• Register for CMS March 23 National Partnership Call: Dementia-Related Psychosis in LTC

    Thursday, March 4, 2021 | CMS
    Long-Term Care: Dementia-related Psychosis Call

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

    • Presentation: Available prior to the event
    • Audio recording and transcript: Available approximately 2 weeks after the event


    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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  • SNF QRP FAQs (3/21)

    Monday, March 1, 2021 | CMS


    March 1, 2021


    An update to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Frequently Asked Questions (FAQs) document is now available. This document has been updated to reflect the finalized policies for the SNF QRP in Fiscal Year (FY) 2021 and other useful resources available to providers.


    Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Overview

    1. What is a Quality Reporting Program?

    2. What are the current measures in the SNF QRP?

    3. What are the FY 2021 updates to the SNF QRP?

    Staying Informed About the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP)

    4. What is the process for adding and removing measures from the SNF QRP?

    5. Are there other resources on the SNF QRP website I can use to stay up-to-date?

    6. Where can I find SNF QRP training materials?

    Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Technical Requirements

    7. How are data collected and submitted for the SNF QRP?

    8. Which items on the SNF MDS are considered for compliance determination?

    9. What are the requirements for the SNF to be considered compliant?

    10. What are the data submission deadlines for the SNF QRP?

    11. Does the definition of “quarter” for the quarterly MDS data submission deadlines include patients admitted during that quarter, discharged during that quarter, or both?

    12. What is QIES? How can I request access to QIES?

    The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) and the Minimum Data Set (MDS)

    13. What is the current version of the MDS?

    14. Where can I find the MDS 3.0 Resident Assessment Instrument (RAI) Manual for the SNF QRP?

    15. Who can complete a SNF MDS?

    Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Reconsiderations, Exceptions, and Extensions

    16. Does the Centers for Medicare & Medicaid Services (CMS) tell SNFs if they are noncompliant with the QRP requirements?

    17. I received a letter of notification that my SNF is non-compliant with the SNF QRP requirements. Can I ask CMS to reconsider the decision?

    18. The county where our SNF is located was affected by a natural disaster. Are we excepted from the QRP reporting requirements?

    Other Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Frequently Asked Questions

    19. Does my SNF need to report health care–acquired infection data under the SNF QRP?

    20. My facility’s demographic data are incorrect on Care Compare. How do I correct them?

    21. Where are SNF quality measure data publicly reported?

    22. Which SNF quality measures are reported on the Care Compare website?

    23. Who can I contact with a specific question about the SNF QRP?

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  • SNF QRP Quick Reference Guide (3/21)

    Sunday, February 28, 2021 | CMS
    The Quick Reference Guides provide high-level information on the SNF Quality Reporting Program, including frequently asked questions and helpful links.
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  • Consolidated Appropriations and Coronavirus Relief Act: Impact on SNF Part A Services (2/21)

    Wednesday, February 24, 2021 | Congress

    Sections addressing SNF VBP changes and access to services for hemophilia residents:




        (a) In General.--Section 1888(h) of the Social Security Act (42

    U.S.C. 1395yy(h)) is amended--

            (1) in paragraph (1), by adding at the end the following new


                ``(C) Exclusions.--With respect to payments for services

            furnished on or after October 1, 2022, this subsection shall

            not apply to a facility for which there are not a minimum

            number (as determined by the Secretary) of--

                    ``(i) cases for the measures that apply to the facility

                for the performance period for the applicable fiscal year;


                    ``(ii) measures that apply to the facility for the

                performance period for the applicable fiscal year.'';

            (2) in paragraph (2)(A)--

                (A) by striking ``The Secretary shall apply'' and inserting

            ``The Secretary--

                    ``(i) shall apply'';

                (B) by striking the period at the end and inserting ``;

            and''; and

                (C) by adding at the end the following:

                    ``(ii) may, with respect to payments for services

                furnished on or after October 1, 2023, apply additional

                measures determined appropriate by the Secretary, which may

                include measures of functional status, patient safety, care

                coordination, or patient experience.

            Subject to the succeeding sentence, in the case that the

            Secretary applies additional measures under clause (ii), the

            Secretary shall consider and apply, as appropriate, quality

            measures specified under section 1899B(c)(1). In no case may

            the Secretary apply more than 10 measures under this


            (3) in subparagraph (A) of each of paragraphs (3) and (4), by

        striking ``measure'' and inserting ``measures''; and

            (4) by adding at the end the following new paragraph:

            ``(12) Validation.--

                ``(A) In general.--The Secretary shall apply to the

            measures applied under this subsection and the data submitted

            under subsection (e)(6) a process to validate such measures and

            data, as appropriate, which may be similar to the process

            specified in section 1886(b)(3)(B)(viii)(XI) for validating

            inpatient hospital measures.

                ``(B) Funding.--For purposes of carrying out this

            paragraph, the Secretary shall provide for the transfer, from

            the Federal Hospital Insurance Trust Fund established under

            section 1817, of $5,000,000 to the Centers for Medicare &

            Medicaid Services Program Management Account for each of fiscal

            years 2023 through 2025, to remain available until expended.''.

        (b) Report by MedPAC.--Not later than March 15, 2022, the Medicare

    Payment Advisory Commission shall submit to Congress a report on

    establishing a prototype value-based payment program under a unified

    prospective payment system for post-acute care services under the

    Medicare program under title XVIII of the Social Security Act (42

    U.S.C. 1395 et seq.). Such report--

            (1) shall--

                (A) consider design elements such as--

                    (i) measures that are important to the Medicare program

                and to beneficiaries under such program;

                    (ii) methodologies for scoring provider performance and

                effects on payment; and

                    (iii) other elements determined appropriate by the

                Commission; and

                (B) analyze the effects of implementing such prototype

            program; and

            (2) may--

                (A) discuss the possible effects, with respect to the

            Medicare program, on program spending, post-acute care

            providers, patient outcomes, and other effects determined

            appropriate by the Commission; and

                (B) include recommendations with respect to such prototype

            program, as determined appropriate by the Commission, to

            Congress and the Secretary of Health and Human Services.




    (a) In General.--Section 1888(e)(2)(A)(iii) of the Social Security

    Act (42 U.S.C. 1395yy(e)(2)(A)(iii)) is amended by adding at the end

    the following:


                        ``(VI) Blood clotting factors indicated for the

                    treatment of patients with hemophilia and other

                    bleeding disorders (identified as of July 1, 2020, by

                    HCPCS codes J7170, J7175, J7177-J7183, J7185-J7190,

                    J7192-J7195, J7198-J7203, J7205, J7207-J7211, and as

                    subsequently modified by the Secretary) and items and

                    services related to the furnishing of such factors

                    under section 1842(o)(5)(C), and any additional blood

                    clotting factors identified by the Secretary and items

                    and services related to the furnishing of such factors

                    under such section.''.


        (b) Effective Date.--The amendment made by subsection (a) shall

    apply to items and services furnished on or after October 1, 2021.

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  • Why Nurses Eat Their Young and How to Stop This Damaging Practice

    Tuesday, February 23, 2021 | Alexis Roam, MSN, RN-BC, DNS-CT, QCP

    There is a phenomenon of hostility among nurses and certified nursing assistants (CNAs), commonly referred to as “nurses eating their young.” This incivility is pervasive, often seen as a rite of passage, and directed at both peers and those at different levels in the organization. Those who demonstrate this hostility justify it by asserting that a nurse or CNA must be initiated through a trial by fire to be included in the facility’s team. Sadly, bullying has been the acceptable form of initiation for too long.


    Read this article to learn more about incivility and its devastating effects, as well as steps leaders can take to change this cultural norm to make facilities more welcoming and safer places to work.

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  • Want Better Care Plans? Look at the CAAs

    Tuesday, February 23, 2021 | Caralyn Davis, Staff Writer

    “The effective completion of the CAAs—and the critical thinking and professionalism that go behind that—ties the MDS into the care planning process and everything else that is interconnected,” says Andrea Otis-Higgins, MBA, RN, CHC, RAC-MT, MLNHA, CHPC. “The CAAs connect to multiple components in addition to individual care plans: survey, risk management against resident/family lawsuits, both the Nursing Home Quality Initiative (NHQI) and the Skilled Nursing Facility Quality Reporting Program (SNF QRP) Quality Measures (QMs), and supporting documentation for payment under the Medicare Part A Patient-Driven Payment Model (PDPM).


    Read this article for steps DNSs can take to help the interdisciplinary team improve the CAAs.

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  • Staffing During the COVID-19 Pandemic: A Guide for Nursing Home Leaders (2/21)

    Tuesday, February 23, 2021 | IHI
    A resource guide, written by and for directors of nursing, administrators, and other nursing home leaders, outlines steps to reduce or eliminate urgent staff shortages, particularly shortages of direct care workers. This guide is from the Institute for Healthcare Improvement (IHI) and Project ECHO, a project of the Agency for Healthcare Research and Quality (AHRQ).
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  • CDC COVID-19 Interim Infection Prevention and Control Recommendations for Healthcare Personnel Updated (2/21)

    Tuesday, February 23, 2021 | CDC

    Updates as of February 10, 2021

    • Updated the Implement Universal Use of Personal Protective Equipment section to expand options for source control and patient care activities in areas of moderate to substantial transmission and describe strategies for improving fit of facemasks. Definitions of source control are included at the end of this document.
    • Included a reference to Optimizing Personal Protective Equipment (PPE) Supplies that include a hierarchy of strategies to implement when PPE are in short supply or unavailable.
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  • Emergency Preparedness Report: Identifying and Overcoming Healthcare Communications Vulnerabilities (2/21)

    Monday, February 22, 2021 | ASPR TRACIE

    ASPR TRACIE Emergency Preparedness Report: Identifying and Overcoming Healthcare Communications Vulnerabilities: Nashville, TN

    While the Christmas morning recreational vehicle blast outside the AT&T transmission facility in Nashville did not cause a mass fatality incident, it significantly impacted healthcare communications throughout the region. This article describes the impacts, lessons learned, strengths, and challenges faced by two professionals with different perspectives of the Nashville healthcare system.

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  • Center for Medicare Advocacy Offers Nursing Home COVID-19 Lessons Learned and Policy Recommendations (2/21)

    Monday, February 22, 2021 | CMA

    The Center for Medicare Advocacy released a new report – Geography Is Not Destiny: Protecting Nursing Home Residents from the Next Pandemic – which explores facilities’ responses to the coronavirus crisis and examines how residents’ deaths were not “inevitable”, as some have claimed. The report contends that COVID-19 exploited and exacerbated long-standing issues, such as staffing, infection control, and management problems, that existed for decades in the long-term care industry.

    As our nation’s nursing homes continue to reel from the unprecedented toll that COVID-19 has taken, questions remain about how many deaths could have been avoided, and – crucially – what can be done to save lives moving forward to prevent a similar catastrophe in the future. Nationwide, 36% of COVID-related deaths have occurred in long-term care facilities (and in some states that figure jumps to over 60%). These statistics are even more shocking considering that less than 1% of the nation’s population live in these facilities.

     “The wrath of COVID-19 in our nursing homes was felt, in large part, because we as a nation have not prioritized fixing these issues,” states Cinnamon St. John, the report’s author – who is also the Center’s Health and Aging Policy Fellow and Associate Director of NYU Rory Meyers’ Hartford Institute of Geriatric Nursing. “COVID-19 will very likely not be the last pandemic we experience in our lifetimes. If we don’t address these issues now, will see these mass casualties again. The good news is that we know more now. The lessons are clear. But we must act. The currency is lives – lives lost, or lives saved,” she added

    The report:

    ·         Analyzes and challenges the assertion that “Geography is Destiny” as the prevailing theory of nursing home transmission (concluding “a facility’s location does not equate to a facility’s fate”)

    ·         Identifies lessons learned for nursing homes

    ·         Provides specific policy recommendations for change

    The report also examines both the challenges and successes of nursing home administrators who have been combatting COVID-19 on a daily basis. “You can either panic during the pandemic or you can be prepared during the pandemic. It’s better to be prepared,” says Reverend Derrick DeWitt, Director and CFO of the Maryland Baptist Aged Home. His nursing home, with about a 90% Medicaid resident population, has remarkably remained COVID-free to this day.

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