Our Toolbox contains information for Members. Use as much of the information as you need…
Organize your department….Train your staff…
Why reinvent the wheel?
Manuals:
- Explanation of Manual Set Up and Content
- Medicare Part A Rules :
- Medicare Part B Rules (SNF, Hospital Outpatient)
- State Operations Manual
- RAI Manual
- Final RAI Manual for October 2018 – Released August 2018
- Final RAI Manual for October 2017 Released August 2017
- New Manual Pages (439 total)
- New Item Sets: Comp | Non-Comp | PPS
- What’s New?
- RAI Manual for October 2016 Released 8/25/16
- 8/10/16 CMS posted the new MDS 3.0 item sets (assessment forms) v1.14.1. These will go into effect 10/1/16.
- *Draft RAI Manual for October 2016 Release
- MDS 3.0 Manual (Updated 10/2015)
- Replacement Manual Pages (Updated 10/2015)
- ICD-10-CM Tabular List of Disease and Injury from CMS.gov
- ICD-10-CM Index List of Disease and Injury from CMS.gov
- ICD-10 Code Look-up Tool from CMS.gov
- Link to AHIMA ICD-10-CM Coding Guidance for SNF’s
- SNF Quality Measures Manual 2017
- SNF Quality Reporting Users Manual 2017
MDS 3.0 Resources:
- **MDS Changes for Oct 1 2018
- CMS Q&A Fact Sheet on 10/1/16 MDS Changes and QRP
- Section GG: Admission/DC Self Care & Mobility Data Collection Tool
- Section G Balance and ROM
- MDS 3.0 Forms: Quarterly, Comprehensive, PPS, SOT, OMRA, Discharge , Part A Discharge
- Section O Therapy Days and Minutes
- Section O: Restorative Nursing
- Respiratory Therapy MDS Audit Tool
- PPS MDS Short Stay Algorithm (Updated 10/2015)
- PPS MDS and Payment Schedule
- ADL Score Determination | Algorithm | Calculation
- PPS MDS COT Algorithm
- MDS Correction Algorithm
Reimbursement – Medicare Part A:
- 2019 SNF PPS Final Rule (FY 2019) Released 7/31/18
- *Includes Patient Driven Payment Model for 10/1/19
- 2019 SNF PPS Proposed Rule (FY 2019) Released 4/27/18
- New Part A Payment Model Proposed for 10/1/19 – Patient-Driven Payment Model
- 2018 SNF PPS Final Rule (FY 2018)
- **New 4/28/17 – Proposed SNF New Payment Model – No RUGS
- 2018 SNF PPS Proposed Rule (FY 2018)
- 2017 SNF PPS Final Rule (FY 2017) PDF Version
- 2017 SNF PPS Proposed Rule (FY 2017)
- 2016 SNF PPS Final Rule (FY 2016)
- 2016 SNF PPS RUG IV Rates
- 2016 SNF Proposed Rule
- 2015 SNF PPS RUG IV Rates
- 2015 SNF PPS Final Rule (FY 2015)
- PPS MDS and Payment Schedule
- Advanced Beneficiary Notice:
- What is Skilled Therapy Fact Sheet
- SNF Billing Fact/Reference Sheet
- SNF Part A Certification and Recertification Requirements (for SNF stay)
- Therapy Schedule and Minute Tracker (sample)
- PPS 100 Day Tracker Sample 1 | Sample 2
- MDS Therapy Data Sheet
- Statistics and Report Forms
- ICD-10-CM Code List: LTC Therapy Most Common Codes (New 10/1/15)
- ICD9 Code List: LTC Therapy Most Commonly Used Medical Dx
- ICD9 Code List: LTC Therapy Most Commonly Used Treatment Dx
- CPT Codes for PT, OT and Speech
- Sample Billing Logs for PT, OT, Speech
- Medicare Part A Weekly Meeting Template
- PPS MDS COT Algorithm
- Med A Triple Check Worksheet
- Therapy Discharge Notice (3 Day Notice to Nursing)
Reimbursement – Medicare Advantage Managed Care / HMO:
- CMS Memo 7/1/14 Regarding Managed Medicare MDS HIPPS Codes
- CMS Memo 5/23/14 Update on MDS Requirments
- CMS Memo 12/4/14 Update on MDS HIPPS Codes
Reimbursement- Medicare Part B:
- Physician Fee Schedule
- Physician Fee Schedule LOOK UP TOOL
- 2018 Therapy Cap
- Med B Therapy Cap
- Med B Functional Limitation Reporting / G Codes
- Advanced Beneficiary Notice Forms CMS-R-131
- Statistics and Report Forms
- Proper use of Modifier 59
- ICD-10-CM Code List: LTC Therapy Most Common Codes (New 10/1/15)
- ICD9 Code List: LTC Therapy Most Commonly Used Medical Dx
- ICD9 Code List: LTC Therapy Most Commonly Used Treatment Dx
- CPT Codes for PT, OT, SLP *Updated with 2018 Changes
- **New CPT Therapy Evaluation Codes 1/1/17
- Med B Triple Check Worksheet
Clinical Information:
- Documentation:
- Fact Sheet: Requirements for Med A vs Med B
- Evaluation Templates (Medicare Compliant)
- PT | OT | Communication | Swallowing
- Progress Report Templates
- PT | OT | Communication | Swallowing
- Daily Treatment Encounter Note Templates
- PT | OT | Communication | Swallowing
- Dysphagia Plan of Care Template
- Home Evaluation Forms
- G-Codes
- Total Hip Replacement Precaution Sheet
- Objective Tests and Measures
- Maintenance Therapy Rules
- ICD-10-CM Code List: LTC Therapy Most Common Codes (New 10/1/15)
- ICD9 Code List: LTC Therapy Most Commonly Used Medical Dx
- ICD9 Code List: LTC Therapy Most Commonly Used Treatment Dx
- CPT Codes for PT, OT, SLP
- **New CPT Therapy Evaluation Codes 1/1/17
- What is Skilled Therapy Fact Sheet
- Skilled Therapy – Action Word Documentation List
- Lab Values: Norms for Geriatric Population
Compliance:
- Practice Act By State: PT, OT, Speech
- State Operations Manual
- Audit Tools for Documentation, Chart Review
- Sample ADR Response Appeal Letter Sample 1 | Sample 2
- Fact Sheet: Documentation Requirements for Med A vs Med B
- Contractures vs MDS Section G ROM
- What is Skilled Therapy: Fact Sheet
- APTA/AOTA/ASHA Consensus Statement on Clinical Judgment/Ethics
- CMS Targeted Probe and Educate (TPE) Audits (New August 2017)
Department Management:
- Medicare Part A / Discharge Planning Meeting Template
- Therapy Schedule and Minutes Tracker
- Billing and Tracking Forms: PT | OT | SLP
- Statistics and Report Forms
- Triple Check Meeting Forms Part A Part B
- Sample ADR Response Appeal Letter Sample 1 | Sample 2
State Survey Information:
- Census and Conditions Report
- QIS Survey Resources and Guides
- Complete list of F Tags
- Survey Preparation Tool for Therapy Staff
State Case Mix:
- State Case Mix Map: Medicaid
- CMI Calculator – NYS
- NYS 2017 Case Mix Census Dates and Roster Upload Info
- NYS 2016 Case Mix Census Dates and Roster Upload Info
- NYS 2015 Case Mix Census Dates and Roster Upload Info
- NYS Dementia / BMI Add-0n Regulations – Criteria
- NYS MDS Roster Submission Op Cert Form
- NYS HCS Access Request Form
- Respiratory Therapy MDS Audit Tool
Nursing:
- ADL Score Determination
- Restorative Nursing Information
- Respiratory Therapy MDS Audit Tool
- What is Skilled Nursing: Fact Sheet
- Triple Check Meeting Forms
- PPS MDS COT Algorithm
- RAI State Coordinators List
- Contractures vs MDS Section G ROM
- PPS 100 Day Tracker Sample 1 | Sample 2
- Laboratory Values: Norms for Geriatric Population
- Nurse Aide Worksheet: Template
- Advanced Beneficiary Notice:
- …and MORE…
If you don’t see what you are looking for, contact us!