The Great Eight: Future of C.A.R.E.
A two-day interdiscliplinary leadership program divided into four modules. Register for one module or all four.
Module 1: The Great Eight: The Future of C.A.R.E.
The speaker will share an overview of the eight major areas of focus for every Skilled Nursing Facility Operator: The New Gold Standard, Requirements of Participation (RoP), Facility Assessment, Patient Centered Care, Resident Classification System, Version 1 (RCS-1), Value-Based Purchasing, Bundled Payments and Clinically Anticipated Stay, Five-Star, Quality Measures, PEPPER, Rehabilitation, and Compliance. The Speaker will discuss the latest compliance risks, and data-driven strategies to help providers address risk.
Module 2: The Future of Reimbursement: MDS & More for the Clinical Leader
Let Quality of Care Lead to Accurate and Appropriate Reimbursement: Skilled Nursing Facilities will see many changes as we approach Fiscal Year 2019 in order to ensure we are accurately and appropriately reimbursed for the care we provide. In addition, the Final Rule for Medicare and Medicaid and the Requirements of Participation (RoP) have overhauled our regulatory requirements. The changes are cumbersome and complicated. What is the bottom line for clinicians? What do these changes mean for the Clinical Leaders? What do Clinical Leaders need to know? We need to become a higher quality Skilled Nursing Facility (SNF)! This course will detail the underlying clinical themes every clinical leader will need to address to ensure compliance with upcoming regulatory and reimbursement changes.
Module 3: Additional Documentation Request (ADRs) and Denial Management
In response to several OIG investigations and reports that Skilled Nursing Homes are overbilling Medicare, the Healthcare Industry is experiencing a surge of Probe Reviews per CMS mandates. Multiple contracted agencies are out in full force investigating Medicare and Medicaid billing practices of Nursing Home providers across the country. Skilled Nursing and Rehabilitation Documentation coupled with MDS 3.0 accuracy is critical to ensuring accurate reimbursement for Medicare claims under the scrutiny of review. The key to success is an understanding of the clinical and technical Medicare requirements. The speaker will explain the OIG Investigation and identify focus areas for educational development for SNF providers. Hear the intrinsic details of how the government approaches Medical Review and determines findings of fraud and denied claims. The attendees will hear detailed clinical and technical Medicare Coverage requirements for improving delivery of care. Current trends in nursing and the healthcare industry impacting the SNF will be presented for nursing and therapy leadership. The Harmony HealthCARE Specialist will disclose techniques for preparing for legal situations as well as strategies for appealing denied claims. The speaker will detail recommended tactics to manage and guide the interdisciplinary team toward absolute compliance.
Module 4: Jumpstart Your QAPI & Compliance Programs
While the utilization of the Quality Assurance and Performance Improvement Plan is in its infancy stage within the Skilled Nursing Facility setting, other Medicare and Medicaid regulated organizations have been responsible for developing a QAPI annually as a standard of practice. Data-driven, quality- focused initiatives that align with the SNF's overall performance goals work in unison to ensure care delivery weaknesses are addressed, and performance improvement measures and data, plans and outcomes are available on request by SNF Boards of Directors as well as Surveyors. The QAPI builds on Quality activities and Compliance investigations to ensure each facility is working together to create a safe, effective, quality program.