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

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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.