Celtic Consulting

What’s behind the unexpected CMS site visits? If your facility has experienced a surprise visit from the National Site Visit Contractors (NSVCs) recently, you’re not alone! CMS has been ramping up these unannounced visits, leaving many providers scratching their heads about what’s going on. The lack of clear communication from CMS about these visits has left facilities unsure about what to expect or how to respond. Celtic's Founder & CEO, Maureen McCarthy, captured this uncertainty in a recent McKnight's Long-Term Care News article, sharing: “When the people who educate consultants and others don’t know about something, it’s concerning. It was so suspicious with the way they came into facilities”. The good news? CMS is working to provide more clarity, but in the meantime, we know how unsettling these visits can feel. Have questions about how to prepare for ongoing NSVC visits? Contact Celtic Consulting, we’re here to help your facility stay prepared, informed, and confident no matter what surprises come your way. Check out the full article below.

?? 4 New SNF VBP Measures Are Here—How Will You Measure Up? On 10/1/24, CMS introduced four new metrics for the SNF VBP program, and yesterday, Maureen McCarthy tackled what they mean for providers at NYSHFA | NYSCAL’s Fall Financial Forum. Her session, “Decoding CMS’s New SNF VBP Metrics: How Will You Measure Up?” broke down the changes and offered actionable strategies to help facilities navigate this next phase of value-based care. Attendees gained a clear understanding of the new measures, how to assess their current performance, and steps to position their facilities for success in this evolving reimbursement landscape. If you couldn’t attend but want help navigating these changes, our team is here to support you! Contact Celtic today!

Join us tomorrow at the MA Senior Care Association's 2024 Annual Meeting & Trade Show at the Wellsworth Hotel in Southbridge! Celtic will be exhibiting at booth #17, and we'd love to connect with you. Stop by to chat with our team of experts about your 2025 outlook. Whether it's managed care strategies, upcoming quality changes, Medicaid CMI improvements, or Medicare revalidations, we’re here to discuss the topics that matter most to you. Let’s explore how we can support your goals for the year ahead. See you there!

Don’t Discount the Value of a Well-Planned Discharge Planning Process! Effective discharge planning is crucial for the success of SNFs and their patients. A comprehensive approach can make all the difference in achieving smooth transitions and better outcomes. ?? See what Maureen McCarthy had to say in McKnight's Long-Term Care News about advocating and collaborating for successful SNF discharges, based on her presentation at the 2024 AAPACN virtual conference. Read more of the McKnight's Article below. Looking for guidance on creating a successful discharge planning process? Contact Celtic Consulting to learn how we can support your team in optimizing patient outcomes and operational success.

?? Sweeping Changes Ahead for New York SNFs! ?? It was a pleasure to see so many engaged professionals at Maureen McCarthy’s recent session with NYSHFA | NYSCAL, "Vacuum the RUGs! Medicaid CMI Transition to PDPM", where we delved into the details of New York’s shift from the RUG-IV model to PDPM for Medicaid reimbursement. As NY SNFs prepare for this significant transition, Maureen outlined actionable steps to ensure they’re not only prepared but well-positioned to excel under the new PDPM system. Key takeaways from the session included: ?? The importance of precise assessment practices to capture resident needs accurately. ?? Leveraging interdisciplinary collaboration to align care and reimbursement. ?? Ensuring comprehensive staff training to support smooth implementation. Thank you to everyone who joined and participated in the conversation. As we “sweep away the old” and step into this new model, Celtic is here to guide you every step of the way. Contact us for tailored support as your SNF navigates the transition, from education and readiness assessments to implementation assistance. Let’s make this change a success!

?????? ???????? ???? ???????? ?????? ???????? ?????????? ???? ??????????? ??????’?? ?????????? ???? ?????? ??????????????????! Recently, we've heard reports from concerned providers questioning the legitimacy of CMS contractor site visits. After investigation into this matter we can confirm that these site visits are, in fact, authorized and legitimate. Here’s what you need to know to feel secure if you’re approached for a CMS site visit: ???????? ???? ????????????: According to CMS’s MLN Connects Newsletter (06/20/2024), these visits verify the operational status of providers and suppliers as part of their enrollment. Inspectors will carry a photo ID and a CMS-issued letter of authorization, which you may review but not retain or copy. ???????? ?????? ???????? ???? ????????: ? ???????????????????????? ????????????????: CMS has designated contractors for these site visits. Providers on the East Coast will be visited by contractors like Palmetto GBA and its affiliates, while West Coast providers are managed by Deloitte Consulting and its affiliates. ? ???????????? ?????? ??????????????: You may not receive advance notice for these visits, but your enrollment record in the Provider Enrollment, Chain, and Ownership System (PECOS) will reflect that a visit was ordered, ensuring it’s an official request. ? ?????????????? ??????????????????????: If you’re uncertain about a visit, you can contact your Medicare Administrative Contractor (MAC) directly. The Medicare Fee-for-Service Provider Enrollment Contact List offers MAC contact details for verification. ???????? ??????????????????? ????’???? ???????? ???? ????????! If you have concerns or need assistance verifying the authenticity of a site visit, please reach out. Celtic is here to support you in navigating this process confidently.

CT SNFs - Avoid Tricks in Your M&S Roster Report! ?? Halloween has arrived, and while the season is full of tricks and treats, your recent Myers and Stauffer Roster Report for CMI should not be one of them! Covering the period from 7/1/24 through 9/30/24, this report is key to determining your Q1 2025 payment rate. If your report brought more “tricks” than “treats,” Celtic is here to help! From verification to corrections, we can guide you through the next steps so you’re fully prepared. Important Dates to Remember: Review and Correct by: 11/14/24 (UTC consideration) Final Rate Letter Release: 12/10/24 Don’t let “tricks” in your report haunt your future payments! Reach out to us today to ensure your CMI capture is optimized and ready for the next quarter.

Celtic's Founder and CEO, Maureen McCarthy, had a fantastic experience at last week’s National Association of Rehab Providers and Agencies fall conference, connecting with so many passionate rehabilitation providers. She enjoyed diving into real-world solutions for navigating managed care challenges and sharing actionable strategies to ensure fair reimbursement. Maureen found it inspiring to witness the industry’s commitment—encouraging everyone to keep fighting the good fight! For any providers seeking support in holding MAOs accountable or guidance on utilizing the latest provisions from the CY24 and upcoming CY25 Final Rules, Celtic is here to help. Reach out to us for assistance!

Don’t miss our special rebroadcast on 10/30 at 1pm ET! A new SNF ABN must be in use by 10/31 - It's scary important to have a solid system in place for ABN utilization, so you can be proactive and avoid the fright of patient appeals or Medicare haunting your doorstep! There's been a lot of confusion about how to interpret changes to the new SNF ABN, but this session will clear it up and prepare you for the this week’s deadline. In this session, we’ll walk you through: ·??????Understanding what the SNF ABN is and why it is required ·??????When and how to complete the newly updated SNF ABN ·??????Explanation of the notice to beneficiaries and its impact ·??????How the SNF ABN (CMS-10055) differs from the ABN (CMS-R-131) Register here: https://lnkd.in/etY-cpRk

Our very own Maureen McCarthy, President of Celtic Consulting, will be presenting on 10/23 at the National Association of Rehab Providers and Agencies fall conference in San Diego! Her session, 'New Rules for Managed Care: How to Hold MCOs Accountable', will arm providers with strategies to navigate the latest managed care challenges. Maureen will dive into the implications of the Final Rule, discuss defensive documentation techniques, and provide actionable approaches to ensure fair reimbursement and accountability from MCOs. This is a must-attend for those looking to strengthen their knowledge and set themselves up for success as the popularity of MA plans continues to grow. If you’re attending, don’t miss this opportunity to gain valuable insights from an expert with decades of experience.