Providers brace for schizophrenia MDS audits; potential for Five-Star rating downgrades and Quality Measure (QM) rating suppression penalties. CMS released memo QSO-23-05-NH, addressing QM ratings based on erroneous schizophrenia coding and processes for posting citations under dispute.CMS has identified a trend of MDS coding residents as having schizophrenia, without supportive documentation. The Five-Star QM percentage … Continue reading
Beginning next week, Kepro appeal notification process changes for post-acute care providers in 29 states. On 1/17/23, post-acute care facilities and Medicare health plans will receive notifications when a new appeal has been filed by FAX ONLY and will no longer receive phone calls for appeal notifications. Notifications will be faxed to the number used … Continue reading
Connecticut Providers- Did your Case Mix index (CMI) averages hit the mark? Final Time Weighted Case Mix Index Resident Roster Reports are available to retrieve from the Myers and Stauffer portal. Celtic assists clients to identify opportunities to enhance case mix system processes. Let’s discuss options to improve capture of CMI data and increase CMI … Continue reading
SNF VBP Quarterly Repots released; providers have a short window to submit corrections that will impact FY 2024 incentive payments. December 2022 Quarterly Confidential Feedback Reports for FY 2024 SNF VBP program are available now in QIES/CASPER. The reports released 12/1/2022 include SNF 30-Day All-Cause Readmission Measure (SNFRM) results for FY 2019, which will be … Continue reading
CT Providers- MDS transmissions due by 11/15/22 for Final Resident Roster Reports. Cut-off to submit corrected MDSs for the Final Resident Roster Report is tomorrow (11/15/22). Take this opportunity to ensure your MDS assessments captured the most accurate CMI for resident care to optimize Medicaid revenue for future payments. Celtic supports our clients by identifying … Continue reading
CT Providers- Preliminary Resident Roster reports are available to retrieve from the Myers and Stauffer portal. You have until 11/15/22 to submit corrections. Are you capturing optimal CMI data? Celtic supports our clients by identifying opportunities to enhance case mix system processes through analysis, targeted education and mentorship. We’ve helped clients in multiple states improve … Continue reading
With new data included, SNFs preview their outcomes for January 2023 refresh. If a provider disagrees with the quality measure results displayed in Preview Reports, they can request CMS review data used. Cutoff to view reports and request review is November 14th. Data within preview reports includes: Quality assessment data submitted for Q2 2021-Q1 2022 … Continue reading
Effective October 13, 2022, the U.S. Department of Health and Human Services renewed the PHE determination for 90 days. This renewal means 3-Day Qualifying Stay and Benefit Period Waivers have been extended through January 12, 2023. To prepare for post-pay audits, providers should ensure supportive documentation is captured when using available SNF 1135 waivers. Celtic … Continue reading
Connecticut Providers- Three days remain to submit assessments to be included in Preliminary Case Mix Roster reports. All MDS assessments must be submitted and accepted by 11:59pm on Saturday, October 15th to be included in the Preliminary Time-Weighted Case Mix Index Resident Roster reports. Celtic assists clients to identify opportunities to enhance case mix system … Continue reading
The Centers for Medicare and Medicaid Services (CMS) announced it will issue another round of updates to QM point thresholds in October, keeping with its plan (QSO-19-08-NH) to increase thresholds every six months. Updates resumed in April 2022 after being on hold due to the pandemic. Increased point requirements will make it more challenging to … Continue reading