Facility Benefits-The No Cost Solution
PrevMED’s Oral Health Maintenance® Program is a multi-step, fully integrated program which includes monthly on-site delivery of clinical services combined with regular communication, products and staff training. The focus of the Program is to remediate infection, control harmful bacteria and help prevent disease.
The OHM® Program professionally supplements and enhances your CNA’s daily oral hygiene care. So much more than just brushing teeth and so much more than just a dental plan…the PrevMED OHM® is the only on-site LTC oral healthcare program that serves every patient, every month. Anything less is not good enough to achieve systemic health benefits and downstream health cost savings.
The initial goal of the OHM® Program is to improve the general condition of the oral cavity. This alone greatly impacts the resident’s quality of life. Many residents do not eat simply because their mouth hurts and they cannot chew. They associate eating with pain. If the mouth has a putrid taste nothing tastes good. If eating is not a pleasure residents do not eat. We work to improve these conditions first. We believe that delivering the very best oral platform is the beginning of a good oral maintenance program.
Legal Compliance
A skilled nursing facility must ensure that a dentist is available for residents. PrevMED offers a fully-insured, third-party-pay program that can provide dental and oral hygiene services at no cost to the facility.
F411 & F412 Annual Assessment
The Federal government has issued a mandate, through regulations F411 and F412, to skilled nursing facilities to provide each resident with “access to dental services”, specifically mandating “an oral exam annually.” When a facility contracts with PrevMED to provide oral hygiene care, PrevMED will perform an oral assessment on all residents. Subsequently PrevMED can provide an assessment when the facility admits new residents.
After the assessment, PrevMED will work with your residents and our partners to process the appropriate paperwork to obtain insurance, and when appropriate, approval from Medicaid , securing reimbursement for qualified residents.
QIS & MDS 3.0
In January 2008, oral hygiene care was included as a marker in the national compliance measurer Quality Indicator Survey (QIS). Failure to provide oral hygiene services could result in deficiencies. Oral hygiene related performance historically accounts for 23% of Stage I deficiencies.
Part of the new comprehensive QIS survey specifically requires the random selection of residents and family members for questioning regarding oral hygiene care. The oral hygiene regime accounts for 8% of the QIS. The PrevMED OHM® Program delivers oral hygiene services to all participating residents in a facility. These services are designed to help facilities meet the new Federal Requirements with respect to the QIS as well as the MDS 3.0.
Fully Insured* 100% Reimbursed Program
In order to offer our OHM® Program to as many residents as possible, PrevMED has partnered with Senior Dental Insurance Solutions (SDIS). SDIS exclusively offers the PrevMED Oral Health Maintenance® Plan as an insurance program with a guaranteed monthly schedule of benefits and fixed monthly premium for all policy-holders. This relationship is designed to meet both the business needs of the facility as well as the clinical needs of the residents. Policy relationships are between SDIS and the resident or family. All policy holders become patients. You can learn more about SDIS by visiting www.seniordentalinsurancesolutions.com.
The PrevMED OHM® Program is available for all residents. For qualifying Medicaid residents, there is no out-of-pocket cost for the program. Funds are made available through an adjustment to the ICP recipient’s post-eligibility calculations, meaning the facility is owed less. Medicaid then reimburses the difference to the facility.
*In Georgia the OHM® is offered as a monthly Health Plan by Senior Dental Solutions and it is not an insurance program. In Texas the Program is a Health Plan covered under a schedule of benefits. See the individual <State> information for details.