Skilled Nursing Facility Open Door Forum Call

CMS held the first skilled nursing facility (SNF) open door forum (ODF) call for this year on February 14, 2019. The call included updates on CMS’ PDPM website, the SNF Quality Reporting Program (QRP), and Payroll-Based Journaling (PBJ).

SNF QRP Update:

  • CMS announced they are contracting with RTI international to develop and maintain additional SNF QRP quality measures.
  • RTI is convening a Technical Expert Panel (TEP) to inform the direction and development of a claims-based measure of healthcare-associated infections in SNF. For information on this project and nomination steps visit the SNF QRP website.

PBJ Update:

  • Fourth quarter (10/1/18-12/31/18) PBJ staffing data will be considered timely if it was submitted by 2/14/19 and will be posted on Nursing Home Compare.

CMS provided separate emails for questions concerning technical aspects and policy related issues.

Skilled Nursing Facility Provider Review Reports

Skilled Nursing Facility (SNF) Provider Preview Reports have been updated and are now available. Providers have until March 4, 2019 to review their performance data prior to the April 2019 Nursing Home Compare site refresh, during which this data will be publicly displayed. Corrections to the underlying data will not be permitted during this time; however, providers can request CMS review of their data during the preview period if they believe the quality measure scores that are displayed within their Preview Reports are inaccurate. 

To view the full memo and data contained within the report click here.

Targeted Prove and Educate Trends

As we move into 2019, our focus is honed on the new payment model going into effect in October, PDPM. However, CMS continues to review current trends and initiate audits without a break in sight. With the continuation of Targeted Probe and Education (TPE) audits on the rise, strong supporting documentation, accurate billing practices and managing patient stays appropriately must be the focus of our treatment each and every day.
Read article here .

CMS Chief Indicates New Set of Quality Measures in the Future

This week, Baltimore hosted CMS’ Quality Conference. McKnight’s Long Term Care News featured a recap of CMS administrator, Seema Verma’s “fiery speech” in which she indicated the Patient Driven Payment Model is the first step to move SNFs toward an “outcomes-based system.” She acknowledged continued focus on meaningful measures and offered insight into the future for CMS’s new app eMedicare and quality measure ratings.
Read full McKnight’s article .

New Medicare Card Mailing Complete

CMS has finished mailing the new Medicare cards to beneficiaries across the United States.
´╗┐CMS states Medicare fee-for-service health care providers submitted 58% of claims with new Medicare Beneficiary Identifiers (MBIs) indicating some success with integration. They encourage providers to utilize the new MBIs for all Medicare transactions even though the former Social Security Number-based health insurance claim numbers are permissible during the transition period.
Old cards may be used through December 2019. If a Medicare beneficiary states they have not yet received a new card, instructions are providedhere .