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Long-Term Care Nurse Fired for Not Falsifying Documentation

Nurse.com

A long-term care nurse shared that her facility was accused of negligence in failing to use bed rails properly to prevent residents from falling out of bed. . The RN did the assessment and documented her results. The administrator had another RN change the documentation done initially by the RN in question.

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Medicare Claims for Unrelated Services Put Hospices at Risk

Hospice News

Medicare claims for unrelated services creates serious financial and legal risks for hospice providers — even if they are not the ones who sent the bill. During recent years, payouts for non-hospice services provided to Medicare beneficiaries have tipped into the billions. Centers for Medicare & Medicaid Services (CMS).

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Regulatory Focus in Hospice Giving Buyers Pause in M&A Deals

Hospice News

A leading cause of fraud involves hospices billing Medicare for services for which patients were not eligible, according to a 2021 report from Bass, Berry, & Sims. Some hospices have already begun seeing penalties from a rise in UPIC audit activity, including reimbursement suspensions or Medicare claim repayments.

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Achieving Person-Centered Care in Hospice: Keys and Best Practices

Hospice News

Person-centered care is becoming increasingly important in all care settings, as the Centers for Medicare and Medicaid Services continues to prioritize value-based care and individual care outcomes. What is person-centered care?

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Avoiding the Pitfalls of Involuntary Nursing Home Discharges/Transfers in Missouri

Healthcare Law Insights blog

Many long-term care residents live in Missouri nursing homes for years. What documentation is required before sending the notice of discharge? If a facility determines that it must involuntarily discharge a resident, the facility must first determine the level of documentation required. 19 CSR 30-82.050(2)(A)-(F).

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Final pay rule and rates: A primer for rehab professionals

Rehab Realities by Renee Kinder

The October 2019 industry shift to the Patient Driven Payment Model allowed all rehabilitation professionals the opportunity to document specific clinical characteristics about the patients we serve and directly tie those areas to reimbursement. Renee Kinder. Quite the shift, right? Knowledge is key here. Let’s begin with some basics on PDPM.

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Ready, set, review!

Rehab Realities by Renee Kinder

Since the initiation of PDPM in October of 2019, providers have been long awaiting medical review to assess the accuracy of interdisciplinary team documentation. The CR is an attempt to increase comprehension of correct billing practices under the PDPM by all SNF providers that bill Medicare. What do rehab teams need to know?