Every year, the National Rehabilitation Awareness Foundation designates the 3rd week in September to educate people about the benefits and impact of rehabilitation. Physical Therapists, Occupational Therapists, and Speech-Language Pathologists all work together to help individuals overcome obstacles and accomplish normal tasks of daily living. Here is a little bit about each therapy discipline: Read more
While Americans are living longer than ever before, it’s a wide known fact that women typically live longer than men. However, according to healthinaging.org, “by taking care of themselves, experts agree, men can boost their odds of living healthier, longer lives.” Read more
Jimmo v. Sebelius – Medicare Lawsuit Summary
Jimmo V. Sebelius is a court case we have all been hearing about and reading about on the internet regarding quality of life. The case involved Medicare beneficiaries and The Center for Medicare Advocacy (non-for-profit) who filed a lawsuit regarding what they have termed the improvement standard by which Medicare beneficiaries who could benefit from services were denied services because they could not make enough progress. The Medicare regulations never held such language as the improvement standard; this was a general guideline that developed with increasing medical review of Medicare claims. Eventually, this standard was stated outright in claim denials for services such as therapy. The lack of progress was typically used to substantiate that the services were not medically necessary or worthwhile. Read more
The U.S. Food and Drug Administration (FDA) released Consumer Guidance regarding portable bed rails safety and tips for caretakers on December 19, 2013. The recommendations were released because of the continuing injuries and deaths related to entrapment and falls associated with bed rail products. Overall, there is no standard definition for bed rails but they are typically divided into three distinct types: adult portable bed rails, child portable bed rails, and hospital bed rails. Adult portable bed rails are different from hospital beds, which feature a unified system of mattress, frame, and rails. Read more
CMS has issued a memo, MM8268, stating that MACs are to redact the HICN number on all MRNs. MRNs are reconsideration request forms. The HICN will only show partial with asterisks in front, similar to what some credit card companies do when sending you a statement. This is to begin January 1, 2014.
See link below:
http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R1296OTN.pdf
This is an update to the issue identified where some SNF claims (type of bill 21x) were being cancelled erroneously for not meeting the three day qualifying hospital stay requirement when in fact the requirement was met. After further analysis by the Common Working File (CWF), it was determined that this only impacted SNF claims where the inpatient claim (type of bill 11x) posted on CWF contained dates of service less then four calendar days and the discharge date was equal to the SNF claim admission date. Read more
The Five Star rating system, upgraded in 2009, combined with increases in online rating systems that the consumer relies on to make decisions, has definitely made a splash in long term care. The Five-Star Rating system has somewhat changed the way we choose communities for our loved ones. Consumer behavior still supports word of mouth references, geographic proximity and appearances certainly are very important when choosing a community; however, many hospital case managers and area agencies are looking for those 5 little stars. Increased need for Five-Stars has also impacted who our hospitals choose to partner with for health services. Let’s face it…even though this rating system doesn’t truly define you, it can make or break you. Read more
The CDC has been tracking a resistant bacteria call carbapenem-resistant Enterobacteriaceae or CRE since 2001. This bacterium causes infections that are resistant to antibiotics and have affected people who are in or recently had inpatient medical care. CRE has affected 4% of short-stay hospitals and 18% of long-term acute care hospitals all having at least one case of CRE. Read more
Jimmo V. Sebelius is a court case we have all been hearing about and reading about on the internet. The case involved Medicare beneficiaries and The Center for Medicare Advocacy (non-for-profit) who filed a lawsuit regarding what they have termed the improvement standard by which Medicare beneficiaries who could benefit from services were denied services because they could not make enough progress. Read more
Multiple Procedures Payment Reduction [MPPR]: What You Need to Know Read more
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