Long-term Care Skilled Services : Applying Medicare's Rules to Clinical Practice

Format:

Book

Author/Creator:

Malzahn, Elizabeth, author.

Language:

English

Subjects (All):

Long-term care facilities.

Nursing services.

Physical Description:

1 online resource (148 p.)

Other Title:

Long-term Care Skilled Services

Place of Publication:

HCPro, Inc.

Summary:

Long-Term Care Skilled Services: Applying Medicares Rules to Clinical PracticeAvoid common mistakes that compromise compliance and paymentTake the mystery out of skilled services and know when to skill a resident based on government regulations, Medicare updates, the MDS 3.0, and proven strategies. Long-Term Care Skilled Services: Applying Medicare's Rules to Clinical Practice illustrates the role played by nurses, therapists, and MDS coordinators in the application and documentation of resident care. Don't miss out on the benefits and reimbursement you deserve, as author Elizabeth Malzahn delivers clear, easy-to-understand examples and explanations of the right way to manage the skilled services process.This book will help you:Increase your skilled census and improve your facilitys reputation with the support of your entire staffAvoid under- and overpayments from Medicare with easy-to-understand explanations of complex rules and regulationsProvide necessary skilled services to each resident through a complete understanding of eligibility requirementsAccurately document skilled services using proven, time-saving solutionsProperly assess skilled services under the MDS 3.0Improve communication to increase resident and family satisfactionReduce audit risk and prove medical necessity through accurate documentationTable of ContentsRules and RegulationsOriginal law - Social Security and Medicare ActCMS publicationsManualsTransmittalsMLN mattersNational and local coverage determinationsRAI User's ManualHierarchy of oversightCMS-MAC/FI, OIG, GAO, etc.Technical Eligibility for Skilled Services in LTCEligibility basicsVerification of current benefitsHow enrollment in other programs impacts coverage under traditional MedicareHospiceHMO/managed care/Medicare AdvantageMedicaid/Medi-CalHospital stay requirement30-Day transfer rule for hospital or SNFUnderstanding benefit periodsCare continuation related to hospitalizationHow does a denial of payment for new admissions impact Medicare SNF admissions?Meeting the Regulatory Guidelines For "Skilled" ServicesSkilled services definedRegulatory citations and referencesClinical skilled servicesTherapy skilled servicesPhysician certifications and recertificationPresumption of coverageUnderstanding "practical matter" criteria for nursing home placementImpact of a leave of absence on eligibilityMDS 3.0 - Assessments, Sections and Selection...Oh My!Brief history of MDS 3.0Types of MDS assessmentsThe assessment scheduleItems to considerImportance of timingReview of each care-related section of the MDS 3.0Proper Communication During the Part A StayMedicare meetingTiminngAgendaWhat to discuss for each residentEnding skilled servicesNotification requirementsDischargingOther notification requirements and communicationOther Important Things to KnowMedicare mythsConsolidated billingMedical reviewAudienceAdministrators, CFO/CEOs, directors of nursing, MDS coordinators, directors of rehab, therapy directors, PT/OT/ST, DONs.

Notes:

Part of the metadata in this record was created by AI.

ISBN:

1-61569-111-1