Impacting the MDS: New Strategies for Assessment, Reimbursement & Survey Results – Daniel Laffery

$85.00

6 Hours 07 Minutes

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.

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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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