On October 1, 2015 a new version of the RAI Manual became effective, Version 1.13. Most of the changes were minor but there is one important change to point out. Prior to the update, Significant Change MDS’s were required if a resident enrolled in or discontinued hospice. Those rules are still in effect, but now, a Significant Change MDS is also required when a resident changes hospice providers and remains a resident at the nursing home. This new rule is in the RAI manual in Chapter 2 on page 21. A Significant Change MDS may also be required in situations when the hospice providing services is purchased by another hospice provider.
The new manual can be found at: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html. Scroll to the bottom of the page. The first link is the ENTIRE Manual. The second link is just the pages that have been changed as of October 1, 2015. You will also find a summary of the changes in the second link.
If you have any questions, you may contact Stacey Bryan, BSN, RN, State RAI Coordinator, Department of Health & Senior Services, Telephone 573-751-6308 or E-mail Stacey.firstname.lastname@example.org.
CMS has released a ICD-10 Resources Guide. The guide concentrates on quick references and key steps to take to get ready for the October 1 transition. Some of the resources include the Quick Start Guide, Infographics, Videos, and more ways to stay up to date on other information regarding ICD-10.
Please see the ICD-10 Resources Flyer for more information located here. You may also visit the CMS ICD web page here and the Road to 10 webpage here for the latest news and resources to help prepare.
Electronic submission of staffing data for long-term care facilities – Payroll Based Journal (PBJ).
Registration is OPEN and ALL Long-term Care facilities are encouraged to register for the voluntary data submission period. Please use the resources listed below to register:
- Obtain a CMSNet User ID for PBJ Individual, Corporate and Third Party users, if you don’t already have one for other QIES applications (https://www.qtso.com/cmsnet.html).
- Obtain a PBJ QIES Provider ID for CASPER Reporting and PBJ system access (https://mds.qiesnet.org/mds_home.html).
- PBJ Corporate and Third-Parties must use the current form based process to register for a QIES ID. Registration forms are available under the Access Request Information / Forms section on the right side of the page (https://www.qtso.com/).
For technical questions on how to register, please email NursingHomePBJTechIssues@cms.hhs.gov.
Additionally, CMS has posted an updated PBJ Policy Manual Draft and a list of frequently asked questions (FAQ) and answers about PBJ instructions and policies. Please visit https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html for more information. For policy related questions, please email NHStaffing@cms.hhs.gov.
August 11, 2015: 2:30-4:00 pm ET (1:30 p.m.-3:00 p.m. CT)
This Medicare Learning Network (MLN) Connects National Provider Call provides an overview of the proposed rule to reform the requirements for long-term care facilities. These requirements are the federal health and safety standards that long-term care facilities must meet in order to participate in the Medicare or Medicaid programs. This presentation provides background for updating these requirements and briefly walks through many of the changes included in the proposal. A question and answer session follows the presentation.
- Highlights of the proposed rule
- Overarching themes of the proposed rule
- Methods for reviewing and commenting on the proposed rule
The registration page is located here: www.eventsvc.com/blhtechnologies/register/8c43349f-8523-4e24-b48f-4c70f0ad8480.
The call detail page is here: www.cms.gov/Outreach-and-Education/Outreach/NPC/National-Provider-Calls-and-Events-Items/2015-08-11-Long-Term-Care.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=descending.
The link to the proposed regulations is here: www.gpo.gov/fdsys/pkg/FR-2015-07-16/pdf/2015-17207.pdf.
The Centers for Disease Control and Prevention (CDC) has issued new recommendations for the pneumococcal vaccine in adults over the age of 65. The CDC recommends that providers now use two pneumococcal vaccines for adults aged ≥65. These vaccinations are 13-Valent Pneumococcal Conjugate Vaccine (PCV13) and 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV23). The CDC recommendations are located at www.cdc.gov/vaccines/vpd-vac/pneumo/default.htm.
CMS has updated the Medicare coverage requirements to align with this recommendation. These Medicare coverage requirements were implemented on February 2, 2015 as posted in the MLN Matters document: MM9051.
Please visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9051.pdf to see that specific MLN Matters document.
CMS has instructed providers to continue to code item O0300 as instructed in the current RAI User’s Manual.
For the past 10 years, the Centers for Medicare & Medicaid Services (CMS) and the States have used two standard survey processes that assess the quality of care and quality of life for nursing home residents. The memo has a review of both the traditional survey and QIS processes. CMS is continuing to make improvements to QIS to address the challenges, concerns and feedback we have received to optimize the effectiveness and efficiency of survey process.
The memo and attachment are both attached or you may visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-15-40.html?DLPage=4&DLEntries=10&DLSort=3&DLSortDir=descending.
Effective October 1, 2014, providers that disagree with actions imposed on their facility must file a hearing request electronically using the DAB’s E-Filing System (DAB E-File). For assistance in submitting a request through the DAB E-File System, filers may call the Civil Remedies Division main telephone line at 202-565-9462. For technical issues regarding the DAB E-File System, filers may contact E-File System Support at OSDABImmediateOffice@hhs.gov.
The memo and two attachments are attached (Memo, DAB e-file instructions, and Appeal Rights) or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-15-36.html?DLPage=4&DLEntries=10&DLSort=3&DLSortDir=descending.