RUG

DOJ the latest to pile on in therapy-billing mess

DOJ the latest to pile on in therapy-billing mess

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Don't let anyone tell you that long-term care operators don't know how to read between the lines. They might not have known to fear a McKnight's Daily Update item before it appeared Sept. 8. But it quickly and definitely earned their attention — and apprehension.

Looking at short stay assessments

Looking at short stay assessments

In reviewing the MDS, there are several areas to check related to short stay requirements. First, is the Start of Therapy assessment checked in A0310C? If there is not a 5-day scheduled assessment or readmission/return assessment checked in A0310B, has this already been done?

MDS data quality: Things are not always as they seem

MDS data quality: Things are not always as they seem

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Open up the hood and look at the engine. Does the data scrubbing module focus only on standard CMS coding and consistency checks and the "RUG" items, or is it more robust and emphasize clinical quality and risk management. We studied MDS data from 11 software vendors and two suppliers of MDS scrubbing services: The "best" had MDS error rates of 62%, the "worst," 79%.

Upon further review

Upon further review

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Providers recoiling from recent uptick in therapy claim audits should expect even more scrutiny in the future as regulators look to increase surveillance.

How to make your nursing facility RAC-ready

How to make your nursing facility RAC-ready

As skilled nursing facilities adjust to the changes to Medicare that arrived early last month, they must be ready for Recovery Audit Contractors. RACs are independent auditors for the government that are preparing to audit every facility that has submitted Medicare claims.

For-profit nursing homes more likely than nonprofits to bill for higher-paying RUG levels, report finds

For-profit nursing homes more likely than nonprofits to bill for higher-paying RUG levels, report finds

For-profit nursing homes may be overbilling Medicare for the costliest services, a report released Thursday by the Office of Inspector General suggests.

What MDS 3.0 will mean for nursing home providers

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So, it's finally here. MDS 3.0, the updated resident assessment tool, has officially taken effect. So how exactly will this highly anticipated system change the way you, nursing home providers, operate? There are several ways.

CMS: It's all systems go for new nursing home assessment tool

CMS: It's all systems go for new nursing home assessment tool

Despite new political turmoil and uncertainty about the fate of healthcare reform, nursing home operators can still expect the scheduled Oct. 1 implementation of the new MDS 3.0 resident assessment tool to take place, federal regulators said Thursday.