KEY ENCORE NEWS
Encore’s Diversity and Inclusion Committee
Encore Rehab is committed to leading the healthcare footprint to create a culture of Diversity and Inclusion. We strive to be a company to see, hear, and respect every employee. Encore sent surveys to the field to solicit concerns and feedback. As a result, individuals from operations, human resources, information technology, clinical education, legal, and support services came together to develop a platform where decisions are equitable so every employee will feel connected and celebrated.
Taking it one step further, Regional Vice President, Noell Cleveland, obtained a certification in Leading Diversity, Equity and Inclusion. Noell will provide the team with an additional direction to create goals through this advanced education utilizing a proven, reputable model. Initial goals will include process changes, recognizing cultural diversity, examining recruitment and retention processes, and fostering an organizational climate that honors diversity.
LOCKING IN CLAIMS
Recovery Audit Contractors (RAC Audits) are resuming: primarily by Cotiviti (Michigan) and Performant (Ohio, Virginia, Kentucky, Michigan) and findings include:
- Medical necessity supported/not supported
- Physician signatures missing
- Initial certification and subsequent certifications did not include the amount of time that the resident would need to remain in the facility
- Encore provides an ADR Specialist - if you get an ADR, reach out to your regional at Encore to put you in touch with someone for ADR support.
All Medicare Administrative Contractors (MACs) have resumed the ADR process, and additional documentation requests are coming consistently.
KEYS TO CODING
Impact of Isolation on Outcomes
Section GG Quality Measure Benchmarks have dropped twice in 2020, in part due to infection control processes. Change in Mobility score is now at 17.9, and Change in Self Care is now at 7.5.
Think outside of the box to obtain outcomes and maintain infection control/safety
- Schedule for the stairs in the gym or on units
- Schedule for walks in the hallway
- Residents wearing PPE during longer walks
- Knowing cleaning and disinfecting protocols - cleaning before disinfecting; knowing your dry times
Rehab Roundtable: Preventing Hospital Readmissions: How Readmission Penalties Impact You
- Overview of the CMS’ Hospital Readmission measurement tools
- Potential 2% reduction in Medicare payments based on readmission rates
- Readmission rates’ impact on referrals, admissions
- What you can do: Analyze your Data
- Create transition strategies
- Utilize your Encore Rehabilitation partner to compare your site to competitors
KEY REGULATORY NEWS
Health Inspection Ratings
CMS will resume calculating nursing homes’ health inspection ratings on January 27, 2021. CMS has instructed State Survey Agencies to resume all surveys as soon as they have the resources (e.g., sta and/or Personal Protective Equipment) to do so (see QSO-20-35-ALL). Furthermore, findings from the focused infection control inspections will be used to calculate each nursing home’s inspection rating. These findings will be included the same way findings from complaint inspections are used in the Five Star Quality Rating System.
The quality measures posted on the Nursing Home Compare website and used in the Five Star Quality Rating System will be updated on January 27, 2021. To update the quality measures, CMS will use data based on the data collection period ending June 30, 2020. Note that these updates do not apply to quality measures that are part of the Skilled Nursing Facility Quality Reporting Program (SNF QRP).
Transition to the New Care Compare Website
As mentioned above, on September 3, 2020, CMS announced the launch of Care Compare, a streamlined redesign of eight existing CMS healthcare compare tools available on Medicare.gov, including Nursing Home Compare. As of December 1, 2020, the legacy Nursing Home Compare website and the data.medicare.gov website (which houses the underlying data for the Nursing Home Compare website) are no longer available, and users will be redirected to the new websites. Note: There is no change in the information available about nursing homes or the methodology used to calculate ratings. The information is now presented in a more user-friendly format.
Please email Ryan Jones for additional information: [email protected]