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The SNF QRP Measure Calculations and Reporting User’s Manual Version 3.0.1 addendum and associated risk adjustment appendix and Hierarchical Condition Category (HCC) crosswalks are now available.
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SNF Quality Reporting Program (QRP) quality data on Nursing Home Compare are updated on a quarterly basis. All data displayed on NH Compare (Skilled Nursing Facility and Nursing Home) include demographic information, such as address, telephone number, and ownership. This demographic data is generated from the information stored in the Automated Survey Processing Environment (ASPEN) system.
Below are the steps to guide providers on how to verify and update Skilled Nursing Facility demographic data.
It is important for providers to review their SNF QRP Preview Reports to verify that the demographic data is accurate. SNF QRP Preview Reports reflect the quality measure data and facility/provider demographic information that will be posted to NH Compare in the following quarter. SNF QRP Preview Reports are available in providers’ shared folder in the Centers for Medicare & Medicaid Services (CMS) designated data submission system, Certification and Survey Provider Enhanced Reporting (CASPER) during the 30-day preview windows prior to the quarterly NH Compare refreshes.
If inaccurate or outdated demographic data is included on the SNF QRP Preview Report or on NH Compare, SNFs need to contact their Medicare Administrative Contractor (MAC) for assistance. When requesting updates to your demographic data, it is important to ask that the MAC send the updated 855A (provider enrollment form) to the CMS Regional Offices in order to update the ASPEN data. Changes to demographic data must be updated and uploaded to the national database via ASPEN in order for the Compare site to be updated.
When requesting updates to demographic data, it is important to ask for updates to the data within the ASPEN system, and not the data on the Compare site.
Please note - updates to demographic information do not happen in real-time and can take up to 6-months to appear on NH Compare. If you encounter difficulty reaching your MAC, or for assistance accessing SNF QRP provider preview reports, please contact the QTSO Help Desk at 1-800-339-9313 or firstname.lastname@example.org.
· Quality Reporting Programs are expected to report their quality data to meet requirements starting Quarter 3, which begins July 1, 2020.
The March 27, 2020 Medicare Learning Network Newsletter (MLN) Exceptions and Extensions for Quality Reporting Program (QRP) Requirements that includes Skilled Nursing Facilities, Home Health Agencies, Hospices, Inpatient Rehabilitation Facilities, and Long-Term Care Hospitals (hereafter referred to as post-acute care (PAC) programs) applies only to Quarter 4 of 2019 (October 1-December 31, 2019) and Quarters 1 and 2 of 2020 (January 1-June 30, 2020). Providers are expected to report data and meet the QRP requirements beginning with Quarter 3, 2020 that starts July 1, 2020.
As stated in that March 27, 2020 MLN Newsletter, “In some instances, these exceptions and extensions are granted because the data collected may be greatly impacted by the response to COVID-19 and therefore should not be considered in the quality reporting program. CMS is closely monitoring the situation for potential adjustments and will update exception lists, exempted reporting periods, and submission deadlines accordingly as events occur.”
Starting with Quarter 3 that begins July 1, 2020, CMS expects providers to report their quality data. CMS will analyze the data for each program recognizing that the COVID-19 public health emergency (PHE) remains in effect and could impact the quality data submitted. CMS will closely monitor the situation for public reporting of the data and provide any updates.
CMS is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs with respect to upcoming measure reporting and data submission for those programs. These actions are part of CMS’s response to 2019 Novel Coronavirus (COVID-19).
Specifically, CMS is implementing additional extreme and uncontrollable circumstances policy exceptions and extensions for upcoming measure reporting and data submission deadlines that will impact both the SNF QRP and the SNF VBP.
Effective 6/1/19, there will be enhancements to the upcoming Provider Preview Reports. The next SNF Provider Preview Report is scheduled for August 1, 2019. The updates will include:
• Pressure Ulcer Measure Transition
-The current pressure ulcer measure, Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (Short Stay) (NQF #0678), will last appear on the May 2019 SNF Provider Preview Report. Starting August 1, 2019, this measure will be removed.
-The new pressure injury measure, Changes in Skin Integrity Post-Acute Care, will first display on the August 2020 Provider Preview Report.
• Ending suppression of the PPR claims-based measure:
-Potentially Preventable 30-Day Post-Discharge Readmission Measure for Inpatient Rehabilitation Facility Quality Reporting Program
• Displaying measure short names in place of their long names and many aesthetic changes to field labels and headings.
• Update of the Discharge to Community Measure
-The refined measure results for the Discharge to Community Measure will be reflected for the first time in the fall 2019 Quarterly Refresh for the Nursing Home Compare website and the related August 2019 Provider Preview Reports.
The DTC-PAC measure was first displayed on the Nursing Home Compare website in fall 2018 and will be refreshed in fall 2019. CMS has refined the statistical methodology for assigning providers to performance categories for public display to align with the Potentially Preventable Readmissions measures in the PAC QRPs and the Hospital-Wide Readmission measure in the Inpatient QRP. This refinement results in greater variation in provider performance categories, allowing better discernment of providers that underperform or overperform considerably compared with the national rate. The refinement will be reflected for the first time in the fall 2019 Quarterly Refresh for the Nursing Home Compare website, and the related August 2019 Provider Preview Reports.
· The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) directed the Secretary to specify and publicly report measures reflecting successful discharge to community for use in the SNF QRP.
· The SNF QRP DTC measure was finalized in the Fiscal Year 2017 SNF PPS Final Rule. Confidential feedback reports were distributed to SNF providers in fall 2017 and the measures were first displayed on the Nursing Home Compare website in fall 2018.
· For the fall 2019 public display refresh of the DTC measure, and in future years, CMS has refined the method by which we assign providers to performance categories to align with the claims-based Potentially Preventable Readmissions measures in the SNF QRP and the Hospital-Wide Readmission measure in the Inpatient QRP.
· Our revised methodology results in greater variation in performance categories, allowing better discernment of provider performance, including those that underperform or overperform considerably compared with the national rate. This refinement will be reflected in the fall 2019 Quarterly Refresh of the Nursing Home Compare website, as well as the August 2019 SNF Provider Preview Reports.
CMS has released two key documents in conjunction with this announcement: FAQS for Potentially Preventable Readmission Measures for the Post-Acute QRPs and Fact Sheet for Potentially Preventable Readmission Measures for the Post-Acute QRPs.
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