Harmony Healthcare Blog

Melissa Fox

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Person-Centered Care Planning: Insight to Resident Assessment

Posted by Melissa Fox on Fri, Jan 20, 2017

C.A.R.E.

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


In our previous blog post (read here), Harmony Healthcare International (HHI) discussed the 4 Foundational Concepts of a Person-Centered Care. As we continue to discuss the concepts, we'll focus on defining the role of Resident Assessment in Person-Centered Care Planning.

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Topics: Requirements of Participation, Person-Centered Care

Person-Centered Care Planning: 4 Foundational Concepts

Posted by Melissa Fox on Wed, Jan 18, 2017

C.A.R.E.

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


Harmony Healthcare International (HHI) continues to work with providers to mine through the implementation of Phase 1 of Requirements of Participation (RoP). One area we begin to discuss is the foundational concept of Person Centered Care Planning.

The Implementation of Phase 1 of RoP, (which began November 28, 2016) reports 4 Foundational Concepts for Person Centered Care Planning:

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Topics: Requirements of Participation, Person-Centered Care

Requirements of Participation (RoP): Cultivating Residents' Rights

Posted by Melissa Fox on Tue, Jan 10, 2017

C.A.R.E.

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


November 28, 2016 Kicked off Phase One of the Requirements of Participation. The Center of Medicare and Medicaid Services, CMS, Action Plan retains all existing resident rights and updates the languages and organization of the resident right provisions.

The foundation of Phase One develops the expanded definitions which include adverse event, exploitation, person-centered care, documentation, posting/displaying, resident representative, abuse, sexual abuse, neglect and “exploitation”, and misappropriation of resident property. 

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Topics: Requirements of Participation

Requirements of Participation (RoP): 5 Operational Strategies Necessary to Maintain CMS Compliance

Posted by Melissa Fox on Thu, Jan 05, 2017

C.A.R.E.

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


The CMS Action Plan details efforts to continue to improve nursing home safety and quality which can be organized into the following Five Operational Strategies.

  1. Enhance consumer engagement
  2. Promote quality improvement
  3. Create strategic approaches through partnerships
  4. Advance quality through innovation and demonstration
  5. Strengthen survey processes, standards and enforcement
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Topics: Requirements of Participation

SNF PEPPER (version Q4FY16): What You Need to Know

Posted by Melissa Fox on Thu, Dec 29, 2016

C.A.R.E.

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


The next SNF PEPPER (version Q4FY16) is scheduled for release on April 17, 2017. The release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2016 will be available for review.  TMF Health Quality Institute is under contract with the Centers for Medicare & Medicaid Services to provide comparative data reports, including the PEPPER, to providers and to Medicare Administrative Contractors in support of the efforts to reduce Medicare fee-for-service improper payments.

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Topics: SNF PEPPER

Decoding the CPT Codes: Physical Therapy and Occupational Therapy Evaluation (Part 2)

Posted by Melissa Fox on Tue, Dec 27, 2016

C.A.R.E.

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


Therapy Providers seek clinical guidance on how to define the new CPT Codes for Occupational Therapy and Physical Therapy evaluations.  The guidelines indicate that the Clinician must consider: 

  • the presenting problem(s)
  • the reason(s) for referral
  • and the patient’s goals 

as a determining factor in which code will be selected.  (Missed Part 1? You can read Part 1 of the CPT Code series by clicking here.)

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Topics: CPT Codes

Decoding the CPT Codes: Physical Therapy and Occupational Therapy Evaluation (Part 1)

Posted by Melissa Fox on Wed, Dec 21, 2016

C.A.R.E.

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


As we approach January 1, 2017, therapy providers are preparing for the New CPT Code for Physical Therapy and Occupational Therapy Evaluations. Many therapists are reviewing the recent American Medical Association Common Procedural Terminology for 2017 manual and questioning the comparison of OT versus PT Evaluation codes. However, the development of each CPT codes was not to parallel the reported outcomes between PT and OT, but to reflect specific elements that reflect the discipline specific role of either a PT or an OT.

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Topics: CPT Codes

Five Steps to Understanding Low Risk Bowel and Bladder Incontinence

Posted by Melissa Fox on Tue, Nov 29, 2016

C.A.R.E.

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


Harmony Healthcare International (HHI) has noted an increase in facilities who wish to improve their measure of this quality indicator on their facility Quality Measure (QM) report. It is important to remember that high ratings may not be an indicator of substandard patient care. Substandard care is not the presence of incontinent residents in your facility. Substandard care is the lack of competent assessment, inappropriate treatment or management of incontinence, and lack of adjustments to clinical care that preserve the dignity of residents who are incontinent. 

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Topics: Quality Measures, Bowel, Bladder

Accountable Care Organizations Update:  ACOs and Medicaid

Posted by Melissa Fox on Wed, Nov 23, 2016

C.A.R.E.

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


Across the country, states are exploring the viability of Medicaid Accountable Care Organizations that align the provider and payer incentive to focus on value instead of volume.  The Center for Medicare and Medicaid Services is currently aligning partnerships in order to identify a collaborative approach to providing better care at an efficient cost.  During the harmony16 LTPAC Symposium, Harmony Healthcare International (HHI) presented on the upcoming changes to CMS initiatives with Medicaid Beneficiaries.  The following topics were discussed:

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Topics: ACOs, Medicaid, Accountable Care Organizations

Maintenance Therapy: Top 10 Things to Know

Posted by Melissa Fox on Tue, Nov 08, 2016

C.A.R.E.

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


During Harmony Healthcare International’s (HHI) LTPAC Interdisciplinary Symposium, harmony16, guest speaker, Ali Bers, Attorney with Center for Medicare Advocacy shared her knowledge and passion for supporting ongoing skilled services to our elder population.  Here are the top ten things you should know about providing Maintenance therapy.

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Topics: Maintenance Therapy, Jimmo

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