Resident interviews are required for each MDS submitted. These interviews must be completed as scripted in very specific timeframes. Deviating from the timeframes can have a negative impact on reimbursement. Resident interviews impact Quality Measures and some of the resident interviews impact Medicare Reimbursement. The resident interviews impact PDPM Medicare reimbursement as well as impacting state case mix payment models. By understanding the interview specific requirements, the NHA, the IDT and MDS team must collect this important data in a timely manner. The webinar will assist the clinical team to learn how this data can be used to guide resident-centered care.
This webinar will cover all of the above topics and each individual nationally validated scripted interview. ThePHQ-9 interview will become a PHQ 2-9 interview. An additional question has been added to the pain interview. There are revised instructions for each of the resident interviews including new instructions about the look-back period required for each interview that become effective 10/1/2023. This webinar will identify those important changes.
1. List which interviews will impact PDPM payment.
2. State the timeframes required to complete resident interviews that must be followed to prevent lost reimbursement.
3. Identify one major change to the PHQ-9 (mood interview) that becomes effective 10/1/2023.
4. Report which resident interviews impact Quality Measures.
Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC
Carol Maher is a Board Certified Gerontological Registered Nurse with over 30 years of long term care experience and has worked in long term care in many roles. She worked as the MDS Coordinator in a 300 bed SNF in Pennsylvania for 8 years before moving to CA to become the MDS Coordinator/Director for a 1200 bed SNF in San Francisco. She has also worked as the MDS Coordinator in a SNF that typically had 60-75 residents on Medicare in addition to 160 long-term care residents. Most recently she was the Senior VP of Utilization Services and Director of Reimbursement for large multi-facility organizations.
Carol has worked as one of the Gold Standard nurses for MDS 3.0, serving on the RAP workgroup to prepare the way for the CAAs for MDS 3.0, and participating on a number of Technical Expert Panels related to MDS, Quality Measures and care planning. A sought-after speaker, she has given presentations at AANAC, AHCA and Leading Age national conferences as well as many state organization presentations. She is also a frequent author of articles related to the RAI process and PPS. Carol served as a member of the AANAC Board of Directors for 9 years. She is presently serving as the chair of the AANAC Expert Advisory Panel and as an AANAC Master Teacher of the RAC-CT and RAC-CTA certification courses. Ms. Maher is the Director of Education for Hansen Hunter & Co. P.C., providing MDS and Medicare classes across the country, presenting monthly educational webinars and completing compliance audits. She is the author of Long-Term Care MDS Coordinator’s Field Guide (HCPRO 2016).
- 1.5 credit hours for RNs
- 1.5 credit hours for NABs
This pre-recorded webinar expires on June 30, 2025.