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Interpreting Your Skilled Nursing Facility PEPPER
Presenter
Keri Hart
Follow us :
A Facility-specific Action Plan in Response to PEPPER Data
2
About Keri
Keri Hart, MS-CCC, SLP, RAC-CT, CHHRP-QT
Keri Hart is the Vice President Clinical
Operations/Education and Training at Harmony
Healthcare International, (HHI) an industry
leader in Long Term Care consulting.
Over 25 Years Experience in Long-term Care
Rehabilitation Management
MDS
Follow Me! @CHHRPHart
Objectives
Learner will be able to:
State three variables contributing to initiation of the
PEPPER in the long-term care setting
Discuss the relevance of PEPPER percentile ranking
Define the calculations leading to Pepper Target Areas
Communicate a summary of their PEPPER data to key
staff
Identify their facility specific risk factors for Medicare
reviews
Develop a facility specific action plan in response to
PEPPER Data
3
PEPPER
This report will contain the SNFs detailed
facility specific Medicare claims data in certain
targeted areas and compare the SNF to other
SNFs nationally
Skilled Nursing Facilities (SNFs) should sign
up to receive email notification that your
PEPPER is available
PEPPERResources.org from the PEPPER
HELP Desk
(http://pepperresources.org/HelpContactUs.aspx)
4
Where is My Pepper?
Updated Release Schedule: On or about
May 6 through May 12, 2014
Staged Release
Freestanding SNFs will receive via a secure
portal on the PEPPERresources.org website
SNFs/Swing beds that are part of a short-term
acute care hospital (3rd digit in the PTAN/CMS
certification number/provider number = “U”) will
receive electronically via QualityNet secure file
exchange
5
Accessing Your SNF PEPPER
Access to the PEPPER will be restricted
to the provider’s Chief Executive Officer,
President or Administrator
Corporate offices and/or facility
management companies will need to
obtain PEPPERs from each individual
provider in their organization
6
PEPPER
Targeted areas were derived from two
recent Office of Inspector General (OIG)
Reports:
“Inappropriate Payments to Skilled Nursing
Facilities cost Medicare more than a Billion
Dollars in 2009” (November 2012)
“Questionable Billing by Skilled Nursing
Facilities” (December 2010)
7
Fraud, Waste and Abuse
The Government Accountability Office
has designated Medicare as a program at
high risk for fraud, waste and abuse
Payments to skilled nursing facilities
(SNFs) have been identified as
vulnerable to abuse
In 2012 the Office of Inspector General
(OIG) found that approximately 25% of
SNF claims were billed in error
8
To see the complete presentation check the
below link:
http://www.audioeducator.com/nurse/skilled-nursing-facility-pepper-08-
07-14.html

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Interpreting Your Skilled Nursing Facility PEPPER

  • 1. Interpreting Your Skilled Nursing Facility PEPPER Presenter Keri Hart Follow us : A Facility-specific Action Plan in Response to PEPPER Data
  • 2. 2 About Keri Keri Hart, MS-CCC, SLP, RAC-CT, CHHRP-QT Keri Hart is the Vice President Clinical Operations/Education and Training at Harmony Healthcare International, (HHI) an industry leader in Long Term Care consulting. Over 25 Years Experience in Long-term Care Rehabilitation Management MDS Follow Me! @CHHRPHart
  • 3. Objectives Learner will be able to: State three variables contributing to initiation of the PEPPER in the long-term care setting Discuss the relevance of PEPPER percentile ranking Define the calculations leading to Pepper Target Areas Communicate a summary of their PEPPER data to key staff Identify their facility specific risk factors for Medicare reviews Develop a facility specific action plan in response to PEPPER Data 3
  • 4. PEPPER This report will contain the SNFs detailed facility specific Medicare claims data in certain targeted areas and compare the SNF to other SNFs nationally Skilled Nursing Facilities (SNFs) should sign up to receive email notification that your PEPPER is available PEPPERResources.org from the PEPPER HELP Desk (http://pepperresources.org/HelpContactUs.aspx) 4
  • 5. Where is My Pepper? Updated Release Schedule: On or about May 6 through May 12, 2014 Staged Release Freestanding SNFs will receive via a secure portal on the PEPPERresources.org website SNFs/Swing beds that are part of a short-term acute care hospital (3rd digit in the PTAN/CMS certification number/provider number = “U”) will receive electronically via QualityNet secure file exchange 5
  • 6. Accessing Your SNF PEPPER Access to the PEPPER will be restricted to the provider’s Chief Executive Officer, President or Administrator Corporate offices and/or facility management companies will need to obtain PEPPERs from each individual provider in their organization 6
  • 7. PEPPER Targeted areas were derived from two recent Office of Inspector General (OIG) Reports: “Inappropriate Payments to Skilled Nursing Facilities cost Medicare more than a Billion Dollars in 2009” (November 2012) “Questionable Billing by Skilled Nursing Facilities” (December 2010) 7
  • 8. Fraud, Waste and Abuse The Government Accountability Office has designated Medicare as a program at high risk for fraud, waste and abuse Payments to skilled nursing facilities (SNFs) have been identified as vulnerable to abuse In 2012 the Office of Inspector General (OIG) found that approximately 25% of SNF claims were billed in error 8
  • 9. To see the complete presentation check the below link: http://www.audioeducator.com/nurse/skilled-nursing-facility-pepper-08- 07-14.html