Compliance, Operations and Reimbursement
As health care experts, The Merritt Search Group provides Skilled Nursing Facilities, Acute Care Hospitals and Hospital Transitional Care Units (TCU) with the clinical expertise to successfully manage the clinical, operational and compliance components of Medicare, Medicaid and Rehabilitation Programs.
In providing external audits as described in the 7 elements of an effective compliance program by the Affordable Care Act, we assist skilled nursing facilities with 3rd party unbiased compliance audits while simultaneously implementing a sustainable compliance culture.
Our team of experienced operators and clinicians partner with all levels of the skilled nursing facility interdisciplinary team in an effort to affect change resulting in higher quality clinical care and optimal compliance. All recommendations are based on patient-specific, clinically-indicated services, combined with the supporting documentation.
• Medicare Reimbursement in a Skilled Nursing Facility – Medicare 101
Reviews the inception of the Prospective Payment System into Skilled Nursing Facility along with the evolution and impact of the Final Rule, Balance Budget Refinement Act and Beneficiary Improvement and Protection Act.
• Medicare Length of Stay (LOS)
Assessment of historical Medicare Part A admissions and discharges over designated period of time. Summary of calculated length of stay, discharge destination, and opportunities for improvement.
• Medicare Documentation for Therapy in a Skilled Nursing Facility
Overview of Medicare Entitlement, eligibility and coverage criteria leading into samples and examples of supporting and non-supporting skilled documentation.
• Resource Utilization Groups (RUGs III – 53): “The Clinical and Financial Perspective”
Detailed review of the “NEW” 53 Medicare Resource Utilization Groups including the specific level criteria in relation to the rate of reimbursement.
• Medicare Entitlement, Eligibility and Cover Criteria in a Skilled Nursing Facility
This program provides a comprehensive training on the rules and regulations allowing Medicare Part A and Medicare Part B coverage during a Skilled Nursing Facility Stay. Topics addressed: Benefit Period, Skilled Care, Denial Letters, Final Rule, Entitlement, Eligibility and Coverage Criteria.
• Medicare Enhancement Tips and Strategies
An overview of the areas that significantly impact Medicare Reimbursement and MDS Integrity. Will discuss areas of opportunity and associated dollar impact. In addition, you will receive strategies to prevent inaccurate MDS’s and enhance overall revenue.
• Denials Management
Consultation/assistance with Medicare Audits and completion of Medicare Medical Record Questionnaires.
• Rehabilitation Systems Management
Financial assessment of existing rehabilitation services arrangement. Recommendations and consultation on implementation of in-house rehabilitation services. (In-house vs. contact labor). New Dimensions Healthcare Consulting can help you determine the benefits and or drawback of managing your therapy program in-house through our in-house versus outsourced therapy presentation.
• Rehabilitation Systems Management
Financial assessment of existing rehabilitation services arrangement. Recommendations and consultation on implementation of in-house rehabilitation services. (In-house vs. contact labor).
Consultation to include:
• Consultation: At the facility’s request, New Dimensions Healthcare Consulting, LLC will complete financial/operational analysis of Medicare and therapy related. Our initial assessment outlines your facility-specific operational and clinical needs. We will also assist you with budgetary recommendations. We will review and make recommendations in the following areas.
• Implementation of operational requirements (staffing, equipment, etc.)
• Implementation of most effective treatment programs
• Establishment of quality assurance program
• Establishment of policy and procedures
• Monthly financial report inclusive of operational variances to budget, productivity, cost per hour, profitability and more
• Management of on-staff clinicians to enhance employee practice patterns, care plans, interdisciplinary treatment and development of new rehabilitation programs
• Assist with community awareness and marketing calls in support of facility marketing strategy
• Establishment of systems for weekly rehabilitation meetings, care plan attendance, and other facility requested requirements
• Assist facility with Denials Management Program
• Mentoring, directing and supporting rehabilitation department
Facility Census Development
Provide facility with Census Development Manual and training to assist with patient identification and development. Will provide Strategic planning and guidance through this process.
Therapy Related Seminars Training Modules
• Restraint Reduction
• Body Mechanics
• Transfer Training
• Restorative Feeding
• Range of Motion
• ADL Training
• Adaptive Equipment
• Functional Maintenance
• Contracture Prevention
• Dementia Management
• Restorative Nursing
• Skilled Documentation
• Wound Care
The Merritt Search Group also offers Human Resource professionals who can evaluate the effectives of your existing HR strategies as well as design and implement state of the art programs to ensure your HR organization is in alignment with overall strategic objectives. We can provide consultation/assistance with policy and procedural development, recruiting and retention strategies, employee handbook development, HR skills training for management, union campaign assistance and union negotiations assistance.
In these highly competitive times, your organization can afford nothing less than maximum commitment, productivity, and participation from its most valuable resource – its people. However, many organizations face challenges in this area such as high turnover, discontent, lower than desired productivity, or perceived pay inequities. Most companies spend upwards of 80% of their budget on people, including salaries, benefits, and taxes. Yet few have a well-developed human resources (HR) management function. Client demand for high quality HR consultation led us to enhance service offerings in this area. Our personnel provide healthcare companies with specialized human resource expertise and consultation. From the specific to the general, our expert staff is ready to partner with you to meet your specific HR needs.
• Customized recruitment and assessment services
• Downsizing support services
• Compensation services so employers can apply salary and pay options accurately and strategically
• We help establish the bottom line benefits of HR initiatives and help articulate them to senior management.
• New Dimensions recognizes the value people bring to an organization and will help work with yours to ensure this resource is developed and utilized to its fullest potential.
• New Dimensions will help design and implement each of our initiatives to fit your organization’s culture and strategic objectives
• Affirmative action compliance
New Dimensions Human Resource expertise will provide consultation and training on the following HR Initiatives:
• Employee Relations
• HR Policies and Procedures
• Environmental Assessments
• Performance Management Process
• Performance Review Systems
• Conflict Management
• Exit Interviews