• SNF QRP’s Drug Regimen Review Items: Coding Tips

    By Caralyn Davis, Staff Writer - December 03, 2018

    Effective Oct. 1, 2018, skilled nursing facilities must capture three new drug regimen review items in section N (Medications) of the MDS for traditional fee-for-service Medicare Part A residents:

     

    ·         On every 5-day PPS MDS (A0310B = 01):

    o   N2001 (Drug Regimen Review), which asks, “Did a complete drug regimen review identify potential clinically significant medication issues?,” and

    o   N2003 (Medication Follow-up), which is completed if N2001 = 1 (yes) and asks, “Did the facility contact a physician (or physician-designee) by midnight of the next calendar day and complete prescribed/recommended actions in response to the identified potential clinically significant medication issues?”; and

    ·         On every Part A PPS Discharge assessment (A0310H = 1):

    o   N2005 (Medication Intervention), which asks, “Did the facility contact and complete physician (or physician-designee) prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the admission?”

     

    These three items play two key roles in the Skilled Nursing Facility Quality Reporting Program (SNF QRP):

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  • TIP: Are you ready for PDPM?

    By AANAC - December 03, 2018
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  • SNF QRP Hurricane Michael Data Submission Exceptions (12/18)

    By CMS - December 03, 2018
    The memo lists specific counties that get the exceptions but also notes that SNFs outside those counties can request exceptions if there are extraordinary circumstances.
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  • SNF QRP October 2018 Help Desk FAQs (11/18)

    By CMS - November 17, 2018

    Skilled Nursing Facility Quality Reporting Program (SNF QRP) Help Desk Questions and Answers (Q+As) and Quarterly Updates October 2018

    The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) was implemented on October 1, 2016. This document is intended to provide guidance on questions that were received by the SNF QRP Help Desk from April 2018 –June 2018 (Section 1). This document also contains quarterly updates and events from April 2018 –June 2018 (Section 2) as well as upcoming updates for the next quarter, from July 2018 –September 2018 (Section 3). Guidance contained in this document may be time-limited and may be superseded by guidance published by CMS at a later date.

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  • What’s New in the 2018 AANAC Quality Measures Survival Guide?

    By Jessie McGill, RN, RAC-MT - November 14, 2018

    Often, when myriad changes hit all at once, even anticipated ones, it is difficult to implement them, especially when they seem to be coming from every direction. Every fall we expect updates from the Centers for Medicare & Medicaid Services (CMS) to the RAI User’s Manual, Five-Star Quality Rating System, Skilled Nursing Facility (SNF) Quality Reporting Program (QRP), and Quality Measures (QMs). When these updates bring big changes—some of which we expect and some, of course, we do not—we have to adapt our facility processes quickly. This is a significant challenge, considering that it requires us as leaders to thoroughly understand many changes from multiple manuals and reporting programs.

    This fall CMS released significant updates to the SNF QRP Measure Calculations and Reporting User’s Manual and the Nursing Home Compare Claims-Based Quality Measure Technical Specifications. AANAC has updated the 2018 AANAC Quality Measures Survival Guide to include these changes. Here’s an overview of what’s new:

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  • MDS Items Impacting Reimbursement for RUG-IV, PDPM, and SNF QRP

    By AANAC - November 12, 2018
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  • Get Serious About Active Diagnoses / ICD-10 to Survive PDPM

    By Caralyn Davis, Staff Writer - October 30, 2018

    Active diagnoses and ICD-10-CM diagnosis codes will be a significant payment driver in the Patient-Driven Payment Model (PDPM) that goes into effect on Oct. 1, 2019, under the skilled nursing facility prospective payment system (SNF PPS) for traditional Medicare Part A residents. Diagnoses will impact all five of the case-mix-adjusted payment categories: physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP), nontherapy ancillary (NTA), and nursing, notes Judy Wilhide Brandt, RN, BA, QCP, CPC, RAC-MT, DNS-CT, principal of Wilhide Consulting in in Virginia Beach, VA.

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  • PDPM and ICD-10-CM Quick Reference Guide

    By AANAC - October 18, 2018
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  • Are You Using the Right FY 2019 Federal RUG Rates?

    By Caralyn Davis - October 16, 2018

    On Oct. 3, CMS published a correction notice for the Fiscal Year (FY) 2019 Skilled Nursing Facility Prospective Payment System (SNF PPS) final rule to address a series of technical errors. “Chief among those” were corrections to the total case-mix-adjusted federal per-diem RUG-IV payment rates that were necessary due to errors in copying values, said officials with the Centers for Medicare & Medicaid Services (CMS) at the Oct. 11 Skilled Nursing Facility/Long-term Care Open Door Forum (ODF).

     

    Specifically, CMS has issued updated versions of both Table 6, “RUG-IV Case-Mix Adjusted Federal Rates and Associated Indexes—Urban,” and Table 7, “RUG-IV Case-Mix Adjusted Federal Rates and Associated Indexes—Rural,” to correct the Total Rate column. For example, those tables in the FY 2019 SNF PPS final rule show federal RUX payment as $832.89 for urban SNFs and $852.10 for rural SNFs. The correction notice changes the federal RUX rate to $832.61 urban and $851.84 rural.

     

    Other FY 2019-specific corrections include the following:

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  • Q&A: Could you please clarify when and where deep tissue injuries (DTI) and other unstageable pressure ulcers will be included in Quality Measures?

    By Scott Heichel RN, DNS-CT, RAC-MT - October 16, 2018
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  • PDPM At-a-Glance Tool

    By AANAC - October 03, 2018
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  • CASPER Reporting User’s Guide for MDS Providers UPDATED (10/18)

    By QTSO - October 01, 2018
    Provides information and instructions pertaining to CASPER Reporting, including accessing Final Validation Reports.
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  • FY 2019 SNF PPS Final Rule PLUS Correction, Updated Wage Index Tables (10/18)

    By CMS - October 01, 2018
    Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities Final Rule for FY 2019, SNF Value-Based Purchasing Program, and SNF Quality Reporting Program

    This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2019. This final rule also replaces the existing case-mix classification methodology, the Resource Utilization Groups, Version IV (RUG-IV) model, with a revised case-mix methodology called the Patient-Driven Payment Model (PDPM) beginning on October 1, 2019. The rule finalizes revisions to the regulation text that describes a beneficiary’s SNF “resident” status under the consolidated billing provision and the required content of the SNF level of care certification. The rule also finalizes updates to the SNF Quality Reporting Program (QRP) and the Skilled Nursing Facility ValueBased Purchasing (VBP) Program. 

    Correction Notice SUMMARY: This document corrects technical errors in the final rule that appeared in the August 8, 2018 Federal Register (83 FR 39162) entitled “Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNF) Final Rule for FY 2019, SNF Value-Based Purchasing Program, and SNF Quality Reporting Program.” DATES: The corrections in this document are effective October 1, 2018 .

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  • At A Glance QM, QRP, and VBP Tool

    By AANAC - September 25, 2018
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  • SNF QRP Measure Calculations and Reporting User's Manual Update (9/18)

    By CMS - September 14, 2018

    This manual presents methods used to calculate quality measures that are included in the Centers for Medicare & Medicaid Services (CMS) Skilled Nursing Facility (SNF) Quality Reporting Program (QRP). This manual provides detailed information for each quality measure (QM), including quality measure definitions, inclusion and exclusion criteria and measure calculation specifications.

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