Resident Transfer and Discharge Requirements
With the implementation of MDS 3.0 the discharge planning process for residents was recharged and clarified effectively in Section Q. The increased volume of communication systems for long term care discharges have been challenged as well.. Recently however new questions have been raised for the purpose of resident protection afforded to residents going through the involuntary transfer or discharge process in the nursing home. To ensure compliance with the involuntary transfer or discharge a review of the regulatory specifics may assist you. The highlight specifics of the federal requirements for transfer and discharge in the nursing home are included but are not limited to this blog:
F201 42 CFR §483.12(a)(2) Transfer and Discharge Requirements defines resident welfare, unable to meet needs, resident health has improved, or safety or welfare of others would be endangered, resident fails to pay or facility ceases to operate.
F203 42 CFR §483.12(a)(4) Notice before Transfer details notification requirements, reasons recorded in the clinical record and completion of the items and timing as required of the facility. The facility must provide the resident and /or legal decision-maker with written notice when a decision has been made to involuntarily discharge the resident from the facility at least 30 days before the resident is transferred or discharged. The notice may be made as soon as practicable when specific criteria are met including: endangerment, health improvement, urgent medical needs present or resident resided in facility for less than 30 days.
42 CFR §483.12(a)(6) Specifics for the Content of the notice must include: the reason, date, location to which the resident is transferred or discharged; statement of right to appeal the action to the State, name, address and telephone number of the State long term care ombudsman or DD Part C contact, and the resident right to appeal the discharge decision must be made by the facility.
It would be recommended that a search of additional State specific criteria be reviewed to assure both Federal and State compliance. At minimum the State requirements include the facility providing the resident or legal representative with contact information such as a long-term care Ombudsman or advocacy organization as possible before issuing the notice to assist the resident in resolving any issue that led up to the discharge decision.
CBRF – WI State Approved Training – Standard Precautions
When: Wednesday, March 9, 2011
Time: 9:00 AM – 12:00 (NOON)
Where: Boyer & Associates, LLC
16655W. Bluemound Rd. Ste. 280
Brookfield, WI 53005
RSVP: (Seats are limited) Lori Yaklovich, Education Coordinator
262-754-0525 office
lyaklovich@boyerandassociates.com
Presenter: Lyn Backhaus, WI State approved trainer for CBRF’s
Cost: (INTRODUCTORY PRICE) $50.00
PLUS
$25.00 State of WI Registry fee
Valentines Special!
Send us your RUGs IV days from October 1, 2010 to December 31, 2010 and we will complete a quick analysis on your RUG levels. We will provide you with a summation of your results and discuss with you any additional suggestions we have to help you maintain adequate reimbursement.
Don’t wait until you see your reimbursement fall to evaluate your results.
Breaking News…this just in!
Congress finally took action this week and recinded the delay in the RUGs IV implementation. What does that mean for you? Pending the Presidents signature (which we’re told won’t be a problem) the RUG level you are billing for and the payment you are receiving is the correct payment. There will be no adjustments in April or May. That is good news for everyone.
In addition to the RUGs IV implementation, passing this law also extended the Therapy Caps exceptions for another year. So, you can continue providing services for Part B residents as you have.
One more piece of good news from CMS. During the Open Door forum held on Thursday the 9th, Tom Dudley announced as change in policy. From Iara Woody at AAHSA…. During yesterday’s SNF Open Door Forum, Tom Dudley from CMS clarified directions outlined in the “MDS 2.0 to MDS 3.0 Transition Document” dated October 2010 for coding of item A0310E. The original guidance indicated that the coding for that item should have been coded as “1” for the initial MDS assessments for all existing residents. During the last Open Door Forum in November, CMS had instructed facilities who coded a “0” on that item to submit a corrected assessment. Because CMS noticed that many facilities missed this item on many of the assessments, CMS decided to reconsider the need for facilities to submit corrections assessment. For assessments submitted during the transition period, CMS has decided that facilities DO NOT need to submit corrected assessments if they miscoded item A0310E. Moving forward, CMS asked that all facilities follow the directions in Chapter 3, Section A of the RAI Manual. The transition documents available on the CMS Web site will be updated to reflect this change.
Billing Webinar
Calling all billers! This is a webinar you don’t want to miss!
Billing for the MDS 3.0, December 21, 2010 from 1pm to 3pm central time zone. The cost of this webinar is $250/site. Check it out! Go to:
http://boyerandassociates.webex.com to register for this webinar.
Please email any questions beforehand to
pboyer@boyerandassociates.com so that she can make sure she addresses all questions during the webinar.
Wishing a Happy Thanksgiving
Boyer & Associates, LLC would like to wish everyone a great Thanksgiving Holiday, this is the time to spend with family and be thankful what you have.
Billing Webinar
October 25, 2010 @ 1:00 PM to 3:00 PM for a 2 hour billing webinar. The cost is $250/computer. You can have as many as you want on the webinar as you can get on a computer. At the completion of this webinar you will be able to: Identify how to bill the RUGs III level for September 2010, determine how to transition to the RUG IV system in October, and discuss transition billing so that all billable days are covered.
MDS 3.0 and RUGs IV Training – Filling up!
Secure your spot now, the space is becoming limited. We are filling up quick! We have 5 seats left for the September 14, 2010 MDS 3.0 training and getting filled for the RUGs, but you still have time, contact lyaklovich@boyerandassociates.com to secure your spot at our office:
16655W. Bluemound Rd. Ste. 280
Brookfield, WI 53005
MDS 3.0 – Section Z and CAAs for MDS Coordinators
When: September 17, 2010 from 1-3pm (CST)
Where: online at http://boyerandassociates.webex.com
To Register: If you would prefer to be invoiced please call, 262.754.0525 or email
lyaklovich@boyerandassociates.com
Cost: $199.00
CEU Credit: 2 contact hours of credit from Wisconsin Nurses Association
Presenter:
Summary:
| Discuss components of Section Z coding
Determine how to properly code dates in Section Z Identify the CAAs and how to “work” them |
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MDS Meeting of the Minds
When: September 28, 2010 from 8:30-10am (onsite only)
Where: Boyer & Associates, LLC in Brookfield, WI
Cost: Free!!
To Register: Call 262.754.0525 or email lyaklovich@boyerandassociates.com
Topic: Covering Section Z and CAAs along with other assessments.
