Category Archives: Home Health


Don’t Miss Out on the Upcoming August Webinars

Pathway Health offers a variety of online training and education courses to support clients in keeping up-to-date with the latest clinical, regulatory, and financial information. Mark your calendar for our upcoming webinars.

Compliance Alert: Monitoring Your System for the Top 5 F-Tags Consistently Cited
August 13, 2013 11:00AM-12:00PM CDT
We know that keeping in compliance can be difficult. This webinar provides “tips of the trade” on monitoring the top 5 F-Tags. Upon completion, attendees will have a better understanding of the key concepts for compliance in regards to:

  • F-441: Infection Control/F-371: Food Sanitation
  • F-323: Accidents and Supervision Guidance
  • F-309: Quality of Care
  • F-279: Comprehensive Care Plans
  • Quality and Compliance Series: QAPI Operationalized! Is Your Facility Prepared!
    August 20, 2013 11:00AM-12:00PM CDT
    If you are a long-term care leader then this webinar is a MUST. Upon completion attendees will understand the national rollout of QAPI, its core elements and its impact on operations.

    ICD 10 Preparation and Implementation Strategies
    August 22, 2013 11:00AM-12:00PM CDT
    The transition to ICD-10 will affect many facets in your organization: ICD coding, financial, preadmission and admission processes, software/hardware upgrades and clinical documentation.  It’s not too early to start preparing for these changes. This webinar will not only help attendees understand the differences between ICD-9 and ICD-10 but will also provide the necessary strategies to ready your organization for the change.

    For more information and to register for any of these upcoming webinars, click here.



    OIG Work Plan Series: Program Integrity Issues

    We have already looked at the first half of the 2013 OIG Work Plan. But, keep in mind that it covers more than just nursing home issues. The second part of the initiative focuses on program integrity issues involving provider enrollment and other areas.

    • Determine the frequency of onsite visits as part of the Medicare enrollment or reenrollment process
    • Review Medicare Part A and Part B claims from error-prone providers
    • Review providers and suppliers who receive Medicare payments after CMS referred them for failure to refund overpayments
    • Review states’ procedures for identifying and collection third-party payments for services
    • Review facilities’ patient accounts for Medicaid overpayments

    Learn how our Compliance Hot Topics – Latest Regulatory Updates webinar can help your facility stay up-to-date with the ever-changing regulatory updates.


    CMS Issues 2014 Payment and Policy Changes for Medicare Skilled Nursing Facilities – Final Rule

    The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for the Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNF) for FY 2014 effective October 1, 2013.

    Revise and Rebase the Market Basket
    This final rule updates the payment rates used under the prospective payment system for SNFs for FY 2014. In addition, it revises and rebases the SNF market basket for FY 2014 and subsequent years to reflect more recent data. The current SNF market basket reflects data from FY 2004 and CMS is updating using data from FY 2010.

    In addition, CMS will make changes to the components of the SNF market basket index by adding five new cost categories and dividing the existing Nonmedical Professional Fees cost category into two separate categories, labor-related and non labor-related Nonmedical Professional Fees (for a total of 29 cost categories), and revising several price proxies, including the Wages and Salaries and Employee Benefit cost component.

    Reporting of distinct therapy days
    CMS is also adding a new item to the Minimum Data Set (MDS), Version 3.0 for recording the number of distinct therapy days provided by each therapy discipline. The addition to the MDS ensures SNFs are paid accurately for the therapy services they provide to their residents.

    ICD-10-CM Implementation
    Finally, this final rule adopts a change to the diagnosis code used to determine which residents will receive the AIDS add-on payment, effective for services provided on or after the October 1, 2014 implementation date for conversion to ICD-10-CM.

    Changes to payment rates
     Based on the changes within this final rule, there will be a net rate increase of 1.3% or $470 million for FY 2014. The 1.3% update is based upon a 2.3% market basket increase, reduced by the 0.5 percentage point forecast error correction and further reduced by the 0.5 percentage point MFP (multifactor productivity) adjustment.  Nationally, the update provides SNFs in urban areas with a 1.4% update and rural facilities with a 1.0% increase.

    To read the complete final rule on the Federal Register, click here.


    Check out these Upcoming August Fireside Courses

    Join us this month in White Bear Lake, MN at our cozy Fireside training facility for the following courses.

    MDS 3.0 Basics: The Fundamentals of the RAI Process and MDS Coding.
    August 13-14
    This NCERS and NAB approved intensive training course is designed for the beginning MDS Coordinator or other long-term care professionals who participate in the RAI/MDS process. This class guides attendees through coding the MDS document section by section and focuses on the basics of the Care Area Assessment and Care Planning processes.

    Medicare Now: MDS 3.0, RUGs IV and Reimbursement Impact on Outcomes
    August 20-21
    This course will help you discover if your facility is in compliance by walking attendees through the provider responsibilities of Medicare, reimbursement strategies and PPS assessment scheduling.

    MDS 3.0 Scheduling and Operational Strategies for OBRA and PPS
    August 22, 2013 9:00AM-4:00PM CDT
    Are you a designated scheduler or backup clinician? If so, you’re aware that navigating through all the scheduling acronyms associated with long-term care can be tough. This seven-hour course will leave participants with a better understanding of scheduling rules assisting you in managing the schedule effectively.

    Care Area Assessments and Care Planning for Quality Outcomes
    August 23, 2013 9:00AM-4:00PM CDT
    At Pathway we know that Care Area Assessments accurately reflect resident’s status and needs and are important to care planning. Participants of this session will be given both lecture and lab time leaving them feeling more comfortable completing CAA’s for MDS 3.0.

    Don’t miss these upcoming August training sessions at our cozy Fireside Education Center!


    Don’t Let Your Financial Performance Go Adrift

    Increased scrutiny is coming from all angles for Long Term Care providers. The Office of Inspector General (OIG) is cracking down on providers who do not accurately code the MDS via RAC, MIC, MAC and ZPIC audits. In particular, the industry is seeing a significant increase in basic MAC denials due to inaccurate coding, lack of skilled documentation to support the MDS and the disconnect between nursing and rehabilitation – reflected in the medical record.

    Providers are seeking out external assistance to mitigate the potential negative quality, regulatory and financial outcomes.

    Pathway Health can assist your crew in getting all hands on deck. Our team of experts can perform the following customized consultation to improve reimbursement, decrease risk, reduce negative regulatory outcomes and increase quality data for short and long term sustainability.

     Reimbursement Consulting Services Include:

    • · ADL Process Improvement
    • · ADR Response and Assistance – Offsite and Onsite
    • · MDS/RAI Process Improvement
    • · Medicare Denial Process Improvement
    • · Medicare Process Improvement
    • · Onsite Education
    • · RAC/ZPIC Vulnerability Assessment
    • · Reimbursement Optimization Reviews


    Ensure your staff has the reimbursement expertise necessary to meet the changing health care environment. For more information, visit or call 877.777.5463 to speak with our Director of Consulting Services.



    Help us welcome Andrea Swayne as our new Director of Interim Services

    Pathway Health is happy to welcome a new member to our leadership team; Andrea Swayne who is joining us as Director of Interim Services. With her background as a Gerontologist, Andrea comes to Pathway with strong leadership skills and vast experience in managing critical issues in healthcare that our clients face.

    Her responsibilities include overseeing day-to-day operations of interim and recruitment services, including marketing services, coordination of contracts, staffing, client relations and employee management.

    Contact Andrea to discuss how Pathway Health can assist your organization and meet its interim or permanent leadership needs.



    MHCA Conference

    ATTENTION all Minnesota Home Care Association Annual Meeting Attendees! “Get Your Game On” and don’t miss the 303/CEU session today! Barb Jezorski and Martha Sandven from Pathway are presenting an informative session on the final rule and operation strategies!

    The Game Changer; PPS Final Rule Impact and Operational Strategies
    2:30 pm – 3:45 pm
    Every year home health agencies are faced with reimbursement reductions and changes in legislation. Your agency’s productivity, revenue and bottom line are at stake due to these significant changes. Don’t miss this session jam-packed with information to get a rundown of the final rule plus an operational guide for maintaining and maximizing growth in 2013. You’ll walk away ready to prioritize the changes that have the most affect to your agency, and offer strategies to minimize the impact. MN Home Care Reg BRO.pdf


    MN Home Care Association Annual Meeting

    Pathway is excited to have representatives exhibiting at the Minnesota HomeCare Association 43rd Annual Meeting! This year’s theme is “Homecare: Get Your Game On!” That being said, attendees “Get Your Game On” and come visit the Pathway Health booth for information on how we can help your organization!