom will return to the community, management of long term care patients is equally essential to the provision of services along the continuum of care. Per CMS regulations, long term care ...

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Managed Medicare: Care Basics
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency Approximately one in three resident referrals to the long-term care space is from a Managed Care entity. Navigating through different payor sources proves to be challenging for most healthcare organizations. The following guidelines may be helpful in the quest for quality service delivery and f...

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RCS-1 (Resident Classification System): Significant Change in Status Assessments
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency The proposed RCS-1 (Resident Classification System) Payment System is creating waves of questions and comparisons to the existing system. Each element leads to hours of discussion in a rabbit hole type of path. In true Harmony Healthcare International (HHI) fashion, we like to distill and synth...

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Resident Classification System RCS-I (Part 2)
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency CMS extended the comment period for the recent ANRP the Advanced Notice of Proposed Rulemaking to August 25th, 2017 at 5:00 p.m. This seems to be a good thing seeing the concepts are a little difficult to assimilate. The logic may be sound via data analysis, but is it applicable? The below bull...

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Skilled Nursing Facility (SNF) Industry Updates
C.A.R.E. Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency The Occupancy Rates for Skilled Nursing Facilities per The National Investment Center for Senior Housing and Care (NIC) increased to 82.6% for the first quarter of 2017, up from the prior quarter, however, down from year to year data as stated in the First Quarter 2017 NIC Skilled Nursing Data Re...