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Category Archives: CMS Memo

Announcement from CMS – National Provider Call: QIO Program Transition

You are invited to join the Centers for Medicare and Medicaid Services (CMS) – Center for Clinical Standards and Quality, for a discussion on the restructuring of Quality Improvement (QIO) Program effective August 1, 2014.  We recognize the unique impact of the changes on the provider community as it relates to areas such as provider’s procedures for notifying beneficiaries regarding rights to appeals of discharge determinations, addressing quality of care concerns, provision of medical records, working on quality improvement initiatives and receiving technical assistance on value and incentive programs.  The purpose of this meeting is to share an overview of the QIO Program changes, provide an update on the transition process, discuss its impact on the provider community, share critical resources, and to answer any questions.

We have scheduled the National Provider Call for Wednesday, July 23, 2014 from 11:00 am – 12:00 pm EDT (10:00 am – 11:00 am CDT) via webinar.

Here is how you can join:

Audio:  Telephone Number: 1-877-267-1577

MeetingPlace ID: 993 182 797 (This meeting does not require a password.)

Webinar:  https://webinar.cms.hhs.gov/qio-provider-call/

Users without an Adobe Connect login may sign-in as a guest.  Pre-registration is not required.  This session will be recorded.  Thank you for your participation in this call to advance health care quality for Medicare beneficiaries.  We look forward to hearing from you.

CMS Memorandum S&C 14-34-NH: Advance Copy of Revised F371; Preparation of Eggs in Nursing Homes

CMS Memorandum S&C 14-34-NH:  Advance Copy of Revised F371; Interpretive guidance and Procedures for Sanitary Conditions, Preparation of Eggs in Nursing Homes

Summary:

  • Guidance for Nursing Homes: Skilled nursing and nursing facilities should use pasteurized shell eggs or liquid pasteurized eggs to eliminate the risk of residents contracting Salmonella Enteritidis (SE).  The use of pasteurized eggs allows for resident preference for soft-cooked, undercooked or sunny-side up eggs while maintaining food safety.  In accordance with the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA) standards, skilled nursing and nursing facilities should not prepare nor serve soft-cooked, undercooked or sunny-side up eggs from unpasteurized eggs.
  • Guidance for Surveyors: Signed health release agreements between the resident (or the resident’s representative) and the facility that acknowledges the resident’s acceptance of the risk of eating undercooked unpasteurized eggs are not permitted.  Pasteurized eggs are commercially available and allow the safe consumption of eggs.  If the facility prepares or serves unpasteurized or undercooked eggs which are not cooked until both the yolk and white are completely firm, surveyors should consider citing deficiencies at F371.  Determination of the appropriate scope and severity shall be based upon the actual or potential negative resident outcomes in accordance with guidance given at F371.  We are revising F371 to clarify this section; a revised F371 is attached.

View the memo here:  S&C 14-34-NH or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-34-.html?DLPage=1&DLSort=2&DLSortDir=descending.

CMS Memorandum S&C 14-30-NH: Grant Solicitation for the Reinvestment of Federal Civil Money Penalty (CMP) Funds

CMS Memorandum S&C 14-30-NH:  Grant Solicitation for the Reinvestment of Federal Civil Money Penalty (CMP) Funds to Benefit Nursing Home Residents

Summary:

  • Grant Solicitation for the Reinvestment of Civil Money Penalty (CMP) Funds to Benefit Nursing Home Residents: As part of the 2010 Affordable Care Act, the Centers for Medicare & Medicaid Services (CMS) is soliciting proposals for a grant opportunity in which Federal CMP Funds will be utilized to support and further expand the National Partnership to Improve Dementia Care in Nursing Homes.
  • Funds: A total of $500,000 for FY2014-2015 will be available for a three year period of performance.  Funding will be awarded in 12 month budget periods.
  • Terms: Further information about this new initiative may be accessed at http://www.grants.gov.

View the memo here:  S&C 14-30-NH or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-30.html?DLPage=1&DLSort=2&DLSortDir=descending.

CMS Memorandum S&C 14-25-NH: Advance Copy – Single Use Device Reprocessing under Tag F441

CMS Memorandum S&C 14-25-NH:  Advance Copy – Single Use Device Reprocessing under Tag F441, Revisions to Interpretive Guidance in Appendix PP, State Operations Manual (SOM) on Infection Control

Summary:

  • Advance Copy: The guidance under Tag F441, Infection Control, Preventing Spread of Infection/Indirect Transmission has been revised.
  • Single-Use Device Guidance: Nursing homes may purchase reprocessed single-use devices when these devices are reprocessed by an entity or a third party reprocessor that is registered with the Food and Drug Administration.
  • Single-Use Device (SUD): A SUD is a device that is intended for one use on a single patient during a single procedure.
  • Reprocessed SUD: A reprocessed SUD is an original device that has previously been used on a patient and has been subjected to additional processing and manufacturing for the purpose of an additional single use on a patient.

View the memo here:  S&C 14-25-NH or visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-25.html?DLPage=1&DLSort=2&DLSortDir=descending.

Cardiopulmonary Resuscitation (CPR) in Nursing Homes – Updated Guidance Clarification Addressing Transportation

 (see bolded, italicized information below)

The Section for Long-Term Care Regulation (SLCR) wants to make certified providers aware that updated guidance from CMS (S&C: 14-01-NH) now requires “certification” of some nursing home staff as part of the nursing home’s compliance with regard to CPR.  Previously, if a question arose during a federal regulatory process regarding whether someone could perform CPR properly, a surveyor may have needed to ask for an explanation of appropriate technique from some available staff member to verify compliance with that requirement, but verifying the certification of a particular staff member typically was not necessary.

This most recent memo states that “certification” of some staff members is mandatory, but the memo does not clarify which certifying agencies are acceptable (i.e., American Heart Association).  SLCR and the Kansas City Regional CMS office requested a clarification of this point.

We have received guidance indicating that the purpose of this memo was to, “…ensure that facilities do not implement facility-wide ‘no CPR’ policies and that facilities have CPR-certified staff available at all times,” but that CMS does not intend to review or approve all certification agencies.

A wide range of organizations offer CPR certification – some are based online and some are conducted in-person.  To this point, CMS has clarified that while S&C: 14-01-NH does not require the use of any specific certifying agency, there are two components that are required with regard to CPR certification:

  • The certification must be designed for healthcare providers (therefore, CPR courses for laypersons which teach chest compressions, but not mouth breathing, are not sufficient); and
  • Nursing home policies should address how staff members should maintain and document their CPR certification.

The American Heart Association certification is acceptable under this guidance, but it is not the only acceptable certification.  Many homes in Missouri are currently obtaining CPR certification through the American Safety & Health Institute (ASHI), which is also acceptable, as are others, as long as they are designed for professional healthcare providers.

In addition, this guidance also applies to nursing home residents who are being transported or accompanied by facility staff to various appointments, outings or events.  Nursing homes will need to ensure that staff who are CPR certified accompany residents during such transports.

You may view the memo here: CMS Memo S&C: 14-01-NH, or visit

http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-01.html?DLPage=4&DLSort=2&DLSortDir=descending.

View all CMS Memos at http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions.html.

ICD-10 Coding Basics National Provider Call – Registration Now Open June 2014

June 4, 2014

12:30 p.m. – 2:00 p.m. Central Time

To Register:  Visit MLN Connects™ Upcoming Calls.  Space may be limited, register early.

HHS expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015.  Providers would have an extra year to prepare.  During this MLN Connects™ National Provider Call, join us for a keynote presentation on more ICD-10 coding basics by Sue Bowman from the American Health Information Management Association (AHIMA), along with updates from CMS.  A question and answer session will follow the presentation.

Agenda:

  • CMS updates, including the partial code freeze and 2015 code updates
  • Why ICD-9-CM is being replaced with ICD-10-CM
  • Benefits of ICD-10-CM
  • Similarities and differences from ICD-9-CM
  • Coding: Process of assigning a diagnosis code, 7th character, placeholder “x,” excludes notes, unspecified codes, external cause of injury codes, type of encounter
  • Documentation tips
  • How to obtain answers to coding questions
  • How to request modifications to ICD-10-CM

Target Audience:  Medical coders, physicians, physician office staff, nurses and other non-physician practitioners, provider billing staff, health records staff, vendors, educators, system maintainers, laboratories, and all Medicare providers.  Continuing education credit may be awarded for participation in certain MLN Connects Calls.  Visit the Continuing Education Credit Information web page to learn more.

Keep up with the latest news regarding ICD-10, visit http://cms.gov/Medicare/Coding/ICD10/Latest_News.html.

CMS Memo: Fiscal Year (FY) 2014 Post Sequester Adjustment for Special Focus Facility (SFF) Nursing Homes

S&C: 14-20-NH

Memorandum Summary:

  • Revised total SFF Slots:  Effective April 2014, we have adjusted the number of designated slots and candidates so States can resume selecting and replacing nursing homes for SFF designation.
  • Adjustment to Number of Slots:  Pursuant to the FY2013 budget sequestration, we reduced the number of SFF slots. We are now re-building the program by a gradual increase in the number of SFF slots from its reduced base. Later, we will also introduce additional methods to address persistently poor quality in nursing homes.
  • Phase in period: States may have the option to start selecting SFFs immediately or phase in the total to meet the required number by July 2014.
  • Continuation of Program Changes: As outlined previously the Centers for Medicare & Medicaid Services (CMS) Regions and States will continue with the Programmatic and Operational Adjustment by conducting the 18-month “last chance” onsite survey and reviewing the progress of all facilities that have been on the SFF list for more than 12 months.

View the memo by visiting www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-14-20.html.