Providers brace for impact on their overall Five Star ratings with the July 2022 refresh. CMS released the Five-Star Technical Users Guide (available to download here), detailing changes to staffing rating and overall quality rating methodologies. Staffing and retention now have a greater influence on a provider’s ability to achieve a 1 Star gain in … Continue reading
The Centers for Medicare and Medicaid Services (CMS) releases several updates to surveyors; changes will impact providers’ compliance this fall (10/24/22). Revisions from the CMS Memo (QSO-22-19-NH) include: Modifications to guidance surveyors use to identify noncompliance in key areas. Revisions to Complaint and Facility Reported Incidents (FRIs) in Chapter 5 of the State Operations Manual, … Continue reading
Today [July 1, 2022], Connecticut LTC Providers enter a new phase of the case mix system rollout, which puts limits on case mix rate financial gains (maximum $6.50/day) . Are you capturing the right data to optimize your Medicaid revenue for future payments? Celtic assists clients to identify opportunities to enhance case mix system processes. … Continue reading
Connecticut Providers- Are your CMI weights what you anticipated? Final Resident Roster reports are available to retrieve from the Myers and Stauffer portal. This Final Resident Roster Report determines CMI rates for payment dates 7/1-9/30/22. Celtic assists clients to identify opportunities to enhance case mix system processes. We’ve helped our clients improve capture of CMI … Continue reading
Celtic Goes to Capitol Hill– Delivers strategies to improve the current care crisis in skilled nursing and plans to prepare for future staffing needs. Maureen McCarthy, President/CEO and William McCarthy, CFO met with Joe Courtney, top aides for Richard Blumenthal, John Larson and Jim Himes, as well as others, to discuss solutions that would immediately … Continue reading
Unjustified payment denials and lowered rates, add insult to injury for providers with Managed Care beneficiaries. Maureen McCarthy, President and CEO of Celtic Consulting, spoke with McKnights Long-Term Care News about the uneven playing field skilled nursing providers are forced to contend with. Read the full article here. Would you like to learn where to verify … Continue reading
Reminder: On claims, not entering your patient’s name as displayed on their Medicare card puts you at risk to have claims returned as unprocessable. Some patient’s Medicare cards don’t display their full name due to a character limit. You are required to enter the patient’s last name, first name, and middle initial, if any, as … Continue reading
Cut-off to submit corrected MDSs for the Final Resident Roster Report is 5/15/22. Data included in this Final Resident Roster Report will determine CMI rates for payment dates 7/1-9/30/22. Use this time to verify that your MDS assessments captured the most accurate CMI for resident care. Celtic assists clients to implement best practices and have … Continue reading
You have until 5/15/22 to submit corrections. Are you capturing the most accurate CMI for resident care? Celtic supports our clients by identifying opportunities to optimize Case Mix system processes through analysis, targeted education and mentorship. Let’s discuss options to achieve your goals in the new system… Continue reading
Providers can view the data refresh on Care Compare and Provider Data Catalog. This refresh is based on quality assessment data submitted by Skilled Nursing Facilities (SNFs) to CMS from Q3 2020 – Q2 2021. Important to note, data for claims-based measure will continue to display data from Q4 2017 – Q3 2019 for this … Continue reading