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Survey Team Composition and Investigation of Complaints: On July 31, 2017, the Federal Register issued the final rule Medicare Program: Prospective Payment - System and Consolidated Billing for Skilled Nursing Facilities (SNF) for FY 2018, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, Survey Team Composition, and Correction of the Performance Period for the NHSN HCP Influenza Vaccination Immunization Reporting Measure in the ESRD QIP for PY 2020. These regulations are effective on October 1, 2017.
“Quite a bit” of the regulatory requirements for survey won’t change with the Nov. 28, 2017, rollout of Phase 2 of the Reform of Requirements for Long-term Care Facilities (aka Mega-Rule), say officials with the Division of Nursing Homes in the Survey and Certification Group at the Centers for Medicare & Medicaid Services (CMS) during the video Appendix PP: Overview of Revised Interpretive Guidance.
“Most of the minimum quality standards that were in the regulation remain,” they explain. “There are still strong resident rights, use of the Minimum Data Set to do assessment and care planning based on the residents’ goals and preferences, and the input of the interdisciplinary team. There are still requirements for a medical director, a full-time licensed nurse, and requirements for medication review.”
Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2018, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, Survey Team Composition, and Correction of the Performance Period for the NHSN HCP Influenza Vaccination Immunization Reporting Measure in the ESRD QIP for PY 2020
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule.
SUMMARY: This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2018. It also revises and rebases the market basket index by updating the base year from 2010 to 2014, and by adding a new cost category for Installation, Maintenance, and Repair Services. The rule also finalizes revisions to the SNF Quality Reporting Program (QRP), including measure and standardized resident assessment data policies and policies related to public display. In addition, it finalizes policies for the Skilled Nursing Facility Value-Based Purchasing Program that will affect Medicare payment to SNFs beginning in FY 2019. The final rule also clarifies the regulatory requirements for team composition for surveys conducted for investigating a complaint and aligns regulatory provisions for investigation of complaints with the statutory requirements.
DATES: These regulations are effective on October 1, 2017
Effective Nov. 28, 2017, state surveyors will use an entirely new numbering system for F-tags. The Centers for Medicare & Medicaid Services (CMS) updated the F-tags to correspond with the new regulatory sections implemented through the roll-out of the Reform of Requirements for Long-term Care Facilities (aka Mega-Rule) updating the Medicare/Medicaid conditions of participation. “Learning the new F-tag numbering system will come with time, but memorizing the numbers shouldn’t be the priority for directors of nursing services (DNSs),” advises Amy Stewart, RN, DNS-MT, QCP-MT, RAC-MT, AADNS curriculum development specialist. “Instead, DNSs should focus on knowing what’s new.”
So what do DNSs need to understand first? Here are Stewart’s two key takeaways:
In October 2016, CMS finalized improvements in care, safety, and consumer protections for long-term care facility residents. Revisions mark first major rewrite of the conditions of participation (CoP) for long-term care facilities since 1991. In July 2017, the agency published some corrections.
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