Harmony Healthcare Blog

SNFs Guide to Understanding Admission Dates on the MDS

Posted by The Harmony Team on Thu, May 21, 2015

Admission Dates A1600, A1700, and A1900 on the MDS

Section A of the MDS 3.0 Assessment provides the assessor with the opportunity to record information about the start date of the current SNF stay and the current episode of a stay.  If these dates do not agree in a logic check performed by the software there will be an error message and the assessment will not be able to be closed until the logic conflict has been resolved.  This is often termed a "warning message", and it is in place to assist providers to correct logic conflicts prior to submitting assessments to the QIES ASAP in order to decrease the number of rejected assessments during submission.

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Topics: MDS 3.0, OBRA, MDS 3.0 Assessment Schedules, Assessment Schedules, Admission Dates

Coordinating Complex Medicare Part A Patient Care in a SNF

Posted by The Harmony Team on Thu, Aug 02, 2012

Managing the care of the patient on a daily basis is very challenging in the SNF. Medicare Part A patients who tend to be somewhat more medically complex and sicker than some of the other patients residing in the nursing home are more complex to manage. One helpful technique that HHI has seen during facility visits is utilizing an individualized patient calendar. Each patient carries their own calendar which will list when the patient is scheduled for physical or occupational therapy. If the patient has a physician visit scheduled within the facility, is going to be transported off site to go to a medical appointment, or some other type of a visit- it will be recorded. This helps the team to be able to plan for care, arrange when to schedule therapy, or note if nursing requires the patient for a particular period of time, such as a wound treatment that needs to occur. This will enable the team to view the patients day at a glance and be able to schedule if you have to perform an interview for the MDS, how to avoid missing a day of treatment if therapy is looking to manage for minimizing change of therapy, or end of therapy assessments. The patient calendar is a strategy that HHI believes can be very helpful, especially if you run a Medicare Census that is upward of 20 maybe 30 patients you are managing a day. We challenge you to employ the individualized patient schedule and see how it works. Try it with a portion of your patient case load and note if this will make a difference in helping to avoid doing some of the unscheduled assessments that can arise while you are managing their day to day treatments and appointments.

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Topics: Assessment Schedules, Patient Calendar

Rehab Case Management for Case Mix

Posted by The Harmony Team on Wed, Jul 25, 2012

Successful case management for Case Mix involves the coding of the accurate minutes of care provided by therapy on the MDS for those patients seen under Medicare Part B. There is significant opportunity to increase the case mix index with the intervention of rehabilitation during the appropriate assessment windows.  Increased communication between the Rehabilitation staff and the MDS Coordinator regarding patients receiving Medicare Part B services has the potential to increase the case mix index in two ways. 

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Topics: Rehab, Medicare Part B, Case Mix, OBRA, Assessment Schedules, Rehab Case Management, MDS Coordinator

10 ways to Increase your Case Mix Index

Posted by Kris Mastrangelo, OTR/L, LNHA, MBA on Mon, Jun 21, 2010

There are numerous ways a facility can increase their Case Mix Index.  Facilities must monitor the follow criteria to ensure proper Medicaid Reimbursement and increase your Case Mix Index.

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Topics: Case Mix, Assessment Schedules, Medicaid Reimbursement

RUGs IV Update

Posted by The Harmony Team on Tue, May 25, 2010

RUGs IV Upate:  The LTC industry eagerly awaits the passing of the American Jobs and Closing Tax Loopholes Act.  Last week the House and Senate reached agreement on the "extenders package", also known as  American Jobs and Closing Tax Loopholes Act. This ensures that RUG IV and MDS 3.0 will be implemented together on October 1, 2010. The House will take up the bill early in the week with the Senate to follow later in the week.  Majority Leader Harry Reid (D-NV) has said he "hopes to finish the spending bill and the so-called extenders bill before the scheduled start of the Memorial Day recess at week's end." 
CMS released a statement that SNF's will recieve interim payment rates, effective October 1, 2010, that reflect not only the use of MDS 3.0, but also the new RUG IV system.  If the bill does not pass, then CMS plans to retroactively adjust the rates to reflect a hybrid RUG-III (HR-III) system which incorporates RUG-IV's specific revisions on concurrent therapy and the look-back period within the framework of the existing 53-group RUG-III system, along with the use of MDS 3.0.  Harmony is closely monitoring the progress on this "Package" and will update the newsletter with any new information.  Please feel free to contact us with any questions.

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Topics: CMS, MDS 3.0, RUGs IV, Assessment Schedules

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