Simplify Success
Falls are a major source of morbidity and mortality in the LTC population as well as a major cost to the federal reimbursement systems. As a result, the long and Short stay falls with major injury quality measures are changing to include claims data. This presentation will give a high level overview of the impending…...
PDPM is complex and mastering the 5 payment categories in this grouper is a must. The nursing category contains an array of clinical data that identifies the resident’s unique needs from a reimbursement and quality perspective. Getting this category right will ensure proper payment for both Medicare and, in many states, Medicaid, proper representation of…...
Antipsychotics are in CMS’ crosshairs. The long stay quality measure has been revised to include claims data and managing antipsychotic use has become a significant challenge. This presentation will cover a high level review of these measures that will invite further conversation for your facility staff to engage and manage these important metrics. Download course…...
The SNF Quality Reporting Program and the SNF Value Based Purchasing Program are both driven by quality measures. These two programs have financial incentives to not only report the data for these measures accurately but to show improvement as well. How facilities manage their quality measures has a significant impact on the outcomes they will…...
Spring is here, and CMS has released the FY 2026 proposed rule. Much is anticipated about what CMS has up its sleeve for the new year. In this presentation BRR will unpack the CMS proposals related to the payment rates, wage index, the PDPM, SNF QRP and SNF VBP programs and ICD-10 mapping revisions. Download…...
Quality Measures are a major driver of a provider’s 5-star rating. Understanding how these measures affect the 5-star rating and how strategic approaches to QM management can ensure a QM rating that reflects your facility’s quality improvement efforts is an essential skill. This presentation aims to help providers understand the QM effect on the 5-star…...
Traditionally, the PDPM nursing category has been underutilized in its representation of resident unique characteristics. With the elimination of section G in MDS 3.0 v1.18.11 in October 2023, states are moving away from RUG based case mix index rate adjustments to PDPM based systems that generally incorporate only the PDPM nursing category in that calculation.…...
Quality Measure Definitions can be confusing. Each of the technical specifications relies heavily on a working knowledge of basic quality measure construction. This presentation aims to unravel the tangle of definitions in chapter 1 of the Quality Measures User’s guide and applies them to example technical specifications. Participants will come away with a working knowledge…...
...
The Long-stay antipsychotic quality measure has been revised. It is essentially a new quality measuring antipsychotic use among the long stay that will rely on MDS and claims data to not only record antipsychotic use but verify excluding diagnose like schizophrenia as well. The 5-star ratings on Care Compare will be updated in January ’26…...