Harmony Healthcare Blog

Conducting Your Skilled Nursing Facility Risk Analysis:  Last year, HIPAA privacy, security and breach notification rules were made applicable to healthcare providers, payers and clearinghouses. The HIPAA Security Rule establishes national standards to protect individuals’ electronic personal health information that is created, received, used, or maintained by a covered entity. The Security Rule requires appropriate administrative, physical and technical safeguards to ensure the confidentiality, integrity, and security of electronic protected health information.

CMS Proposed Rule FY2015:  On May 6,2014, the Centers for Medicare and Medicaid Services (CMS) issued a Proposed Rule [CMS-1605-P] under the Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities. The Proposed Rule illustrates the proposed Fiscal Year 2015 Medicare payment rates for skilled nursing facilities (SNFs).  The Proposed Rule outlines an estimated increase in SNF payments of 2.0%.  This estimated increase is attributable to the 2.4% market basket increase, reduced by the 0.4% point multifactor productivity adjustment required by law.  As the actual amount of change in the market basket index at -0.3 did not exceed the 0.5 percentage point threshold, the payment rates for FY2015 do not include a forecast error adjustment. 

For those of you that have heard me speak about Medicare, Therapy, Case Mix, MDS, PPS or simply my four daughters, there probably has never been a session that I do not utter my favorite words that “Nurses Rule the World!”  Being intimately familiar with the day-to-day tasks (or should I say night-to-night tasks, as well) of patient care, medication administration, documentation, physician interactions, family discussions, caregiver communication, and so on, only one in the healthcare field sees the heart, sweat and tears this profession renders to their patient caseload.  Too often, the value of the nursing profession is taken for granted, especially when they do their job well.  Frequently, the field underestimates the complexity and finesse required to successfully care for the geriatric patient.

Often times, clinical records reflect the limited skilled nursing documentation representing the critical thinking of a licensed nurse. The documentation that supports the ongoing skilled nursing care including the risk of exacerbation of medical signs and symptoms. Consider patients who require a continuum of care and may present as medically stable, however, require education and preventative treatment to promote optimal health and wellness.