RUGs - McKnight's Long Term Care News

RUGs

Steven Littlehale

Are your Ultra High RUGs putting you at risk?

The 2016 Office of Inspector General work plan calls for increased scrutiny of the Ultra High therapy billing category because the amount of this therapy delivered has increased over time, despite resident characteristics not having changed. This work plan is a reminder that providers need to have all of their processes in order.

Ask the payment expert ... about the observation stay loophole

Ask the payment expert … about MDS

The state may be using the MDS data and RUG levels to determine the “expected staffing” that compares the staffing levels to the RUGs levels.

Shelly Mesure, MS, OTR/L

No more Rehab Medium RUG defaults

Well, Oct. 1 has passed, and we’re all still hanging in. The biggest changes we saw to rehab were the addition of reporting co-treatment minutes on our billing logs and Section O on the MDS. And, the new question of “how many DISTINCT calendar days” were received between SLP, OT, and PT.

Changes to MDS 3.0, RUGs the focus of free Sept. 11 Super Tuesday webcast

The MDS 3.0 now plays central payment role in long-term care. But new rules and regulations are constantly emerging — and the stakes for providers have never been higher. An informative, live, one-hour webcast will help sort things out on Sept. 11. Leading the presentation will be Leah Klusch, RN, BSN, FACHA, executive director of The Alliance Training Center. Participants on the day of the webcast can earn continuing education credit, which also comes at no cost.

Leah Klusch, RN, BSN, FACHCA

Rehab reimbursement and audits the focus of July Super Tuesday webcast

Nursing home administrators who can’t back up every minute of rehab therapy delivered in their building leave themselves open to auditing, warns an MDS 3.0 expert during the July 10 McKnight’s Super Tuesday webcast. Every skilled nursing facility billing minutes to rehab services must be able to verify that he or she has read all of the updates to the RAI Manual, as well as all of the changes that took effect April 1, adds Leah Klusch, RN, BSN, FACHA. That and much more was discussed during the free webcast, which remains available for viewing in an online archive for a year.

CMS Administrator Donald Berwick, M.D.

OIG report: Correct nursing home Medicare pay ‘immediately’

Medicare payments to skilled nursing facilities increased unexpectedly by $2.1 billion (16%) during the first six months of fiscal 2011, according to a new report issued by the Office of the Inspector General. The OIG has asked Centers for Medicare & Medicaid Services Administrator Donald Berwick to take “immediate action” to correct this overpayment.

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