LINKS

CMS NURSING HOMES GUIDANCE TO LAWS AND REGULATIONS - NURSING HOMES

https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Nursing-Homes.html

CMS Internet Only Manuals

http://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs.html

MDS Manuals

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html

CMS Skilled Nursing Facility

http://www.cms.gov/Center/Provider-Type/Skilled-Nursing-Facility-Center.html

CMS Survey and Certification Memo

http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions.html

Pennsylvania Department of Health Regulations

http://www.health.pa.gov/facilities/Consumers/Health%20Facilities/Nursing%20Homes/Nursing%20Homes/Pages/Long-Term-Care-Licensure-Regulations.aspx#.VX3TJWnbI5s

Pennsylvania Department of Human Services - Long Term Care

http://www.dhs.state.pa.us/provider/doingbusinesswithdhs/longtermcarecasemixinformation/index.htm

TMF - PEPPER Reports

http://www.pepperresources.org/

CMS SNF Quality Measures

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures.html

PATIENT DRIVEN PAYMENT MODEL (PDPM)

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/therapyresearch.html

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/PDPM.html

SKILLED NURSING FACILITY QUALITY REPORTING MEASURES

https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Measures-and-Technical-Information.html


PATIENT DRIVEN PAYMENT MODEL (PDPM)

PDPM_ICD10_Mappings_Clinical_Category - Copy.csv

PDPM_FAQ_Final_v5.zip

PDPM_Fact_Sheet_AdminPresumption_Final.pdf

PDPM_Fact_Sheet_AIDS_Final.pdf

PDPM_Fact_Sheet_Template_CGLimit_Final.pdf

PDPM_Fact_Sheet_FunctionalCognitiveScoring_Final.pdf

PDPM_Fact_Sheet_InterruptedStay_Final.pdf

PDPM_Fact_Sheet_MDS_Changes_Final.pdf

PDPM_Fact_Sheet_NTAComorbidityScoring_Final.pdf

PDPM_Fact_Sheet_Template_Payment_Overview_Final.pdf

PDPM_Fact_Sheet_VPD_Final.pdf


PDPM SUMMARY OF PDPM CASE MIX ASSIGNMENT.pdf



TOOLS AND TIPS

Admission and Discharge Assessments.pdf

Medical Record and ADR PANAC.pdf

QM Long Stay Antipsychotics.pdf

Mutifactoral Approach to Falls in the Elderly algorithm.pdf

Medicare Skilled coverage..pdf

medicareadvocacy.org-Practice Tip Orders Needed for Maintenance Skilled Care.pdf

OM_EndingCareAppeal_Chart.pdf

snf-notices-of-non-coverage.pdf

core-elements-antibiotic-stewardship-checklist (2).pdf

Change_Package QIO_20170511_508.pdf

Medicare Triple Check Worksheet PEPPER.pdf

Medicare Beneficiary Notice Tip Sheet.pdf

Pressure Ulcer Tracking tool AE.xls

AE_PainManagementTrackingTool_v3.0_2-11-13.xls

AE_PainManagementTrackingToolINSTRUCTIONS_2-15-13[1].pdf

AE_PressureUlcerTRACKINGTOOL_V3.1_10-27-12.xls

AE_PressureUlcerToolINSTRUCTIONS_10-27-12[1].pdf

AE_SafelyReduceHospitalizationsTrackingTool_v2.0_2-5-13.xls

AE_SafelyReduceHospitalizationsINSTRUCTIONS_1-15-13[1].pdf

Antipsychotic_Tool[1].pdf

Fall Risk Assessment Form.pdf

MDS and Respiratory Therapy.pdf



PASRR

PASRR 9 1 18.pdf

PASRR II 9 1 18.pdf

PASRR clarifications.pdf

PASRR FAQ.pdf


SECTION S UPDATE EFFECTIVE 10/1/2017

PA Section S Effective 10.01.2017.pdf


REVISED STATE OPERATIONS MANUAL 11/22/17

https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/GuidanceforLawsAndRegulations/Nursing-Homes.html

Advance-Appendix-PP-Including-Phase-2-.pdf

SOM Draft 11 10 16 Survey-and-Cert-Letter-17-07.pdf

List-of-Revised-FTags.pdf

Entrance Conference Form.pdf

Matrix with Instructions.pdf


PATIENT DRIVEN PAYMENT MODEL (PDPM)

PDPM_Technical_Report_508-1.pdf

PDPM Fed Reg 2018-09015-1highlighted.pdf

PDPM_FAQs_vf.pdf

PDPM_Grouper_Tool.xlsx

PDPM_Grouper_Tool_Grouper.csv

PDPM_Grouper_Tool_HIPPS.csv

PDPM_Grouper_Tool_Instructions.csv

PDPM_Grouper_Tool_NTA.csv

PDPM_Grouper_Tool_Nursing.csv

PDPM_Grouper_Tool_OT.csv

PDPM_Grouper_Tool_Overview.csv

PDPM_Grouper_Tool_PT.csv

PDPM_Grouper_Tool_RUG_IV.csv

PDPM_Grouper_Tool_SLP.csv

PDPM_NTA_Comorbidity_ICD_10_Mapping_508.csv

PDPM_NTA_Comorbidity_ICD_10_Mapping_508.xlsx

PDPM_NTA_Comorbidity_ICD_10_Mapping_Overview_508.csv

PDPMClinicalCategoryMapping.xlsx

PDPMClinicalCategoryMapping-ClinicalCategroybyDx.csv

PDPMClinicalCategoryMapping-Instructions.csv

PDPMClinicalCategoryMapping-NonOrthoSurgery.csv

PDPMClinicalCategoryMapping-OrthoSurgery.csv

PDPMClinicalCategoryMapping-Overview.csv

PDPM-Grouping-Tool-Help-Document_final.pdf



JIMMO VS SIBELIUS - REHAB SERVICES FOR LTC RESIDENTS

MM8458 Jimmo V Sibelius 12 6 13.pdf

R175BP Jimmo v Sibelius 12 6 13.pdf

CFR-2011-title42-vol2-sec409-32.pdf

 

HOSPICE 

Hospice SNF contract requirements Federal Regiter 2013.pdf

 

PEPPER REPORTS

SNF_PEPPER_training_2013.pdf

SNFPEPPERUsersGuide_Edition1.pdf

LTPEPPERUsersGuide_Edition7.pdf

 

STAFF AND MDS FOCUSED SURVEY 

MDS Focused Survey (00099058).PDF

MDS Focused Review Survey-and-Cert-Letter-15-25[1].pdf

MDS Focused Review Survey-and-Cert-Letter-15-06[1].pdf

MDS Focused Review Survey-and-Cert-Letter-14-22[1].pdf

MDS Focused Survey worksheet.pdf

 

QUALITY MEASURES 

MDS-30-QM-Users-Manual-V70[1].pdf

MDS-30-QM-Users-Manual-V60[1].pdf

MDS30-QM-UsersManual-ErrataVersion50[1].pdf

MDS30QM-Manual[1].pdf

Final-MDS-30-Data-Set-Version-1160-Change-Table-Effective-October-1-2018.pdf

Risk-Adjustment-Appendix-File-for-SNF-Measure-Calculations-and-Reporting-Users-Manual-V20.xlsx


SNF/QRP

SNF-QRP-Table-for-Reporting-Assessment-Based-Measures-for-the-FY-2020-SNF-QRP-APU.pdf

SNF-Measure-Calculations-and-Reporting-Users-Manual-V20-Change-Table.pdf

SNF-QRP-Table-for-Reporting-Assessment-Based-Measures-for-the-FY-2020-SNF-QRP-APU(2).pdf

SNF-QRP-Table-for-Reporting-Assessment-Based-Measures-for-the-FY-2020-SNF-QRP-APU(1).pdf

SNF-QRP-Measure-Calculations-and-Reporting-Users-Manual-V20.pdf

SNF-QRP-APU-Table-for-Assessment-Based-Measures-for-FY2019_8-18-17-FINAL.pdf

SNF-QM-Users-Manual-V10-FINAL-5-22-17.pdf

 

RESIDENT DATA REPORTING MANUAL

Resident Data Reporting Manual 6 2015.pdf

 

RAI/MDS RESOURCES/MANUAL

1-MDS-30-RAI-Manual-v1-16-October-1-2018.pdf

2-MDS-30-RAI-Manual-v1-16-and-Change-Tables-October-1-2018.zip

3-MDS-30-RAI-Manual-v1-16-Replacement-Manual-Pages-and-Change-Tables-October-2018.pdf

5-MDS-Forms-Item-Sets-v1-16-1-October-1-2018.zip

Appendix-B-07-26-2018.pdf

Final-MDS-30-Data-Set-Version-1160-Change-Table-Effective-October-1-2018.pdf

Final-MDS-30-Data-Set-Version-1160-Effective-October-1-2018.pdf



MDSSchedTool2013_MDS_3_0.pdf

BIMS Cue Cards for non verbal resident.pdf

BIMS Cue Cards with pictures for non verbal resident.pdf

BIMS cue cards.pdf

MDS30TheUseOfDashes 6 11.pdf

Medicare Short Stay Assessment Algorithm.pdf

CAA Resource Guide.pdf

MEDICARE 100 DAY TOOL without therapy minutes revised 07182011.xlsx

RUG-IV Hierarchy PANAC.pdf

January 2013 Proposed MA CMI rates XL file

hipps.pdf

Definition and Uses of HIPPS Codes 1 2010.pdf

HIPPS Code Master List 4 1 11.zip

HIPPS_Modifiers_Table.pdf

Change Request Process HIPPS Code Set.pdf

MM6916_SNFHIPPS.pdf

Medicare Claims Processing Manual.pdf

CaseMixManual Change Document 20110801.pdf

Billing Best Practice.pdf

Exp_vs_Act_RUG4_8mos_Final.pdf

Fed Reg MC Program PPS and Consolidated Billing for SNF for FY 2012.pdf

 

ADVANCED BENFICIARY NOTICE

ABNAnnouncementFAQs.pdf

ABNFormInstructions.zip

RevABNManualInstructions.pdf

 

5 STAR RATING 

5 star cut points table 9 2013.pdf

5 Star staffing data file 9 2013.zip

NHCRatings 5 star rating 2009 2013.zip

Casper COVER _ TABLE OF CONTENTS_10-2012.pdf

CASPER SECTION 3 - UTILITY REPORTS_11-2012.pdf

Casper SECTION 11 - QM REPORTS_10-2012.pdf 

cspr_sec3_mds_prvdr_10-2011.pdf

 

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