Regulatory Reminder! Final MDS 3.0 v1.18.11 and Draft RAI Manual v1.18.11 Released

CMS promised a final version of the MDS 3.0 v1.18.11 data set and a Draft version of the RAI manual on or around April 1, 2023, and they have delivered. This morning CMS posted both in the downloads section of the MDS 3.0 website. The final MDS zip file contains 11 unique data sets and…...

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Regulatory Reminders: IQIES and the RAI Manual

Here are a few reminders IQIES IQIES: It’s official. The transition from QIES to IQIES will occur on April 17th. That means that as of that date, providers will no longer be able to submit MDS assessments through the current QIES system. If you have not prepared, NOW is the time. On the CMS LTC…...

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Regulatory Reminder: Unwinding the PHE

Well, the time has come for us to fully consider what the end of the COVID-19 PHE will mean. In other words, we need to ask ourselves, “how will I function differently as an operator on May 12th than I did on May 11th?”. The answer lies in how deeply the flexibility and waivers offered…...

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North Carolina Medicaid – Insiders Detail

Yesterday I blogged all about North Carolina Medicaid. You can read that blog here. I thought Insiders might appreciate some detail I left out of the public article. COVID-19 Add-On I made this statement: The average skilled nursing facility could see a reduction of $137,402.60 per quarter. Me ~ Less than 24 hours ago. You…...

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Regulatory Reminders: The True End of the PHE

Now that the dust has settled related to the president’s surprise announcement last Friday, that the COVID-19 PHE will end on May 11, 2023, CMS released official word supporting the president’s declaration. CMS released two important documents that detail the road map to the end of the PHE. The first was a Letter to U.S.…...

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Regulatory Reminders: The End of the PHE?

I am writing this reminder with some hesitation. On January 30, 2023, the Biden-Harris Administration announced its intent to end the national emergency and public health emergency (PHE) declarations related to the COVID-19 pandemic on May 11, 2023. Note that there has yet to be an official announcement from CMS or DHS. However, the current…...

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√ Reflections: ABNs and NOMNCs: What, Why, How and When

The ABNs and NOMNCs: What, Why, How and When? Notices of non-coverage in the SNF can be confusing and this can cause providers are not compliant. This presentation will untangle CMS guidance and regulatory requirements to help providers become more proficient at notifying beneficiaries of non-coverage issues specifically related to the SNF ABN, CMS-R-131, NOMNC…...

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Med A Census Navigator™ Update!

Oh man, it’s been a LONG time since I posted something on here. It feels good to be back. Today, we’re announcing an update to Med A Census Navigator! It’s a pretty big update too. DRG Codes are here! Based on lots of feedback, we heard that you’d like to be able to see the…...

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Regulatory Reminders: BFCC-QIO Announcement

It really is starting off to be a busy regulatory year and we’re trying to keep up. As you may be aware, in February, our Broad River Rehab Reflections topic will be Notices of Non-Coverage. And it could not be more timely. On Friday I learned of a significant announcement made by both Beneficiary and…...

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Regulatory Reminder! Inappropriate Schizophrenia Diagnosis/Coding and Survey Citation Posting

It’s a new year and CMS has not wasted any time in making clear their efforts to stem the tide of what they perceive to be inappropriate diagnosing and coding of Schizophrenia. There are going to be some pretty significant adjustments to the 5-star rating system and Care Compare posting of survey citations under dispute.…...

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