Compliance & Regulation

  • Requirements of Participation: Action Briefs

    Contains 18 Component(s)

    ACTION BRIEFS - provide highlights, specific information, tips and resources about a particular topic.

  • Behavioral Health and Trauma Informed Care

    Contains 6 Product(s)

    Phase 3 of the RoPs goes into effect on November 28, 2019. AHCA has developed resources to help you navigate the new requirements. This package includes resources applicable to Behavioral Health and Trauma Informed Care.

  • CMS PDPM-Related PDPM/MDS/SNF QRP Resources

    Contains 63 Component(s)

    On May 7-8, 2019 and again (with minor updates) on August 13-14, 2019 the Centers for Medicare and Medicaid Services (CMS) conducted a two-day train-the-trainer session on the October 1, 2019 updates to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP). Examples of agenda items directly relevant to PDPM include: discussions on how to properly code Section GG of the MDS, Changes in Sections A, I, J, and O of the MDS, PDPM: What is changing and what is not, and Integrated coding & PDPM Case Study. This PDPM Academy toolkit includes all available CMS agenda, slides, and video resources related to these training dates. Additionally, this toolkit contains a direct link to the CMS PDPM-Related MDS-RAI Resources webpage containing the most current minimum data set resident assessment instrument (MDS-RAI) manual. Scroll to the bottom of the page and download the file under “Related Links” labeled MDS 3.0 RAI Manual v1.17 October 2019. • Chapter 2 contains a significant rewrite due to the elimination of the RUG-IV scheduled and unscheduled assessment types, and the introduction of the new SNF PPS Interim Payment Assessment (IPA) as well as the new Optional State Assessment (OSA). • Chapter 3 contains instructions for completion of new or revised MDS items that impact PDPM and SNF QRP, including new Sectikon J2100-J5000 surgery items and I0020B primary reason for the SNF stay ICD-10 diagnosis code. • Chapter 6 is a complete rewrite of the SNF PPS resident classification process and other policies including the new IPA, interrupted stay, and late assessment/default payment policies.

  • CMS MDS Section GG Training Resources

    Contains 6 Component(s)

    The SNF PPS Patient Driven Payment Model (PDPM) relies on accurate coding of several MDS Section GG mobility and self-care items that impact the PT, OT, and Nursing component per-diem case-mix payment rates. This toolkit contains a collection of Section CC training materials that the Centers for Medicare and Medicaid Services (CMS) has provided on their website that may be useful for provider PDPM training of nurses, certified nursing assistants, and therapists.

  • Tools to Prevent and Address Resident to Resident Mistreatment

    Contains 3 Component(s)

    ​It is critical for nursing centers and assisted living communities to address and mitigate reported incidents of resident-to-resident mistreatment. While mistreatment may or may not meet the definition of abuse, it would include negative and aggressive physical, sexual, or verbal interactions between long-term care residents that is unwelcome and have high potential to cause physical or psychological distress in the recipient.

NCAL AHCA