Many changes will impact the social determinants of health.
On May 8, the Centers for Medicare & Medicaid Services (CMS) announced a delay in implementation of updated assessment instruments for Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs), home health, and Skilled Nursing Facilities (SNFs). Details can be located online here: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/IRF-Quality-Reporting/Spotlights-Announcements.
The delays impact both the transfer of health information in quality measures and the new and revised Standardized patient Assessment Data Elements (SPADEs) – many of which relate to social determinants of health (SDoH) and are included in the updated assessment instruments that were to be implemented this fall.
Inpatient Rehabilitation Facilities and Long-Term Care Hospitals
The announcement reads:
Delayed: Release of Updated Versions of IRF and LTCH Assessment Instruments (and Supporting Training)
CMS is delaying the release of updated versions of the item sets needed to support the Transfer of Health (TOH) Information Quality Measures and new or revised Standardized Patient Assessment Data Elements (SPADEs) in order to provide maximum flexibilities for providers of Inpatient Rehabilitation Facilities (IRFs) and Long-Term Care Hospitals (LTCHs) to respond to the COVID-19 Pubic Health Emergency (PHE).
The release of updated versions of the IRF Patient Assessment Instrument (IRF-PAI) and the LTCH Continuity Assessment Record and Evaluation Data Set (LTCH CARE Data Set) will be delayed until Oct. 1 of the year that is at least one full fiscal year after the end of the COVID-19 PHE. For example, if the COVID-19 PHE ends on Sept. 20, 2020, LTCHs and IRFs will be required to begin collecting data using the updated versions of the item sets beginning with patients discharged on Oct. 1, 2021.
Home Health
The announcement reads:
Delayed: Release of Updated Version of the Home Health Assessment Instrument (and Supporting Training)
CMS is delaying the release of the updated version of the Outcome and Assessment Information Set (OASIS) needed to support the Transfer of Health (TOH) Information Quality Measures and new or revised Standardized Patient Assessment Data Elements (SPADEs) in order to provide maximum flexibilities for providers of Home Health Agencies (HHAs) to respond to the COVID-19 Pubic Health Emergency (PHE).
The release of the updated version of the OASIS will be delayed until Jan. 1 of the year that is at least one full calendar year after the end of the COVID-19 PHE. For example, if the COVID-19 PHE ends on Sept. 20, 2020, HHAs will be required to begin collecting data using the updated versions of the item sets beginning with patients discharged on Jan. 1, 2022.
Skilled Nursing Facilities
The announcement reads:
Delayed: Release of Updated Versions of SNF Assessment Instrument (and Supporting Training)
CMS is delaying the release of the updated versions of the Minimum Data Set (MDS) needed to support the Transfer of Health (TOH) Information Quality Measures and new or revised Standardized Patient Assessment Data Elements (SPADEs) in order to provide maximum flexibilities for providers of Skilled Nursing Facilities (SNFs) to respond to the COVID-19 Pubic Health Emergency (PHE).
The release of updated versions of the MDS will be delayed until Oct. 1 of the year that is at least two full fiscal years after the end of the COVID-19 PHE. For example, if the COVID-19 PHE ends on Sept. 20, 2020, SNFs will be required to begin collecting data using the updated versions of the item sets beginning with patients discharged on Oct. 1, 2022.
What This Means for Post-Acute Facilities
The delays allow all PAC settings more flexibility in dealing with current issues related to the PHE, and more time to prepare for changing documentation requirements.
Our Advice to Providers
Don’t lose focus on the requirements! At some point, the current waivers and flexibilities will expire, and PAC providers will once again be held accountable for compliance with regulatory requirements. Further, we believe that there will be audits related to care provided during this time to determine that the requirements not covered by a waiver were met, and that the requirements for the waivers were also met. As always, documentation is the key. To the extent possible, providers need to continue strong compliance practices and preparations for the upcoming implementations, as well continue to have strong documentation practices to support their efforts during the PHE.
Programming Note: Listen to Angela Phillips report this story live during a special 60-minute edition of Monitor Mondays, May 18, 10-11 a.m. EST.
Well, one of our clients recently got me really excited. They received a denial of an inpatient admission from a well-known Medicare Advantage (MA) plan
The Self-Disclosure Protocol (SDP) can certainly be daunting. Most of my clients, after they discover abnormalities or aberrant billing, the questions become: The answer is
Please log in to your account to comment on this article.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
This webcast, presented by Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, a recognized expert with over 30 years of experience, offers essential strategies to improve outpatient clinical documentation integrity. You will learn how to enhance the accuracy and completeness of patient records by adopting best practices in coding and incorporating Social Determinants of Health (SDOH). The session also highlights the role of technology, such as EHRs and CDI software, in improving documentation quality. By attending, you will gain practical insights into ensuring precise and compliant documentation, supporting patient care, and optimizing reimbursement. This webcast is crucial for those looking to address documentation gaps and elevate their coding practices.
ICD10monitor has teamed up with renowned CDI expert Dr. Erica Remer to bring you an exclusive webcast on how to recognize sepsis, how to get providers to give documentation that will support sepsis, and how to educate to avert sepsis denials. Register now and become a crucial piece of the solution to standardizing sepsis clinical practice, documentation, and coding at your facility.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
This webcast, presented by Tiffany Ferguson, LMSW, CMAC, ACM, addresses the critical gap in Social Determinants of Health (SDoH) reporting for pediatric populations. While SDoH efforts often focus on adults, this session emphasizes the unique needs of children. Attendees will gain insights into the current state of SDoH, new pediatric Z-codes, and the importance of interdisciplinary collaboration. By understanding and applying pediatric-specific SDoH factors, healthcare professionals can improve data capture, compliance, and care outcomes. This webcast is essential for those looking to enhance their approach to pediatric SDoH reporting and coding.
Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, VP of CDM, for a webcast addressing oncology service coding challenges. Learn to navigate coding for infusions and injections alongside Evaluation and Management (E/M) services, ensuring compliance and accurate reimbursement. Gain insights into documenting E/M services for oncology patients and determining medical necessity. This webcast is essential to optimize coding practices, maintain compliance, and maximize revenue in oncology care.
During this webcast Dr. Ronald Hirsch delves into the inpatient admission order process including when to get it, when it becomes effective, its impact on billing and payment, who can write it, how to cancel it, the effects on the beneficiary, and more. You’ll leave with a clear understanding of inpatient orders and guidelines for handling improper orders that you can implement immediately.
Copyright © 2024 RACmonitor. Powered by MedLearn Media.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
