• Register for CMS March 23 National Partnership Call: Dementia-Related Psychosis in LTC

    By CMS - March 04, 2021
    Long-Term Care: Dementia-related Psychosis Call

    When: Tuesday, March 23, 2021, from 1:30 to 3 pm ET

    • Presentation: Available prior to the event
    • Audio recording and transcript: Available approximately 2 weeks after the event

    Description:

    National Partnership to Improve Dementia Care and Quality Assurance Performance Improvement

    During this call, learn about the appropriate assessment, accurate diagnosis, and approaches to care for dementia-related psychosis in the long-term care setting. Hear about customized care strategies for nursing home residents. A question and answer session follows the presentations.

    Speakers: Dr. George Grossberg, Dr. Alexis Eastman, Susan Scanland, and Dr. Chad Worz from the Gerontological Society of America’s Workgroup on Dementia-Related Psychosis

    Target Audience:

    • Consumer and advocacy groups
    • Nursing home providers
    • Surveyor community
    • Prescribers
    • Professional associations
    • Other interested stakeholders
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  • Pitfalls of Missing Shortness of Breath Documentation

    By Jessie McGill, RN, RAC-MT, RAC-MTA - March 02, 2021

    Chronic conditions and comorbidities are common among both long-term residents and short-term patients in skilled nursing facilities. However, when the symptoms from these chronic conditions become part of the resident’s normal routine, they may be under-charted—which could result in inaccuracies in MDS assessments, care plans, Quality Measures, and reimbursement.

     

    Read this article to learn why reporting episodes of shortness of breath, even when they are not abnormal for the resident, is so important for the resident's care and your success as a NAC.

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  • Coding N2001 – N2005: Part A Drug Regimen Review

    By Caralyn Davis, Staff Writer - March 02, 2021

    “CMS has been concerned about medication-related adverse events for many years. Identifying potential and actual clinically significant medication issues, communicating those issues to the physician, and then implementing physician-prescribed or physician-recommended interventions in a timely manner—at admission and throughout the Medicare Part A resident’s stay—are critical components of ensuring both resident safety and quality of life,” says Melanie Tribe-Scott, BSN, RN, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, QCP.

     

    Read this article to learn ways NACs can improve the coding for N2001 – N2005 and the processes they need to have in place to keep up with these MDS items.

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  • SNF QRP FAQs (3/21)

    By CMS - March 01, 2021

    Updates

    March 1, 2021

    SNF QRP FAQs

    An update to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Frequently Asked Questions (FAQs) document is now available. This document has been updated to reflect the finalized policies for the SNF QRP in Fiscal Year (FY) 2021 and other useful resources available to providers.

    Contents

    Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Overview

    1. What is a Quality Reporting Program?

    2. What are the current measures in the SNF QRP?

    3. What are the FY 2021 updates to the SNF QRP?

    Staying Informed About the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP)

    4. What is the process for adding and removing measures from the SNF QRP?

    5. Are there other resources on the SNF QRP website I can use to stay up-to-date?

    6. Where can I find SNF QRP training materials?

    Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Technical Requirements

    7. How are data collected and submitted for the SNF QRP?

    8. Which items on the SNF MDS are considered for compliance determination?

    9. What are the requirements for the SNF to be considered compliant?

    10. What are the data submission deadlines for the SNF QRP?

    11. Does the definition of “quarter” for the quarterly MDS data submission deadlines include patients admitted during that quarter, discharged during that quarter, or both?

    12. What is QIES? How can I request access to QIES?

    The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) and the Minimum Data Set (MDS)

    13. What is the current version of the MDS?

    14. Where can I find the MDS 3.0 Resident Assessment Instrument (RAI) Manual for the SNF QRP?

    15. Who can complete a SNF MDS?

    Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Reconsiderations, Exceptions, and Extensions

    16. Does the Centers for Medicare & Medicaid Services (CMS) tell SNFs if they are noncompliant with the QRP requirements?

    17. I received a letter of notification that my SNF is non-compliant with the SNF QRP requirements. Can I ask CMS to reconsider the decision?

    18. The county where our SNF is located was affected by a natural disaster. Are we excepted from the QRP reporting requirements?

    Other Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Frequently Asked Questions

    19. Does my SNF need to report health care–acquired infection data under the SNF QRP?

    20. My facility’s demographic data are incorrect on Care Compare. How do I correct them?

    21. Where are SNF quality measure data publicly reported?

    22. Which SNF quality measures are reported on the Care Compare website?

    23. Who can I contact with a specific question about the SNF QRP?

    Read more
  • SNF QRP Quick Reference Guide (3/21)

    By CMS - February 28, 2021
    The Quick Reference Guides provide high-level information on the SNF Quality Reporting Program, including frequently asked questions and helpful links.
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  • New NAC: Five Tips for Successful Orientation

    By Jessie McGill, RN, RAC-MT, RAC-MTA - February 24, 2021

    One year. When asked how long it takes a new nurse assessment coordinator (NAC) to fully learn the job, AAPACN curriculum development specialist, Jessie McGill says at least one year. The volume and complexity of information NACs must master can make orientation a challenge. However, the right orientation plan can pave the way to a long, satisfying MDS career.

     

    For those tasked with orienting a new NAC, read this article for five tips that will help guide the process.

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  • MDS Item C1310: Keys to Navigating the CAM

    By Caralyn Davis, Staff Writer - February 24, 2021

    The Confusion Assessment Method (CAM) is a standardized cognitive assessment that determines whether a resident has signs and symptoms of delirium. “Understanding that delirium is serious and treatable is critical,” says Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC. “This section requires the assessor to really drill down into whether there has been an acute change in cognitive status and whether the behaviors seen fluctuate or are always there."

     

    Read this article for steps NACs can take to help ensure this MDS items and all subitems are coded accurately.

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  • Consolidated Appropriations and Coronavirus Relief Act: Impact on SNF Part A Services (2/21)

    By Congress - February 24, 2021

    Sections addressing SNF VBP changes and access to services for hemophilia residents:

     

    SEC. 111. IMPROVING MEASUREMENTS UNDER THE SKILLED NURSING FACILITY VALUE-BASED PURCHASING PROGRAM UNDER THE MEDICARE PROGRAM.

     

        (a) In General.--Section 1888(h) of the Social Security Act (42

    U.S.C. 1395yy(h)) is amended--

            (1) in paragraph (1), by adding at the end the following new

        subparagraph:

                ``(C) Exclusions.--With respect to payments for services

            furnished on or after October 1, 2022, this subsection shall

            not apply to a facility for which there are not a minimum

            number (as determined by the Secretary) of--

                    ``(i) cases for the measures that apply to the facility

                for the performance period for the applicable fiscal year;

                or

                    ``(ii) measures that apply to the facility for the

                performance period for the applicable fiscal year.'';

            (2) in paragraph (2)(A)--

                (A) by striking ``The Secretary shall apply'' and inserting

            ``The Secretary--

                    ``(i) shall apply'';

                (B) by striking the period at the end and inserting ``;

            and''; and

                (C) by adding at the end the following:

                    ``(ii) may, with respect to payments for services

                furnished on or after October 1, 2023, apply additional

                measures determined appropriate by the Secretary, which may

                include measures of functional status, patient safety, care

                coordination, or patient experience.

            Subject to the succeeding sentence, in the case that the

            Secretary applies additional measures under clause (ii), the

            Secretary shall consider and apply, as appropriate, quality

            measures specified under section 1899B(c)(1). In no case may

            the Secretary apply more than 10 measures under this

            subparagraph.'';

            (3) in subparagraph (A) of each of paragraphs (3) and (4), by

        striking ``measure'' and inserting ``measures''; and

            (4) by adding at the end the following new paragraph:

            ``(12) Validation.--

                ``(A) In general.--The Secretary shall apply to the

            measures applied under this subsection and the data submitted

            under subsection (e)(6) a process to validate such measures and

            data, as appropriate, which may be similar to the process

            specified in section 1886(b)(3)(B)(viii)(XI) for validating

            inpatient hospital measures.

                ``(B) Funding.--For purposes of carrying out this

            paragraph, the Secretary shall provide for the transfer, from

            the Federal Hospital Insurance Trust Fund established under

            section 1817, of $5,000,000 to the Centers for Medicare &

            Medicaid Services Program Management Account for each of fiscal

            years 2023 through 2025, to remain available until expended.''.

        (b) Report by MedPAC.--Not later than March 15, 2022, the Medicare

    Payment Advisory Commission shall submit to Congress a report on

    establishing a prototype value-based payment program under a unified

    prospective payment system for post-acute care services under the

    Medicare program under title XVIII of the Social Security Act (42

    U.S.C. 1395 et seq.). Such report--

            (1) shall--

                (A) consider design elements such as--

                    (i) measures that are important to the Medicare program

                and to beneficiaries under such program;

                    (ii) methodologies for scoring provider performance and

                effects on payment; and

                    (iii) other elements determined appropriate by the

                Commission; and

                (B) analyze the effects of implementing such prototype

            program; and

            (2) may--

                (A) discuss the possible effects, with respect to the

            Medicare program, on program spending, post-acute care

            providers, patient outcomes, and other effects determined

            appropriate by the Commission; and

                (B) include recommendations with respect to such prototype

            program, as determined appropriate by the Commission, to

            Congress and the Secretary of Health and Human Services.

     

     SEC. 134. IMPROVING ACCESS TO SKILLED NURSING FACILITY SERVICES FOR HEMOPHILIA PATIENTS.

       

    (a) In General.--Section 1888(e)(2)(A)(iii) of the Social Security

    Act (42 U.S.C. 1395yy(e)(2)(A)(iii)) is amended by adding at the end

    the following:

     

                        ``(VI) Blood clotting factors indicated for the

                    treatment of patients with hemophilia and other

                    bleeding disorders (identified as of July 1, 2020, by

                    HCPCS codes J7170, J7175, J7177-J7183, J7185-J7190,

                    J7192-J7195, J7198-J7203, J7205, J7207-J7211, and as

                    subsequently modified by the Secretary) and items and

                    services related to the furnishing of such factors

                    under section 1842(o)(5)(C), and any additional blood

                    clotting factors identified by the Secretary and items

                    and services related to the furnishing of such factors

                    under such section.''.

     

        (b) Effective Date.--The amendment made by subsection (a) shall

    apply to items and services furnished on or after October 1, 2021.


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  • National Healthcare Safety Network (NHSN) Long-term Care Facility COVID-19 Reporting Module Website UPDATED (2/21)

    By CDC - February 21, 2021

    CDC’s NHSN provides healthcare facilities, such as long-term care facilities (LTCFs), with a secure reporting platform for reporting outcomes and process measures in a systematic way. Reported data are immediately available for use in strengthening local and national surveillance, monitoring trends in infection rates, assisting in identifying resource insecurities, and informing progress toward infection prevention goals.

    The NHSN Long-term Care Facility Component supports the nation’s COVID-19 response through the LTCF COVID-19 Module. Facilities eligible to report data to NHSN’s COVID-19 Module include nursing homes/skilled nursing, long-term care for the developmentally disabled, and assisted living facilities.

    Data reported into the LTCF COVID-19 Module Surveillance Reporting Pathways facilitate assessment of the impact of COVID-19 through facility reported surveillance data. Examples of data reported in the pathways include:

    ·         Counts of residents and facility personnel newly positive for COVID-19 based on viral test results.

    ·         COVID-19 vaccination status of residents newly positive for COVID-19.

    ·         Re-infections in residents and facility personnel previously infected with COVID-19.

    ·         COVID-19 related death counts among residents and facility personnel.

    ·         Staffing shortages.

    ·         Availability and surge capacity use of personal protective equipment (PPE) and alcohol-based hand rub.

    ·         Monoclonal therapeutic availability and use.

    ·         Ventilator capacity and supplies for facilities with ventilator-dependent units.

    The Point-of-Care (POC) Test Reporting Tool is a separate reporting option for LTCFs to report SARS-CoV-2 test results provided by a POC device. NHSN routes reported POC laboratory test result data to the public health agency at the local or state level with jurisdictional authority and responsibility for receiving those data. Important: the reporting of POC test result data in this tool does not take the place of answering POC related questions in the Resident Impact and Facility Capacity surveillance reporting pathway.

    Weekly reporting of COVID-19 vaccination data for residents and healthcare personnel is another option available to LTCFs. Additional information about surveillance and vaccination reporting, please visit the Weekly HCP & Resident COVID-19 Vaccination webpage.

    LTCF data submission options include manual data entry, CSV file submission by individual facilities or bulk CSV file upload for multiple facilities, and/or NHSN DIRECT CDA Automation for the Point-of-Care (POC) Test Reporting Tool.

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  • SNF Healthcare-Associated Infections Requiring Hospitalization for the SNF QRP Technical Report (2/21)

    By CMS - February 21, 2021
    The Improving Post-Acute Care Transformation Act of 2014 (IMPACT Act) requires the Secretary to specify resource use measures, on which post-acute care (PAC) providers, including skilled nursing facilities, are required to submit necessary data specified by the Secretary. The Centers for Medicare and Medicaid Services (CMS) has contracted with Acumen, LLC and RTI International to develop the SNF HAI measure under the Quality Measure & Assessment Instrument Development & Maintenance & QRP contract (75FCMC18D0015, Task Order 75FCMC19F0003).

    This report presents the SNF HAI technical measure specifications. Section 2 provides an overview of the measure and is a high-level summary of the key features of the measure that are described in detail in the remaining sections of the document. Section 3 describes the methodology used to construct the SNF HAI measure including its data sources, study population, measure outcome, regression model, and steps for calculating the final measure score. Section 4 discusses SNF HAI measure testing including the measure’s reportability, variability, reliability, and validity testing results. Appendix A displays the ICD-10 codes used to identify HAI conditions included in the measure. Appendix B presents the results of the risk adjustment model. Lastly, Appendix C details a flow chart for calculating the measure. 
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  • CMS Updates SNF PPS Legislative History (2/21)

    By CMS - February 20, 2021
    Historically, each rule or update notice issued under the annual Skilled Nursing Facility (SNF) prospective payment system (PPS) rulemaking cycle included a detailed reiteration of the various individual legislative provisions that have affected the SNF PPS over the years, a number of which represented temporary measures that have long since expired. This document now serves to provide that discussion.
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  • CMS COVID-19 Emergency Declarations and Specific SNF/NF Flexibilities UPDATED (2/21)

    By CMS - February 19, 2021

    COVID-19 Emergency Declaration Blanket Waivers & Flexibilities for Health Care Providers (PDF) UPDATED (2/19/21)

    Long Term Care Facilities (Skilled Nursing Facilities and/or Nursing Facilities) (PDF) UPDATED (02/03/21)

    Read more
  • COVID-19 Medicare FAQs Updated (2/21)

    By CMS - February 19, 2021

    Documents include: 

    • Frequently Asked Questions to Assist Medicare Providers
    • Medicare Telehealth Frequently Asked Questions (PDF) (now included in all-inclusive FAQs) 
    • Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction
    • Frequently Asked Questions (FAQs), CLIA Guidance During the COVID-19 Emergency

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  • Five-Star Helpline Open Feb. 22 - 26

    By QTSO - February 17, 2021

    The Five Star Preview Reports were available on February 15, 2021. 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 the February Five Star data on February 24, 2021.

    Important Note: The 5 Star Help Line (800-839-9290) will be available February 22 through February 26, 2021.

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

    Read more
  • SNF Consolidated Billing: COVID-19 Monoclonal Antibody Treatment (2/21)

    By CMS - February 16, 2021
    CMS Takes Further Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment·

    COVID-19 Vaccines and Monoclonal Antibody Infusion: Enforcement Discretion Relating to SNF Consolidated Billing

    Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction

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