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Category Archives: CMS Memo

CMS Memo S&C 15-36-ALL: New Instructions for Providers Filing an Appeal with the Departmental Appeals Board (DAB)

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.

CMS Memo S&C 15-37-NH: Proposed Rule: SNF Medicare FY 2016 Payments, Quality Reporting, Value-Based Purchasing and Staffing Requirements – Informational Only

CMS has issued a new S&C memo regarding their new proposed rule to implement requirements regarding the submission of staffing data based on payroll and other verifiable and auditable data.  Specifically, long-term care facilities would be required to submit to CMS direct care staffing information including: the category of work for each individual that performs direct care (including, but not limited to, whether the individual is a registered nurse, licensed practical nurse, licensed vocational nurse, certified nursing assistant, therapist, or other type of medical personnel specified by CMS); resident and census data; and information on staff turnover and tenure.  Long-term care facilities would also be required to specify whether the individual is an employee of the facility, or engaged by the facility under contract or through an agency.  Staffing data would be submitted to CMS no less frequently than quarterly.

The proposed rule “FY 2016 SNF PPS for Staffing Data Collection in Long-Term Care Facilities” was published on April 20, 2015.  The document can be found at www.gpo.gov/fdsys/pkg/FR-2015-04-20/pdf/2015-08944.pdf.

The public has until 5 p.m. on June 19, 2015 to comment on the proposed regulatory document.

Contact:  Questions regarding this memorandum should be addressed to NHStaffing@cms.hhs.gov.

Please see the complete memo attached or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-15-37.html?DLPage=4&DLEntries=10&DLSort=3&DLSortDir=descending.

Survey and Certification Memos

15-31:  Focused Dementia Care Survey Pilot (NH – 3/27/15)

Attached to this memo is a final report that outlines the basis for the Focused Dementia Care Survey Pilot, the process utilized, conclusions gathered based upon post-pilot data analysis, as well as next steps for the future.  The CMS plans to expand upon the work of the focused survey pilot and has invited States to conduct such surveys in FY2015 on a voluntary basis.  The expansion project will involve a more intensive, targeted effort to improve surveyor effectiveness in citing poor dementia care and the overutilization of antipsychotic medications, and broaden the opportunities for quality improvement among providers.  Deficient practices noted during the surveys will result in relevant citations.  In the event that additional care concerns are identified during on-site reviews, those concerns will be investigated during the survey or will be referred to the SA as a complaint for further review.  The memo is attached here and one attachment is attached here.

15-34:  Grant Award: Reinvestment of Federal Civil Money Penalty (CMP) Funds to Benefit Nursing Home Residents (NH – 4/3/15)

The Centers for Medicare & Medicaid Services (CMS) invited proposals for a grant opportunity to utilize Federal CMP Funds for the support and further expansion of the National Partnership to Improve Dementia Care in Nursing Homes.  The Eden Alternative, Inc. was deemed to be the most eligible applicant and has been awarded a grant, in the amount of $293,129.00, for their project entitled, “Creating a Culture of Person-Directed Dementia Care.”  The memo is attached here.

15-35:  Implementation of Section 6106 of the Affordable Care Act – Collection of Staffing Data for Long Term Care Facilities (NH – 4/10/15)

In this memorandum, CMS notified States of the posting of technical specifications and related information for the electronic submission of staffing information based on payroll data.  This information is posted at: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html.  The memo is here.

CMS National Nursing Home Quality Care Collaborative (NNHQCC) Change Package v2.0 – Now Available

The Change Package developed as part of the CMS National Nursing Home Quality Care Collaborative is being used by CMS and Quality Improvement Organizations and is intended to complement evidence-based tools and resources.  A change package is a menu of strategies, change concepts and specific actionable items that any nursing home can choose from to begin testing for purposes of improving quality of care.

Please visit Advancing Excellence’s website here for more information and to download the full package.

RAI Manual Update

On February 5, 2015, CMS posted a new Errata document on the RAI manual page of their website.  It is designed so that you can remove the old page of the RAI and insert the new corrected page.  The revisions to pages in Chapter 2 & 3 clarify the meaning of entry/reentry and the coding for A1600, A1700, A1800 and A1900.  You can find the revised pages on CMS’s website by clicking here.

If you have any questions, please contact Stacey Kempker, BSN, RN, State RAI Coordinator for DHSS, by calling 573-751-6308 or via email at stacey.kempker@health.mo.gov.

CMS Announces Important Changes to Nursing Home Compare Website

CMS has announced that they are preparing to make changes to the Nursing Home Compare website this month.  Specific changes include:

  • Addition of two (2) quality measures for antipsychotic medication use in nursing homes to the Five Star rating system calculations.
  • Raising the standard for nursing homes to achieve a high rating on all measures publicly reported in the Quality Measure (QM) dimension on the website
  • Adjustment of the algorithm used for calculating staffing ratings to more accurately reflect staffing levels.

CMS discussed these important changes and the impact on the Five Star rating system during the CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum that was held Thursday, February 12, 2015.

Please visit here on the CMS website where you will find more information.

New Generations Quarterly Newsletter – Fall 2014

The Section for Long-Term Care has published New Generations – Volume 12, Issue 3, Fall 2014.  This issue is now accessible here.  Please visit our website here to view this edition along with an archive of previous newsletters.