April 27

The Texas Department of Aging and Disability Services (DADS) informed nursing facilities, community services, ICF/MR, and therapy providers about the National Provider Identifier (NPI) reporting process.

An NPI is a 10-digit number used to identify health care providers. To prevent delays in billing, all providers that contract with DADS are required to report an NPI or Atypical Provider Identifier to DADS before June 1, 2007. For more information, download the letter here.

May 1

DADS notified assisted living, adult day care, nursing, ICF/MR, and home and community support facilities that all applicants, controlling parties, and affiliates will be asked to give their Social Security numbers and dates of birth on license applications so that DADS can run criminal history checks, effective June 1, 2007. For more information, download the letter here.

In a letter dated April 26, the Texas Department of Aging and Disability Services informed nursing facility providers new to the STAR+PLUS program about the program’s enrollment procedures and assured them that effective January 1, 2007, the STAR+PLUS enrollment will not impact the nursing facility process.

For more information, download the letter here.

The Centers for Medicare and Medicaid Services released a memo dated April 20 to state survey agency directors concerning “Permitted Gaps in Corridor Doors and Doors in Smoke Barriers” in hospitals, surgery centers, nursing homes, and other provider facilities.

Briefly, the purpose of the memo is to clarify requirements for door gaps. The memo contains a drawing for clarification and frequently asked questions. For example:

Question 1: Does the Life Safety Code limit the gap between the edge of a corridor door and the door frame to 1/8-inch?

Answer: No. However, because the door stop functions as an astragal, the gap between the edge of a door and the door frame shall not be greater than the depth of the door stop.

For more information, download the memo here.

On Friday, March 23, 2007, the Centers for Medicare and Medicaid Services (CMS) broadcast a two-hour presentation on improving nursing home quality and payments via satellite and the Internet. The presentation was shown on the CMS digital network channel 712.

Providers interested in seeing the presentation can watch it via webcast for up to 12 months at CMS’s webcast page. For more information about topics discussed, download the memo here.

In a letter dated March, 6, the Texas Department of Aging and Disability Services (DADS) reminded nursing facilities of the state requirement that medications of deceased residents, expired medications, and discontinued medications must be disposed as instructed by government laws and rules. For more information, download the letter here.

DADS also issued a federal survey and certification letter (CMS) and a state memo. Download the federal survey letter, Clarification of Provider Number Nomenclature, and the state memo, Pandemic Influenza.

In a letter to Home and Community Support Services Agencies, the Texas Department of Aging and Disability Services (DADS) reminds these providers of the requirement to report allegations of abuse, neglect, or exploitation of clients to DADS and the Department of Family and Protective Services (DFPS).

These incidents previously were investigated by on-site visits. In September 2004, the process was changed to allow desk reviews instead of on-site visits. The provider letter answers frequently asked questions about the desk review process. You may download the letter here.

In other provider news, DADS issued a letter to Nursing Facilities, Community Services Providers, ICF/MR Providers, and Therapy Providers about the National Provider Identifier (NPI) Collection Process.

The agency will begin collecting NPI from all heath care entities contracting with it. For information on how NPI notifications will be accepted and where to send them, download the letter here.

There will be a public hearing for comment on the proposed payment rates for state-owned veterans nursing facilities on October 19, 2006, at 10:00 a.m. in the Permian Basin Room of Building H, Braker Center at 11209 Metric Boulevard, Austin, Texas.

The hearing will be conducted by the Texas Health and Human Services Commission. See the Texas Register for more information.

1) The Texas Department of Aging and Disability Services (DADS) informed providers about an electronic procedure for submitting documents following a visit from a surveyor and the finding of a deficiency or violation. From the letter (dated July 31):

Question: Does sending the Statement of Deficiencies form (CMS-2567) or Statement of Violations form (DADS-3724) with the Plan of Correction (PoC) by electronic mail (e-mail) satisfy the State Operations Manual (SOM) requirement and state requirement to send/mail the completed PoC to the survey office?

Answer: Yes, and the same timeframes apply to electronic transmission as apply to regular mail or fax. However, providers should be sure to get confirmation that the documents (3724 and/or 2567) were received by requesting and printing out a copy of a “read receipt” or other return e-mail which clearly shows that the intended individual received the sender’s e-mail.

You may download the letter here.

2) DADS issued an addendum to Provider Letter 06-24, which stated that all nursing facilities are required to electronically submit MDS assessments on private-pay residents.

The addendum was issued to help providers simplify the process of initial submissions. You may download the letter (dated July 31) here.

The Texas Department of Aging and Disability Services reminds providers that in fiscal year 2007, any claims remaining from fiscal year 2004 become miscellaneous and won’t be paid through the standard Claims Management System payment process.

If the service dates on a claim are earlier than two previous fiscal years and the current year, it is dubbed “miscellaneous.” For more information, download the letter here.

In a letter that replaces PL #06-08, the Texas Department of Aging and Disability Services (DADS) alerted Home and Community Support Services Agencies (HCSSA) to expect more delays for initial licensure and Medicare certification. Region 6 (Houston Regional Office) and Region 3 (Arlington Regional Office) could see delays of up to a year.

In the updated letter, DADS added or changed information about the process. For example, providers must request initial licensure at least six months before the license expiration date and notify regional HCSSA program managers if they fall below the required census level for initial certification survey (10 patients served with 7 active).

You may download the letter here.

In a provider letter dated June 30, 2006, the Texas Department of Aging and Disability Services reminded community service providers, ICF-MR provider agencies, nursing facilities, and therapy providers of the “importance and usefulness” of Remittance and Status reports (R&S).

Providers should review the reports to make sure billing is correct and recoupments are valid. Providers should also alert the state office staff about incorrect billing and invalid recoupments within the 12-month filing period so that services can be re-billed. Inaccurate R&S reports can result in penalties and audits.

You may download the letter here.