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This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2019. This final rule also replaces the existing case-mix classification methodology, the Resource Utilization Groups, Version IV (RUG-IV) model, with a revised case-mix methodology called the Patient-Driven Payment Model (PDPM) beginning on October 1, 2019. The rule finalizes revisions to the regulation text that describes a beneficiary’s SNF “resident” status under the consolidated billing provision and the required content of the SNF level of care certification. The rule also finalizes updates to the SNF Quality Reporting Program (QRP) and the Skilled Nursing Facility ValueBased Purchasing (VBP) Program.
Training materials for the upcoming 2-day Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Provider Training event on July 31, and Wednesday, August 1, at the Four Seasons Hotel Baltimore (200 International Drive, Baltimore, MD 21202), are now available under the Downloads section below. Training materials include PowerPoint presentations and related materials to complete exercises that will be used during the event. Paper copies of presentations will not be available at the training, so it is recommended that you download and/or print the training materials if you would like to reference them during the training.
Reminder of the August PBJ reporting deadline:
For April 1 –June 30, 2018, data, the deadline is August 14.
Reminder of the August SNF QRP reporting deadline:
For January 1 – March 31, 2018, data, the deadline is August 15
TEP Summary Report Available: Development of Quality Measures for the Transfer of Health Information and Care Preferences Domain - Transfer of Medication Profile
The technical expert panel (TEP) Meeting 4 summary report for the Development of Measures under the Transfer of Health Information and Care Preferences domain is now available. This report summarizes proceedings from a follow-up cross-setting TEP meeting, which included in-depth discussion and input on the following topics:
· Revisions to the measure concept and measure specifications since the TEP last met
· The draft cross-setting Transfer of Medication Profile measures for Skilled Nursing Facilities, Inpatient Rehabilitation Facilities, Long-Term Care Hospitals, and Home Health Agencies
· The items used to calculate the quality measure
· Importance and feasibility of Information to be included in the medication profile to meet the measure criteria
· Items collecting routes of transfer of the medication profile
Topics covered include:
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).
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