AADNS News Feed

Sorting through all that is happening in LTC and then figuring out just what you need to know can be a daunting task. Luckily, we’re here to help. Our nursing experts scour through mountains of information to identify the breaking news and important updates and changes that you need to know today. Find the latest on important topics with links to resources, websites, and tools to keep you up-to date.

  • FY 2022 SNF PPS Proposed Rule Puts the Spotlight on Quality Measures

    By Caralyn Davis, Staff Writer - April 13, 2021
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  • 3 Steps to Improving Resident Safety in a Skilled Nursing Facility

    By Denise Winzeler, BSN, RN, LNHA, DNS-CT, QCP - April 13, 2021

    The safety of residents is a top priority for a skilled nursing facility. But how does one promote safety in such a dynamic environment? Three critical steps the director of nursing services (DNS) and other facility leaders can take are: cultivate trust and transparency with staff, residents, and families; conduct thorough investigations of allegations and incidents; and develop a systematic approach to interpreting incident data and implementing process changes to mitigate or prevent future occurrences.

     

    Read this article to learn about concrete suggestions DNSs and other facility leaders can apply to improve resident safety in their facilities.

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  • Common Concerns in Med Pass: Where to Target Audits

    By Caralyn Davis, Staff Writer - April 13, 2021

    While areas of concern related to medication administration (i.e., medication pass or med pass) are specific to each facility, there are certain common issues. Read this article for tips directors of nursing services can use to prioritize mini-audits in between the consultant pharmacist’s full observation audits of their medication administration protocols.

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  • CMS QSO Memo: Some Expirations of COVID-19 Survey/Regulatory Waivers Begin May 10 (4/21)

    By CMS - April 09, 2021

    CMS continues to review the need for existing waivers issued in response to the Public Health Emergency (PHE). Over the course of the PHE, nursing homes have developed policies or other practices that we believe mitigates the need for certain waivers.

    • Therefore, CMS is announcing it is ending:
      • The emergency blanket waivers related to notification of Resident Room or Roommate changes, and Transfer and Discharge notification requirements;
      • The emergency blanket waiver for certain care planning requirements for residents transferred or discharged for cohorting purposes.
      • The emergency blanket waiver of the timeframe requirements for completing and transmitting resident assessment information (Minimum Data Set (MDS).
    • CMS is providing clarification and recommendations for Nurse Aide Training and Competency Evaluation Programs (NATCEPs).
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  • FY 2022 SNF PPS Proposed Rule Considers PDPM Parity Adjustment and Other Changes (4/21)

    By CMS - April 08, 2021

    Fiscal Year (FY) 2022 Skilled Nursing Facility Prospective Payment System Proposed Rule (CMS 1746-P) Fact Sheet

    CMS issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility (SNF) prospective payment system (PPS) for fiscal year (FY) 2022. In addition, the proposed rule includes proposals for the SNF Quality Reporting Program (QRP), and the SNF Value-Based Program (VBP) for FY 2022. CMS is publishing this proposed rule consistent with the legal requirements to update Medicare payment policies for SNFs on an annual basis. The major provisions of the proposed rule include the following:

    • FY 2022 Proposed Updates to the SNF Payment Rates  
    • Methodology for Recalibrating the PDPM Parity Adjustment
    • Rebase and Revise the SNF Market Basket
    • Section 134 of the Consolidated Appropriations Act, 2021  – New Blood Clotting Factor Exclusion from SNF Consolidated Billing 
    • Proposed changes in PDPM ICD-10 Code Mappings 
    • Skilled Nursing Facility Quality Reporting Program (SNF QRP) update
    • Closing the Health Equity Gap – RFI
    • Skilled Nursing Facility (SNF) Healthcare-Associated Infections (HAI) Requiring Hospitalization Measure
    • COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) Measure
    • Transfer of Health (TOH) Information to the Patient-PAC Quality Measure
    • Public Reporting of Quality Measures with Fewer than Standard Numbers of Quarters Due to COVID-19 Public Health Emergency (PHE) Exemptions
    • Fast Healthcare Interoperability Resources (FHIR) in support of Digital Quality Measurement in Quality Reporting Programs – RFI
    • Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program
    • Proposal to suppress the SNF readmission measure in the SNF VBP Program
    • Expanded SNF VBP Program
    Read more
  • April 15 SNF/LTC Open Door Forum

    By CMS - April 07, 2021

    The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for:  

    Date:  Thursday, April 15, 2021

    Start Time:  2:00 PM – 3:00 PM Eastern Time (ET);

    Please dial-in at least 15 minutes before call start time.

    Conference Leaders: Todd Smith & Jill Darling

    **This Agenda is Subject to Change**

    1.     Opening Remarks

    Chair – Todd Smith (Center for Medicare)

    Moderator – Jill Darling (Office of Communications)

    1.     Announcements & Updates

    ·  FY 2022 SNF PPS Proposed Rule-

    o    FY 2022 Annual Rate Updates

    o    SNF Quality Reporting Program

    o    SNF Value Base Purchasing

    ·  Important QRP Reminder for Non-CAH Swing Beds

    III. Open Q&A

    **DATE IS SUBJECT TO CHANGE**

    Next ODF: TBD

    Mailbox: SNF_LTCODF-L@cms.hhs.gov

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  • COVID-19 Blanket Waivers List Updated (4/21)

    By CMS - April 07, 2021

    COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers 

    The Administration is taking aggressive actions and exercising regulatory flexibilities to help healthcare providers contain the spread of 2019 Novel Coronavirus Disease (COVID-19). CMS is empowered to take proactive steps through 1135 waivers as well as, where applicable, authority granted under section 1812(f) of the Social Security Act (the Act) and rapidly expand the Administration’s aggressive efforts against COVID-19. As a result, the following blanket waivers are in effect, with a retroactive effective date of March 1, 2020 through the end of the emergency declaration. For general information about waivers, see Attachment A to this document. These waivers DO NOT require a request to be sent to the 1135waiver@cms.hhs.gov mailbox or that notification be made to any of CMS’s regional offices.

    Long-Term Care Facilities and Skilled Nursing Facilities (SNFs) and/or Nursing Facilities (NFs) 

    Updated April 9, 2021, the SNF/NF section now shows which regulatory waivers expire May 10, 2021.
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  • CDC Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes Updated (4/21)

    By CDC - April 05, 2021
    Summary of Recent Changes

    Updates as of March 29, 2021

    • Two prior guidance documents, “Responding to COVID-19 in Nursing Homes” and “Performing Facility-wide SARS-CoV-2 Testing in Nursing Homes” were merged with this guidance.
    • The criteria for health department notification was updated to be consistent with Council of State and Territorial Epidemiologist (CSTE) guidance for reporting.
    • Information on the importance of vaccinating residents and healthcare personnel (HCP) was added along with links to vaccination resources.
    • Visitation and physical distancing measures were updated.
    • Added  proper use and handling of personal protective equipment (PPE).
    • Added  universal PPE use to align with the interim infection prevention and control guidance for HCP.
    • Added considerations for situations when it might be appropriate to keep the room door open for a resident with suspected or confirmed SARS-CoV-2 infection.
    • A description was included about when it may be appropriate for a resident with a suspected SARS-CoV-2 infection to “shelter-in-place.”
    • Added management of residents who had close contact with someone with SARS-CoV-2 infection which includes a description of quarantine recommendations including resident placement, recommended PPE, and duration of quarantine.
    • Added addressing circumstances when quarantine is recommended for residents who leave the facility.
    • Added responding to a newly identified SARS-CoV-2-infected HCP or resident.
    • Added addressing quarantine and work exclusion considerations for asymptomatic residents and HCP who are within 90 days of resolved infection.
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  • Using Observational Audits to Assess Staff Skills to Prevent COVID-19 Infection: AHRQ ECHO Tools (4/21)

    By AHRQ - April 05, 2021

    Two new resources from AHRQ are part of the agency’s ongoing efforts to protect nursing home residents and staff from COVID-19. Both are intended to support the use of observational audits, which help facilities understand if staff members are fully complying with infection prevention practices:

    ·  Competency Check vs. Observational Audit: Validate Nursing Home Staff Performance to Improve Infection Prevention Processes for COVID-19. This comparison tool helps skilled nursing facilities differentiate between competency validation for regulatory compliance and observational auditing for quality assurance performance improvement activities.

    ·  Observational Audits: A Pathway to Improving Infection Prevention and Preventing the Spread of COVID-19. This step-by-step guide helps facilities establish a process for observational auditing to provide a true assessment of performance in the actual work environment, and helps facilities collect data to support improvements in infection prevention.

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  • National Healthcare Safety Network (NHSN) Long-term Care Facility COVID-19 Reporting Module Website UPDATED (4/21)

    By CDC - April 05, 2021

    CDC’s NHSN provides healthcare facilities, such as long-term care facilities (LTCFs), with a secure reporting platform for reporting outcomes and process measures in a systematic way. Reported data are immediately available for use in strengthening local and national surveillance, monitoring trends in infection rates, assisting in identifying resource insecurities, and informing progress toward infection prevention goals.

    The NHSN Long-term Care Facility Component supports the nation’s COVID-19 response through the LTCF COVID-19 Module. Facilities eligible to report data to NHSN’s COVID-19 Module include nursing homes/skilled nursing, long-term care for the developmentally disabled, and assisted living facilities.

    Data reported into the LTCF COVID-19 Module Surveillance Reporting Pathways facilitate assessment of the impact of COVID-19 through facility reported surveillance data. Examples of data reported in the pathways include:

    • Counts of residents and facility personnel newly positive for COVID-19 based on viral test results.
    • COVID-19 vaccination status of residents newly positive for COVID-19.
    • Re-infections in residents and facility personnel previously infected with COVID-19.
    • COVID-19 related death counts among residents and facility personnel.
    • Staffing shortages.
    • Availability and surge capacity use of personal protective equipment (PPE) and alcohol-based hand rub.
    • Monoclonal therapeutic availability and use.
    • Ventilator capacity and supplies for facilities with ventilator-dependent units.

    The Point-of-Care (POC) Test Reporting Tool is a separate reporting option for LTCFs to report SARS-CoV-2 test results provided by a POC device. NHSN routes reported POC laboratory test result data to the public health agency at the local or state level with jurisdictional authority and responsibility for receiving those data. Important: the reporting of POC test result data in this tool does not take the place of answering POC related questions in the Resident Impact and Facility Capacity surveillance reporting pathway.

    Weekly reporting of COVID-19 vaccination data for residents and healthcare personnel is another option available to LTCFs. Additional information about surveillance and vaccination reporting, please visit the Weekly HCP & Resident COVID-19 Vaccination webpage.

    LTCF data submission options include manual data entry, CSV file submission by individual facilities or bulk CSV file upload for multiple facilities, and/or NHSN DIRECT CDA Automation for the Point-of-Care (POC) Test Reporting Tool. Information about the Direct protocol can be found here. Send questions to NHSNCDA@CDC.GOV with Subject line “Direct Submissions for POC data.”

    For additional information about the LTCF COVID-19 Module, reporting options, data collection forms, form instructions, archived and upcoming trainings, and future updates, please review the resources on this page.

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  • Updated Guidance for Emergency Preparedness-Appendix Z of the State Operations Manual (SOM): CMS Memo QSO-21-15-ALL (4/21)

    By CMS - April 02, 2021
    Memo # QSO-21-15-ALL

    Posting Date 2021-03-26

    Fiscal Year 2021

    Summary

    Burden Reduction Final Rule Interpretive Guidelines: The Centers for Medicare & Medicaid Services (CMS) is releasing interpretive guidelines and updates to Appendix Z of the State Operations Manual (SOM) as a result of the revisions of the Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction (CoPs) (CMS 3346-F) Final Rule.

    Expanded Guidance related to Emerging Infectious Diseases (EIDs): CMS is also providing additional guidance based on best practices, lessons learned and general recommendations for planning and preparedness for EID outbreaks. 

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  • March 23 CMS Long-Term Care: Dementia-related Psychosis Call: Audio Recording and Transcript Available (3/21)

    By CMS - April 02, 2021
    Date 2021-03-23

    Event Long-Term Care: Dementia-related Psychosis Call

    Topic Dementia Care in Nursing Homes

    When: Tuesday, March 23, 2021, from 1:30 to 3 pm ET

    Description:

    National Partnership to Improve Dementia Care and Quality Assurance Performance Improvement

    During this call, learn about the appropriate assessment, accurate diagnosis, and approaches to care for dementia-related psychosis in the long-term care setting. Hear about customized care strategies for nursing home residents. A question and answer session follows the presentations.

    Speakers: Dr. George Grossberg, Dr. Alexis Eastman, Susan Scanland, and Dr. Chad Worz from the Gerontological Society of America’s Workgroup on Dementia-Related Psychosis

    Target Audience:

    • Consumer and advocacy groups
    • Nursing home providers
    • Surveyor community
    • Prescribers
    • Professional associations
    • Other interested stakeholders
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  • MDS Items D0200 and D0300 Coding: Resident Mood Interview (PHQ-9) Video Tutorial (4/21)

    By CMS - April 02, 2021

    NEW TRAINING AVAILABLE – Resident Mood Interview (PHQ-9) for the Skilled Nursing Facility (SNF) Setting Video Tutorial

    CMS Resident Mood Interview (PHQ-9) for the SNF Setting Video Tutorial

    The Centers for Medicare & Medicaid Services (CMS) is releasing a video tutorial that depicts a scenario that demonstrates the interview of a resident and subsequent coding of D0200. Resident Mood Interview (PHQ-9©) and D0300. Total Severity Score. Various interviewing tips and techniques are highlighted in the video to promote accurate coding. The video tutorial is approximately 30 minutes in length and is designed to be used on demand anywhere you can access a browser.

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  • Postacute Sequelae of SARS-CoV-2 Infection (4/21)

    By ASPR TRACIE / HHS - April 01, 2021
    ASPR TRACIE (part of the US Department of Health and Human Services) received a request for information on clinical presentation, disease progression, and related information from clinicians in the field treating COVID-19 patients after the acute phase of the virus has passed, frequently referred to as “COVID long haulers.”
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  • QTSO Notice: MDS Long-Stay Residents in CASPER (4/21)

    By QIES Technical Support Office - April 01, 2021
    Attention QIES Users: CMS is in compliance with disposition authority N1-440-09-03 and only retains assessment and supporting data that is less than 10 years old in the QIES National database. Therefore, assessment-based quality measures generated in CASPER for reporting periods of 9 years* or older may be calculated with less than a full set of original assessment records. These reporting periods may not reflect the actual quality of care performed for episodes and stays within that time frame.

    *Note: Some assessment-based quality measures require a 2-year lookback period based on the target date of the stay or episode.

    CASPER reports currently impacted by the data retention policy:

    • MDS 3.0 Facility Level Quality Measure Report
    • MDS 3.0 Resident Level Quality Measure Report
    • MDS 3.0 Facility Characteristic Report
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