CMS Will Conduct Focused Surveys in 2015
The Centers for Medicare & Medicaid Services (CMS) has announced that they will conduct focused surveys in certified nursing facilities nationwide in 2015. The focused surveys will review MDS 3.0 coding and staffing levels using record review, observations, and interviews with staff and residents.
CMS piloted the focused survey earlier this year, surveying five facilities in each of five states, including Minnesota. The pilot focused on the resident assessment processes in more detail than the annual surveys. Findings from the pilot included inaccurate staging and documentation of pressure ulcers, lack of knowledge regarding the classification of antipsychotic drugs, and poor coding regarding the use of restraints. All but one of the 25 facilities had deficiencies cited by the surveyors.
OIG Releases 2015 Work Plan for SNFs
The Office of the Inspector General (OIG) has released its 2015 work plan for skilled nursing facilities (SNFs), which identifies five areas it will investigate:
- Medicare Part A billing by SNFs: OIG will review the changes that the Centers for Medicare & Medicaid Services (CMS) implemented between 2011 and 2013 to see whether CMS was successful in preventing SNFs from increasingly billing for the highest therapy level even though beneficiary characteristics remain largely unchanged.
- Questionable billing patterns for Part B services during nursing home stays: OIG will review whether SNFs are providing excessive services and billing Part B for residents not in a Part A stay.
- State agency verification of deficiency corrections: OIG will determine whether state survey agencies verify correction plans for deficiencies. CMS requires state survey agencies to verify the correction of identified deficiencies through onsite reviews or by obtaining other evidence of correction.
- Program for national background checks for long-term-care employees: OIG will review the procedures implemented by participating states for long-term-care facilities or providers to conduct background checks on prospective employees and providers who would have direct access to patients and determine the costs of conducting background checks. OIG will determine the outcomes of the states’ programs and determine whether the programs led to any unintended consequences.
- Hospitalizations of nursing home residents for manageable and preventable conditions: OIG will determine the extent to which Medicare beneficiaries residing in nursing homes are hospitalized as a result of conditions thought to be manageable or preventable in the nursing home setting.
Does your facility have the security of a proven EMR solutions partner to insure the highest degree of protection from inaccurate reporting or are you still doing your MDS reporting the old fashioned way with hand written notes and paper forms? There will be even more scrutiny by teams of surveyors next year!
If you do already employ an EMR, does it give you the benefit of the innovative thinking that produced:
- The MDS Worksheet: Protecting you against Provider Liability Days.
- The most comprehensive and easy to use ADL documentation for CNAs with Touch Screen Kiosks
- Automated MDS Scheduler and CAAs
- Real Time 672s and 802s
These are all innovations from Optimus EMR. The future is here and now! Are you ready for it? Contact us today to learn more about how Optimus EMR can benefit your organization.