Long-Term Care Survey Alert

Published on Mon Jun 27, 2011 PDF

Question: Can long-term care residents who are private pay or Medicaid and have Part B receive the new Medicare annual wellness exam? If so, what are the requirements in terms of who can provide the wellness visit?

Answer: "The annual wellness exam can be completed on an annual basis for all Medicare Part B participants," says Deb Philips, RN, RAC-CT, director of regulatory affairs for the Polaris Group in Tampa, Fla. "This can be completed in a skilled nursing facility by a nurse practitioner and does not replace the regulatory required visits in a SNF."

According to a CMS MLN Matters article, the following providers can perform the annual wellness visit:

• A physician (an MD or DO)
• A physician assistant, nurse practitioner, or clinical nurse specialist
• A medical professional, which includes "a health educator, registered dietitian, or nutrition professional or other licensed practitioner or a team of such medical professionals, working under the direct supervision of a physician ..."

The exam includes screening for cognitive impairment and risk factors for depression, as well as an effort to formulate a recommended preventive screening program for the patient.

"An annual wellness exam focused on prevention and assessing cognition can be very valuable -- if people do it," says Diana Waugh, RN, BSN, a consultant in Waterville, Ohio.

For more information about coverage and billing, see the MLN Matters article at http://www.cms.gov/MLNMattersArticles/downloads/MM7079.pdf.