Memo # QSO-23-21-NH Posting Date 2023-09-20 Fiscal Year 2023 Title Memorandum Summary • Adjustment to Staffing and Quality Measures: CMS will update the staffing level case-mix adjustment methodology and replace some of the Quality Measures …
The Center of Excellence for Behavioral Health in Nursing Facilities (COE-NF), which opened its online doors in December 2022 thanks to a three-year grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), is …
Next month, The Centers for Medicare & Medicaid Services (CMS) will release two new Health Equity Confidential Feedback Reports to post-acute care (PAC) providers in the Home Health (HH), Inpatient Rehabilitation Facility (IRF), Long-Term Care …
In February 2022, the Biden-Harris Administration announced a comprehensive set of reforms aimed at improving quality and safety for residents in nursing homes. One aspect of this initiative was conducting a new Nursing Home Staffing …
Resources: Press Release: The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), issued a proposed rule that seeks to establish comprehensive staffing requirements for nursing homes—including, …
Effective August 21, 2023, MDS 3.0 Frequency data will be available from a new location on the data.cms.gov website (https://data.cms.gov/quality-of-care/minimum-data-set-frequency). This new website replaces the previous MDS 3.0 Frequency Report webpage which was decommissioned on …
The Centers for Medicare & Medicaid Services (CMS) added administrator exclusion criteria to the PBJ public use files. The updated criteria excludes administrator data if a nursing home reports five or more administrators on four …
Memo # QSO-23-02-ALL (EXPIRED) Posting Date 2023-07-25 Fiscal Year 2023 EXPIRATION INFORMATION: CMS PUBLISHED A FINAL RULE WHICH ENDED THE REQUIREMENTS RELATED TO STAFF VACCINATION FOR ALL PROVIDER TYPES, EFFECTIVE ON 8/05/23. ADDITIONALLY, THIS RULE …
Recent severe weather events have highlighted the need for and importance of emergency power systems for nursing homes. Nursing homes are required to provide an alternate source of energy (usually a generator) to maintain temperatures …
Occupational Safety and Health Administration 29 CFR Part 1904 [Docket No. OSHA-2021-0006] RIN 1218-AD40 Improve Tracking of Workplace Injuries and Illnesses AGENCY: Occupational Safety and Health Administration (OSHA), Labor. ACTION: Final rule. SUMMARY: OSHA is …
Memo # QSO-23-18-NH Posting Date 2023-06-28 Fiscal Year 2023 Memorandum Summary • Posting Nursing Home Affiliation on Nursing Home Care Compare: CMS will include ownership and operatorship affiliation information on our Nursing Home Care Compare …
The Centers for Medicare & Medicaid Services (CMS) updated two data products with skilled nursing facility utilization data for beneficiaries enrolled in Medicare Advantage (MA). The Medicare Advantage Geographic Variation PUF (MA GV PUF) now …
From MLN Connects: CMS finalized staff education requirements while ending the COVID-19 staff vaccination requirements for Long-Term Care Facilities and Intermediate Care Facilities for Individuals with Intellectual Disabilities. These provisions were included in the “COVID-19 …
A facility-initiated transfer or discharge of a resident from a nursing home can be an unsafe and traumatic experience for the resident and the resident’s family. To address these concerns, Congress passed the Nursing Home …
Executive Order (in particular, section 2 is worth reading for nursing home-specific information): By the authority vested in me as President by the Constitution and the laws of the United States of America, it is …
Alert: Electronic medical records (EMRs) and electronic health records (EHRs) are often used interchangeably. An EMR allows the electronic entry, storage, and maintenance of digital medical data. EHRs contain patients’ records from doctors and include …
CMS will be transitioning to a new data source for a provider’s demographic data for all five Post-Acute Care (PAC) provider types (Skilled Nursing Facilities / Nursing Facilities (SNF/NFs), Home Health Agencies (HHAs), Inpatient Rehabilitation …
For 67 of the 100 sampled nursing homes, the Centers for Medicare & Medicaid Services (CMS) did not accurately report on Care Compare 1 or more deficiencies that surveyors identified during yearly and complaint inspections. …
CoreQ: Short Stay Discharge Survey CoreQ Short Stay Discharge Survey Protocols and Guidelines Manual and additional resources CMS-10852 (ZIP) From https://www.cms.gov/regulations-and-guidance/legislation/paperworkreductionactof1995/pra-listing/cms-10852
On April 4, 2023, the Centers for Medicare & Medicaid Services (CMS) posted the Fiscal Year (FY) 2024 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule for public inspection. The payment news is …
Memo # QSO-23-11-LSC Posting Date 2023-03-31 Fiscal Year 2023 Summary Various CMS regulations governing certain providers and certified suppliers require compliance with the 2012 edition of the National Fire Protection Association (NFPA) Health Care Facilities …
When a skilled nursing facility (SNF) is operating on a tight budget, while also being census- and staff-challenged, the director of nursing services (DNS) needs to be more directly and proactively involved in fiscal management …
The Medicare Payment Advisory Commission (MedPAC) has released its March 2023 Report to the Congress: Medicare Payment Policy. The report includes MedPAC’s analyses of payment adequacy in traditional fee-for-service (FFS) Medicare and reviews the status of Medicare …
The American Association of Post-Acute Care Nursing (AAPACN) will host the annual conference this year April 19 – 21 in Las Vegas, NV. Long-term and post-acute care professionals from across the nation will gather to …
The National Emerging Special Pathogen Training and Education Center (NETEC) has released a workbook for “assessing operational elements for special pathogen preparedness, response, and recovery unique to the long-term care setting.” The workbook is designed …
The March 2023 Quarterly Confidential Feedback Reports for the FY 2024 SNF VBP Program are now available to download via the Quality Improvement and Evaluation System (QIES)/Certification and Survey Provider Enhanced Reports (CASPER) reporting system. …
Significant changes are coming with the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, version 1.18.11, which will become effective October 1, 2023. Facilities that prepare ahead of time will integrate the updates into …
Updated for 2023. It includes a SNF Checklist for potential admissions and families to use to assess each SNF. Medicare and Skilled Nursing Facility Care Benefits: Getting Started
“As explained by Petitioner, and not disputed by CMS, Petitioner’s former executive director became the executive director at another facility and reported data on behalf of that facility to the NHSN. Petitioner determined, with the …
Memo # Admin Info -23-06-NH Posting Date 2023-02-10 Fiscal Year 2023 Summary Implementation Dates for the Revised Chapter 5 – CMS expects the state survey agencies (SAs) to implement the revised timeframes for investigating nursing …
You do have to register, but it’s free: Enhancing Quality Improvement Adoption in US Nursing Homes Johnson M, Renton M. Enhancing Quality Improvement Adoption in US Nursing Homes. Boston: Institute for Healthcare Improvement; 2023. (Available …
There are nursing home-specific recommendations: SummaryThe Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory about infections with an extensively drug-resistant strain of Verona Integron-mediated Metallo-β-lactamase (VIM) and …
From the John A. Hartford Foundation: Public Policy & Aging Report (PP&AR) has released a Special Issue, “2022 NASEM Quality of Nursing Home Report: Moving Recommendations to Action.” PP&AR, a publication of The Gerontological Society of America, supplemental issue focuses …
From the John A. Hartford Foundation: Health Affairs Forefront: Payment for Comprehensive Dementia Care – Five Key Recommendations Health Affairs Forefront has published an article on “Payment for Comprehensive Dementia Care: Five Key Recommendations,” calling on the Centers …
Proposed rule would require disclosure of additional ownership and management information to shine a light on private equity ownership Administration seeking to implement Section 6101(a) of the Affordable Care Act As President Biden made clear …
SUBJECT: Revisions to State Operations Manual (SOM), Chapter 7 I. SUMMARY OF CHANGES: Technical Changes – Changed “regional office” to “CMS Location” and “Central Office” to “CMS Headquarters”. NEW/REVISED MATERIAL – EFFECTIVE DATE: February 10, …
Registration to obtain this is free: Bolender T, DeSmidt B, Feske-Kirby K, Imbeah K, Sampath B. Organizational Trustiworthiness in Health Care. Boston: Institute for Healthcare Improvement; 2022. (Available at www.ihi.org) Trust between patients and clinicians, …
Weekly / February 10, 2023 / 72(6);145–152 Summary What is already known about this topic? COVID-19 vaccine effectiveness decreased with waning of vaccine-derived immunity and emerging Omicron sublineages. An updated (bivalent) booster dose enhances protection against …
GAO-23-104813 Published: Jan 03, 2023. Publicly Released: Feb 02, 2023. https://www.gao.gov/products/gao-23-104813 Fast Facts Care Compare is a web-based tool that lets consumers compare the quality ratings of health care providers participating in the Medicare program. …
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 …
More Than a Thousand Nursing Homes Reached Infection Rates of 75 Percent or More in the First Year of the COVID-19 Pandemic; Better Protections Are Needed for Future Emergencies (OEI-02-20-00491) Nursing homes had a surge of …
The U.S. Department of Health and Human Services’ Administration for Strategic Preparedness and Response has released an information sheet, COVID-19 Treatments: Key Messages for Long-Term Care Facilities. https://www.aapacn.org/wp-content/uploads/2023/01/ASPR-Info-Sheet_COVID-Tx_LTC-Key-Messages_1.5.2023-1.pdf
By Cody Campbell and AAPACN Leadership pioneer and scholar, Warren Bennis once said, “Leadership is the capacity to translate a vision into reality.” This quote inspires in moments of stress and anxiety related to work, …
Meaning “This study suggests that day-to-day staffing instability is an important marker of nursing home quality, limiting measurement, reporting, or policy to average hours per resident-day likely will miss important opportunities to improve care.” https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800160
Emergency preparedness planners in nursing homes can adapt this new On-Campus Hospital Armed Assailant Planning Considerations document to help prepare their facilities to mitigate, respond to, and recover from an armed assailant or active shooter situation on …
The HCP Influenza Vaccination module in the HPS component of the NHSN is where SNFs enter data for the SNF QRP’s HCP Influenza Vaccination measure. This website offers access to training slides and other educational …
The National Center for State Courts (NCSC) has released an updated online course that explains options for assisting individuals who need decision-making support. Finding the Right Fit: Decision-Making Supports and Guardianship is a free, …
Outbreak Duration Averaged 4 Weeks and Was Strongly Associated with Community Spread Highlights Page (1 page) Full Report (70 pages) What GAO Found GAO analysis of data from the Centers for Disease Control and Prevention …
TMF Health Quality Institute, a Centers for Medicare & Medicaid Services (CMS) Quality Innovation Network-Quality Improvement Organization (QIN-QIO), works with nursing homes and skilled nursing facilities in Arkansas, Mississippi, Nebraska, Puerto Rico and Texas to …
A report released by the U.S. Department of Health and Human Services (HHS) highlights patients’ experience of Long COVID to better understand its complexities and drive creative responses by government leaders, clinicians, patient advocates and …
Written by Michael Daniels, RN, DNS-CT, QCP, RAC-CT, RAC-CTA All one needs to do is peruse the long-term care (LTC)/skilled nursing facility (SNF) job openings online for a few minutes to realize that something is …
Title Memo # Posting DateSort ascending Fiscal Year Transitioning Certification Functions for Changes of Ownership, Administrative Changes, and Initial Enrollment Performed by the SOG Locations ***Revised to Transition Several Providers and Suppliers and Provide Additional …
CMS has updated resources for applying for CMP funds. State CMP Reinvestment Projects Funded by Calendar Year (ZIP) CMP Reinvestment Application Resources_ Updated October 2022 (ZIP) CMP Reinvestment State Plan Resources_ Updated October 2022 (ZIP) …
Memo: QSO-23-01-NH (PDF) Press release: Changes to CMS’ Special Focus Facilities program will increase scrutiny, hold facilities accountable for substandard safety and quality, and improve care for residents As part of the Biden-Harris Administration’s continued commitment …
Two journal articles involving just culture: Rooting an error review process in just culture: lessons learned.Neiswender K, Figueroa-Altmann A, Granahan K, et al. Patient Safety. 2022;4(3):34-38. Fatal Solutions: How a Healthcare System Used Tragedy to Transform Itself …
It is well known that in the early weeks of the COVID-19 pandemic in the United States much of the devastation was concentrated in nursing homes. In addition to the staggering death toll, isolation and …
On Oct. 24, 2022, surveyors will begin using new survey guidance to identify noncompliance with QAPI, trauma-informed care, and resident safety, including abuse, neglect, and exploitation. Skilled nursing facility (SNF) leaders should be in the …
The Skilled Nursing Facility (SNF) Cost Report dataset is a public use file that provides select measures from the skilled nursing facility annual cost report. This data includes provider information such as facility characteristics, utilization data, …
Transmittal # R207SOMA Issue Date 2022-09-30 Subject Revisions to State Operation Manual (SOM), Appendix PP Guidance to Surveyors for Long Term Care Facilities Implementation Date 2022-10-01 CR # N/A Publication # 100-07 I. SUMMARY OF CHANGES: …
In this QAPI video series, a QI expert walks through best practices for starting and leading a successful PIP/QIP, looking at important decisions to consider in starting a performance improvement plan, as well as highlighting …
Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 Summary of Recent Changes Updates as of September 23, 2022 In most circumstances, asymptomatic HCP with higher-risk exposures do not require work restriction. Updated …
Strategies to Mitigate Healthcare Personnel Staffing Shortages Summary of Recent Changes Updates as of September 23, 2022 Conventional strategies were updated to advise that, in most circumstances, asymptomatic healthcare personnel (HCP) with higher-risk exposures do not …
QSO-22-25-CLIA DATE: September 26th, 2022 TO: State Survey Agency Directors FROM: Director, Quality, Safety & Oversight Group (QSOG) SUBJECT: CMS Rescinds December 7, 2020, Enforcement Discretion for the Use of SARS CoV-2 Memorandum Summary CMS …
The FDA published the FDA Voices: “FDA Issues New Guidance to Help Facilitate Availability of Naloxone to Prevent Opioid Overdoses and Reduce Death,” by Marta Sokolowska, Ph.D., Deputy Center Director for Substance Use and Behavioral …
Guidance for Federal Monitoring Surveys (FMS) Memo # Admin Info-22-09-All Posting Date 2022-09-21 Fiscal Year 2022 Summary • Provide guidance on how CMS Location staff will conduct Federal Monitoring Surveys (FMS) in FY2022 and FY2023. …
By Melanie Tribe-Scott, BSN, RN, RAC-MT, RAC-MTA, QCP The U.S. Surgeon General recently issued an advisory highlighting the urgent need to address the health worker burnout crisis across the country (Office of the U.S. Surgeon …
Certain Nursing Homes May Not Have Complied With Federal Requirements for Infection Prevention and Control and Emergency Preparedness (A-01-20-00005) Selected nursing homes may not have complied with Federal requirements for infection prevention and control and emergency …
Audits of Nursing Home Life Safety and Emergency Preparedness in Eight States Identified Noncompliance With Federal Requirements and Opportunities for the Centers for Medicare & Medicaid Services to Improve Resident, Visitor, and Staff Safety We …
The unified approach to case-mix adjustment includes standardized patient assessment data collected by the four PAC providers. Unified PAC Report to Congress (PDF) | Unified PAC Report to Congress Appendices (ZIP) Section 2(b)(2)(A) of the Improving Post-Acute …
On June 29, the Centers for Medicare & Medicaid Services (CMS) issued a major update to surveyor guidance via Quality, Safety and Oversight (QSO) memo QSO-22-19-NH to strengthen the implementation of the already-in-effect Phases 2 …
Memo # QSO-22-17-ALL Surveys for compliance with Omnibus COVID-19 Health Care StaffVaccination Requirements Posting Date 2022-06-14 Fiscal Year 2022 Summary • Survey oversight of the staff vaccination requirement for Medicare and Medicaid-certified providers and suppliers …
This manual provides general background and information about the submission requirements, such as sample submission screens, submission deadlines, and definitions of job categories. Note: Changes from the previous version of this policy manual are identified …
Guidance related to Emergency Preparedness- Exercise Exemption based on A Facility’s Activation of their Emergency Plan Memo # QSO-20-41-ALL REVISED 05.26.2022 Posting Date 2022-05-26 Fiscal Year 2022 Summary • Emergency Preparedness Training and Testing Program …
Nurse leaders are essential to any long-term and post-acute care facility. These nurses fearlessly take responsibility for the success of their team and for quality resident care delivery. They spearhead the nursing department, overcoming obstacles …
Proposed Specifications for the Skilled Nursing Facility Value-Based Purchasing (SNF VBP) Program: Total Nursing Hours per Resident Day Measure (PDF) From https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/SNF-VBP/Measure
AHRQ has created a guide for nursing home leaders as they implement COVID-19 vaccination programs among staff members. The resource identifies important factors to consider from planning to implementation, including guidance on updating policies and …
Three new online resources from AHRQ are available to help nursing homes adopt best practices aimed at controlling and preventing infection and improving the emotional well-being of staff and residents: Best Practices Guide for COVID-19 Infection Control …
Nursing Home Capabilities and Collaboration to Ensure Resident Care During Emergencies Nursing homes face a broad range of challenges from public emergencies, such as emerging infectious disease outbreaks and natural disasters. To protect residents and …
Jan 26, 2022 As part of its commitment to improve transparency and help families and caregivers find the best quality of nursing home care for their loved ones, the Centers for Medicare & Medicaid Services …
This CISA Insights is intended to ensure that senior leaders at every organization in the United States are aware of critical cyber risks and take urgent, near-term steps to reduce the likelihood and impact of …
Columbia, MD – Workers in Medicare- or Medicaid-funded health-care provider organizations are now required by the Centers for Medicare & Medicaid Services (CMS) to be vaccinated against COVID-19 as a condition of participation in Medicare …
The last two weeks of data show steep increases in staff and resident COVID-19 cases, particularly staff cases: https://data.cms.gov/covid-19/covid-19-nursing-home-data
Memo # QSO-22-08-NH Posting Date 2022-01-07 Fiscal Year 2022 Summary CMS will begin posting the following information for each nursing home on the Medicare.gov Care Compare website: Weekend Staffing: The level of total nurse and …
Transitioning Certification Functions for Changes of Ownership, Administrative Changes, and Initial Enrollment Performed by the CMS Survey and Operations Group Memo # Admin Info: 22-02-ALL Posting Date 2021-12-23 Fiscal Year 2022 Summary The Centers for …
Case Marks First Charges Brought in District of South Carolina Related to Fraudulent Vaccine Cards Columbia, South Carolina — Acting United States Attorney M. Rhett DeHart announced today that a Federal Grand Jury in Columbia returned …
These brief videos offer self-paced learning for those on the front lines of nursing home care. This includes nursing assistants, housekeeping, dietary, and maintenance staff, and others. Emotional and Organizational Support for Staff Series This …
The magnitude of facility-initiated discharges in nursing homes remains unknown. Many challenges exist to identifying and addressing inappropriate facility-initiated discharges, including that neither Administration for Community Living (ACL) nor Centers for Medicare and Medicaid Services …
Electronic access (PDF) to this book is free with IHI membership (also free). Leape LL. Making Healthcare Safe. Springer; 2021. Written by Lucian Leape, a pioneer of the patient safety movement, this book describes how patient safety became …
A Resource for Providers Participating in the CDC COVID-19 Vaccination Program, Long-term Care Residents & Their Families On This Page Is medical consent required for LTC residents to receive a booster shot of Pfizer-BioNTech COVID-19 …
Sep 24, 2021 Following the Food and Drug Administration’s (FDA) recent action that authorized a booster dose of the Pfizer COVID-19 vaccine for certain high-risk populations and a recommendation from the Centers for Disease Control …
The Centers for Disease Control and Prevention (CDC) offers nursing homes and other long-term care providers guidance on how to ensure their residents and staff have access to COVID-19 vaccines, including booster shots. It covers …
PUBLIC HEALTH SEPTEMBER 9, 2021 Estimates of COVID-19 Cases and Deaths Among Nursing Home Residents Not Reported in Federal Data Karen Shen, PhD; Lacey Loomer, PhD, MSPH; Hannah Abrams, MD; et al. This cross-sectional study examines the magnitude of unreported COVID-19 …
CMS’s COVID-19 Data Included Required Information From the Vast Majority of Nursing Homes, but CMS Could Take Actions To Improve Completeness and Accuracy of the Data (A-09-20-02005) Centers for Medicare and Medicaid Services’ (CMS’s) COVID-19 data …
Case Western Reserve University researchers, in partnership with Brown University, examine vaccine’s effectiveness over time on seniors and their caregivers 1-Sep-2021 5:00 PM EDT, by Case Western Reserve University Newswise — CLEVELAND—A new, multi-institutional study led by …
For Older LGBTQ+ Adults, Entering a Nursing Home Can Feel Like Coming out All Over Again New study by Rush researchers calls for a change in practices in long-term care settings 4-Aug-2021 Newswise — As …
The mAbs Calculator is a free decision-support tool that enables healthcare facilities to make data-informed choices about resource allocations needed to effectively and efficiently provide monoclonal antibody therapeutics to qualified patients. The mAbs Calculator can …
Memorandum Summary CMS is hereby removing the July 7, 2017 Memo (S&C 17-37-NH) from its guidance repository. Discussion CMS is hereby removing the July 7, 2017 Memo (S&C 17-37-NH) from its guidance repository. In that …