Category: CMS

CMS Creates a SNF 5-Claim Probe and Educate Review Webpage

The Centers for Medicare & Medicaid Services (CMS) recently announced the start of the SNF (skilled nursing facility) 5-Claim Probe & Educate Review program. As part of the effort to lower the SNF improper payment rate, Medicare Administrative Contractors (MACs) will be reviewing a small number of claims from every Medicare-billing SNF in the country. The SNF will then be offered education to address any errors identified, helping them to avoid future claim denials and adjustments.

Find out more by going to https://www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-Creates-a-SNF-5-Claim-Probe-and-Educate-Review-Webpage-.aspx

CMS Announces Ending of COVID Staff Vaccine Requirement, Other Protocols

Today, t​he Centers for Medicare & Medicaid Services (CMS) released a new regulatory memo QSO-23-13-ALL​ entitled “Guidance for Expiration of the COVID-19 Public Health Emergency (PHE) on May 11, 2023.” The memo outlines each waiver CMS put into place during COVID-19 and how the end of the PHE will affect those waivers. Additionally, the memo outlined timelines for certain regulatory requirements issued through the PHE. This memo applies to Long Term Care (LTC), Intermediate Care Facilities (ICF), and other provider types.
Find out more at https://www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-Announces-Ending-of-COVID-Staff-Vaccine-Requirement,-Other-Protocols.aspx

CDC Provides New Initiative to Increase COVID-19 Vaccination in LTC Settings

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​​With increasing cases of respiratory disease, including COVID-19, this winter, it is imperative to encourage residents, staff, and family members to receive the updated (bivalent) COVID-19 boosters.

A recent CDC report​ showed:
  • Adults ages 65 years and older:
    • ​Continue to have the highest COVID-19-related mortality rates.
    • The COVID-19-related death rate among unvaccinated people who are 65 years and older has consistently been higher than the rate among vaccinated people.
  • Adults ages 85 years and older:
    • ​Remain at particularly high risk of dying of COVID-19.
    • The proportion of COVID-19–related deaths accounted for by adults in this age group increasing during April–September 2022 from 28% to around 40% of COVID-19–related deaths. ​

Find out more by going to https://www.ahcancal.org/News-and-Communications/Blog/Pages/CDC-Provides-New-Initiative-to-Increase-COVID-19-Vaccination-in-LTC-Settings.aspx

Listen to HealthCap’s Free Podcast Highlighting ROP3 Changes.

CMS began surveying against Phase 3 of Requirements of Participation for Nursing Homes on October 24, 2022. With 180 pages of guidance, revisions, and updates affecting 52 F-tags, many providers are feeling anxious about compliance with the new guidance.

Angie Szumlinski, Director of Risk Management for HealthCap, recently spoke with Crystal Bowens, Associate AHCA/NCAL VP of Regulatory Services, about the updates. You can hear from these in​dustry experts by listening to the free podcast here. As a reminder, AHCA/NCAL members can always reach out with their compliance questions via email at Regulatory@AHCA.org​.
https://www.ahcancal.org/News-and-Communications/Blog/Pages/Listen-to-HealthCap%E2%80%99s-Free-Podcast-Highlighting-ROP3-Changes.aspx

CMS Releases Revisions to the Special Focus Facility Program

The Centers for Medicare & Medicaid Services (CMS) has released a revised Special Focus Facility (SFF) Program policy memo QS0-23-01-NH and updated the monthly SFF posting​. These revisions are meant to increase the requirements for completion of the program and enforcement for facilities that do not demonstrate improvement.

Read more at https://www.ahcancal.org/News-and-Communications/Blog/Pages/CMS-Releases-Revisions-to-the-Special-Focus-Facility-Program.aspx

CMS Releases Revised Guidance on Vaccine Mandate IFR

CMS has released revised interpretive guidance for the COVID-19 vaccine mandate interim final rule (IFR). Three memoranda have been updated, including QSO-22-07-ALL-Revised, QSO-22-09-ALL-Revised, and QSO-22-11-ALL-Revised.
The revisions were made to clarify the expectations for assessing compliance with the requirement to ensure all staff are vaccinated. AHCA/NCAL has highlighted key revisions below, but providers are encouraged to review the Long-Term Care and Skilled Nursing Facility Attachment A-Revised, as well as the applicable memo listed above, for detailed changes.

CMS Adds Staffing Measures to Five Star Rating System

The Centers for Medicare and Medicaid Services (CMS) posted QSO memo 22-08-NH last week indicating that it will begin posting staffing turnover and weekend staffing levels for each nursing home on the Medicare.gov Care Compare website​ in January and add the measures to staffing domain of Five Star Rating system in July 2022.
  • Weekend Staffing: The level of total nurse (RN, LPN & CNA) and registered nurse (RN) staffing on weekends provided by each nursing home over a quarter.  This will be reported as average hours worked per resident per day on weekends.
  • Staff Turnover:
    • ​The percent of RN staff that left the facility over the last year.
    • The percent of total nurse staff that have left the facility over the last year.
    • The number of administrators that have left the facility over the last year.
The technical specifications for weekend staffing and staff turnover measures will be included in the Five Star Rating System Technical Users’ Guide on January 14, 2022.

Find out more at https://bit.ly/3Ai2VLo

CMS Updates Guidance for Emergency Preparedness Regulations

Today, CMS posted a Quality, Safety, and Oversight Group (QSO) memo updating the State Operations Manual (SOM) Appendix Z that outlines emergency preparedness (EP) requirements. The SOM has been updated to reflect the revisions made within the 2019 final rule Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction (CoPs) (CMS 3346-F). CMS has also added new guidance related to Emerging Infectious Diseases (EIDs) outbreaks, including best practices, lessons learned, and general recommendations for planning and preparedness.
This guidance is effective immediately. CMS is currently working on relevant updates to the Emergency Preparedness Basic Surveyor Training Course which will be available at a later date.
The changes are extensive, and members are encouraged to review the complete QSO memo​ in full. AHCA/NCAL has also provided a high-level summar​y​ of the memo.

 

CMS Issues New Nursing Facility COVID Testing FAQs

CMS has released FAQs related to new guidance on testing in nursing facilities. The FAQs address long-standing questions posed from providers. The questions address various issues including false negatives with point of care antigen tests, triggering of outbreak status, testing of emergency medical personnel and clarification on turnaround time for tests. The FAQs can be found here