• SNF QRP QMs: NACs Should Review ‘The Report Card’ for PDPM

    By Caralyn Davis, Staff Writer - December 04, 2019

    The Patient-Driven Payment Model (PDPM) under the Skilled Nursing Facility Prospective Payment System (SNF PPS) pushes providers to implement value-driven care, which gives added significance to the Skilled Nursing Facility Quality Reporting Program (SNF QRP) quality measures (QMs), says Maureen McCarthy, BS, RN, RAC-MTA, RAC-MT, DNS-MT, QCP-MT, president/CEO of Celtic Consulting in Torrington, CT.

     

    “The SNF QRP QMs are now the report card for PDPM,” she explains. “The Centers for Medicare & Medicaid Services (CMS) has made it clear that the agency will be watching quality of care throughout PDPM implementation. If your care model changes and your quality goes down, you are likely to be audited. Nurse assessment coordinators (NACs) and any other interdisciplinary team (IDT) members who complete the MDS need to be mindful as to how that MDS data will impact not only payment but also quality, especially as more QMs continue to be added to the program.”

    Read more
  • NACs Need to Know: 5 Key Medicare Part A Requirements That Haven’t Changed Under PDPM

    By Caralyn Davis, Staff Writer - December 04, 2019

    The nurse assessment coordinator (NAC) often handles the entire Medicare program in the facility, from managing the PPS schedule to leading the skilled coverage decision. With PDPM in full swing, a lot seems to have changed, but some things have not.

     

    “The implementation of the Patient-Driven Payment Model (PDPM) changed the payment system used for traditional Part A residents,” says Suzy Harvey, RN-BC, RAC-CT, managing consultant at BKD in Springfield, MO. “It did not change the coverage policies for skilled services.”

    Key requirements that remain in place—and that NACs need to know about—include the following:

    Read more
  • Static OBRA Scheduling Tool

    By AANAC - December 04, 2019
    Read more
  • Interactive OBRA Scheduling Tool

    By AANAC - December 04, 2019
    Read more
  • jRAVEN 1.7.2 Free MDS Submission Software Updated (12/19)

    By CMS - December 04, 2019

    jRAVEN (version 1.7.2) is now available for download which contains the following updates:  

    • A defect has been corrected that was causing the HIPPS score that is calculated in jRAVEN to not match the score calculated by the Submission System
    • Changes in support of the MDS Data Specifications Errata V3.00.3
    • The new MDS VUT, version 3.2.0, also updated in support of the Errata V3.00.3
    • All enhancements included with jRAVEN V1.7.0 & V1.7.1:
    Read more
  • CASPER Reporting User’s Guide for MDS Providers UPDATED (12/19)

    By QTSO - December 04, 2019
    Provides information and instructions pertaining to CASPER Reporting, including accessing Final Validation Reports.
    Read more
  • MDS 3.0 Provider User's Guide Updated, Including Validation Rpt Error Messages (12/19)

    By QTSO - December 04, 2019
    Key information about how to submit MDS files and how to obtain and understand error messages on initial and final validation reports. 
    Read more
  • Five Star Help Line Available Dec. 2 - 6

    By CMS - December 02, 2019

    The Five Star Preview Reports are available as of November 19, 2019. 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 November's Five Star data on December 4, 2019.

    Important Note: The 5 Star Help line (800-839-9290) will be available December 2, through December 6, 2019. Please direct your inquiries to BetterCare@cms.hhs.gov if the Help Line is not available.

    Read more
  • CMS Memo: Phase 3 Survey Guidance Will Be Released in Calendar 2Q 2020

    By CMS - November 27, 2019

    The Centers for Medicare & Medicaid Services (CMS) is announcing updates and initiatives aligning with the CMS strategic initiative to Ensure Safety and Quality in Nursing Homes. These updates and initiatives include:

     

    • Phase 3 Interpretive Guidance: CMS will be releasing updated Interpretive Guidance and training for the Requirements for Participation for Long-Term Care (LTC) Facilities. However, this guidance will not be released by the November 28, 2019 implementation date of the regulations. We will be releasing the guidance in the second quarter of calendar year 2020, along with information on training and implementing related changes to The Long Term Care Survey Process (LTCSP). While the regulations will be effective, our ability to survey for compliance with these requirements will be limited until the Interpretive Guidance is released.

    • Medicare and Medicaid Programs; Revision of Requirements for Long-Term Care Facilities: Arbitration Agreements: On July 18, 2019, the Department of Health and Human Services (HHS) published a final rule establishing requirements related to the use of binding arbitration agreements. This final rule amends the requirements that Long-Term Care (LTC) facilities must meet to participate with Medicare and Medicaid. 

    • Actions to Improve Infection Prevention and Control in LTC Facilities: CMS has created a nursing home antibiotic stewardship program training; updated the Nursing Home Infection Control Worksheet as a self-assessment tool for facilities; and is reminding facilities of available infection control resources.

    • Release of Toolkit 3, “Guide to Improving Nursing Home Employee Satisfaction”: CMS has created a toolkit that helps facilities improve employee satisfaction.

    Read more
  • Coding Section GG: A Case Study Review

    By Jessie McGill, RN, RAC-MT, RAC-MTA - November 25, 2019

    Collaboration. It is one of the key terms used to describe data collection for section GG, Functional Abilities and Goals. Collaboration among clinicians, to identify usual, and baseline conditions—these are also important terms used throughout section GG. But in a profession that is used to coding section G, Activities of Daily Living (ADLs), and calculating the Rule of 3, the process of determining usual performance for section GG holds some challenges. Does the data collected and documentation actually support how we are coding section GG? Let’s take a look at a case study of Mrs. Georgia Geoffrey and how the clinicians determined usual performance for some of the key GG tasks on her 5-Day assessment.

    Mrs. Georgia Geoffrey admitted to Happy Valley Nursing Facility following a knee replacement due to osteoarthritis. The wheelchair transport van wheeled her into the nursing home, and the nurse aide assigned to her alerted the nurse of her arrival and propelled her down the hall to her room. 

    Read more
  • Final Validation Reports: Best Practices for NACs

    By Caralyn Davis, Staff Writer - November 25, 2019

    A surprising number of nurse assessment coordinators (NACs) still don’t monitor the Final Validation Reports that the QIES ASAP MDS submission system automatically generates when each batch of MDS records is submitted, says Carol Maher, RN-BC, RAC-MTA, RAC-MT, CPC, director of education for Hansen, Hunter & Co. PC in Vancouver, WA.

     

    “When I go into facilities to work on a problem and ask MDS coordinators if they received any error messages or warnings on the Final Validation Reports for the MDSs in question, they often don’t know what I’m talking about,” notes Maher. “Some NACs have never even seen the Final Validation Reports because another staff member does the MDS transmissions on their computer.”

     

    These NACs are missing out on a critical step in the MDS submissions process, stresses Maher. “Reviewing every Final Validation Report allows the NAC to make sure that all of the MDSs were accepted into the federal database and to follow up on any fatal error or warning messages. While some software systems can show whether an MDS was accepted or rejected, they often don’t show warning messages—and each warning message is very important, giving you the information needed to determine if something should be modified or changed in that MDS.”

    Read more
  • LTCSP Survey Resources: Surveyor Tools (11/19)

    By CMS - November 25, 2019
    This ZIP file contains resources for surveyors conducting initial surveys under the Long-term Care Survey Process (LTCSP).
    Read more
  • LTCSP Procedure Guide - Updated (11/19)

    By CMS - November 25, 2019

    The LTCSP Procedure Guide provides instruction on the procedural and software steps necessary for completing the Long-term Care Survey Process. Surveyors use the Procedure Guide for all standard surveys of SNFs and NFs, whether freestanding, distinct parts, or dually participating. The LTCSP steps are organized into seven parts: 1) offsite preparation; 2) facility entrance; 3) initial pool process; 4) sample selection; 5) investigation; 6) ongoing and other survey activities; and 7) potential citations. Below is a broad overview of the key onsite parts of the LTCSP (parts 3 – 7).

     
    Read more
  • Calendar 2020 Medicare Part A and B Premiums, Deductibles, and Coinsurance (11/19)

    By CMS - November 18, 2019
    The Centers for Medicare & Medicaid Services (CMS) announced the 2020 premiums, deductibles, and coinsurance amounts for Medicare Parts A and B.
    Read more
  • Trauma-Informed Care and Care Planning: Implementation Tips for NACs

    By Caralyn Davis, Staff Writer - November 13, 2019

    This November 28, nursing homes will be required to implement new trauma-informed care regulations as part of the Phase 3 rollout of the revised Medicare/Medicaid requirements of participation. These regulations will be executed under F-tags F699 (Trauma-Informed Care) and F658 (Services Provided Meet Professional Standards), as well as potentially under F741 (Sufficient/Competent Staff‐Behavioral Health Needs) and/or F949 (Behavioral Health Training). Here are the two key regulations:

    Read more
1 of 37 Next