• Five-Star Helpline Open 2/24 - 2/28

    By CMS - February 21, 2020

    The Five Star Preview Reports are available as of February 18, 2020. To access these reports, select the CASPER Reporting link located on the CMS QIES Systems for Providers page. Once in the CASPER Reporting system, select the 'Folders' button and access the Five Star Report in your 'st LTC facid' folder, where st is the 2-character postal code of the state in which your facility is located and facid is the state-assigned Facility ID of your facility.

    Nursing Home Compare will update with February's Five Star data on February 26, 2020.

    Important Note: The 5 Star Help line (800-839-9290) will be available February 24, through February 28, 2020.


    Please direct your inquiries to BetterCare@cms.hhs.gov  if the Help Line is not available

    Read more
  • Appendix Z, Emergency Preparedness, State Operations Manual Update (2/20)

    By CMS - February 21, 2020

    SUBJECT: Revisions to the State Operations Manual (SOM) Appendix A - Hospitals, Appendix AA – Psychiatric Hospitals, Appendix B – Home Health Agency, Appendix D - Portable X-Ray, Appendix G - Rural Health Clinics/Federally Qualified Health Centers, Appendix H- End Stage Renal Disease Facilities (ESRD), Appendix K – Comprehensive Outpatient Rehabilitation Facility, Appendix L - Ambulatory Surgical Centers, Appendix M – Hospice, Appendix U - Religious Nonmedical Healthcare Institutions, Appendix W - Critical Access Hospitals (CAHs), Appendix X - Organ Transplant Program and Appendix Z - Emergency Preparedness

     

    I. SUMMARY OF CHANGES:

     

    This Transmittal includes regulatory revisions based on recent federal regulation changes (CMS-3346-F; CMS-3334-F; CMS-3295-F; CMS3277-CN). In addition, several updates to the appendices have been made for technical correction and clarity. The psychiatric hospital tags have moved from Appendix AA to Appendix A. Appendix AA is being deleted as surveyors will now refer to Appendix A for the psychiatric special condition tags and guidance. Specific references to the United States Pharmacopeia (USP) have been removed from Appendices A, G, and W accordingly, as CMS requires compliance with applicable Federal and State law and adherence to accepted general standards of practice or guidelines for pharmaceutical services and medication administration issued by nationally recognized professional organizations. Appendix H updates the regulatory text based on requirements set forth in the 2008 Conditions for Coverage for ESRD Facilities and also includes revisions based on recent Federal regulation changes set forth in “Fire Safety Requirements for Certain Dialysis Facilities (CMS-3334-P).” Revisions to Appendix W also include renumbering the C-Tags; inserting regulations §485.601, §485.603, §485.604, and §485.606; and inserting the CAH Distinct Part Unit and Emergency Medical Treatment and Labor Act (EMTALA) C-Tags for reference. This transmittal will assure each of the appendices are updated to reflect the current regulatory language within the Medicare conditions. More substantive interpretive guidance revisions in several sections are pending and will be updated with a future release. 

    Read more
  • How to Begin Prepping for October 1 MDS Changes

    By Caralyn Davis, Staff Writer - February 19, 2020

    With the implementation of the Patient-Driven Payment Model (PDPM) now fully under way for the Skilled Nursing Facility Prospective Payment System (SNF PPS), the Centers for Medicare & Medicaid Services (CMS) has begun turning the attention of nurse assessment coordinators (NACs) toward a new slate of changes that will implement this October 1, 2020. In December, CMS posted the draft version 1.18.0 MDS item sets, and in January, the agency followed up with the release of the 43-page MDS 3.0 Item Set Change History for October 2020 Version 1.18.0, which lays out—item by item—what new or revised items will be added to which item sets, as well as what items will be deleted from which item sets.

     

    Changes will occur in the following MDS sections:

    Read more
  • 3 Simple Ways Nurse Assessment Coordinators (NACs) Can Help Support Staff Retention

    By Jessica Kunkler, MA, Staff Writer - February 19, 2020

    Staff turnover is everyone’s problem, and in facilities across the United States, it’s a big one. One in four  nursing assistants and one in five home health aides report that they are actively looking for another job, according to the Recruitment and Retention Guide For Employers by PHI.

    Not only is turnover expensive, it negatively impacts residents. High turnover can result in less personalized care, an increased risk of infectious diseases among residents, and lowered quality of life and care.

    It also makes everyone’s job harder. As every NAC knows, a rotating door of floor nurses, CNAs, and other NACs means constant trainings on the same processes and repetitive reminders about how things are done correctly as newbies get up to speed.  

    Here are three ways that the NAC can support staff retention and make everyone’s time in their long-term care facility better.

    Read more
  • CMS Tool

    By AANAC - February 19, 2020
    Read more
  • FY 2022 SNF QRP Quick Reference Guide (2/20)

    By CMS - February 18, 2020
    Quick Reference Guide for FY 2022 is now available. The Quick Reference Guides provide high-level information on the SNF Quality Reporting Program, including frequently asked questions and helpful links.
    Read more
  • FY 2021 SNF QRP Quick Reference Guide (2/20)

    By CMS - February 18, 2020

    Quick Reference Guide for FY 2021 is now available. The Quick Reference Guides provide high-level information on the SNF Quality Reporting Program, including frequently asked questions and helpful links.

    Read more
  • CMS Proposes PASRR Changes (2/20)

    By CMS - February 18, 2020

    DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42 CFR Parts 431, 433, 435, 441, and 483 [CMS-2418-P] RIN 0938-AT95 Medicaid Program; Preadmission Screening and Resident Review

    AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.

    ACTION: Proposed rule.

    SUMMARY: This proposed rule would modernize the requirements for Preadmission Screening and Resident Review (PASRR), currently referred to in regulation as Preadmission Screening and Annual Resident Review, by incorporating statutory changes, reflecting updates to diagnostic criteria for mental illness and intellectual disability, reducing duplicative requirements and other administrative burdens on State PASRR programs, and making the process more streamlined and person-centered.

    Read more
  • CMS QSO Memo Explains 2 New Toolkits to Ensure Safety and Quality in Nursing Homes (2/20)

    By CMS - February 18, 2020

    CMS developed optional toolkits to aid nursing home teams with reducing adverse events and improving dementia care. These toolkits were the result of CMS work with nursing home Breakthrough Communities—a learning collaborative design where a subset of nursing homes joined learning sessions and team calls to learn about quality improvement concepts.

    Memorandum Summary

    The Centers for Medicare & Medicaid Services (CMS) is announcing the release of two toolkits that align with the CMS strategic initiative to Ensure Safety and Quality in Nursing Homes.

    • Developing a Restful Environment Action Manual (DREAM) Toolkit – CMS has created a toolkit that offers education and person-centered, practical interventions that nursing home administrators, directors of nursing, and bedside staff can implement to promote high-quality sleep for residents living with dementia.

    • Head-to-Toe Infection Prevention (H2T) Toolkit – CMS has created a toolkit that offers educational materials and practical interventions for bedside staff designed to prevent common infections by improving activities of daily living (ADL) care.

    Read more
  • CMS QSO Memo re: Coronavirus and Healthcare Facility Expectations (2/20)

    By CMS - February 10, 2020

    Memo #20-09-ALL

    Posting Date 2020-02-06

    Fiscal Year 2020

    Summary

    • Information Regarding Patients with Possible Coronavirus Illness: the U.S. Centers for Disease Control and Prevention (CDC) has issued information on the respiratory illness caused by the 2019 Novel Coronavirus (2019-nCoV). Links to these documents are provided.
    • Healthcare Facility Expectations: CMS strongly urges the review of CDC’s guidance and encourages facilities to review their own infection prevention and control policies and practices to prevent the spread of infection.
    Read more
  • Do You Know Who Your New QIN-QIO Is? (2/20)

    By Staff - February 05, 2020

    In November 2019, the Centers for Medicare & Medicaid Services quietly implemented the 12th Statement of Work for the Quality Improvement Network Quality Improvement Organizations (QIN-QIOs).

    This five-year contract includes a shift in how/where the QIN-QIOs operate. There are now 14 Medicare-funded QIN-QIOs nationwide. For example, IPRO is a lead contractor partnering with two other QIOs to cover 11 states and the District of Columbia. IPRO will direct activities in New York, New Jersey, and Ohio; Healthcentric Advisors will cover all six New England states (Maine, New Hampshire, Vermont, Massachusetts, Connecticut, and Rhode Island); and Qlarant will handle Maryland, Delaware, and the District of Columbia.

    "QIN-QIOs serving under the 12th Statement of Work will provide customized quality improvement to nursing homes and providers, serving rural communities and the most vulnerable populations. Through this body of work, CMS is focusing on results, protecting taxpayer dollars, and most importantly, ensuring the safety and quality of care delivered to every Medicare beneficiary," says HealthCentric Advisors.

     The QIN-QIOs will address nursing home and community coalition quality improvement in the following areas:

    • Improving Behavioral Health Outcomes – Including Opioid Misuse
    • Increasing Patient Safety
    • Increasing Chronic Disease Self-Management
    • Increasing the Quality of Care Transitions
    • Improving Nursing Home Quality
    Read more
  • MDS 3.0 Quality Measures (QM) User's Manual V13.0 (2/20)

    By CMS - February 05, 2020

    The MDS 3.0 QM User’s Manual V13.0 and Quality Measure Reporting Module Table V1.8 have been posted. The MDS 3.0 QM User’s Manual V13.0 contains detailed specifications for the MDS 3.0 quality measures. The MDS 3.0 QM User’s Manual V13.0 can be found in the Downloads section of this webpage and the MDS 3.0 QM User’s Manual V12.1 has been moved to the Quality Measures Archive webpage.

    The Quality Measure Reporting Module Table V1.8 documents CMS quality measures calculated using MDS 3.0 data and reported in a CMS reporting module, with a unique CMS identification number specified for each QM. The Quality Measure Reporting Module Table V1.8 can be found in the Downloads section of this webpage and the Quality Measure Reporting Module Table V1.7 has been moved to the Quality Measures Archive webpage.

    Two files related to the MDS 3.0 QM User’s Manual have been posted:

    1. MDS 3.0 QM User’s Manual V13.0 contains detailed specifications for the MDS 3.0 quality measures. MDS 3.0 QM User’s Manual V13.0 is included in the zip file titled User Manuals - Updated 01-21-2020 (ZIP).
    2. Quality Measure Identification Number by CMS Reporting Module Table V1.8 documents CMS quality measures calculated using MDS 3.0 data and reported in a CMS reporting module. A unique CMS identification number is specified for each QM.

    The MDS 3.0 QM User’s Manual V13.0 and Quality Measure Reporting Module Table V1.8 have been posted. The MDS 3.0 QM User’s Manual V13.0 contains detailed specifications for the MDS 3.0 quality measures. The MDS 3.0 QM User’s Manual V13.0 can be found in the Downloads section of this webpage and the MDS 3.0 QM User’s Manual V12.1 has been moved to the Quality Measures Archive webpage. The Quality Measure Reporting Module Table V1.8 documents CMS quality measures calculated using MDS 3.0 data and reported in a CMS reporting module, with a unique CMS identification number specified for each QM. The Quality Measure Reporting Module Table V1.8 can be found in the Downloads section of this webpage and the Quality Measure Reporting Module Table V1.7 has been moved to the Quality Measures Archive webpage.

    Two files related to the MDS 3.0 QM User’s Manual have been posted:

    1. MDS 3.0 QM User’s Manual V13.0 contains detailed specifications for the MDS 3.0 quality measures. MDS 3.0 QM User’s Manual V13.0 is included in the zip file titled User Manuals - Updated 01-21-2020 (ZIP).
    2. Quality Measure Identification Number by CMS Reporting Module Table V1.8 documents CMS quality measures calculated using MDS 3.0 data and reported in a CMS reporting module. A unique CMS identification number is specified for each QM.
    Read more
  • PAC/SNF QRP Web-Based Training From CMS on Oct. 1, 2020 Changes

    By CMS - February 04, 2020

    The Centers for Medicare & Medicaid Services (CMS) is offering a quick web-based training to walk providers through upcoming changes to the Quality Reporting Programs (QRPs) for the following post-acute care settings along with an overview of existing and upcoming training activities designed to support providers in successfully complying with associated reporting requirements:

    o    Home Health

    o    Inpatient Rehabilitation Facility (IRF)

    o    Long-Term Care Hospital (LTCH)

    o    Skilled Nursing Facility (SNF)


    This web-based training will:

    • Demonstrate how the quality measures used in the Home Health, IRF, LTCH, and SNF QRPs tie to CMS’ Meaningful Measures Initiative;  
    • Provide a detailed list of data elements that have already been incorporated into the post-acute care QRPs along with those being implemented in the IRF, LTCH, and SNF care settings on October 1, 2020, and the Home Health care setting on January 1, 2021;
    • Provide links to training resources to support providers in implementing existing reporting requirements associated with the QRPs; and
    • Offer a preview of upcoming training activities to support the implementation of new reporting requirements, including dates, so that providers can begin to plan to incorporate these important training events into their busy schedules.

    If you have technical questions or feedback regarding the training, please email the PAC Training mailbox. Content-related questions should be submitted to the Quality Reporting Program Help Desk for your care setting.

    Read more
  • ICD-10 Code Lookup Tool / National Center for Health Statistics (2/20)

    By MX - February 04, 2020

    What is the ICD-10-CM Browser Tool [ Beta Version]

    The National Center for Health Statistics ICD-10-CM Browser tool is a user-friendly web-based query application allows users to search for codes from the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) and provides instructional information needed to understand the usage of ICD-10-CM codes. The application provides access to multiple fiscal year version sets that are available with real-time comprehensive results via the search capabilities.

    The National Center for Health Statistics updates ICD-10-CM on an annual basis.  In addition to the new browser tool, ICD-10-CM and all approved updates to the classification are still available on this webpage for public use.

    Features include:

    Online user’s guide

    Preface

    • The Official ICD–10–CM Coding Guidelines
    • ICD–10–CM Tabular List of Diseases and Injuries
    • ICD–10–CM Index to Diseases and Injuries
    • ICD–10–CM External Cause of Injuries Index
    • ICD–10–CM Table of Neoplasms
    • ICD–10–CM Table of Drugs and Chemicals

    Functionality features include:

    • Search Index for main term or subterms
    • Search by ICD–10–CM code
    • Pop-up instructional notes
    • Ability to toggle from the Index to the Tabular list.
    Read more
  • Five-Star Technical User's Guide Plus Claims-Based Measures Appendix (2/20)

    By CMS - February 04, 2020

    CMS created the Five-Star (5-Star) Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily. The Five-Star Quality Rating System Technical Users' Guide provides in-depth descriptions of the ratings and the methods used to calculate them. Updated twice in October 2019.


    October 2019 Revisions

    In October 2019, several changes were made to the Nursing Home Compare website and the Five-Star Quality Rating System. These changes affected the health inspection and quality measure domains. This section provides details on these changes.

    Ratings changes for facilities that receive the abuse icon: To make it easier for consumers to identify facilities with instances of non-compliance related to abuse, starting in October 2019, CMS added an icon to highlight facilities that meet either of the following criteria: 

    1. Harm-level abuse citation in the most recent survey cycle: Facilities cited for abuse where residents were found to be harmed (Scope/Severity of G or higher) on the most recent standard survey or on a complaint survey within the past 12 months. 
    2. Repeat abuse citations: Facilities cited for abuse where residents were found to be potentially harmed (Scope/Severity of D or higher) on the most recent standard survey or on a complaint survey within the past 12 months and on the previous (i.e., second most recent) standard survey or on a complaint survey in the prior 12 months (i.e., from 13 to 24 months ago). 

    Nursing homes that receive the abuse icon have their health inspection rating capped at a maximum of two stars. Due to the methodology used to calculate the overall rating, the best overall quality rating a facility that receives the abuse icon can have is four stars. 

    Removal of quality measures related to pain: CMS removed two quality measures (QMs) from the Nursing Home Compare website and the Five-Star Quality Rating System in October 2019. These measures are: 

    • Percentage of short-stay residents who report moderate to severe pain. 
    • Percentage of long-stay residents who report moderate to severe pain. 

    As a result of dropping these two measures, the cut-points for the long-stay, short-stay, and overall QM ratings changed. These changes were made to maintain, as close as possible, the same distribution of short-stay and long-stay QM ratings as were posted on Nursing Home Compare in July 2019. 

    January 2020 addition: Technical specifications for claims-based measures

    Read more
1 of 35 Next