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Tips

Tips from AAPACN

  • TIP: CMS Released the FY 2022 SNF PPS Final Rule
    CMS released the SNF PPS final rule postponing any PDPM parity adjustment changes and adopting two new SNF QRP claims-based measures: 1. SNF Healthcare-Associated Infections (HAI) Requiring Hospitalization Measure 2. COVID-19 Vaccination Coverage among Healthcare …
  • TIP: AAPACN Curriculum Development Specialist, Denise Winzeler, Contributed to CDC White Paper with LTC/PAC Workgroup
    The Healthcare Infection Control Practices Advisory Committee (HICPAC) is a federal advisory committee chartered to provide advice and guidance to the Centers for Disease Control and Prevention (CDC) and the Secretary of the Department of …
  • TIP: CMS Scheduled Care Compare Refresh with Revised Discharge to Community Measure Data
    The Centers for Medicare & Medicaid Services (CMS) discovered an error in the calculations for the Discharge to Community measure and will be updating the Care Compare website with the corrected data on Sept. 29, …
  • TIP: QRP Non-Compliance Notifications Sent to Facilities
    CMS recently announced they provided notifications to facilities that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2020, which will affect their FY 2022 Annual Payment Update (APU). …
  • TIP: AHRQ Toolkit to Improve Antibiotic Use in Long-Term Care
    The Agency for Healthcare Research and Quality (AHRQ) has released a toolkit to assist facilities with antibiotic stewardship. This toolkit focuses on three critical areas: Developing and improving a facility’s antibiotic stewardship program Creating a …
  • TIP: FY 2022 ICD-10 Coding File Released
    In late June, CMS released the ICD-10-CM coding files that will become effective Oct. 1, 2022. The addendum file contains a list of changes and revisions, including many revisions from Excludes1 to Excludes2 coding conventions. …
  • TIP: OSHA Releases New Standard to Mitigate COVID-19 Spread
    The Occupational Safety and Health Administration (OSHA) released a new emergency temporary standard for healthcare settings that includes skilled nursing facilities (SNFs). This standard requires SNFs to conduct a hazard assessment and have a written …
  • TIP: MACs Resume Post-Payments Medical Reviews
    On June 3, 2021, CMS announced that Medicare Administrative Contractors (MACs) may now begin conducting post-payment medical reviews for dates of service after March 2020. Early in the COVID-19 public health emergency (PHE), CMS held …
  • TIP: New Tool to Assist With PPE Tracking
    The Agency for Healthcare Research and Quality (AHRQ) has developed a new PPE tracking tool along with a user’s guide to assist facilities in identifying performance patterns and to target improvement areas regarding PPE use.The …
  • TIP: How Do Your Wages Compare?
    On June 1, AAPACN sent out the 2021 Work Study survey link—this survey will collect valuable information from both the nurse assessment coordinator (NAC) and director of nursing services (DNS) on wage, job satisfaction, and job …
  • TIP: New Five-Star Data on Care Compare
    The newest Five-Star data is to be released on the Care Compare website on May 26, 2021.  AAPACN recommends reviewing this data on the website to ensure it is correct, especially if the Five-Star preview …
  • TIP: CMS Finalizes COVID-19 Vaccine Reporting Requirements
    On May 11, 2021, CMS released an Interim Final Rule with Comment Period (IFC), [CMS-3414-IFC], which includes new requirements for educating residents or resident representatives and staff regarding the benefits and potential side effects associated …
  • TIP: CMS Releases New Interim Final Rule and QSO Memo on COVID-19 Vaccination Requirements
    On May 11, 2021, the Centers for Medicare & Medicaid Services (CMS) released a new interim final rule and QSO memo regarding new COVID-19 vaccination immunization requirements for residents and staff.  Facilities will now be …
  • TIP: NHSN is Hosting Webinar Trainings for Updates to the Weekly COVID-19 Vaccination Modules
    NHSN hosted a live webinar training for the updates to the weekly COVID-19 Vaccination modules. If you missed this live training, don’t worry, NHSN will rebroadcast this training for more times followed by a live …
  • Tip: CMS Releases Updated Visitation Guidance
    On April 27, 2021, CMS issued revised guidance for visitation in nursing homes during the COVID-19 public health emergency, which includes the impact of COVID-19 vaccination. For more details, see the revised QSO-20-39-NH. For permission to …
  • TIP: CMS Updates QSO Memos Related to Visitation and Testing; CDC Releases Updated Healthcare Infection and Control Recommendations
    The Centers for Medicare & Medicaid Services (CMS) update the Nursing Home Visitation – COVID-19 memo, QSO-20-39-NH, and the Interim Final Rule (IFC), CMS-3401-IFC, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public …
  • TIP: Update to CMS Blanket Waivers
    On Thursday April 8, 2021, CMS issued the QSO-21-17-NH  announcing the end of the following three blanket waivers: 1. The emergency blanket waivers related to notification of Resident Room or Roommate changes, and Transfer and Discharge notification …
  • Tip: CMS Announces Updates to Long-Term Care (LTC) Emergency Regulatory Waivers Issued in Response to COVID-19
    The Centers for Medicare & Medicaid Services (CMS) announced in an April 8, 2021, QSO memo the following updates: • CMS is announcing that select blanket waivers are ending: o The emergency blanket waivers related to notification …
  • Tip: CDC Updated Recommendations to Prevent Spread of SARS-CoV-2 in Nursing Homes
    The Centers for Disease Control and Prevention (CDC) updated the Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes. This guidance merges two prior documents (Responding to COVID-19 in Nursing Homes …
  • TIP: CMS Hosts SNF QRP Training
    On March 30, 2021, the Centers for Medicare & Medicaid Services (CMS) provided a 90-minute webinar on best practices to achieve a full annual payment update (APU). This training covered CMS quality goals, Skilled Nursing …
  • TIP: CMS Issues Updated Nursing Home Visitation Guidance
    On March 10, the Centers for Medicare & Medicaid Services (CMS) issued updated guidance for nursing homes to safely expand visitation options. According to the updated guidance, issued in collaboration with the Centers for Disease …
  • TIP: CMS Posts SNF PPS Legislative History
    In this document, CMS states, “Historically, each rule or update notice issued under the annual Skilled Nursing Facility (SNF) Prospective Payment System (PPS), rulemaking cycle included a detailed reiteration of the various individual legislative provisions …
  • TIP: CMS Offers New Section N Web-Based Training
    The Centers for Medicare & Medicaid Services (CMS) is offering a 45-minute course that provides an overview of the assessment and coding of the Drug Regimen Review standardized patient assessment data elements (SPADEs).   For permission to …
  • TIP: HHS Renews COVID-19 Public Health Emergency
    On Jan. 7, 2021, the COVID-19 public health emergency (PHE) was renewed, effective Jan. 31, 2021, for an additional 90 days. However, in a letter to the governors, the acting Secretary of Health and Human …
  • TIP: Did Your Stars Change? CMS Released Updated Five-Star Manual
    CMS released an updated Five-Star Users’ Manual on Jan. 15, 2021, announcing changes which could potentially impact your star rating with the January refresh. Here are a few highlights of the changes: CMS resumed calculating …
  • TIP: CMS Releases Update to PDPM Grouper
    In early January, CMS released an update to the PDPM Grouper and an updated PDPM ICD-10-CM Codes for I0020B file (dated 1-01-2021). This update added new diagnoses since the Oct. 1, 2020, ICD-10-CM update and …
  • TIP: CMS Updates Five-Star Quality Measure Domains
    On Dec. 4, 2020, the Centers for Medicare & Medicaid Services (CMS) released an update to the Health Inspection and Quality Measure domains of the Five-Star Quality Rating System. In this Memorandum (QSO 21-06-NH), CMS also noted …
  • TIP: Nursing Home Compare Website Retired Dec. 1, 2020
    In early September, CMS announced the launch of Care Compare, which streamlined the eight original care comparison tools. While both the new Care Compare tool and the original care tools have been available for a transition period, Dec. 1, …
  • TIP: CMS Clarifies Billing Instructions for Benefit Period Waiver
    On Nov. 9, 2020, CMS released MLN Matters Number (SE20011 Revised) for Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19). This update provided clarification on pages 14 to 16 on …
  • TIP: Nursing Home Compare and Five-Star Updates
    The October 2020 refresh of Nursing Home Compare (NHC) included the Skilled Nursing Facility Quality Reporting Program (SNF QRP) data for the following measures: Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury (reported on NHC …
  • TIP: Public Health Emergency Renewed
    The Secretary of Health and Human Services renewed a declaration that the public health emergency (PHE) exists and has existed nationwide since Jan. 27, 2020, issued on Oct. 2, 2020. This notice extends the PHE effective Oct. …
  • TIP: CMS Updates CASPER Reporting User’s Guide for MDS Providers
    The Certification and Survey Provider Enhanced Reports (CASPER) Reporting User’s Guide for MDS Providers provided updates both dated 09/2020 to Sections 11 (MDS 3.0 Quality Measure (QM) Reports v1.05) and Section 13 (SNF Quality Reporting …
  • TIP: SNF QRP Updates
     On Sept. 8, 2020, CMS posted an updated Skilled Nursing Facility (SNF) Quality Reporting program (QRP) COVID-19 Tip Sheet and the updated SNF QRP Measure Calculations and Reporting User’s Manual V3.0.1 Addendum. Here is a high overview of …
  • TIP: Recommendations Released for 2020-21 Influenza Season
    The Advisory Committee on Immunization Practices (ACIP) recently released new recommendations for the 2020-21 Influenza Season. Here is a summary for adults 65 years or older: Persons aged ≥65 years may receive any age-appropriate IIV …
  • TIP: CMS Will Publicly Report Six SNF QRP Measures in Fall 2020
    CMS will begin publicly reporting six Skilled Nursing Facility Quality Reporting Program (SNF QRP) Measures this fall during the October 2020 refresh of Nursing Home Compare: Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury Drug Regimen Review …
  • TIP: Ended, Renewed, or Held Constant? Quick Tips and Links to Recent Updates
    1. Public Health Emergency (PHE) – Renewed Effective July 25, 2020, Secretary of Health and Human Services Alex Azar used his authority and renewed the public health emergency that was declared Jan. 27, 2020. The …
  • TIP: SNF Quality Reporting Program Non-Compliance Letters for FY 2021 APU
    CMS is providing notifications to facilities that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2019, which will affect their FY 2021 Annual Payment Update (APU) starting Oct.1, …
  • TIP: Medicare Part B ABN Form Renewed, Effective Jan. 1, 2021
    Note: CMS has subsequently amended the mandatory date for implementation, pushing it back to 01/01/2021.  —- CMS recently announced the renewal of the Medicare Part B Advanced Beneficiary Notice (ABN) with an expiration date of …
  • TIP: CMS Released FAQs about Published COVID-19 Data
    The Centers for Medicare and Medicaid Services (CMS) COVID-19 National Healthcare Safety Network (NHSN) reporting requirements for nursing homes became effective on May 8, 2020. Data submitted to NHSN are shared with CMS on a …
  • TIP: COVID-19 Data and Infection Control Inspection Results Publicly Reported
    Thursday, June 4, the Centers for Medicare & Medicaid Services (CMS) posted the first set of underlying coronavirus disease 2019 (COVID-19) nursing home data. Earlier this spring, CMS announced the requirement for nursing homes to inform …
  • TIP: CMS Releases Final MDS Item Set for Oct. 1, 2020
    CMS Releases Final MDS Item Set for Oct. 1, 2020 CMS delayed the 1.18 updates that were slated for Oct. 1, 2020, which would have contained 59.5 changes to the MDS and recently released an …
  • TIP: CMS Releases Updated Five-Star User’s Guide
    On April 29, 2020, CMS released an updated Five-Star User’s Guide. CMS summarized the April 2020 Revisions: Temporary Changes due to COVID-19 as the following: On March 23, CMS announced a new, targeted inspection plan designed to …
  • TIP: CMS Updates COVID-19 FAQS
    On April 17, CMS updated the COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing document. Skilled Nursing Facility (SNF) related questions start on pages 34-35 of the 38-page resource. In this FAQ document, …
  • TIP: CMS Grants Relief to Providers for SNF QRP and SNF VBP
    In a recent press release, CMS stated: For those programs with data submission deadlines in April and May 2020, submission of those data will be optional, based on the facility’s choice to report. In addition, …
  • TIP: CMS Announced Waiver for Three-Day Qualifying Hospital Stay
    CMS is waiving the requirement at Section 1812(f) of the Social Security Act for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF) stay provides temporary emergency coverage of SNF services without …
  • TIP: AAPACN 2020 Conference – New Dates and Format
    The AAPACN 2020 Conference has been rescheduled for June 3-5, 2020, and will be held virtually. Learn more. If you registered for the ICD-10 or RAC-CT Recertification preconference workshop, they will proceed virtually with live …
  • TIP: Understanding Skilled is a Level of Care
    Skilled is not a level of payment—skilled is a level of care.   “It’s not the diagnosis or condition, it’s what you are doing about it that determines a Skilled Nursing Facility (SNF) level of …
  • TIP: Medicare QIO – New Case Management Protocols
    The Medicare QIO, Livanta, posted an announcement regarding new protocols due to the transition to the new CMS review system, QMARS (Quality Management and Review Systems). For more information, please see the provider bulletin.   …
  • TIP: CMS Blog—A New Look is Coming to Nursing Home Compare
    CMS plans to launch “Medicare Care Compare” this spring, which will provide a streamlined experience to consumers by combining and standardizing the eight different existing compare tools (Hospitals, Nursing Homes, Dialysis Facilities, Long-Term Care Hospitals, …
  • TIP: No Provider Preview Report for December 2019
    Did you think you missed your Five-Star Provider Preview Report in December?   You did not, but get ready, the next refresh is coming soon! CMS posted on the QTSO webpage:   “Important – Due …
  • TIP: CASPER Reports Updated
    CMS recently updated the CASPER reports in section 11, MDS 3.0 Quality Measure (QM) Reports (v.1.04) and section 13, SNF Quality Reporting Program (v.1.07). Here is a highlight of some of the major updates: The short-stay …
  • TIP: Item O0400 – Therapy Start Data Following an Interrupted Stay
    On the Dec. 12, 2019, SNF LTC Open Door Forum (ODF), CMS clarified how to code the Therapy start date at O0400 when a resident starts therapy, has an interrupted stay, and the 5-day assessment …
  • TIP: Claims Must Use New Medicare Beneficiary Identifiers (MDIs) Starting Jan. 1, 2020
    CMS announced in a Medicare Learning Network newsletter that if the facility does not use the Medicare Beneficiary Identifiers (MBIs) on claims after Jan. 1, 2020, rejection codes will be received:  Electronic claims reject codes: …
  • TIP: Updates Coming to the Final Validation Report Fatal Error Codes
    CMS will delete fatal error code -3941 and replace it with a new code -3965, to go into effect Dec. 3, 2019. Once in production, these changes will be retroactive, applying to all assessments submitted …
  • TIP: CMS Provides Update on Skilled Nursing Facility (SNF) Claims
    CMS released the following news item on Nov. 7: As CMS has undertaken the implementation of the Patient Driven Payment Model (PDPM), we are holding a limited number of Skilled Nursing Facility (SNF) claims while …
  • TIP: Section GG Coding and IPAs
    A common misconception about how section GG is assessed on the Interim Payment Assessment (IPA) occurs when the SNF team applies Step 5 of the Steps For Assessment (p. GG-10, RAI User’s Manual): Step 5 …
  • TIP: PDPM Resources Updated
    CMS updated several PDPM documents on the PDPM homepage on Aug. 30, 2019:  Concurrent and Group Therapy Limit PDPM Functional and Cognitive Scoring Interrupted Stay Policy MDS Changes PDPM Patient Classification PDPM FAQs PDPM ICD-10 Mappings
  • TIP: MDS Items for SNF QRP
    Do you know exactly which MDS items are being used for the SNF QRP data collection period for calendar year 2019?   CMS recently posted the SNF QRP Table for Reporting Assessment-Based Measures for the FY …
  • TIP: New Section GG Training Videos
    Need section GG training for your team? CMS recently posted three training videos:   1. Prior Device Use Video: With information from multiple sources, this 4-minute video demonstrates how a caregiver can utilize information collected from …
  • TIP: April 2019 Five-Star Quality Rating Technical Users’ Guide
    Having trouble aligning your stars? You may not have the most recent version of the April 2019 Five-Star Quality Rating Technical Users’ Guide.   There were two separate updates in April and if you saved the earlier copy, …
  • TIP: It’s Time to Look at Your Stars
    Changes to the Five-Star Rating System went into effect April 24, 2019—unfreezing the health inspection star rating and changing the methodology of the staffing domain. CMS also made multiple changes to the QM domain, including: …
  • TIP: CASPER SNF QRP Review and Correct Reports
    For data starting in quarter 1 2019, you will be able to select from the following measures: Application of Falls Application of Functional Assessment/Care Plan DRR Pressure Ulcer/Injury Discharge Self-Care Score Discharge Mobility Score Change …
  • TIP: PDPM Resources Updated
    On the CMS SNF LTC Open Door Forum nationwide call Feb. 14, 2019, officials announced updates to several resource documents on the PDPM webpage. One of the updated documents, the PDPM Frequently Asked Questions, includes …
  • TIP: CMS Releases GG Tool
    Section GG is currently used only for SNF QRP Measures. However, as of the Oct. 1 implementation of PDPM, this data will have a greater impact on Medicare reimbursement than ever before, making accuracy crucial …
  • TIP: Do you understand your SNF VBP report?
    CMS recently posted an educational video to help facilities understand their SNF VBP reports. This 15-minute video walks you through each tab of the SNF VBP Annual Performance Score Report and provides guidance how to …
  • TIP: Another Medicare Watchdog
    Have you heard who else is looking over your Medicare claims shoulder? The Target Probe and Educate (TPE) program scrutinizes your Medicare claims and allows you time to discuss problems with the Medicare reviewers. Here …
  • TIP: Who needs to sign the baseline care plan and when?
    We know the baseline care plan must be developed within 48 hours of admission and that the summary must be provided by the completion of the comprehensive care plan, but what are the rules about …
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