Profile
A
comprehensive review of the Minimum Data Set and Management Minutes
Questionnaire from a regulatory and PPS perspective. Appropriate for
administrators and all nursing staff. Participants will gain strategies
for developing proactive policies and procedures with the intention
of integrating facility systems and team members.
Recommended
Audience
CEOs, COOs, Administrators, MDS Coordinators, Nurse Managers, Nursing
Staff, Social Workers, Therapy Managers, Therapists.
Objectives
I. The learner will be able to summarize Medicare, MDS, MMQ Requirements.
II. The learner will be able to list Medicare, MMQ and MDS Definitions.
III. The learner will be able to list MDS, MMQ and PPS Documentation
forms.
IV. The learner will be able to summarize strategies for successful
integration of the three reimbursement systems.
Goals
This program reviews reimbursement requirements touching on MMQ, RUG
classifications for Medicare, MDS, Plan of Care, Survey, and Quality
indicators. Medicaid as primary revenue is discussed and an understanding
of the 100% audit is presented.
Content
I. Overview of
Clinical Reimbursement and Regulatory Requirements
- MDS
- Plan of
Care
- Survey
- Quality
Indicators
- Federal
and State
- RUG classification
for Medicare
- MMQ
- Medicaid
as the primary revenue
- MMQ 100%
audit
- Medicare (PPS)
- RUG based
(MDS)
- Short
term Quality Indicators
- Skilled
documentation requirements
II. MDS Requirements
and Definitions
- ARD defined
- R2B and Vb2
defined
- Completion
Requirements
- Significant
Change Requirements
- Transmission
requirements
- MDS Definitions
III. Medicare
Requirements
- Nursing Observation
and Assessment
- ADL impact
– Late loss ADL’s
- Skin
- Daily Documentation
to support a skilled level of care
- Respiratory
Therapy
V. MMQ Requirements
- Effective
Date Defined
- Completion
Requirements
- Significant
Change Requirements
- ADL Definitions
- Care plan
Requirements
- Respiratory
Treatment
- Behavior
- Nursing Summary
V. Documentation
Review
- Physician
Orders
- Nursing Notes
- Nursing Summary
- Rehabilitation
Documentation
- Dietary Notes
- Care Plan
- Respiratory
Flowsheets and Oxygen
- ADL Flowsheets
- Positioning
Sheets
- Medication
Administration Sheets
- MDS
VI. United Front
- Significant
Change
- ADL’s
- Treatment
Documentation
- Care plan
- Last Covered
Day Medicare
- Skilled Observation
and Assessment
- Skin Documentation
- Respiratory
Assessment
- Team Approach
