General – Coretactics

Protect Your Skilled Nursing Facility’s Revenue Through Audit Readiness and Compliance

Is your Skilled Nursing Facility (SNF) prepared to respond to audits, medical record reviews, reimbursement challenges, and potential claim denials? SNFs face a variety of reviews from Medicare Administrative Contractors (MACs), Medicare Advantage and other commercial payers, program integrity contractors, regulatory agencies, and internal compliance teams. These reviews aim to identify concerns related to medical…
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Stay On Top of Things!

Are You Among the 12% Qualifying for CMS’s Streamlined Risk-Based Survey? The Centers for Medicare & Medicaid Services (CMS) has implemented its Risk-Based Survey (RBS) process nationwide for skilled nursing facilities. RBS is designed to reward top-performing nursing homes with a significantly lighter regulatory burden and reduced on-site survey footprint, but only ~12% of facilities…
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Are You Ready for the New SNF Data Validation Audits?

CMS has officially launched a new initiative to validate MDS assessment accuracy—and the stakes are high. Under the SNF PPS Fiscal Years 2024 and 2025 final rule, 1,500 SNFs will be randomly selected each year for intensive data audits. Non-compliance could result in a 2% reduction in your Annual Payment Update (APU). Coretactics is currently…
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Understanding Your Value Based Purchasing (VBP) Program Performance Score

How VBP WorksThe SNF VBP program works by withholding 2% of a SNF's Medicare Part A payments. Based on the SNF's performance score, a portion of this withheld amount (between 50% and 70%) is redistributed as incentive payments. This means that a higher performance score can lead to a positive adjustment in your Medicare Part…
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Infection Control: Good Leadership Wins Tough Battles

Infection prevention and control is one responsibility skilled nursing facilities can better manage when leadership takes a proactive stance. Here are some key points: Understand your staff’s needs. Purchase effective cleaners and disinfectants that can be employed easily and efficiently. Choose easy-to-use products with a tolerable odor and low toxicity to kill a broad range…
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Urgent Update: New Nursing Home Posting Requirement Effective Dec. 26th

Mandated by a NYS law enacted in Sept. 2024, as of Dec. 26, 2024, nursing homes will be required to post their CMS Five-Star ratings in each of the three domains (health inspections, staffing, and quality measures) in addition to the overall rating currently required to be publicly posted. All Five-Star ratings are required to be…
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2025 NHSN Reporting Changes for Nursing Homes

Scheduled to take effect January 1, 2025, National Healthcare Safety Network (NHSN) plans to make permanent more time-consuming data collection from SNFs. Although Centers for Medicare & Medicaid Services (CMS) has proposed a boost of 1.3% in 2025 Medicare payments to skilled nursing facilities, that same proposed home health pay rule will also make permanent…
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Revised Long-Term Care (LTC) Surveyor Guidance for 2025

Significant Revisions to Enhance Quality and Oversight of the LTC Survey Process – Summary of Revised Surveyor Guidance – Admission, Transfer, and Discharge: Chemical Restraints/Unnecessary Psychotropic Medication: Professional Standards and Medical Director: Accuracy/Coordination/Certification: Other areas of change include: Coretactics recommends you review of the QSO memo for complete details. An Advance copy of Appendix PP and the…
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