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Part 2 – Section GG Expansion to OBRA Assessments July 1, 2021

In part 1 of this blog series, we discussed the new ruling concerning the Section GG coding requirement on OBRA assessments in Pennsylvania, effective July 1, 2021. This blog will focus on additional details and Frequently Asked Questions related to the directive. What Should I Remember About OBRA Section GG Requirements? What Error Messages Will Be Reported on Validation Reports if Section GG Isn’t Completed? What Are Some Recent Frequently Asked Questions Related to Section GG for…

Patient-Driven Groupings Model (PDGM) -Primary Diagnosis

The Patient-Driven Groupings Model (PDGM) is the Home Health Prospective Payment System (HH PPS) used for reimbursement that went into effect on January 1, 2020. Before PDGM, the HH PPS was based on the therapy volume as a threshold for reimbursement. With PDGM, the reported diagnoses (ICD-10-CM), and specific items coded on the Outcome and Assessment Information Set (OASIS) represent the patient characteristics to determine reimbursement. PDGM uses 30-day periods as the basis for reimbursement,…

New Nursing Home Survey Process Triggers SNF Beneficiary Protection Notification Reviews

The new survey process for nursing homes went into effect November 28, 2017.  The surveyors will be conducting a Beneficiary Protection Notices Review. The survey team coordinator (TC) will make offsite unit assignments and mandatory facility task assignments for the surveyors. There are nine mandatory facility tasks which include the Beneficiary Protection Notification Review. The objective of the Beneficiary Protection Notices Review is to determine if the facility issued the Notice of Medicare Non-Coverage as required…