July 25, 2023

Understanding PDPM and the SLP Component

For the Speech Language Pathology (SLP) component, the Patient-Driven Payment Model (PDPM) uses a number of different patient characteristics that were found to be predictive of increased SLP costs. These include identification of any diagnosis in the Acute Neurologic clinical classification and identified SLP-related comorbidities.There are twelve SLP-related comorbidities. These include aphasia, CVA, TIA or stroke, hemiplegia or hemiparesis, traumatic brain injury, tracheostomy or ventilator, laryngeal cancer, apraxia, dysphagia, ALS, oral cancers, or speech and…

Will Your Late Entry Process Withstand an Integrity Audit?

In recent months, LW Consulting, Inc. (LWCI) has been assisting clients with responding to Safeguard Unified Program Integrity Contractors (UPICs) and Medicare Administrative Contractors (MACs). During this process, LWCI has observed an increase in denials purely based on delayed or late entries within the documentation submitted for review to the UPICs and MACs. Over the next few weeks, LWCI will be reviewing the Centers for Medicare & Medicaid Services’ (CMS) signature requirements and late entries…

Understanding the Baseline Care Plan and Summary

In October 2016, the final rule revised the Medicare and Medicaid requirements of participation for nursing homes. There was new language in the definition of person-centered care plan, which was to focus on the resident as the locus of control to support the resident in making their own choices and to allow them control over their daily lives. The facility’s responsibility was to focus on verbal and non-verbal communication, identify what is important to the resident…