Upcoming Events

SNFs began transmitting Payroll Based Journal (PBJ) information effective July 1, 2016; and CMS released that information to the public on November 1, 2017.  PBJ data may come back to haunt some facilities, as it impacts Five-Star ratings.  This session will explore the foundation and mechanics of the PBJ reporting system to assist SNFs in accurately and completely capturing reportable data.

This program will advise SNF teams on how to utilize various tools to improve care delivery, reduce hospital readmission and capture reimbursement-sensitive conditions.  The presenters will explain how to use technology and dynamic clinical tools to design early warning systems and direct clinical efforts in "real time" to prevent re-hospitalizations and functional declines.

SNFs are required to deliver Medicare denial letters to beneficiaries upon termination of a coverage period.  However, the rules governing denial letter structure differ for Medicare Part A and B, as do the scenarios in which they must be issued.  Adding to the confusion are the incongruent scenarios in which  denial letters are not required.  This session will focus on regulatory guidelines covering denial notices, and will include case-studies to enhance the learning process.

SNF managed care admissions have increased dramatically as Medicare Advantage penetration now exceeds one-third of all beneficiaries nationally.   This population comes with onerous administrative and documentation requirements that ultimately determine pre- and continued authorization for SNF care.  This session will provide strategies to organize facility responses, improve the authorization process (including contract exclusion capture) and accurately communicate the need for skilled care to the MCO.