Strategies for Medicare and PPS

ComplianceStaying in compliance with both Medicare requirements and ensuring MDS accuracy takes a team and knowledge of the

rules.  Compliance is a requirement, so this session will review rules and best practices to ensure compliance which

includes methods to oversight Medicare Part A program.  This session will first review Medicare compliance requirements

to eligibility, physician certifications, notices, and strategies to ensure nursing and therapy document to support the

medical necessity of the Part A services.  Will include a review of notices and QA oversight to ensure accuracy of the

claim.  MDS timing and requirements will be reviewed and impact of missed/late MDS on billing as well as strategies to

ensure accurate Part A Revenue.   Will discuss high risk areas for denial and oversight needed to decrease risk.

July, 28

6 CEUs

applied for

8:30-9:00 Registration

9:00-12:00 Education Session

12:00-1:00 Lunch

1:00-3:00 Education Continues

3:00-3:30 Evaluation & Wrap Up

AGENDA

Strategies for Medicare and PPS Compliance

Location

Columbia Conference Center

169 Laurelhurst Avenue

Columbia

Overview:

Staying in compliance with both Medicare requirements and ensuring MDS accuracy

takes a team and knowledge of the rules.  Compliance is a requirement, so this

session will review rules and best practices to ensure compliance which includes

methods to oversight Medicare Part A program.  This session will first review Medicare

compliance requirements to eligibility, physician certifications, notices, and strategies

to ensure nursing and therapy document to support the medical necessity of the Part A

services.  Will include a review of notices and QA oversight to ensure accuracy of the

claim.  MDS timing and requirements will be reviewed and impact of missed/late MDS

on billing as well as strategies to ensure accurate Part A Revenue.   Will discuss high

risk areas for denial and oversight needed to decrease risk.

Learning Objectives:

1. Achieve understanding of Medicare Requirements.2. Will demonstrate understanding of MDS requirements and best practices for

success.3. Will be able to implement oversight of Medicare Part A program to increase

accuracy of claim and decrease risk of denials

Administrators

DON

MDSC

Therapy Staff

Compliance Staff

QA Staff

Billing Staff

.

Who Should Attend

Kate Dennison, RN,RAC-CT

Nurse ConsultantPolaris Group

Kate Dennison has over 30 yearsof healthcare experience in both

the acute and long-term caresetting and has provided

consulting and training for severalyears in MDS and Medicarecompliance. Having served in

several capacities of nursing fromDirector of Staff Development,

MDS Coordinator, ResidentService Director, Senior ClinicalReimbursement Consultant, and

Regional Director of ClinicalReimbursement, and currently as

Nurse Consultant for PolarisGroup, Kate brings expertise and

experience in assisting facilities inimprovement in regulatory,reimbursement, and clinical

compliance. She has providedtrainings nationally including for

state healthcare associations.Kate obtained her RN degreefrom Westbrook College, aka

University of New England in herhome state of Maine. Having

served on the AmericanAssociation of Nurse AssessmentCoordinator’s Board of Directors

(AANAC), she continues toremain an honorary life-timemember. She is the author of a

published article on MDS and hasparticipated in several Center for

Medicare and Medicaid (CMS)initiatives having served as a

Technical Expert Panel Member(TEP) for CMS’ Quality

Measures during the transition toMDS 3.0 and is recognized as a

contributor for CMS-671 GeneralInstructions and Definitions,

Long Term Care Application forMedicare and Medicaid utilized

during Annual Surveys and CMS’5-Star Rating System. Kate is also

recognized for her significantcontribution as an “Expert in

Long -Term Care” asacknowledged in CMS’ MDS 3.0

RAI User’s Manual.

CMS will beconducting MDS

Focused Surveys. Isyour facility ready?

01.

02.

03.

Accurate timing of assessments.

MDS Accuracy

MDS Compliance.

CEUsPlease remember to have your

attendance slip punched. If you arean administrator, please provide your

license number on the form. Leavethe yellow copy with SCHCA staff.

Keep the white copy for your records.

Dress in layers or bring a

sweater or light jacket to

insure your comfort.

This seminar is open for SCHCAmembership only.