The Centers for Medicare and Medicaid Services (CMS) has released the Fiscal Year 2020 final rule for the Prospective Payment System (PPS) and Consolidated Billing for Skilled Nursing Facilities (SNF). This final rule finalizes the new payment system, Patient Driven Payment Model (PDPM), that goes into effect with dates of service on and after October 1, 2019. In addition, the final rule revises the definition of group therapy under the SNF PPS and updates requirements for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Purchasing (VBP) Program. To access the final rule, click HERE. In addition, Gawenda Seminars

Due to a recent finding by the Office of the Inspector General (OIG) finding that the Medicare program improperly paid for Skilled Nursing Facility (SNF) services when the Medicare 3-Day inpatient hospital stay requirement was not met, the Centers for Medicare and Medicaid Services (CMS) has developed a Fact Sheet to explain the SNF 3-day rule billing as well as several other resources. To access the Fact Sheet and additional resources, click HERE.

The Centers for Medicare and Medicaid Services (CMS) has released the Skilled Nursing Facility (SNF) fiscal year (FY) 2020 proposed rule. CMS has published a fact sheet that highlights 3 major provisions of the proposed rule that are: The proposed changes to SNF payment policy under the SNF Prospective Payment System (PPS) The SNF Value-Based Purchasing Program (VBP) The SNF Quality Reporting Program (QRP) In FY 2020, CMS expects payments to SNF’s to increase by 2.5% compared to FY 2019. CMS is proposing to change the definition of group therapy in the SNF Part A setting to align with the

Wisconsin Physician Services (WPS) has several webinars upcoming for the skilled nursing facility (SNF setting. Upcoming webinars include, but are not limited to: SNF Coverage Requirements & Admission Procedures SNF Billing Basics, Adjustments, & Cancellations SNF Benefits Exhaust & No-Pay Billing SNF Billing Beyond the Basics SNF Consolidated Billing (Part 1) SNF Consolidated Billing (Part 2) For detailed information on each webinar and to register, click HERE.

Do you work in a skilled nursing facility (SNF) or a Swing Bed organization. Are you in a management role in a SNF or Swing Bed organization? Do you know how to find the latest news, references and manuals, training, and FAQs applicable to the SNF and Swing Bed settings? If you answered yes to one or both of the first 2 questions and no to the last question, this article will help you immensely. This article will provide links to the latest news impacting the SNF and Swing Bed settings, references and manuals pertaining to MDS 3.0 Provider User’s

The Centers for Medicare and Medicaid Services (CMS) has released updated skilled nursing facility (SNF) provider feedback reports. The data contained within the Preview Reports is based on quality data submitted by SNFs during the following quarterly timeframes: Quarter 3 – 2017 to Quarter 2 – 2018 data Application of Percent of Residents Experiencing One or More Falls with Major Injury (Long Stay) (#0674) Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (Short Stay) (NQF #0678) Application of Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan That

Wisconsin Physician Services will be providing 8 webinars focused on the Skilled Nursing Facility setting. The webinar series begins on April 11, 2019 and concludes on November 14, 2019. To view each webinar topic, description, objectives and to register, click HERE.

The Centers for Medicare and Medicaid Services (CMS) has released an updated transmittal providing instructions when a skilled nursing facility (SNF) should and should not issue an advance beneficiary notice of non-coverage (ABN) to a Medicare beneficiary. To read the SNF ABN instructions of when to and when not to issue a SNF ABN, ABN specific delivery issues, special rules for SNF ABN’s, establishing when beneficiary Is on notice of non-coverage, and sources of beneficiary notification, click