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

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

CMS Releases FY 2021 Proposed Rule: SNF’s In-Line for 2.3% Payment Increase

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 and opens a comment period for stakeholders to review and provide comments before CMS releases the final rule.

WHAT YOU NEED TO KNOW
On April 10th CMS issued proposed rule (CMS-1737-P) for FY 2021. CMS recognizes that the healthcare industry is focused on the COVID-19 public health emergency, and as such, this proposed rule contains statutorily required payment updates as well as proposals that reduce provider burden which may help in their COVID-19 response. 

Key elements of the proposed rule include:

  • A net market basket increase of 2.3% resulting in an increase of $784 million in Medicare payments for SNF providers
    > Please refer to the table below for Unadjusted Federal Per Diem
    Rates by PDPM Component
  • Proposal to adopt the revised Office of Management and Budget (OMB) statistical area delineations with a 5% cap on wage index decreases from FY 2020 to FY 2021
  • Updates to the ICD-10 code mappings with additional codes/diagnosis now qualifying for “May be Eligible for Non-Orthopedic Surgery Category” or “May be Eligible for One of the Two Orthopedic Surgery Categories”
    > Additional substantive changes to clinical category as well as NTA
    mappings are also proposed that impact only a few diagnosis/ICD-10
    codes
  • CMS acknowledged it continues to monitor the impact of PDPM on patient outcomes and program payments but stated it would be premature to release any information or make changes to case-mix weights with the limited data available
    > CMS did state they may consider adjustments to case-mix weights in
    future rulemaking in order to maintain budget neutrality
  • Proposals related to the Skilled Nursing Facility Value Based Purchasing Program (SNF VBP)
    > Apply a 30-day Phase One Review and Correction Deadline to the
    baseline period
    > Estimated FY 2023 SNF VBP Program Performance Standards
    > > Achievement Threshold: 0.79025 (readmission rate of 21.0%)
    > > Benchmark: 0.82917 (readmission rate of 17.1%)
  • No changes to the Skilled Nursing Facility Quality Reporting Program (SNF QRP) were proposed

Preferred Therapy Solutions continues to provide its partners with 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 Matt Nash, Vice President of Strategic Development at mnash@preftherapy.com

SOURCE: CMS



















*TIME SENSITIVE* SNF Provider Preview Reports Now Available

REVIEW BEFORE DATA MADE PUBLIC

Background
Prior to the release of SNF QRP data on Nursing Home Compare, SNFs have the opportunity to review their quality measure results during a 30-day preview period. Providers have until March 4, 2019, to review QRP data prior to the April 2019 Nursing Home Compare site refresh, during which this data will be publicly displayed. SNFs are encouraged to review the SNF Provider Preview Report, issued quarterly by CMS and accessed through the CASPER system. Instructions on how to access these reports are located here.

Corrections to the underlying data will not be permitted during this time, however, providers can request a 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.

What you need to know

The data contained within the Preview Reports is based on quality data submitted by SNFs during the following quarterly time frames:

  • Quarter 3 – 2017 to Quarter 2 – 2018 data
    • Percent of Residents Experiencing One or More Falls with Major Injury (Long Stay)
    • Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (Short Stay)
    • Percent of Long-Term Care Hospital Patients with an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function
  • Quarter 4 – 2016 to Quarter 3 – 2017 data 
    • Medicare Spending Per Beneficiary – Post-Acute Care (PAC) Skilled Nursing Facility Measure
    • Discharge to Community- Post Acute Care (PAC) Skilled Nursing Facility (SNF) Quality Reporting Program (QRP)

As we stated in our last alert, CMS announced in October 2018 that it will not publish the 6th previously posted quality measure, Potentially Preventable 30-Day Post-Discharge Readmissions, at this time. According to CMS, additional time will allow for more testing to determine if modifications to the measure and method of displaying it are needed. This additional testing will ensure that the future publicly reported measure is thoroughly evaluated so Nursing Home Compare users have an accurate picture of provider quality. While CMS conducts this additional testing, the agency will not post reportable data for this measure, including each SNF’s performance, as well as the national rate. To view the updated quality data, please visit the Nursing Home Compare website.

Courtesy of NASL

If you have any questions, please contact Maria Maggi, Vice President of Compliance mmaggi@preftherapy.com.