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In May 2017, CMS released an Advanced Notice of Proposed Rulemaking (ANPRM) which outlined a new case-mix model, the Resident Classification System, Version I (RCS-I), that would be used to replace the existing RUG-IV case-mix model, used to classify residents in a covered Part A stay into payment groups under the SNF PPS. Since the ANPRM, we continued our stakeholder engagement efforts to address the concerns and questions raised by commenters with RCS-I. This resulted in significant changes to the RCS-I model, which have prompted us to rename the proposed model discussed in the FY 2019 SNF PPS Notice of Proposed Rulemaking (NPRM) the SNF Patient Driven Payment Model (PDPM).
The Centers for Medicare & Medicaid Services (CMS) will be hosting a 2-day Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) in-person ‘Train the Trainer’ event for providers on July 31 and August 1, 2018, at the Four Seasons Hotel Baltimore, 200 International Drive, Baltimore, MD 21202. This event will be open to all SNF providers, associations, and organizations.
The primary focus of this 'Train-the-Trainer’ event will be to provide those responsible for training staff at SNFs with information about SNF QRP changes and updates to the Minimum Data Set (MDS) 3.0 Version 1.16.0, effective October 1, 2018. Topics will include information on new and changed items, including changes associated with Section M (Pressure Ulcer/Injury), the introduction of Section N (the Drug Regimen Review Measure), Section O (including updates to guidance on Chemotherapy and Ventilator Guidance), and Section GG (Functional Mobility). Presenters will also discuss resources available on cms.gov, and support available through the SNF Help Desks.
The SNF QRP Table for Reporting Assessment-Based Measures for the FY 2020 SNF QRP APU is now available for download on the SNF Quality Reporting Program Measures and Technical Information webpage. This table indicates the MDS data elements that are used in determining the APU minimum submission threshold for the FY 2020 SNF QRP determination.
Since November 28, 2017, there have been nearly 100 citations for QAPI failures, according to the Full Text of Statements of Deficiencies released in March 2018. Almost half of the citations are attributed to F867, QAA Activities.
So, what are other facilities being cited for, and how can you prepare?
Skilled nursing facilities should save approximately $2 billion in aggregate reduced administrative costs over the next 10 years ($12,000 and 183 hours in savings per provider annually), said officials with the Centers for Medicare & Medicaid Services (CMS) in a review of key aspects of the Fiscal Year (FY) 2019 SNF PPS Proposed Rule during the May 1 Skilled Nursing Facility/Long-term Care Open Door Forum. This estimate is based on the proposed changes to the skilled nursing facility prospective payment system (SNF PPS) assessment schedule associated with the Patient-Driven Payment Model (PDPM) if it’s implemented as proposed on Oct. 1, 2019.
“While the current [RUG-IV] system requires substantial paperwork to track the volume of service utilization over time, PDPM eliminates the need of these frequent patient assessments and allows clinicians to focus more time on treating the patient,” noted officials. Note: PDPM is based on the Resident Classification System, Version I, or RCS-I, that CMS presented last year.
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