The Long Goodbye

Saying goodbye to a loved one usually involves a nice long bear hug, followed by a warm statement of, “I’ll see you soon.” This is not the case when leaving a loved one afflicted with Alzheimer’s disease. Goodbye is repeated over and over again, in hopes that the person remembers who we are, why we are leaving, and will they remember any glimpse of us when we return. Many families, friends, and caregivers express a deep sadness when saying
goodbye. This June is Alzheimer’s and Brain Awareness Month. Alzheimer’s dementia is a devastating disease that slowly destroys the brains and lives of those diagnosed. The impact is broad-reaching as it pillages family and friends. This disease is often referred to as “The Long Goodbye,” reflecting how families and friends must watch their loved ones slowly fade away. The word dementia encompasses a range

CMS to End Certain COVID-19 Waivers

CMS TO END CERTAIN COVID-19 WAIVERS

BACKGROUND
The Center for Medicare and Medicaid Services released a memorandum on April 7th  to state agencies announcing the ending of specific Public Health Emergency (PHE) waivers in two different time frames: May 7th and June 7th.

WHAT YOU NEED TO KNOW
The following waivers related to SNF’s will end on May 7th:

  • Resident Groups: This waiver permitted the facility to restrict in-person meetings during the PHE
  • Physician Visits: CMS waived the requirement for physicians and non-physician practitioners to perform in-person visits for nursing home residents and allow visits to be conducted, as appropriate, via telehealth options
  • Physician Delegation of Tasks in SNFs: CMS waived the requirement that prevents a physician from delegating a task when the regulations specify that the physician must perform it personally
  • Quality Assurance & Performance Improvement (QAPI): CMS modified certain requirements which require long-term care facilities to develop, implement, evaluate, and maintain an effective, comprehensive, data-driven QAPI program
  • Detailed Information Sharing for Discharge Planning for LTC Facilities: CMS modified the requirement that LTC facilities are to assist residents and their representatives in selecting a post-acute care provider
  • Medical Records: CMS modified the requirement which requires long-term care (LTC) facilities to provide a resident a copy of their records within two working days

The following waivers related to SNF’s will end on June 7th:

  • Physical Environment: CMS waived requirements to allow for a non-SNF building to be temporarily certified and available for use by a SNF in the event there were needs for isolation processes for COVID-19 positive residents
  • Facility & Medical Equipment Inspection, Testing & Maintenance: CMS waived ITM requirements for facility and medical equipment to reduce exposure to COVID-19
  • Life Safety Code (LSC) and Health Care Facilities Code (HCFC) ITM: CMS waived ITM required by the LSC and HCFC, with specified exceptions, which permitted facilities to adjust scheduled ITM frequencies and activities
  • Outside Windows and Doors: CMS waived the requirement to have an outside window or outside door in every sleeping room. This permitted spaces not normally used for patient care to be utilized for patient care and quarantine.
  • Paid Feeding Assistants for LTC Facilities: CMS modified the requirements regarding required training of paid feeding assistants to allow that training can be a minimum of one hour in length
  • In-Service Training for LTC Facilities: CMS modified the nurse aide training requirements for SNFs, which required the nursing assistant to receive at least 12 hours of in-service training annually
  • Training and Certification of Nurse Aides: CMS waived the requirements which require that a SNF  may not employ anyone for longer than four months unless they met the training and certification requirements

Source:  CMS’ Memorandum: QSO-22-15-NH & NLTC & LSC


Preferred Therapy Solutions continues to provide vital information that may impact rehabilitation management, reimbursement policies, and clinical programs, supported by compliance and regulatory requirements that are necessary for a thorough understanding of practices and procedures. If you have any questions, please contact Maria Maggi, Vice President of Quality, Outcomes, and Compliance: mmaggi@preftherapy.com

 

May Celebrates Speech and Better Hearing Month

Preferred Therapy Solutions would like to thank everyone in the Speech Pathology discipline for all of your hard work in supporting our most vulnerable population. This May we celebrate Better Hearing & Speech Month and the people that work with those affected by communication and hearing disorders. #itsallaboutthepatient #celebratespeechpathologist #nationalbetterspeechandhearing

EDUCATIONAL WEBINAR: FY 2023 SNF PPS Proposed Rule – What’s Ahead for PDPM, QRP & VBP!

The FY 2023 Proposed Rule is out and CMS is following through on the recalibration of PDPM, adding new measures for quality and value-based care, and building upon the Biden-Harris Administration’s commitment to advance health equity, drive person-centered care and promote sustainability of the program. Register below to join this informative webinar.


MAY 17TH | 12:30 PM | CLICK HERE TO REGISTER
FY 2023 SNF PPS Proposed Rule: What’s Ahead for PDPM, QRP & VBP!

Attendees of this session will gain insight on:

  • Understand the proposed changes to Medicare PPS reimbursement and quality reporting
  • Identify the potential impact of the proposed changes and begin strategic planning initiatives
  • Learn how to submit comments and provide feedback to CMS on the proposed changes

This program has been approved for Continuing Education for 0.50 total participant hours by NAB/NCERS—Approval #20230516-0.50-A83943-DL

CMS Releases FY 2023 Proposed Rule

BACKGROUND

The Centers for Medicare and Medicaid Services (CMS) are legally required to update the Medicare payment rates and quality programs on an annual basis. Each April, CMS publishes a proposed rule for the upcoming fiscal year (FY) and opens a comment period for stakeholders to review and provide comments to CMS before releasing the final rule.

WHAT YOU NEED TO KNOW

On April 11th CMS issued proposed rule CMS-1765-P for FY 2023. This proposed rule contains many areas of importance and significance for SNF providers specifically as it relates to payment, quality, staffing, and more.

Preferred Therapy Solutions is thoroughly reviewing the proposed rule and has planned an in-depth webinar for May 17th, which has already received program approval from the National Association of Long Term Care Administrators Board (NAB).

Key elements of the proposed rule include:

  • PAYMENT UPDATES
    CMS estimates the aggregate impact of payment policies would result in a decrease of approximately $320 million in Medicare Part A payments to SNFs in FY 2023
  • The actual payment update for FY 2023 is a 3.9% increase based on SNF market basket and forecast error adjustments but this increase is offset by a 4.6% decrease in SNF PPS rates as a result of a proposed recalibrated parity adjustment
  • An additional $186 million in reductions is estimated based on the SNF VBP program

UPDATED BASE RATES FOR PDPM COMPONENTS

PATIENT DRIVEN PAYMENT MODEL

  •  Recalibrating the PDPM Parity Adjustment
    • The purpose of the parity adjustment is to ensure budget neutrality between RUG-IV and PDPM
    • In last year’s proposed and final rules, CMS shared that the transition from RUG-IV to PDPM was not budget neutral with a 5% increase in Medicare Part A payments to SNFs under PDPM. They sought feedback from stakeholders regarding how and when to recalibrate the PDPM parity adjustment, but never proposed an actual parity adjustment
    • In this year’s proposed rule, CMS improved its methodology to determine the necessary parity adjustment and is proposing a 4.6% decrease in PDPM payments
    • CMS is proposing to accomplish the parity adjustment by recalibrating all PDPM CMI’s equally (PT, OT, SLP, Nursing, and NTA)
    • CMS is proposing to implement the entire recalibration all at once, without delay or phase-in
  • CMS is proposing several changes to the PDPM ICD-10 code mappings and lists

SNF QUALITY REPORTING PROGRAM (QRP)

  • CMS is proposing to adopt one new quality measure to become part of the SNF QRP for FY 2025: Influenza Vaccination Coverage among Healthcare Personnel (HCP) measure
  • CMS is proposing to revise the compliance dates for specific SNF QRP requirements
  • CMS is seeking comments on 3 subjects
    • Future measures for SNF QRP
    • Overarching principles for measuring equity and healthcare disparities
    • Inclusion of CoreQ: Short Stay Discharge Measure in the SNF QRP

SNF VALUE-BASED PURCHASING (VBP) PROGRAM

  • CMS is proposing to suppress the SNF 30-day All-Cause Readmission Measure for the FY 2023 SNF VBP due to the COVID-19 PHE
    • In order to maintain compliance with the statutory requirements of the SNF VBP program, CMS is proposing to do the same process implemented last year as it relates to the SNF VBP
      • CMS will continue to withhold 2% of Medicare Part A FFS payments per statute
      • CMS will “award” SNF’s 60% of the withhold, resulting in a 1.2% payback
      • The proposal will result in 0.8% decrease in Medicare Part A FFS payments for all SNF’s except those that are subject to the Low Volume Adjustment policy
  • CMS is proposing to add two new measures to the FY 2026 SNF VBP and one new measure to the FY 2027 SNF VBP
    • FY 2026: addition of SNF Healthcare-Associated Infections Requiring Hospitalization and Total Nursing Hours per Resident Day measures
    • FY 2027: addition of Discharge to Community – Post-Acute Care Measure for SNFs
  • CMS is seeking feedback on the following for the SNF VBP
    • Implementing a Nursing Home Staff Turnover measure
    • Scoring methodology and how it converts to incentive payments
    • Incorporating adjustments related to health equity

Finally, Preferred Therapy Solutions will be submitting comments and feedback to CMS to advocate for therapy services, SNF providers, and most importantly, the residents we are privileged to serve. We encourage all providers to do the same!

NAB APPROVED WEBINAR
Join our webinar on May 17th to learn more about the proposed rule and how to advocate for our industry and patients. Details and links to join this webinar will be provided at a later date.

Preferred Therapy Solutions continues to provide vital information that may impact rehabilitation management, reimbursement policies, and clinical programs, supported by compliance and regulatory requirements that are necessary for a thorough understanding of practices and procedures. If you have any questions, please contact Matt Nash, Vice President of Strategy and Business Development: mnash@preftherapy.com

April Celebrates Occupational Therapy Month

Preferred Therapy Solutions would like to extend its sincere gratitude to all of our professionals within the Occupational Therapy discipline. Through your work, we can get the best outcomes for our patients, and you have helped us build our reputation for clinical excellence. This April, we thank YOU, our Occupational therapists, for being part of our team and helping to make a difference in our patients’ lives. #celebrateoccupationaltherapymonth #OTmonth #thankyouoccupationaltherapists

Celebrate Occupational Therapy Month

WHAT YOU NEED TO KNOW ABOUT OSHA INSPECTIONS

BACKGROUND

On March 7th, the Occupational Safety and Health Administration (OSHA) announced highly focused inspections directed at hospitals and skilled nursing care facilities that treat or handle COVID-19 patients. The timeframe will be from March 9,- June 9, 2022.

WHAT YOU NEED TO KNOW

OSHA’s goal is to expand its presence to ensure the following:

  • Continued mitigation to control the spread of COVID-19 and future variants
  • Compliance with infection control policies and standards, including appropriate fit testing and required documentation for the use of N95 masks
  • Protect the health and safety of healthcare workers at heightened risk for contracting the virus
  • Complete follow-up inspections at sites that were previously issued citations

The Department of Labor’s memorandum on OSHA’s inspections can be found here.

Preferred Therapy Solutions continues to provide vital information that may impact rehabilitation management, reimbursement policies, and clinical programs, supported with compliance and regulatory requirements that are necessary for a thorough understanding of practices and procedures. If you have any questions, please contact Maria Maggi, Vice President of Quality, Outcomes, and Compliance at mmaggi@preftherapy.com

Solutions Syllabus: Quality Measures

Preferred Therapy Solutions is hosting a monthly educational series based on the RAI Manual for coding the MDS to ensure accuracy with Quality Measures (QMs).

Our Solutions Syllabus will provide extensive guidance on the importance of accurate coding of the MDS and the impact on Quality Measures. This educational series will include a comprehensive guide on QM’s and corresponding MDS sections that affect regulatory programs such as 5-Star and are publicly reported through Care Compare. Understanding the data and the significance of coding is vital for SNFs and LTC communities to thrive in the ever-changing healthcare industry.

Throughout the year, we will cover several QMs for an in-depth review. REGISTER NOW FOR THESE INFORMATIVE SESSIONS

MARCH 22 | 1:30 PM | CLICK HERE TO REGISTER
Introduction to QMs: Quality Measures Made Easy

APRIL 26 | 1:30 PM | CLICK HERE TO REGISTER
MDS Section G – QMs Related to Daily Activities and Mobility
This program has been approved for Continuing
Education for 0.50 total participant hours by
NAB/NCERS—Approval #20230425-0.50-A83211-DL

MAY 31 | 1:30 PM | CLICK HERE TO REGISTER
MDS Section J – QMs Related to Falls
NAB/NCERS—Approval #20230530-0.50-A83992-DL

JUNE 28 | 1:30 PM | CLICK HERE TO REGISTER
MDS Section GG QM Self Care & Mobility
This program is pending NAB/NCERS—Approval

INTERDISCIPLINARY PRACTICES DESIGNED FOR OPTIMAL
PATIENT-CENTERED PERFORMANCE

This past January, CMS released their updated Long-Term Care Survey Process Materials. In addition to a focus on infection control policies and procedures, CMS surveyors will now investigate any concerns related to residents who have experienced a significant decline in their condition during the Public Health Emergency. The COVID-19 impact on the elderly population has been significant. There is an increase in isolation, decreased socialization, and limited interaction with caregivers. Understanding the surveyor’s guidance is the first step to a successful survey. Proactive measures, as well as accuracy in baseline data for all residents, will improve the survey process, and enhance the quality of care provided. Click here for the complete article.