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**Updated February 7, 2012 - A Vendor IRF-PAI Informational Call to cover topics such as the data specification updates for the October 1, 2012 release, and the new process to submit the IRF-PAI records to the Assessment Submission and Processing (ASAP) System, is scheduled for February 23rd, 2012 from 1:00 pm -2:00pm (ET). To facilitate this call, we are requesting that vendors review the draft technical specifications prior to this call and use the following mailbox to submit any comments or questions related to the technical aspects of the IRF PAI: IRFTECHIssues@cms.hhs.gov by 6 pm, ET, February 16, 2012. Please refer to the CMS Webpage http://www.cms.gov/InpatientRehabFacPPS/06_Software.asp#TopOfPage for the technical specifications which can be found in the downloads section. Also, for information about the Vendor call taking place on February 23rd, 2012, specifically, please find the February Vendor Call Memo document for additional information about the Vendor Call on the new web page: http://www.cms.gov/InpatientRehabFacPPS/11_TechInfo.asp#TopOfPage.
This document can be found in the downloads section. The mail box for submitting technical specifications questions and comments, IRFTECHIssues@cms.hhs.gov<mailto:IRFTECHIssues@cms.hhs.gov> can be found in the links section on this page. **Updated January 25, 2012 - The revised "Swing Bed Services" fact sheet (ICN 006951) is now available in downloadable format (http://www.cms.gov/MLNProducts/downloads/SwingBedFactsheet.pdf). It includes the following information: background, requirements that apply to hospitals and Critical Access Hospitals, and swing bed services payments. **Updated January 24, 2012- The next Skilled Nursing Facility (SNF)/Long Term Care (LTC) Open Door Forum is scheduled for Thursday, March 1, 2012 from 2pm-3pmET. This Forum is an audio only streaming web forum. Registration for audio only streaming web forum will open on February 23, 2012. You will receive the registration link in a separate notice. Please see the Downloads section below for the full announcement. Thank you for your continued interest in the CMS Open Door Forums. **Additional update January 24, 2012 - CLARIFICATION: At the January 19th skilled nursing facility (SNF) Open Door Forum, a caller inquired about a situation in which a beneficiary goes to a hospital but is not admitted as an inpatient, and instead spends several days there receiving outpatient observation services. Consequently, because the beneficiary does not have a qualifying 3-day inpatient stay in the hospital, Medicare does not cover the subsequent SNF stay. However, the hospital later decides to convert the beneficiary's status retroactively from outpatient to inpatient, thus making the hospital stay a qualifying one for SNF benefit purposes. The caller's actual question was when the 3-day count toward a qualifying hospital stay would commence, and Bill Ullman correctly answered that it would begin on the day that, under the hospital's revised determination, the beneficiary was formally admitted to the hospital as an inpatient. However, Mr. Ullman then erred by expressing the belief that a hospital can make such an outpatient-to-inpatient change in status only prior to the beneficiary's departure from the hospital. He subsequently realized that the policy on which he based this statement, regarding the use of Condition Code 44, actually involves exactly the opposite situation: that of a hospital which initially admits a beneficiary as an inpatient and later decides to convert the inpatient admission retroactively to outpatient status. The applicable instructions in §50.3.2 of the Medicare Claims Processing Manual, Chapter 1 (available online at www.cms.gov/manuals/downloads/clm104c01.pdf) explain that such an inpatient-to-outpatient change in status can only occur ". . . prior to discharge or release, while the beneficiary is still a patient of the hospital." However, we wish to clarify that the limitation discussed in this instruction does not apply to the reverse (outpatient-to-inpatient) type of conversion. ***Update November 9, 2011- The Centers for Medicare and Medicaid Services 2012 MDS National Conference is a 2-day conference that will be held twice. One on March 6-7 and repeated on March 8-9, 2012, at the Hyatt Regency St. Louis at the Arch in St. Louis, MO. The conference registration will begin November 14, 2011 and close on December 30, 2011. Please visit the CMS MDS 3.0 Training Conference Information page: http://www.cms.gov/NursingHomeQualityInits/40_NHQIMDS30TrainingConferenceInformation.asp#TopOfPage for additional information. ****** Skilled Nursing Facilities/Long Term Care Open Door Forum (ODF) Overview: The Skilled Nursing Facilities / Long-Term Care Open Door Forum (ODF) addresses the concerns and issues of both the Medicare SNF, the Medicaid NF, and the nursing home industry generally. The types of issues that come up during this forum are often related to the Minimum Data Set, SNF Consolidated Billing, the roles and responsibilities of different SNF, NF or LTC professional staff under CMS regulations, clarifications of issues that are covered during a survey and certification process, and the many rules and requirements under which different related services can be payable. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the forums.
Page Last Modified: 02/07/2012 8:12:08 AM
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