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How Do We Get Paid for Medicare Part-A Beneficiaries?
April 16, 2015, 10:00–11:30 a.m. (Pacific)
Now that we know what comprises the skilled level of care services, we will continue our
focus on the Medicare resident, but this time on the payment system – RUG IV (Resource
Utilization Groups, Version IV). What are all those acronyms like RUC, RMA, and CB2? We
will review the components of the Resource Utilization Group IV methodology for PPS
(skilled Medicare) reimbursement, what specific items from the MDS 3.0 drive
reimbursement and how they impact the payment categories. We also will briefly review the
scheduling dilemmas caused by the multiple Other Medicare Required Assessments
(OMRAs), such as the End of therapy, Start of therapy and Change of Therapy.
OBJECTIVES:
At the end of the session, participants will be able to:
1. Identify the items on the MDS 3.0 that drive reimbursement.
2. Delineate the RUG IV methodology, including index maximizing, ADL scores,
grouping criterion and the resulting payments for PPS.
3. Describe the scheduling requirements for the Other Medicare Required Assessments
(OMRAs) and the impact on payment.
AGENDA:
Time Frame
Minutes
10:00 am to 10:15 am
15
RUG-IV Grouper and How It Works
10:15 am to 10:45 am
30
Review of the RUG Criterion
10:45 am to 11:00 am
15
The OMRAs – when and how to schedule
11:00 am to 11:15 am
15
Impact on PPS payments
11:15 am to 11:30 am
15
Questions and Answers
90
Topic
Thirteenth session in our 2015 MDS 3.0/RUG IV Distance Learning Series*:
How Do We Get Paid for Medicare Part-A Beneficiaries?
April 16, 2015, 10:00–11:30 a.m. (Pacific)
ROUTE TO: _Executive Director; _Administrator; _Director of Nursing; _Therapists; _Corporate Staff
Prior to this event the key contact as provided below will receive an e- confirmation with access directions, handouts and
other details and is responsible for disseminating this information for all participants within their organization.
Now that we know what comprises the skilled level of care services, we will continue our focus on
the Medicare resident, but this time on the payment system, RUG IV (Resource Utilization
Groups, Version IV). What are all those acronyms like RUC, RMA, and CB2? We will review the
components of the Resource Utilization Group IV methodology for PPS (skilled Medicare)
reimbursement, what specific items from the MDS 3.0 drive reimbursement and how they impact
the payment categories. Also, we will review the scheduling dilemmas caused by the multiple
Other Medicare Required Assessments (OMRAs), such as the End of therapy, Start of therapy and
Change of Therapy.
Target Audience
Administrators, nurses and therapists. (1.5) DSHS Education Credits.
Speaker
Jane Belt, Consulting Manager, Plante Moran, PLLC, Columbus; Jane Belt has been involved with
long-term care for over 39 years serving as a director of nursing and a nurse consultant. She has
a Master’s in Nursing and is a Certified Resident Assessment Coordinator and a Master Teacher
through the American Association of Nurse Assessment Coordinators (AANAC).
Fees
Per Phone Line Fee for ea. session
Per Phone Line Fee + session CD
1.
LeadingAge Member/Current PM Client
$75
$95
Nonmember
$95
$125
Key Contact: ___________________________E-mail: ________________________________
Community: __________________________________________________________________
Address: ___________________________________________Phone: ___________________
City: __________________________________ State: ______________ Zip: ______________
2.
Check attached_______
Please invoice me_______
Credit Card:__________
Card Number: ___________________________ Exp. Date: _________ Total: _____________
Name on Card: _______________________________3-Digit Number/Back of Card: ________
Cancellations received 3 days prior of a session will be refunded less a $25 processing fee for
each cancellation transaction. Replacements are encouraged. Three options to register:
1) Scan and send completed registration form to cmeritt@leadingagewa.org
2) Fax completed registration to LeadingAge WA at (253) 964-8876.
3) Mail completed registration to LeadingAge WA, 1495 Wilmington Drive, Suite 340, DuPont WA
98327.
Your registration will be made upon receipt of this form. Confirmations will
be emailed. If you do not receive a confirmation 3 days prior to each
session, please feel free to contact our office.
Questions? Call (253) 964-8870
*See complete audio conference series information on our events page at
.www.LeadingAgeWA.org and www.plantemoran.com.