Ask the payment expert: When will we see the new Care Area Assessment?

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Ask the payment expert
Ask the payment expert
When will we see the new Care Area Assessment?

The Care Area Assessment (CAA) chapter of the Resident Assessment Instrument (RAI) manual has finally been published. Guidance is provided to each provider on the structure and content of the Care Area Assessment.

The Care Area Triggers (CATs) are MDS items that compel further evaluation. The difference between the old Resident Assessment Protocols (RAPs) and Care Area Triggers is minimal. The biggest difference is that the RAI guidelines do not give the writer a framework for completion. The CAAs simply refer to utilization of evidence-based standard of clinical practice.

This, however, provides a challenge to providers to identify a source of guidelines they utilize. Providers must identify the source they use and to follow that framework for assessment.  

A great source of information can be the American Medical Director Association (AMDA) guidelines or other clinically acceptable standard of practice such as the Centers for Disease Control and Prevention (CDC) or Advancing Excellence.

What do we do if the RUG-IV system is delayed?

The Senate did call for a one-year delay of the RUG-IV system implementation.

Some sources tell us that a healthcare association actually asked congressional leaders to proceed with the

 implementation in October 2010.  Even if there is a delay, The Centers for Medicare & Medicaid Services (CMS) has indicated it would proceed with a revised RUG-III system, which would still implement the tracking of concurrent therapy minutes and eliminate the use of hospital data for IV medications and IV fluids to drive skilled nursing facility payment.

So, either way, it looks like reimbursement will be significantly changed as of Oct. 1.