November 29, 2017
Volume I, Issue 4
In this edition:
-Breaking News
-Money Matters
-Coming Down the Pike
-Follow-up to October
-ACT Senior Living
    Consulting Services

The leaders and team members of ACT contributed to our communities during the past three months through fundraising efforts that benefited the following:   YWCA, Habitat for Humanity, St. Jude's, Hurricane Harvey Disaster Relief, and Boy Scouts of America.

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Breaking News

The Centers for Medicare & Medicaid Services (CMS) has published the new Long Term Care Survey Process (LTCSP) Procedure Guide. Effective November 28, 2017, this guide provides instruction on the procedure and software steps for all standard surveys for SNFs and NFs. The first eight to ten hours on-site will primarily be spent by surveyors on the "initial pool process." Residents who are selected off-site based on complaints or facility-reported incidents (FRI) or by MDS indicators will be interviewed, observed, and have a limited record review. Residents selected on-site for the initial pool will include a sample based on concerns identified from interview, observation, limited record review, and consideration of resident-specific data. The sample size will be based on the facility census and up to 70% of the expected sample will be based on MDS indicators. However, the ratio of residents identified for the sample may change once the surveyors are onsite. Dining observations will continue to be made on the first day of the survey. The 42 page procedure guide provides a broad overview of the key onsite survey steps, steps 3-7.

Money Matters

Therapy Cap Values for the Calendar Year (CY) 2018 have been released and published in the CMS Manual System Medicare Claims Processing Publication transmittal 3918, dated November 9, 2017. This transmittal replaces 3886 that was dated October 20, 2017. The caps are for Outpatient therapy, including Part B therapy services. The therapy caps for CY 2018 will be $2,010 for physical therapy and speech-language pathology combined and $2,010 for occupational therapy.

Coming Down the Pike

The Medicare Learning Network is holding a National Partnership to Improve Dementia Care and Quality Assurance Performance Improvement (QAPI) Call on December 14th from 1:30 p.m. to 3:00 p.m. The call will address working with physicians to ensure compliance with new psychotropic medication prescribing requirements and putting the new QAPI requirements into practice. There will be a question and answer session following the presentations. Registration is required to participate.

Follow-up to October

CMS published a revised MDS Manual Appendix B on October 26, 2017. The document includes updated contact information for the State RAI Coordinators, the RAI Coordinator Panel, the State MDS Automation Coordinators, and the Regional Office RAI Contacts.

  ACT Senior Living Consulting Services

The seasoned consultants with ACT's Senior Living Consulting team evaluate reimbursement practices by conducting a thorough review of the RAI process, determining whether documentation practices support the care and services being provided. We can help you identify opportunities for improving coding practices and staff documentation.

Contact us by email to determine how we can meet your needs, email us at 

Stay up-to-date with important news by accessing this newsletter and more in the Knowledge Center on our ACT website!