Welcome to The Billers' Association For Long-Term Care

The Billers’ Association for Long-Term Care (BALTC) is a membership community created specifically for professionals involved in the long-term care revenue cycle. This national association provides members with a resource of continuously updated tools, reimbursement and regulatory guidance, and education to help prevent revenue loss and documentation and billing errors so providers can withstand audits at any point in time. With its involved expert advisory board members and active talk group, this engaged group of professionals is a great place for sharing and receiving best practices, tips, and tools with your peers.

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RCS-1 draft model calculation worksheet

Mar 08, 2018
The Bottom Line

SNF providers are on the edge of their seats as they anticipate CMS’ consideration of a replacement for the Resource Utilization Group (RUG) system, which will change the way facilities are reimbursed for SNF Medicare Part A residents beginning as early as FY2019. The Resident Classification System, Version 1 (RCS-1) will be the most significant change in the current reimbursement model, which has been in place for nearly two decades.

While providers wait for an official implementation date, CMS has laid a lot of groundwork and published several documents regarding RCS-1 in draft format, including a calculation worksheet for SNFs.

CMS explains that the purpose of this worksheet is to provide a step-by-step walk-through to manually determine a resident’s RCS-I classification based on the data from an MDS assessment. To download this draft document, click here.

For more guidance on how this new payment system will affect reimbursement in your facility, including how to use the new proposed case mix methodology and new ADL scoring, tune in to Goodbye RUG-IV, Hello RCS-1: How to Achieve Quality Outcomes Under a New Payment System led by industry expert Maureen McCarthy, BS, RN, RAC-MT, QCP-MT.

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