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  2. Minimum Data Set - Wikipedia

    en.wikipedia.org/wiki/Minimum_Data_Set

    MDS assessments are required for residents on admission to the nursing facility and then periodically, within specific guidelines and time frames. Participants in the assessment process are health care professionals and direct care staff such as registered nurses , licensed practical or vocational nurses (LPN/LVN), Therapists, Social Services ...

  3. Deemed status - Wikipedia

    en.wikipedia.org/wiki/Deemed_status

    In 1994 about 5000 hospitals were eligible to receive CMS funding as a result of being reviewed by the Joint Commission. [9]The Medicare Improvements for Patients and Providers Act of 2008 removed the deemed status of the Joint Commission and directed it to re-apply to CMS to seek continued authority to review hospitals for CfC and CoP.

  4. Medicare dual eligible - Wikipedia

    en.wikipedia.org/wiki/Medicare_dual_eligible

    A study by the Government Accountability Office (GAO) found that the integration of Medicare and Medicaid benefits generally improves the care provided to dual-eligibles but does not lead to Medicare savings or a reduction in costly Medicare services (i.e., emergency room visits, hospital admissions, and 30-day risk-adjusted all-cause ...

  5. Patient Self-Determination Act - Wikipedia

    en.wikipedia.org/wiki/Patient_Self-Determination_Act

    The Patient Self-Determination Act (PSDA) was passed by the United States Congress in 1990 as an amendment to the Omnibus Budget Reconciliation Act of 1990.Effective on December 1, 1991, this legislation required many hospitals, nursing homes, home health agencies, hospice providers, health maintenance organizations (HMOs), and other health care institutions to provide information about ...

  6. Consumer Assessment of Healthcare Providers and Systems

    en.wikipedia.org/wiki/Consumer_Assessment_of...

    They focus on aspects of healthcare quality that patients find important and are well-equipped to assess, such as the communication skills of providers and ease of access to healthcare services. [2] To customize a standardized CAHPS survey, users can add questions on a variety of topics.

  7. Need help with Medicare open enrollment? Oklahoma Hospital ...

    www.aol.com/help-medicare-open-enrollment...

    The Oklahoma Hospital Association published a free resource for Oklahoma seniors to navigate choosing a Medicare plan during open enrollment, which goes through Dec. 7.. Rich Rasmussen, the ...

  8. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

    Specialty services require a specific referral from the PCP to the specialist. Non-emergency hospital admissions also require specific pre-authorization by the PCP. Typically, services are not covered if performed by a provider not an employee of or specifically approved by the HMO unless it defines the situation to be an emergency.

  9. Ambulatory Payment Classification - Wikipedia

    en.wikipedia.org/wiki/Ambulatory_Payment...

    APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United States) program. A part of the Federal Balanced Budget Act of 1997 made the Centers for Medicare and Medicaid Services create a new Medicare "Outpatient Prospective Payment System" (OPPS) for hospital outpatient services -analogous to the ...