• Q&A: I am being pressured to lie on the MDS. What actions can I take?

    By Judy W. Brandt, RN, BA, QCP, CPC, RAC-MT, DNS-CT - February 12, 2018
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  • At A Glance QM, QRP, and VBP Tool

    By AANAC - February 10, 2018
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  • The Quality Measure Survival Guide: What It Is and Why You Need It

    By Jessica Kunkler, MA, Staff Writer - December 04, 2017

    The new frontier of Quality Measures in long-term care is more challenging than ever and with so much updated information, it can feel like you are lost without a compass. Not only are there three quality reporting programs—MDS 3.0 Quality Measures, Quality Reporting Program (QRP) Measures, and SNF Value-Based Purchasing Program (VBP) Measures—there are more than 51 Quality Measures (QMs). Not to mention all the manuals in which the measures are currently found: Quality Measures Technical User’s Guide, Five-Star User’s Manual, Quality Reporting Program Technical User’s Guide, Nursing Home Compare Technical User’s Guide, SNF QM User’s Manual V1 (QRP Manual), and Nursing Home Compare Quality Measure Technical Specifications. All these programs, all these manuals, all these measures—how will you ever find the way?

    The experts at the American Association of Nurse Assessment Coordination created the Quality Measure Survival Guide to be your easy-to-use map to understanding the measures, explaining them to your team, and auditing your facility’s information in a way that makes sense.

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  • SNF VBP FY 2019 Incentive Payments Add Another Layer to the QM Mix

    By Caralyn Davis, Staff Writer - December 04, 2017

    The Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program has been on the back burner at most facilities as the Centers for Medicare & Medicaid Services (CMS) worked out the program details over the past few years. However, on Oct. 1, 2018, the SNF VBP program will begin impacting all traditional Medicare Part A payments made to SNFs under the skilled nursing facility prospective payment system (SNF PPS).


    The SNF VBP program is completely unrelated to the Skilled Nursing Facility Quality Reporting Program (SNF QRP). “The SNF VBP program is required by the Protecting Access to Medicare Act of 2014 (PAMA), whereas the SNF QRP is required under the Affordable Care Act,” pointed out CMS officials during the Nov. 16 SNF VBP Program FY 2018 SNF PPS Final Rule Call. Note: Access the call slides here. When available, access the transcript and recording here.


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  • Q&A: Will the new MDS items change the way Quality Measures are calculated?

    By Jessie McGill, RN, RAC-MT - November 01, 2017
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  • Covariates: A Quick List of 10 MDS Items to Watch

    By AANAC - October 05, 2017
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  • C1000: Don’t Let Assessors Under-Code This Key MDS Item

    By Caralyn Davis, Staff Writer - October 05, 2017

    Nurse assessment coordinators (NACs) frequently don’t code MDS 3.0 Section C (Cognitive Patterns), including the critical item C1000 (Cognitive Skills for Daily Decision-Making), notes Kristin Bernard Breese, BSN, RN, CPC, RAC-MT, owner of Post-Acute Clinical Advisors LLC in North Granby, CT. “The social worker is often making the coding decision for C1000, and MDS coordinators as a rule aren’t going back and checking their work.”


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  • MDS-Based Covariates: What They Are and Why They Matter

    By Caralyn Davis, Staff Writer - September 26, 2017

    Nine quality measures (QMs) across two different programs are calculated using MDS-based covariates. These measures include three publicly reported claims-based Five Star Quality Rating System QMs, five publicly reported MDS-based Five Star QMs, and one MDS-based Skilled Nursing Facility Quality Reporting Program (SNF QRP) QM that will be publicly reported beginning in fall 2018. In addition, effective Oct. 1, 2018, SNFs will be submitting MDS data for five SNF QRP QMs that have MDS-based covariates, increasing the total number of QMs with MDS-based covariates across both programs to 13.

    With covariates playing a growing role in QM calculation, nurse assessment coordinators (NACs) should pay attention to more than simple numerators, denominators, and exclusions. So a key question that all NACs need to be able to answer is: What exactly is a covariate?

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  • SNF QRP 101: Understanding the Data Threshold Requirement

    By Caralyn Davis, Staff Writer - September 06, 2017

    The Skilled Nursing Facility Quality Reporting Program (SNF QRP) is a pay-for-reporting program. SNFs must report all of the required data elements applicable to the program year on at least 80 percent of the MDS assessments that they submit for that program year. For example, for Fiscal Year (FY) 2019 beginning Oct. 1, 2018, SNFs must complete all required data elements on at least 80 percent of the required 5-Day PPS MDSs and Part A PPS Discharge assessments that they submit during FY 2019’s associated reporting period of Jan. 1, 2017 – Dec. 31, 2017.


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  • CMS Irons Out Details for FY 2019 SNF VBP Launch

    By Caralyn Davis, Staff Writer - August 16, 2017

    In the Fiscal Year (FY) 2018 Skilled Nursing Facility Prospective Payment System (SNF PPS) Final Rule, the Centers for Medicare & Medicaid Services sailed smoothly toward implementation of the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) program, implementing all policies as proposed in the FY 2018 SNF PPS Proposed Rule. The program will launch using the Skilled Nursing Facility 30-Day All-Cause Readmission Measure (SNFRM) (NQF #2510) and will impact Medicare Part A payments in FY 2019 effective Oct. 1, 2018. CMS plans to transition to another measure, the Skilled Nursing Facility 30-Day Potentially Preventable Readmission Measure (SNFPPR), “as soon as practicable.”


    CMS anticipates that the first opportunity to replace the SNFRM with the SNFPPR would be the FY 2021 program year. “However, we have not yet determined if it would be practicable to replace the SNFRM at that time,” the agency said. Note: CMS expects to submit the SNFPPR to NQF for endorsement consideration as soon as possible.


    “We intend to provide SNFs with SNFPPR rates [in their quarterly reports] prior to the replacement [of the SNFRM] for SNFs to learn more about the measure and incorporate [it] into their quality improvement and care transitions efforts to reduce readmissions. We also intend to further analyze the SNFPPR prior to replacing the SNFRM for any association with social risk factors. …,” said the agency. “We intend to update affected stakeholders on timing in future rulemaking.”

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  • Q&A: How long does a fall with fracture stay on the Quality Measures?

    By Scott Heichel, RN, DNS-CT, RAC-CT - August 16, 2017
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  • 9 CASPER Reports Available Now to Help with the SNF QRP

    By Caralyn Davis, Staff Writer - August 01, 2017
    The Review and Correct Reports for Q1 2017 (Jan. 1, 2017 – March 31, 2017) in the Skilled Nursing Facility Quality Reporting Program (SNF QRP) are now available by request via the CASPER reporting program in the QIES ASAP system. The data submission deadline for that data collection period is Aug. 15, 2017. However, the Review and Correct Reports contain facility-level quality measure (QM) data. Resident-level QM Reports are not slated to be available until October 2017, and threshold reports that will indicate whether SNFs are meeting the 80 percent threshold requirement don’t even have a release date yet.
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  • SNF QRP Review and Correct Reports: The Basics

    By Caralyn Davis, Staff Writer - July 11, 2017
    After a misfire, the first Skilled Nursing Facility Quality Reporting Program (SNF QRP) Review and Correct Reports for the data collection period of Jan. 1, 2017 – March 31, 2017, are now available to SNFs. (See the notice here.) This data collection period will remain open so that providers can continue to make relevant MDS submissions or corrections until the data correction deadline 4.5 months later on Aug. 15, 2017. As of that date, the MDS data for that quarter will be frozen for the purposes of meeting the SNF QRP data submission threshold for the MDS-based SNF QRP quality measures (QMs), as well as for the upcoming SNF QRP public reporting.
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  • Q&A: How can I check for errors on the SNF Review and Correct Report?

    By Carol Maher, RN-BC, CPC, RAC-CT - July 11, 2017
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  • SNF QRP Quarterly Deadlines Impact Payment and Public Reporting

    By Caralyn Davis, Staff Writer - June 20, 2017

    The next upcoming data reporting deadline for the Skilled Nursing Facility Quality Reporting Program (SNF QRP) is Aug. 15, 2017, for the data collection period of Jan. 1, 2017 – March 31, 2017. The SNF QRP quarterly data submission/correction deadlines are critical in two key ways, revealed the May 2 Review and Correct Reports Provider Training webinar held by the Centers for Medicare & Medicaid Services (CMS). (Access the recorded webcast here, the webcast slides here, and the participant Q&A document here.) The quarterly reporting deadlines occur 4.5 months after the end of each quarter, freezing the data for the following purposes:

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