IMPACTING THE MDS: NEW STRATEGIES FOR ASSESSMENT, REIMBURSEMENT & SURVEY RESULTS – DANIEL LAFFERY
The MDS has become one the most important documents in long-term care. It not only is a key resident assessment tool, it drives your reimbursement, care plan, survey, 5 Star rating – and more! An interdisciplinary team who has a strong understanding of the RAI process can make your facility rise or fall. The MDS has evolved and requires more than just the basic understanding; it requires complex critical thinking skills and an understanding of the impact on each item coded.
Daniel Laffery, RN, RAC-CT, the presenter for this hard hitting, comprehensive day, will share new strategies to effectively deliver care that rises well above the standard. Topics will include:
- Documentation for Skilled Nursing Facilities: Evaluating for Gaps
- MDS Coding for Accuracy & Error Prevention
- The Importance of Timing and Scheduling for OBRA/PPS
- Billing and the MDS: What is Essential for YOU to Understand
- Strategies to Reduce Audit Recoveries
- Managing the RAI Process Requires an IDT Approach
- New Critical Thinking Skills for Individualized Resident Care Plans
- QI, QM and QAPI: Preparations for the Next Survey
OUTLINE
Pulling it All Together: Key Documentation Required for SNFs
- Different approaches to comprehensive clinical documentation
- Components of documentation as it relates to the MDS specifically
- What about the “holes” in documentation?
- Strategies to evaluate current documentation practices for gaps
Coding of the MDS: Are You Confident in Your Assessments?
- Appropriate interpretation of the question
- Taking credit for the care delivered – across the interdisciplinary team
- How and when to conduct resident interviews
- The financial impact on reimbursement
- Key sections of the MDS: Demonstration of accurate (and inaccurate) coding
MDS Coding for OBRA and PPS
- Qualifying for a Medicare benefit
- Tips to manage the Medicare stay
- The most common MDS coding errors – and how to avoid them!
- The “normal” PPS schedule – as well as special circumstances
- Considerations when setting the ARD (timing/scheduling)
- Managing the OMBRA schedule – and the impact on reimbursement
Medicare Compliance: The Clinical and Billing Connection
- Calculation of RUGs from the MDS (accounting for acuity)
- HIPPS codes and the impact on payment dates
- How payment dates are determined based on MDS coding
- Implementation of a “Triple Check Process” prior to submission of the UB04
- Strategies to reduce audit recoveries
Managing the RAI Process Requires an Interdisciplinary Approach
- Do you really understand how CATs are triggered?
- Determine root cause of a CAT
- The components of a CAA – and how it links to the care plan
Individualized Care Plans: Achieve the Goal of Person-Centered Care
- Best practice standards
- Learn how critical thinking can be applied to the assessments
- Methods to successfully link it all together:
- Person-Centered Care, Standards of Practice, Pay-for-Performance, Medicare, and Survey Results
Quality Measures/Quality Indicators: Use the Data to Improve Facility Operations and Delivery of Care
- Prepare yourself….the impact and role of QI/QM in the survey process
- Do you know how to validate the QI/QMs as compared to MDS coding?
- Your QAPI process: Incorporate the QI/QM results for improvement
OBJECTIVES
- Evaluate new strategies to manage the documentation required for Skilled Nursing Facilities.
- Practice coding of the Minimum Data Set (MDS) for key sections to avoid future errors.
- Demonstrate the essential considerations for OBRA and PPS timing and scheduling.
- Formulate new approaches to ensure compliance with Medicare intent and reduce audit recoveries.
- Manage the RAI process through an efficient, yet comprehensive, interdisciplinary approach.
- Design individualized resident care plans to incorporate unique interventions and approaches to care.
- Explain how Quality Measures/Quality Indicators can improve facility operations and delivery of care.
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