• CMS PDPM Education Website

• NTA TIpsheet designed by Judy Brandt

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COVID 19

CMS Info:

• 1/7/2021: Sec Azar extends PHE for another 3 months, effective 1/21/2021  (5thth renewal since 1/31/20)

• CMS Fact Sheet updated Nov 2020:  LTC/SNF CMS Flexibilities to Fight COVID-19

• 11/9/20:  Instructions on billing (or re-billing rejected) DR claims in a SNF:Skilled Nursing Facility (SNF) Benefit Period Waiver - Provider Information. Start on page 14.

• 11/9/20:  Instructions on when a resident qualifies for the 3 day stay waiver and the wellness period waiver.  Start on page 13.

• CMS waiver website

• April 13 S&C Letter Supplemental info on SNF to SNF transfer

• CMS FAQ on 1135 Waiver dated 4/9/20 SNF info begins on page 34 (This is a supplement to the 3/15/20 document

• CMS 3/15/20 1135 Waiver document

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ICD 10 Coding

• FY 21 (Dec 20) Official Coding Guidelines (with new COVID-19 codes effective 1/1/21

• FY21 (Dec 20)  Code Sets (with new COVID-19 codes and guidance. Changes in alphabetic index and tabular list.)

Quality Assurance Performance Improvement (QAPI) // 

• Section M Coding: Free CMS web-based training for coding Section M Skin Conditions

• CMS QAPI site

• QAPI Plan How To Guide:  By Lake Superior Quality Innovation Network (QIO for Michigan, Minnesota and Wisconsin

• CMS Guide for developing a QAPI Plan

SNF PPS Medicare Information //  MA Plan Information //

• SNF skilled services defined: Ch 8 Medicare Benefit Policy Manual

• Regulatory Requirement for Physician Certification in a SNF:  Section 30, Chapter 4, Medicare General Information, Eligibility, and Entitlement Manual

• CR 11454 10/4/19:  For Physician Certification in a SNF -  Adding the interrupted stay language to General Entitlement Manual.

• CMS Booklet describing the SNF benefit

• FY2014 SNF & CB Final Rule

• FY2015 SNF & CB Final Rule

• FY2016 SNF & CB Final Rule

• FY2017 SNF & CB Final Rule

• FY2018 SNF& CB Final Rule

• FY2019 SNF & CB Proposed Rule

• FY2019 SNF & CB Final Rule

• FY2020 SNF & CB Final Rule

• FY2021 SNF & CB Final Rule

• CMS SNF PPS Website

• Find your MAC, RAC, ZPIC: CMS Interactive Map

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MDS Information //

• CMS MDS 3.0 Website

• MDS Interview Cue Cards

• Casper Reporting User's Guide

Beneficiary Notices In A SNF //

• CMS Beneficiary Notice Website

• Livanta Website

• KeyPro Website

• New Survey Pathway for SNF beneficiary notice investigation (07/2018)

• MLN Corrected Article: guidance NOMNC

• Notice of Medicare Non-Coverage/DENC Form & Instructions

• Guidance on CMS-R-131 & Therapy Caps

• SNFABN for Mandatory Use May 7, 2018

• SNFABN Instructions for Mandatory Use May 7, 2018

• MA Plan Regulatory Guidance NOMNC

Other Resources For Long Term Care //

• Family Caregiver Alliance: Guide to understanding dementia behaviors

• CMS Surveyor Training on Dementia Behaviors

• CMS Nursing Home Antimicrobial Stewardship Guide

Pepper Report Information //

• SNF Pepper Resources Website

Medicare Medical Review //

• Targeted Probe and Educate (TPE) Website

• Palmetto TPE Letter to SNF Sample

• CR 10249 Introducing TPE

• Aug 2015: MLN Limiting the Scope of Review on Redeterminations & Reconsiderations of Certain Claims

• Medicare Program Integrity Manual (Instructions to reviewers)

• CMS Medical Review Website

• Medicare A&B Appeals Process:  MLN Publication

• 2017 Part A,B,C,D Appeals Flowchart

• Provider Legibility in the TPE Probe

CMS LTC Regulatory Information //

      New LTCSP 11.2 updated survey process April 2018

• CMS LTC Survey Process (LTCSP) Website with new Appendix PP (Survey regulations and interpretative guidelines), new F-tag list, pathways & other announcements about new survey process

• CMS Surveyor Training Website Open to Public

• CMS Frequently Asked Questions about LTCSP 2/2018

• CMS S&C 17-37NH 7/7/17 Revision of Civil Money Penalty (CMP) Policies and CMP Analytic Tool 

• CMS State Survey Agency Contact List:  All States

• CMS 671 & Instructions

• CMS 672 & Instructions

• Safety Risk Assessment ToolKit from AHRQ for falls, infections, etc.