New Year’s Uber Rides and SNF Contracted Personnel

Man Using the Uber Taxi App on Iphone in NYC

This week’s tip is for the Skilled Nursing Facility (SNF) folks, but also has relevance to hospitals.

Each New Year’s Eve, there is demand for taxis—and now Uber drivers—to safely transport revellers home .This year, it was reported that Uber prices surged by nearly 10X during peak times (between midnight and 3:00 a.m.) following celebrations.

A similar situation exists for health care providers and the demand for their services. With the current strong economy, it has become a huge challenge for SNFs and hospitals to find personnel to provide necessary services to residents and patients. People have their choice of employer and locations in this competitive environment. Health care providers often have to resort to using contract nurses and other professionals who may have to travel several hours to a facility. In addition to an hourly wage, the facility may have to pay mileage, hotel and other travel costs to the contractor or an agency.

CMS recognizes that contracted personnel is a necessary and allowable expense, but there are further rules that govern what can be included for wage index computations (see Tips# 4 & 8 for further insight on wage index).

Tip #24:

SNF contracted personnel costs should not include miscellaneous items, such as travel or supplies expense. (Pub. 15-2, §4105.1).

Further guidance can be found on the Centers for Medicare and Medicaid Services (CMS) website:

Provider Reimbursement Manual 15-2

Questions? Please contact Marie White at 612.253.6546 or mewhite@eidebailly.com.

 

Documentation: “If a Tree Falls . . .”

“If a tree falls in a forest and no one is around to hear it, does it make a sound?”

Marie White

Marie White

One of the most challenging issues in health care is documentation. Like the above quote, it’s become somewhat of a cliché, but nevertheless it’s true: if you didn’t document it, you didn’t do it or it didn’t happen. This mantra is equally important for services you provide to patients, as well as services you purchase from others.

The hospital must ensure that supporting documentation for both salaries and hours are based on actual data maintained in a form that permits validation by the contractor. The use of estimates for these amounts is unacceptable for the wage index.

Tip #5:

When reporting contract labor for wage index, ensure you have hours to match expense (Pub 15-2, §4005.2)

Further guidance on the types of hours that should be included on Worksheet S-3, part II can be found on the Centers for Medicare and Medicaid Services (CMS) website:

Provider Reimbursement Manual 15-2

Questions? Please contact Marie White at 612.253.6546 or mewhite@eidebailly.com.

Wage Index Contract Labor – It Takes a Village

Marie White

Marie White

There’s an expression, “It takes a village to raise a child.” The same could be said for a hospital—it takes a village to run a hospital. Beyond the nurses and doctors who take care of the patients, there are housekeepers, radiology and laboratory techs, maintenance folks, and a myriad of others who all contribute to the day-to-day operations of the hospital.

Worksheet S-3, Part II is used to report wage and hour data which is needed to update the hospital wage index applied to the labor-related portion of the national average standardized amounts of the PPS. It is important for hospitals to ensure that the data reported on Worksheet S-3, Parts II, III and IV, are accurate.

Tip #4:

For Wage Index contract labor you may include clinical/patient care-related and/or executive/administrative services (Pub 15-2, §4005.2).

Further guidance on the types of expenses that should be included on S-3, Part II can be found on the Centers for Medicare and Medicaid Services (CMS) website:

Provider Reimbursement Manual 15-2

Questions? Please contact Marie White at 612.253.6546 or mewhite@eidebailly.com.