CMS Nursing Home Data Sets Updated

Five-Star, NHQI, SNF QRP, SNF VBP, PBJ data Announcement: January 2023: Data have been refreshed for January 2023. Because of COVID-19 reporting exceptions, the claims-based measures were calculated excluding Q1 and Q2 2020.  For additional information, visit the Skilled Nursing Facility Center and view the SNF QRP COVID-19 Public Reporting Tip Sheet …

Five-Star Technical User’s Guide Plus Claims-Based Measures Appendix (Updated)

CMS created the Five-Star Quality Rating System to help consumers, their families, and caregivers compare nursing homes more easily. The Nursing Home Compare Web site features a quality rating system that gives each nursing home a rating of between 1 and 5 stars. Nursing homes with 5 stars are considered …

Q&A: Does AAPACN have any webinars on the changes coming this year with the elimination of G to GG for CNA documentation?

Question: Does AAPACN have any webinars on the changes coming this year with the elimination of G to GG for CNA documentation? Answered by Jessie McGill, RN, RAC-MT AAPACN offers an on-demand workshop for section GG, the Section GG Train-the-Trainer certificate program, as well as many free member tools and resources …

Substantive Changes to the Draft MDS Nursing Home Item Sets

On Dec. 23, 2022, the Centers for Medicare & Medicaid Services (CMS) released an updated draft of the MDS Nursing Home Comprehensive (NC) Item Set version 1.18.11. Nursing homes will be required to implement the new item sets—with their many changes—beginning Oct. 1, 2023, as finalized in the Fiscal Year …

SNF Medicare Provider Enrollment, Change of Ownership, and Revalidation Procedures Updated

The CY 2023 PFS Final Rule contains provisions concerning Medicareprovider enrollment. These principally involve the following: (1) Moving skilled nursingfacilities (SNFs), various provider enrollment ownership changes, and certain other providersand suppliers into the “high” level of categorical screening; and (2) expanding several of provider enrollment denial and revocation reasons. This …

Q&A: Where can I find information about iQIES?

Question: Where can I find information about iQIES? Answer from Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT: The Centers for Medicare & Medicaid Services (CMS) recently released the new iQIES Reports User Manual. This manual includes instructions on how to get started, along with how to manage reports in the …

TIP: CMS Releases QSO Memo with Updates to Care Compare and Quality Measure Ratings

The Centers for Medicare & Medicaid Services (CMS) released a memo last week containing updates to Care Compare and Quality Measure ratings. These changes include: CMS will consider a lesser action to the star ratings for facilities that admit miscoding prior to the survey such as suppression of the QM …

How to Lead the Team When Everyone is Tired

With a long-lasting pandemic, staff shortages, increased federal reporting requirements, and survey changes in 2022, and new MDS changes in the year to come, one thing is certain—everyone is tired. Amid all this, the director of nursing services (DNS) has the daunting challenge of leading and motivating the team, even …

Q&A: How long can a COVID-19 positive resident who met the criteria of strict isolation be covered under Medicare Part A?

Question: How long can a COVID-19 positive resident who met the criteria of strict isolation be covered under Medicare Part A? Answer from Janine Cortesa RN, BSN:Isolation is not a daily skilled need, so that cannot be the service that skills them. What are you doing for the resident that …

Q&A: If a resident has a chronic urinary tract infection (UTI) and the physician ordered a prophylactic antibiotic, do I code UTI on the MDS as an active diagnosis?

Question: If a resident has a chronic urinary tract infection (UTI) and the physician ordered a prophylactic antibiotic, do I code UTI on the MDS as an active diagnosis? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: The diagnosis of UTI is coded if the infection meets both …