SNF VBP and SNF QRP MUC List Includes VBP Nursing Hours Measure (12/21)

The annual Measures Under Consideration (MUC) List from CMS includes four SNF VBP measures and two SNF QRP measures. 2021 MUC List (PDF) from https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures/Pre-Rulemaking See Appendix A for measure specifications. MUC ID Measure Title Description Measure Type Measure Steward CMS Program(s) MUC2021 -095 CoreQ: Short Stay Discharge Measure The …

Q&A: When a Medicare Part A resident discharges to another SNF and will continue skilled Medicare there, what assessments are required and what is the date used in A2400C?

Question: I have a Medicare Part A resident discharging to another SNF and will continue skilled Medicare there. Would I combine the OBRA Discharge with a PPS Part A Discharge assessment?  In A2400, would I put the day she discharged as her Medicare Part A end of stay or would …

How to Be Proactive in Approaching Part B Denials with Erin DuPrae

In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, vice president of education and certification strategy for AAPACN and Erin DuPrae, OTR/L, clinical support specialist with AAPACN Diamond Partner, Synchrony Rehab, discuss how facilities can be proactive with Part B denials and how to prepare for appeals.

COVID-19 MLN Matters Article SE20011 Update Highlights Need to Meet Part A Level-of-Care Requirements (9/21)

The section “SNF Qualifying Hospital Stay (QHS) and Benefit Period Waivers” in MLN Matters Special Edition Article SE20011 Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) has been updated. The emergency SNF QHS and benefit period requirements under Section 1812(f) of the Social Security Act …

Introduction to the SNF QRP Web-Based Training From CMS (8/21)

The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training course for those who are new to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP). This course is designed to provide a general overview of the program as well as a variety of links and resources …

Q&A: Can a resident disenroll in a Medicare Advantage (MA) plan and revert back to Original Medicare when the 3-day qualifying hospital stay was waived for the MA plan?

Question: A resident admitted for skilled care under a Medicare Advantage (MA) plan. The plan did not require a 3-day qualifying hospital stay (QHS) and the resident was hospitalized for observation only. The resident has elected to disenroll in the MA plan and revert back to Original Medicare. Is this …

Interim Payment Assessment Considerations Tool

A question that comes up often lately for nurse assessment coordinators (NACs) is, “Should I do an IPA?” The assessment is optional, which can also make deciding when to complete one a challenge. Depending on the situation and changes the resident has experienced, there are several considerations the NAC will …

Consolidated Appropriations and Coronavirus Relief Act: Impact on SNF Part A Services (2/21)

  Full text:  https://www.congress.gov/bill/116th-congress/house-bill/133/text   Sections addressing SNF VBP changes and access to services for hemophilia residents:   SEC. 111. IMPROVING MEASUREMENTS UNDER THE SKILLED NURSING FACILITY VALUE-BASED PURCHASING PROGRAM UNDER THE MEDICARE PROGRAM.       (a) In General.–Section 1888(h) of the Social Security Act (42 U.S.C. 1395yy(h)) is amended–         …

SNF Healthcare-Associated Infections Requiring Hospitalization for the SNF QRP Technical Report (2/21)

The Improving Post-Acute Care Transformation Act of 2014 (IMPACT Act) requires the Secretary to specify resource use measures, on which post-acute care (PAC) providers, including skilled nursing facilities, are required to submit necessary data specified by the Secretary. The Centers for Medicare and Medicaid Services (CMS) has contracted with Acumen, …

SNF Consolidated Billing: COVID-19 Monoclonal Antibody Treatment (2/21)

·  CMS Takes Further Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment ·  COVID-19 Vaccines and Monoclonal Antibody Infusion: Enforcement Discretion Relating to SNF Consolidated Billing Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction (PDF) (2/16/21)