Harmony Healthcare Blog

Question of the Week: Short Stay Assessments

Posted by The Harmony Team on Tue, May 23, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Question:  Does the therapist need to treat the day of discharge in order to qualify for the short stay? 

Answer:  No, the therapist does not need to treat the day of discharge.  Points to know: 

  • Therapy is "ongoing", meaning the treatment sessions would have continued if the patient was not discharged. 
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Topics: Therapy, MDS Short Stay

MDS 3.0 OMRA Management: Change of Therapy (COT) and Start of Therapy (SOT)

Posted by Kris Mastrangelo on Thu, May 18, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


What is trending this week? A bit of confusion with OMRA Assessment completion. Let’s simplify.

Defining Start of Therapy OMRA

  1. Optional Assessment: 
    • Completed only to classify a resident into a Rehabilitation group after therapy initiates
    • Not required if current nursing rate is higher
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Topics: OMRA, Change of Therapy

Need to Know: Skilled Nursing Documentation for Admissions

Posted by Kathy Monahan on Tue, May 16, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Admission and Re-admission Nursing Notes: Harmony Healthcare International (HHI) suggests that the following information be included in all admission notes: 

  • Time and date of admission.
  • Mode of Transportation, assist level and number of assist with transfers and bed mobility.
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Topics: Documentation

Alert: CMS Glitch Regarding Quality Reporting Program (QRP)

Posted by Sally Fecto on Fri, May 12, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


(**UPDATED - See response from CMS below)

Yesterday, many Providers received an email reminding them that the upcoming submission deadline for the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) is approaching.  The email also notified Providers of missing data submissions.  We believe the following information was sent in error:

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Topics: Quality Reporting Program

ICD-10 Coding: Diagnosis of B20 (HIV)

Posted by Sally Fecto on Tue, May 09, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Audits this week prove to be interesting.  As we focus on the accurate coding of HIV, there seems to be opportunity with understanding the definition and the significance in the reimbursement. 

Often times the need for additional supportive documentation in determining the appropriate ICD-10 for HIV.  Limited information is in the medical record.  To code B20, the condition is active and meets criteria versus Z21, asymptomatic HIV.

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Topics: ICD-10

New Medicare Part A Payment System Proposed: Top 14 Points

Posted by Sally Fecto on Thu, May 04, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


CMS (Centers for Medicare and Medicaid Services) just made available details of the proposed payment system in a document called the Advanced Notice of Proposed Rulemaking.   The document defines the proposed revisions to the currently used Case-Mix Methodology with time for public feedback and opinions on the possibility of replacing the SNF PPS existing Case-Mix Classification Model, Resource Utilization Groups, (RUG-IV) Case Mix Classification Model with the Resident Classification System, Version I (RCS-I). Comments must be received no later than 5 p.m. on June 26, 2017. 

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Topics: proposed rule

Top Ten Points: Proposed Rule for SNFs

Posted by Kris Mastrangelo on Tue, May 02, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Last week, the Government announced and published the ideas and concepts for Skilled Nursing Payments for Medicare Part A Beneficiaries effective October 2017 (Fiscal Year 2018).  CMS (Centers for Medicare & Medicaid Services) authored the documents and awaits feedback from the industry.  Upon review of the responses, CMS will adjust and release a Final Rule within approximately 60 days (July 2017)

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Topics: proposed rule

Two Types of MDS Discharges

Posted by Sally Fecto on Thu, Apr 27, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Discharge Assessments are required on patients discharged from the facility as well as when a patient’s Medicare Part A Stay ends and the patient remains in the facility.  It is important to understand that there are now two types of discharges: 

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Topics: Discharge Assessment

AHCA Provider Lounge Series: Building Quality-Driven Communities

Posted by Kris Mastrangelo on Thu, Apr 20, 2017

Interview with Phil Scalo, CEO of Bartley Healthcare

Kris Mastrangelo, President of Harmony Healthcare International (HHI) interviews Phil Scalo, CEO of Bartley Healthcare located in New Jersey, in the AHCA Provider Lounge.  Phil discusses the importance of providing quality-driven customer-based services.   Phil runs his campus as a community, where individuals can feel confident that when they move in they will always have a place for whatever care they need.    Through customer service initiatives such as surveys, Phil is prepared to meet all of his residents' needs - be it bringing rehab to Assisted Living or providing more private rooms for incoming baby boomers (Audio transcription below).

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Topics: Person-Centered Care, Baby Boomers

The Medicare Spell of Illness (Benefit Period)

Posted by Sally Fecto on Thu, Apr 13, 2017

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


These past few weeks of on-site audits with the Harmony Team continue to reinforce the need for everyone to get back to basics.  All of the hype and frenzy over payment reform is distracting and disrupting the focus on the simplest of tasks.   What task you ask?  Spell of Illness. 

In order to successfully operate in the Skilled Nursing Facility space, Kris Mastrangelo continually messages these 3 focal points:

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Topics: Medicare, Spell of Illness

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