Testing Guidelines for Nursing Homes FRIDAY, JULY 17, 2020

Revisions were made on July 17, 2020, to reflect the following:

• Updated “Testing to determine resolution of infection” to add information about people who are severely immunocompromised.

Changes to Staffing Information and Quality Measures Posted on the Nursing Home Compare Website and Five Star Quality Rating System due to the COVID-19 Public Health Emergency

Memo #QSO 20-34-NH

Posting Date 2020-06-25

Fiscal Year 2020

Summary

The Centers for Medicare & Medicaid Services (CMS) is committed to transparency about changes in publicly reported information on nursing homes during the COVID-19 public health emergency. Changes to the Nursing Home Compare Website and Five Star Quality Rating System:

• Staffing Measures and Ratings Domain: On July 29, 2020, Staffing measures and star ratings will be held constant, and based on data submitted for Calendar Quarter 4 2019.

o Also, CMS is ending the waiver of the requirement for nursing homes to submit staffing data through the Payroll-Based Journal System. Nursing homes must submit data for Calendar Quarter 2 by August 14, 2020.

• Quality Measures: On July 29, 2020, quality measures based on a data collection period ending December 31, 2019 will be held constant.

The Occupational Safety and Health Administration (OSHA) is committed to protecting the health and safety of America’s workers and workplaces during these unprecedented times. The agency will be issuing a series of alerts designed to keep workers safe. In a nursing home or long-term care facility, the following tips can help reduce the risk of exposure to the coronavirus.

A revised version of the PBJ Data Specifications (Version 4.00.0) is available to Users. The new release of the Data Specifications reconciles changes to the file layout, fileSpecVersion 4.00.0. Census tags have been removed from the 4.00.0 version due to CMS no longer collecting Census data from PBJ as of April, 2018. No immediate changes are needed when using the current PBJ Submission File fileSpecVersions (2.00.0 and 2.00.3), however, Users are encouraged to begin using PBJ fileSpecVersion 4.00.0.  XML files submitted with versions other than 4.00.0 on or after June 2, 2020 will be rejected. Please note this does not apply to the PBJ Administration Submission File format. Users who use this file format for linking employees should continue to use fileSpecVersion 1.00.0. 

On April 21, CMS added an errata:

4.00.0 fileSpecVersion: CMS is delaying the previously communicated June 1, 2020 date for rejecting PBJ file Spec Versions 2.00.0 and 2.00.3. The PBJ system will continue to accept PBJ fileSpecVersions 2.00.0, 2.00.3 and 4.00.0 until further notice from CMS. Details can be found in the following document: Errata V4.00.1 for PBJ Data Submission Specifications (V4.00.0) 04-16-2020.

On a day-to-day basis, the DNS can become so busy with staff and resident care that they completely lose track of employee files. However, the DNS is often either directly responsible for or works with human resources to manage employee files. Compiling and maintaining these files needs to be a priority in order to stay in compliance with survey requirements, avoid legal hurdles, and have a reference of past behavior when it’s time to evaluate or promote staff.

To keep these important documents up to date, here’s what the DNS should know about employee files:

One in four nursing assistants and one in five home health aides report that they are actively looking for another job. That’s a lot of unhappy employees.

This turnover comes at a high price for facilities. It costs an estimated $2,200 to replace a nursing assistant or home care worker, according to the Recruitment and Retention Guide For Employers by PHI (formerly the Paraprofessional Healthcare Institute).

Moreover, frustration in the workplace can be contagious; unsatisfied staff members have a negative impact on residents and their peers alike.

There are books and guides devoted to programs for staff retention. Better hiring processes, rewards systems, and staff training can yield positive returns for facilities—but overhauling an entire program can feel daunting for busy nurse managers.

Here are four simple ways to promote staff retention, starting right where you are.

The QIES Technical Support Office has updated its Payroll-Based Journal Frequently Asked Questions.

UPDATE 1/08/19: The electronic versions of the Nurse and Management Assessment have been updated.

Toolkit 1: Nursing Home Staff Competency Assessment

Quality care is complex. That’s why the CMPRP competency assessment helps nursing homes break down and self-examine some of the most important building blocks of quality care. Use the competency assessment to identify areas where your nursing home is doing well, versus where your facility might need support. Once you know where you need support, CMPRP can provide funding, technical assistance and learning opportunities to help address some of your facility’s toughest challenges, in order to offer the best possible care to your residents.

There are three competency assessments in print and electronic formats:

1) Certified Nursing Assistants (CNA)/Certified Medication Technicians (CMT)

2)Licensed Practical/Vocational Nurses (LVN/LPN) and Registered Nurses (RN)

3) Assistant directors of nursing (ADON), directors of nursing (DON) and administrators.