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Talino

Talino

ER CCU MICU SICU LTC/SNF
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Talino specializes in ER CCU MICU SICU LTC/SNF.

don't bother, 'am boring

Talino's Latest Activity

  1. Talino

    Managed Medicare and HIPPS code

    Although the HIPPS code is required, most Medicare Advantage plans pay by levels or a pre-contracted rate. If this is the case, Copy the Adm MDS and code it as a 5-Day. Set the ARD the same as the Adm but no later than day 8. Complete all items not included in the Adm item set. Dash-fill Section GG or select not assessed, whichever your software requires. If there is no recent MDS to copy or a resident goes out to the hospital and returns under the MA plan, create a standalone 5-Day or even IPA. Both assm’ts will yield the HIPPS. Again dash-fill Section GG. If the MA plan does pay according to the HIPPS code (I don’t know of one that really pays the full HIPPS rate) then you will have to complete Section GG. As usual, do not submit these MDSs.
  2. Talino

    ST wanting to do BIM's

    True, it is widely endorsed, which aligns the tasks with ST’s role in capturing the SLP component. We may all agree the task can be conducted by whomever with the skills (Nurse, OT, ST, or SW). However, there are some factors that should be considered to maximize revenue: A resident admitted on Friday night may not always be evaluated by the SLP until Monday. Considering a new environment, deconditioning post hospitalization / recuperating from a condition, BIMS conducted immediately upon admission may differ 2-3 days later when resident has acclimated. “Sundowners” BIMS in am may not be the same in pm. That said, it’s not really a matter of who conducts the BIMS but when. Let us not, however, confuse this as a misrepresentation of the resident’s cognitive abilities for care delivery.
  3. Talino

    Flu vaccine

    Humbly request she sign the particular Section/Item only based on her interpretation. You simply sign the completion of the assessment. YOU are a true MDS coordinator abiding by the guidelines stated in the RAI.
  4. Hi- I'm unable to send a Private message.. not sure why. I was wondering if I could have the password for the GG trackers

    1. Talino

      Talino

      Password - loveanurse

    2. GenaP

      GenaP

      Thank you!!

  5. Talino

    Section GG Tracker

    Need a password to open, send a pm SECTION GG - ADMISSION.pdf SECTION GG - DISCHARGE.pdf
  6. Talino

    Flu vaccine

    "None of the above" would be the logical answer. But not to repudiate the DON, notify her you'll seek guidance from the state RAI coordinator.
  7. Talino

    Happy PDPM Eve

    A toast, one IPA to you. We'll drink the rest, cheers!
  8. Talino

    PDPM Admission

    Just to add to ... Admissions on or after October 1st, Admission and 5-day may be combined. Admissions prior to October 1st, during the last week of September, combining the 5-day and Adm is a bit tricky. Just remember, the OBRA Adm still has up to 14 days to be completed. Med A admission during the last week of September must have an ARD no later than 9/30. Example: If resident is admitted on 9/28, your 5D ARD should be no later than 9/30. Hence it would be unwise to combine the OBRA Admission with a very short look back period. Not To Forget: All currently Med A residents admitted prior to October 1st with benefits extending after September 30, require the IPA with ARD set no later than October 7. Example: Resident admitted on 9/28 need a 5-day with ARD no later than Sept. 30. He will also need the IPA w/ ARD set between Oct 1-7. Medicare Advantage: Do not combine the Adm and 5D. The 5D for medicare advantage are not to be submitted. Most MAO only need the HIPPS (Z0100A) yielded by OBRA Adm so a standalone 5D may not be necessary. You should ask the MA carrier if they will be following the new PDPM scheduling or still rely on the prior - 14, 30, 60, etc. If they do, does your software still allow the creation of theses types of PPS assm't on or after October 1st.
  9. Talino

    UTI timeline

    Yes, the medical treatment is still present...
  10. Talino

    How does Hospice affect CMI score

    You may want to direct the inquiry here for your state's case mix reimbursement contact.
  11. Talino

    How does Hospice affect CMI score

    Medicaid hospice reimbursement may be state-specific. When you code O0100K: Hospice care, the state may exclude or include the resident from the case mix, or adjust the rate.
  12. Talino

    hospital observation stay

    Code 03 does not distinguish inpatient and observation stay in a hospital. It is used primarily for demographic tracking to assist in care planning, not reimbursement. But if you have a more specific reference to clarify the RAI, please share. We may be deviating from original poster’s question. When in doubt, contact your state RAI Coordinator.
  13. Talino

    hospital observation stay

    Individual facilities may designate this type of admission as they wished. In the MDS world, we abide by a more stringent regulation ... RAI, pp A-24, A-25
  14. Talino

    hospital observation stay

    Considering duration of stay, regardless of statuts, hospital.
  15. Talino

    GG/discharge functional performance

    SNF QRP User's Manual from p47
  16. Talino

    Facility just starting MDS

    1. Assumably a case mix state's requirement to determine scores for medicaid funding or a requirement prior to certification. 2. Unless this is a precertification requirement, with which assessments are not submitted to the QIES, but are required to demonstrate compliance, all 80 residents will start with a comprehensive assessment (like a new admission) with completion no later than 14 days adhering to the OBRA guideline. It is best to contact the state's RAI Coordinator.
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