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CMS has released a newly revised SNFABN along with newly developed, concise and separate instructions for form completion. The revised SNFABN has the requirements from the denial letters and looks very similar to the ABN with 3 different options.
CMS will be discontinuing the 5 SNF Denial Letters and the Notice of Exclusion from Medicare Benefits - Skilled Nursing Facility (NEMB-SNF). Since the NEMB-SNF was used as a voluntary notice for care that is never covered by Medicare, CMS will continue to encourage SNFs to issue the revised SNFABN in this voluntary capacity. Chapter 30, Section 70 of the Medicare Claims Processing Manual revisions will be forthcoming.
The revised SNFABN will be mandatory for use on May 7, 2018.
Medicare beneficiaries, including elders and disabled persons, are being treated at inpatient and outpatient medical facilities for conditions that may be the result of abuse or neglect. The Elder Justice Act recognizes an older person's rights, including the right to be free of abuse, neglect, and exploitation. In addition, all 50 States have mandated reporter laws for the reporting of the potential abuse or neglect of elders and vulnerable persons. Prior OIG reviews have shown that there are problems with the quality of care and the reporting and investigation of potential abuse or neglect at group homes, nursing homes, and skilled nursing facilities. By analyzing the treating medical facilities' diagnoses, we will determine the prevalence of the potential abuse or neglect of Medicare beneficiaries. We will also determine whether the potential abuse or neglect occurred at a medical facility or at another location, such as the Medicare beneficiary's home.
Memo # 18-06-NH
Fiscal Year 2018
The Centers for Medicare & Medicaid Services (CMS) will be piloting a two phase Federal Oversight Support Survey (FOSS) process beginning in January of 2018. This pilot will replace the FOSS process used for traditional surveys and the Federal Oversight of Quality Indicator Survey (FOQIS) process used for Quality Indicator Survey (QIS), and includes the following:
CMS survey-and-certification (S&C) memo provides an 18-month moratorium on the imposition of certain enforcement remedies for specific Phase 2 requirements. This 18-month period will be used to educate facilities about specific new Phase 2 standards. Other changes addressed in the memo include: the freezing of Health Inspection Star Ratings; the Availability of Survey Findings; and Methodological Changes and Changes in Nursing Home Compare.
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