Conference Name: An Encore Presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
Scheduled Conference Date: Thursday, February 9th, 2006
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Scheduled Conference Duration: 90 Minutes
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An encore presentation - RUGs53: Navigating the new
payment categories from theSNF PPS Final Rule
1:00 p.m.–2:30 p.m. (Eastern)
12:00 p.m.–1:30 p.m. (Central)
11:00 a.m.–12:30 p.m. (Mountain)
10:00 a.m.–11:30 a.m. (Pacific)
presents . . .
A 90-minute interactive audioconference
Thursday, February 9, 2006
ii An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
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iiiAn encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
The “An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPSFinal Rule” audioconference materials package is published by HCPro, 200 Hoods Lane, P.O. Box 1168,Marblehead, MA 01945.
Copyright 2006, HCPro, Inc.
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iv An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
Dear colleague,
Thank you for participating in our “An encore presentation - RUGs 53:Navigating the new payment categories from the SNF PPS FinalRule” audioconference with Ronald Orth, RN, NHA, RAC-C, moderatedby Noelle Shough. We are excited about the opportunity to interact withyou directly and encourage you to take advantage of the opportunity toask our experts your questions during the audioconference. If you wouldlike to submit a question before the audioconference, please send it [email protected] and provide the program date in the subject line. Wecannot guarantee your question will be answered during the program, butwe will do our best to take a good cross section of questions.
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Shannon TierneyAudioconference coordinatorFax: 781/639-2982E-mail: [email protected]
200 Hoods LaneP.O. Box 1168
Marblehead, MA 01945Tel: 800/650-6787Fax: 800/639-8511
vAn encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
Agenda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vi
Speaker profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
Exhibit A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1 Presentation by Ronald Orth, RN, NHA, RAC-C
Exhibit B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25RUG III PPS Grouper Version 5.20—Case Mix Indices
Exhibit C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27RUG 53 Classification System, Version 5.20
Exhibit D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29ARD Selector Worksheet
Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Contents
vi An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
Agenda
I. Why RUG refinement
II. Introduction to nine new RUG categoriesA. Qualifiers
III. Overview of Case Mix Maximization
IV. Introduction to 5.20 grouper logic
V. Impact of Assessment Reference Date (ARD) and Activities of Daily Living (ADL) coding on RUG assignment and reimbursement
VI. CMS transition plan from 44 RUG to 53 RUG systemA. Billing purposes
Live Q&A
viiAn encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
Speaker profiles
Noelle Shough, Moderator
Noelle Shough is the Executive Editor of Long-Term Care. She edits books, newsletters, and e-zines thatfocus on the MDS, Medicare billing, survey, and staff training. In her six-year stint at HCPro, she has alsowritten and researched in the areas of rehab, credentialing, patient safety, nurse management, physicianpractices, and compliance.
Ronald Orth, RN, NHA, RAC-C
Ronald Orth is the owner and president of Clinical Reimbursement Solutions, LLC. He has more than 20years of experience in the healthcare field and has spent the past eight years specializing in the area ofMedicare SNF regulations and the PPS reimbursement system. Orth holds an associate degree in nursingand a bachelor’s degree in healthcare administration. He also holds a nursing home administrator’s license inthe state of Arizona.
Clinical Reimbursement Solutions offers an array of consulting services in the area of clinical reimbursement.For additional information, visit www.clinicalreimbursement.com.
Exhibit A
Presentation by Ronald Orth, RN, NHA, RAC-C
EXHIBIT A
2 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
1
RUGS 53: Navigating theNew Payment Categories
Clinical Reimbursement Solutions, LLCClinical Reimbursement Solutions, LLC
2
Why RUG Refinements??
• RUGs system inadequate in defining clinicalcomplexities of NH population
• Miscalculation of Medicare savings by CMS
• Increased costs since 1995 cost reports
• Some organizations ill prepared for changein reimbursement system
3An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
3
Impact on Industry
• 9 of the top 10 nursing home organizationsfiled bankruptcy
• Represents approx. 10% of the industry
• Unable to meet contractual agreements
• Generated concern that NH placement maybecome difficult for many acute careproviders
4
Government Response
• BBRA of 1999
– Temporary increase in payment rates by 20%for 15 of the RUG classification
– 4% increase in all RUG classifications
– Mandated refinement of RUGs system orpayment system
– Caused a Case Mix Index Maximization‘Anomaly’
– Rehab Medium RUGs paid more than Rehab High
– Rehab Medium had lower Case Mix Index
EXHIBIT A
4 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
5
Government Response cont’d
• BIPA of 2000
– Requires CMS to conduct a study of alternatecase-mix classification systems for SNF PPS
– Add-on for Rehab RUGs changed from 20%to 6.7%
– 6.7% add-on to remaining RUGs
– Continuation of 20% add-on for 12 NursingRUGs implemented in 1999
Problem Solved?
6
Broken Case Mix Maximization
• SE3 had lower CMI than many of theRehab RUGs however it paid MORE.
• Proper Case Mix Maximization = higherCMI higher payment
5An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
7
Broken Case MixMaximization cont’d
SE3 36 $374.96
RMC 37 $344.10
Lower
Weight
Higher
Payment
8
RUG Refinements 2006
EXHIBIT A
6 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
Rehabilitation
Extensive Services
Special Care
Clinically Complex
Cognitively Impaired
Reduced Phys. Funct.
Behavioral
Reduced Phys. Funct.
Behavioral
Cognitively Impaired
Clinically Complex
Special Care
Extensive Services
Rehabilitation
Rehab/Extensive
PresentPresent FutureFuture
7An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
11
New RUG LevelsRehabilitation/Extensive ServicesRehabilitation/Extensive Services
Category ADL Score
RUX 16-18
RUL 7-15
RVX 16-18RVL 7 -15
RHX 13-18
RHL 7-12
RMX 15-18
RML 7-14
RLX 7 -18
12
New RUG Criteria
Rehabilitation Component
• Remains unchanged from current system
• Therapy projection rules remain unchanged for 5-day and return/readmission assessments
EXHIBIT A
8 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
13
New RUG Criteria cont’d
Extensive Services Component
Must have ONE of the Extensive Services
K5a IV Fluids/TPN (7-day lookback)
P1ac IV Meds (14-day lookback)
P1ai Suctioning (14-day lookback)
P1aj Trach (14-day lookback)
P1al Vent/Respirator (14-day lookback)
ANDAND……
14
New RUG Criteria cont’d
ADL Component
ADL Score must be >=7
Same as current Extensive
Services criteria
9An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
15
Case Example
Resident received 250 minutes PT over 5days, 150 minutes OT over 5 days. IVmedications given in past 14 days, ADLscore 10.
Current RUG = RHB
New RUG = RHL (so you think!!)
Things that Make you go Hmmmmm……
16
New CMI and Hierarchy
• New system has resolved hierarchalissue
• Can be viewed as looking at two differentsystems
• 53 RUG System
• 44 RUG System
EXHIBIT A
10 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
30RLB30RLB
31SE231SE2
32RLX32RMA
33RMA33RLX
34RMB34RHA
35RHA35RMB
36RMC36RMC
37RHB37RHB
38SE338RVA
39RHC39RHC
40RVA40SE3
41RHL41RHL
42RHX42RHX
43RVB43RVB
44RML44RML
45RVC45RVC
46RVL46RVL
47RMX47RMX
48RVX48RUA
49RUA49RVX
50RUB50RUB
51RUC51RUC
52RUL52RUL
53RUX53RUX
Rural CMIRUGUrban CMIRUG
RUGIII 53 CMIRUGIII 53 CMI
Grouper Version 5.20Grouper Version 5.20
1. Resident can qualify
for multiple RUGs
2. Index Maximized –
will assign RUG
with highest CMI
3. Higher the CMI
higher the Payment
4. CMI Values 1-53
18
Case Mix Index Maximization
Mr. Smith’s 14-day MDS reveals the following:
5-days and 500 minutes of therapy
Dialysis
Short Term Memory Problem
Poor Decision Making
IV Meds
Pneumonia
Fever
ADL Score 10
11An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
19
Case Mix IndexMaximization cont’d
Mr. Smith’s would qualify for the followingRUG Categories:
5-days and 500 minutes of therapy
(RV,RH,RM)
Dialysis (Clinically Complex)
Short Term Memory Problem/Poor Decision Making (Impaired Cognition)
IV Meds (Extensive Services)
Pneumonia (Clinically Complex)
Fever (w/pneumonia = Special Care)
20
Strategies for Success
Main Considerations
�Accurate ARD Selections
�Accurate ADL Capturing
�Capturing Hospital Services
EXHIBIT A
12 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
21
Strategic ARD Selection
On Day 5 – Can capture 325 minutes and IV Meds, ADL Score 10
Day 6 – Can capture 350 minutes, however no IV Meds, ADL score 10
Which do you choose?
22
Strategic ARD Selection cont’d
Day 5 – Can capture 325 minutes and IV Meds, ADL Score 10 = RHL (41)
Day 6 – Can capture 350 minutes, however noIV meds, ADL score 10 = RHB (37)
Although resident qualifies for the RHL RUG category,grouper will place in RML due to higher CMI score.
Difference = $60.81/day
13An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
RUG-III Nursing Therapy Nursing Therapy Non-case Mix Non-case Mix Total
Category Index Index Component Component Therapy Comp Compo-RUX 1.90 2.25 $261.42 $233.19 $70.22 $564.83
RUL 1.40 2.25 $192.63 $233.19 $70.22 $496.04
RVX 1.54 1.41 $211.89 $146.13 $70.22 $428.24
RVL 1.33 1.41 $182.99 $146.13 $70.22 $399.34
RHX 1.42 0.94 $195.38 $97.42 $70.22 $363.02
RHL 1.37 0.94 $188.50 $97.42 $70.22 $356.14
RMX 1.93 0.77 $265.55 $79.80 $70.22 $415.57
RML 1.68 0.77 $231.15 $79.80 $70.22 $381.17
RUC 1.28 2.25 $176.12 $233.19 $70.22 $479.53
RUB 0.99 2.25 $136.21 $233.19 $70.22 $439.62
RUA 0.84 2.25 $115.58 $233.19 $70.22 $418.99
RVC 1.23 1.41 $169.24 $146.13 $70.22 $385.59
RVB 1.09 1.41 $149.97 $146.13 $70.22 $366.32
RVA 0.82 1.41 $112.82 $146.13 $70.22 $329.17
RHC 1.22 0.94 $167.86 $97.42 $70.22 $335.30
RHB 1.11 0.94 $152.72 $97.42 $70.22 $320.36
RHA 0.94 0.94 $129.33 $97.42 $70.22 $296.97
RMC 1.15 0.77 $158.23 $79.80 $70.22 $308.25
RMB 1.09 0.77 $149.97 $79.80 $70.22 $299.99
RMA 1.04 0.77 $143.09 $79.80 $70.22 $293.11
SE3 1.86 $255.92 $13.65 $70.22 $339.79
SE2 1.49 $205.01 $13.65 $70.22 $288.88
SE1 1.26 $173.36 $13.65 $70.22 $257.23
SSC 1.23 $169.24 $13.65 $70.22 $253.11
SSB 1.13 $155.48 $13.65 $70.22 $239.35
SSA 1.10 $151.35 $13.65 $70.22 $235.22
CC2 1.22 $167.86 13.65 70.22 $251.73
24
Strategic ARD Selection
On Day 5 – Can capture 325 minutes and IV Meds, ADL Score 10
Day 6 – Can capture 350 minutes, however no IV Meds, ADL score 10
Which do you choose?
EXHIBIT A
14 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
25
Strategic ARD Selection cont’d
Day 5 – Can capture 325 minutes and IV Meds, ADL Score 10 = RHL (41)RHL (41)
Although resident qualifies for the RHL RUGAlthough resident qualifies for the RHL RUGcategory, grouper will place in RML (44) due tocategory, grouper will place in RML (44) due to
higher CMI score.higher CMI score.
Day 8 – Can capture 510 minutes, however no IV meds, ADL score 10 = RVB (43)
Difference = $ 14.85Difference = $ 14.85
26
Strategic ARD Selection cont’d
Day 1 – Can capture SE3 RUG score, no therapy yet initiated
Day 3 – Can capture 300 minutes, can continue to capture enough extensive services to get SE2, ADL score 15
Day 8 – Unable to capture any extensive services qualifiers, ADL score up to16, therapy minutes 585.
Which do you choose?Which do you choose?
15An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
27
Strategic ARD Selection cont’d
Day 1 – Can capture SE3 RUG score, no therapy yet initiated = SE3 (40)
Day 3 – Can capture 300 minutes, can continue to capture enough extensive services to get SE2, ADL score 15 = RMX (47)RMX (47)
Day 8 – Unable to capture any extensive services qualifiers, ADL score up to 16, therapy minutes 585 = RVC (45)
28
Strategic ARD Selection cont’d
Day 1 – Can capture SE3 RUG score, no therapy yet initiated
Day 3 – Can capture 300 minutes, can continue to capture enough extensive services to get SE2, ADL score 15
Day 8 – Unable to capture any extensive services qualifiers, ADL score up to 15, therapy minutes 725.
Which do you choose?Which do you choose?
EXHIBIT A
16 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
29
Strategic ARD Selection cont’d
Day 1 – Can capture SE3 RUG score, no therapy yet initiated = SE3 (40)
Day 3 – Can capture 300 minutes, can continue to capture enough extensive services
to get SE2, ADL score 15 = RMX (47)
Day 8 – Unable to capture any extensive services qualifiers, ADL score up to 15, therapy minutes 585 = RUB (50)RUB (50)
30
Strategic ARD Selection cont’d
• Do not RUSH to choose date
• Must be flexible
• Must be reviewed frequently
• May have to wait until last day ofobservation period to determine best date
17An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
31
Strategic ARD Selection cont’d
Accurate ARD selection will greatly
depend on:
– Obtaining and reviewing hospital records forextensive service qualifiers
– Identify furthermost ARD date to capture newextensive/rehab RUG
– Establish estimated therapy plan for first 8 days
– ARD planning between the MDS Coord and Rehabmanager/staff
– Estimation/calculation of ADL score on frequent basis
32
Accurate ADL Capturing
ADLs drive nursing index of each RUG score
Number of RUGs requiring an ADL score > 6increases from 6 to 15
• Rehab/Extensive 9 RUGs
• Extensive Services 3 RUGs
• Special Care 3 RUGs
EXHIBIT A
18 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
33
Accurate ADL Capturing cont’d
Financial Impact of Inaccurate ADL coding
225 minutes therapy, IV meds, ADL score of 6
RUG = RMA = $293.11
225 Minutes therapy, IV meds, ADL score 8
RUG = RML = $381.17
Difference $ 88.06 x 14 days = $1232.84
34
Accurate ADL Capturing cont’d
Financial Impact of Inaccurate ADL coding
550 minutes therapy, IV meds, ADL score of 15
RUG = RVL = $399.34
550 Minutes therapy, IV meds, ADL score 16
RUG = RVX = $428.24
Difference $ 28.90 x 14 days = $404.60
19An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
35
Medicare ADL < 7Loss during first 14 days
SE3 SSA: ($104.57/day)
($1,463.98)
SE2 SSA: ($53.66/day)($751.24)
SE1 SSA: ($22.01/day)
($308.14)
36
Accurate ADL Capturing cont’d
Key points to remember regarding ADLS
• (A) Self Performance is 3 occurrences inassessment period, not 3 shifts
• (B) Support Provided need ONLY occur ONCEin lookback period
• Review all areas of the clinical record, includingtherapy notes
• Interview staff, resident if documentation notavailable
• Assess ADL status in person, if needed
• Clarify conflicting data in separate note, ifneeded
EXHIBIT A
20 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
37
Hospital Documentation
• CMS did not eliminate the lookback period
into the hospital, imperative to receive the
following
• MARS, TARS
• IV Records
• I & O
• H & P
• Most recent labs
• Physician progress notes/orders
• Nurses Notes
38
Hospital Documentation cont’d
Don’t forget aboutreadmissions to the SNF after
a rehospitalization!!!!
21An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
39
Hospital Documentation cont’d
• Be alert to key hosp. admitting diagnosis
• Chest Pain
• MI
• CHF
• Pulmonary Edema
• Pneumonia
• UTI
• Dehydration
40
Billing Implications
EXHIBIT A
22 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
41
Billing Implications
• New RUGs effective 1/1/06
– Service Dates beginning 1/1/06
– Assessments may be billed under bothsystems (44 Rug & 53 Rug)
– CMS has a transition plan
42
Billing Implications cont’d
• Transition Plan
– CMS is requesting software vendors tobe compliant with 53 RUG grouper by11/22/05
– Software should calculate both RUGscores between 11/22/05 and 1/13/06
23An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT A
43
Billing Implications cont’d
• Transition Plan
– Assessments with an ARD 11/22/05have the potential to be billed underboth systems.
– Assessments with an ARD up to 1/13/06have the potential to be billed underboth systems
44
Billing Implications cont’d
• Transition Plan
– Will need to review current billingprocesses to ensure billing the approp.RUG score effective 1/1/06
– No change in HIPPS codes
EXHIBIT A
24 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
45
Billing Implications cont’d
• Transition Plan
– Submission reports will display both RUG
classifications beginning 11/22/05 thru
1/13/2006
ClinicalClinical
Reimbursement Reimbursement
Solutions, LLC Solutions, LLC
““Keeping you Informed, Compliant and SuccessfulKeeping you Informed, Compliant and Successful””
www.clinicalreimbursement.comwww.clinicalreimbursement.com
Exhibit B
RUG III PPS Grouper Version 5.20—Case Mix Indices
Source: Ronald Orth, RN, NHA, RAC-C. Reprinted with permission.
EXHIBIT B
26 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
Exhibit C
RUG III PPS Grouper Version 5.20—Case Mix Indices
Source: Ronald Orth, RN, NHA, RAC-C. Reprinted with permission.
EXHIBIT C
28 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
Exhibit D
ARD Selector Worksheet
Source: Ronald Orth, RN, NHA, RAC-C. Reprinted with permission.
30 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
EXHIBIT D
Resources
PPS Alertfor Long-Term Care
PPS Alert for Long-Term Care is the industry's original and leading resource devoted specifically to theneeds of the MDS coordinator. This monthly newsletter will become your survival guide to the ResidentAssessment Instrument.
PPS Alert for Long-Term Care readers receive a 12-page issue every month, chock-full of:
• Up-to-the-minute analyses on the latest MDS coding changes to the form itself• Easy-to-understand explanations of government MDS accuracy programs, such as CERT, the
Comprehensive Error Rate Testing program and the next incarnation of DAVE• Painstaking dissections of all the trickiest coding sections of the form, such as the ADLs in Section
G, ulcers in Section M, and pain in Section J• Two pages of MDS Q&A each month written by industry expert Julia Hopp
As a special offer for our audioconference attendees, we'll take 20% off your invoice—and we'll guarantee
your satisfaction with our no-questions-asked 100% money-back guarantee.
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33An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
RESOURCES
Speaker resources
Ronald Orth, RN, NHA, RAC-CClinical Reimbursement Solutions, LLC215 W Maple Street, Suite 107Milwaukee, WI 53204Phone: 888/225-7147E-mail: [email protected] site: www.clinicalreimbursement.com
HCPro sites
HCPro: www.hcpro.com
With more than 17 years of experience, HCPro, Inc., is a leading provider of integrated information, educa-tion, training, and consulting products and services in the vital areas of healthcare regulation and compliance.The company’s mission is to meet the specialized informational, advisory, and educational needs of thehealthcare industry and to learn from and respond to our customers with services that meet or exceed thequality they expect.
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34 An encore presentation - RUGs 53: Navigating the new payment categories from the SNF PPS Final Rule
The Greeley Company: www.greeley.com
Get connected with leading healthcare consultants and educators at The Greeley Company’s Web site. Thisonline service provides the fastest, most convenient, and most up-to-date information about our quality con-sulting, national-education offerings, and multimedia training products for healthcare leaders. Visitors will finda complete listing of our services that include consulting, seminars, and conferences.
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Visitors of www.greeley.com will also find
• faculty and consultant biographies. Learn about our senior-level clinicians, administrators, and faculty whoare ready to assist your organization with your consulting needs, seminars, workshops, and symposiums.
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New!• Discharge Planning Summit• Core Privileging Advanced Course• Front-End Solutions Workshop• Physician Performance Profile Course
• Public Accountability for Quality• Case Management Institute
To register, call 800/801-6661 or visit www.greeley.com
Seminar Calendar
Spring
2006
9th Annual
Credentialing Resource Center
Symposium
May 17th & 20th
Pre- and Post- Conferences
Send a Team and Save!
Sears Tower, Chicago, IL
Viva Las Vegas!
Sunny Amelia Island, FL
Phoenix,
Golf
A S U P P L E M E N T T O H C P R O P U B L I C A T I O N S
April 6-7, 2006, The Ritz-Carlton Hotel, Phoenix, AZ
NEW! Case Management Institute: Managing by influence to maximize the effectiveness of your case management program
Through the institute’s step-by-step strategies, leaders can find solutions to problems related to excessive utilization andclinical resource costs, the enhancement of quality (while keepingexpenditures in check), and the improvement of communication/cooperation between case management, physician, and hospital leaders.
Early-Bird Discount: Register by February 2 to save $100!
April 6-7, 2006, The Ritz-Carlton Hotel, Phoenix, AZ
Effective JCAHO Survey Preparation for the Medical Staff
The JCAHO is seeking to re-engage physicians in a new, moredynamic survey process. Train your physicians and their teamson what to do when they disagree with the surveyor’s findings,the 2006 standards and patient safety goals, documentationchallenges, and much more.
Early-Bird Discount: Register by February 2 to save $100!
April 7, 2006, The Westin Hotel, Michigan Avenue, Chicago, IL
NEW! Discharge Planning Summit
Decrease denials, maximize length of stay, and increase efficiency. Learn how to comply with significant federal regulations and use your discharge planning process to support the business side of healthcare. You’ll walk away from this summit with strategies to boost revenue without losing sight of the needs of the patient.
Register early for team discounts!
April 20–21, 2006, The Ritz-Carlton Golf Resort, Naples, FL
UPDATED! Medical Staff Quality: Practical strategies for effective peer review, physician performance feedback, and managing physician performance
Get concrete steps to make your medical staff quality programtruly effective. Learn how to encourage positive physician performance, create effective physician performance feedbackreports, solve the challenges of peer review, improve hospitalsystems, and address clinical performance problems.
Early-Bird Discount: Register by February 16 to save $100!
April 20–21, 2006, The Ritz-Carlton Golf Resort, Naples, FL
Advanced Medical Staff Leadership Retreat: Where today’sleaders come to solve their toughest medical staff problems
Get an in-depth look at the six toughest challenges faced bymedical staff leaders today: ED coverage, disruptive physicianbehavior, physician/hospital collaboration and competition,matching proven competency with clinical privileges, physi-cian/physician and physician/hospital conflict, lack of effectivephysician leaders.
Early-Bird Discount: Register by February 16 to save $100!
April 21–22, 2006, The Ritz-Carlton Golf Resort, Naples, FL
Surgical Team Summit: Bringing together chiefs of surgery, chiefs of anesthesia, and surgical services leadership to tackle the toughest OR challenges
Surgical teams can bring in some of the highest revenue foryour facility. However, stress-free, efficient operating-room (OR) management is difficult to attain. Improve revenue andreduce inefficiencies while getting practical strategies for ORmanagement, regulatory compliance, turf-battle resolution,credentialing, and patient flow.
Early-Bird Discount: Register by February 16 to save $100!
Spring 2006 Seminar Calendar
MARCHMarch 3, 2006, MGM Grand Hotel, Las Vegas, NV
Rapid Response Team Retreat
Learn how to create Rapid Response Teams—dedicated staff that respond to an emergency before it occurs. This life-saving patient safetyinnovation—featured in the Wall Street Journal and part of The Institute for Healthcare Improvement’s (IHI) 100,000 Lives Campaign—hasbeen adopted by facilities of all sizes to decrease mortality rates by reducing adverse events and codes in critically ill patients.
Register early for team discounts!
APRIL
To register, or for continuing education credit opportunities for these seminars, call 800/801-6661 or visit www.greeley.com.
©2006 The Greeley Company, a Division of HCPro, Inc. HCPro is not affiliated in any way with the Joint Commission onAccreditation of Healthcare Organizations, which owns the JCAHO trademark.
June 1–2, 2006, The Ritz-Carlton, Amelia Island, Amelia Island, FL
Medical Executive Committee Institute: The essential trainingprogram for all medical staff leaders
Gain skills never taught in medical school. Topics include how to solve MEC challenges (turf battles, disruptive physicians, ED coverage, impaired physicians, conflict of interest, medical recordscompletion, external peer reviews, fair hearings, physician apathy)and improve performance for medical staff leaders.
Early-Bird Discount: Register by March 30 to save $100!
Coming Soon (June date and location to be announced)
Public Accountability for Quality
Hospital and physician data is being measured and reportedpublicly with consequences for marketing, reimbursement andaccreditation. This program will teach hospital teams responsiblefor improving performance on publicly reported data how togather data, interpret data, train management on how to usedata, and much more.
Ask about additional discounts!
May 17, 2006, Mandalay Bay Resort & Casino, Las Vegas, NV
NEW! Core Privileging Advanced Course: Design and implementation
Are you charged with the job of reviewing and recommending aredesign to core privileging? Where do you start, and how can youavoid the roadblocks that can hamper smooth implementation ofcore privileges? A pre-conference to the 9th Annual CredentialingResource Center Symposium, this full-day offering will takeparticipants through the key steps needed to design, modify, andimplement core privileges.
Ask about additional discounts!
May 18–19, 2006, Mandalay Bay Resort & Casino, Las Vegas, NV
UPDATED! The 9th Annual Credentialing Resource CenterSymposium
Learn practical and innovative approaches to solving your toughestcredentialing and medical staff challenges. For the past nine years,experts from The Greeley Company have offered medical staff andcredentialing professionals nationwide seminars on credentialinghot topics. Past topics have included low-volume/no-volumeproviders, core privileging, physician performance profiles, newtechnology, and much more.
Early-Bird Discount: Register by March 16 to save $100!
May 18–19, 2006, Mandalay Bay Resort & Casino, Las Vegas, NV
UPDATED! Achieving Continuous Survey Readiness ThroughPatient Tracers: A practical 5-step model to compliance
On January 1, 2006, the unannounced survey process goes intoeffect. Prepare now with the 5-step model to continuous surveyreadiness, a look at JCAHO hot spots, what’s new for 2006.
Early-Bird Discount: Register by March 16 to save $100!
May 18–19, 2006, Mandalay Bay Resort & Casino, Las Vegas, NV
Magnet Resource Center Advanced Workshop
Confused and overwhelmed by how to achieve Magnet status—the highest seal of nursing excellence? Then attendthis seminar to work one-on-one with the elite few nursingprofessionals who have already achieved Magnet status. These experts will outline clear action plans toward successfulcompletion of your Magnet application.
Register early for team discounts!
May 18–19, 2006, Mandalay Bay Resort & Casino, Las Vegas, NV
NEW! Front-End Solutions Workshop
Need help in improving your front end payment collections?Worried about the challenges of collecting high deductiblesand negotiating patient drug coverage that will change underMedicare Part D? Learn how to collect copays, respond to payment refusals, reduce bad debt, track results, and interactwith customers to help increase future business.
Ask about additional discounts!
May 20, 2006, Mandalay Bay Resort & Casino, Las Vegas, NV
NEW! Physician Performance Profile Course: Quality data andcurrent competence
Understand the collection and use of quality data to improvephysician performance and appraise the ongoing competenceof your medical staff. Topics include the domains of physicianperformance, the use and application of rule, rate and reviewindicators, and gaining physician buy-in.
Ask about additional discounts!
MT42135
MAY
JUNE
200 Hoods Lane, P.O. Box 1168, Marblehead, MA 01945 • tel 800/801-6661 • fax 800/738-1533 • e-mail [email protected] • web www.greeley.com
Spring 2006 Seminar Calendar