NH Provider Action Required (PAR) Workflow

Five LTC Online Portal error messages were being transferred to the NH (Nursing Home) Provider Action Required (PAR) workflow on May 29, 2009.  The NH PAR Workflow allows nursing facility (NF) providers to independently manage their assessments and forms when errors occur.  This enables providers to identify and correct their errors in a timely manner, rather than having to call DADS or TMHP to determine why their forms did not process. 

Two of the five messages [NF-0004 & NF-0032] can involve processing issues which will require DADS to deploy a June 5, 2009, system fix.  It may take up to a week for this fix to cycle through the inventory.  Providers may choose to wait until June 12, 2009, to begin working these two error codes.  Note that all corresponding admissions and discharges (3618/3619) must be submitted for these forms to process.

However, only 10% of the NF-0004 errors have these processing issues; the vast majority of these errors are due to missing NF admission/discharge pairs (3618/3619).  Providers can take immediate action on these rejected forms as follows:

Ø      NF-0004:  The request cannot be processed because the client does not have a corresponding Nursing Facility admission (missing 3618/3619).  Please verify that the admission 3618/3619 has been processed.

Modifications with Purpose Code (PC) E

On May 8, 2009, TMHP released changes to the LTC Online Portal that no longer require a Modification to be submitted as a PC E [default Resource Utilization Group (RUG) value].

Modifications with a PC E that were submitted prior to this release, and which had a prior on-time original assessment, will be adjusted to pay at the calculated RUG rate.  DADS had anticipated having this process completed by May 29, 2009, but due to complexities in automating the process, will not have this completed until mid-June.  A subsequent broadcast will be released to notify providers of the planned dates when these changes will be run.