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PDPM Skilled, Reasonable and Necessary Care

According to the Centers for Medicare & Medicaid Services (CMS), the transition to the Patient Driven Payment Model (PDPM) relates to reimbursement only. Clinical care delivery is expected to remain the same. Although there has been a multitude of new information related to calculating the Health Insurance Prospective Payment System (HIPPS) code, which supports reimbursement, there have not been any changes to the Medicare Benefit Policy Manual (MBPM) Chapter 8: Coverage of Extended Care (SNF) Services Under…

F-Tags in Review: F607 Policies for Abuse & Neglect of Residents

This week’s “F-Tags in Review” focuses on F607 – Development and Implementation of Policies for the Prevention, Identification and Training on Abuse and Neglect of Residents. This regulation was identified and implemented in the November 2018 Phase II of the Centers for Medicare and Medicaid Services’ roll-out of new survey procedures.   The intent of this regulation is “…to provide protections for the health, welfare and rights of each resident residing in the facility. In order…

Understanding the July 2023 Regulatory Changes for PA SNFs

Do you have the right people in place to initiate and enforce the updated regulations that will impact Pennsylvania skilled nursing facilities starting July 1, 2023? Pennsylvania will be rolling out the newly revised Centers for Medicare & Medicaid Services (CMS) regulatory changes which will begin being enforced on July 1, 2023. These proposed changes, which have been evolving since July 2021, were adopted by the PA Department of Health (DOH) in December 2022. These…