As we posted last week, CMS released the Survey and Certification group’s FY2016-FY2017 Nursing Home Action Plan which included five actionable strategies that mean more pressure on providers to perform. The first strategy for the Plan is to “Enhance Consumer Awareness and Assistance.” The most obvious tool to assist with that strategy is Nursing Home Compare, full of its new Quality Measures, information on staffing and of course, your facility’s Five Star Quality Rating. In recent years, CMS has made a concerted effort to provide as much information to the public as possible, and recent initiatives reflect this strategy to inform consumers as well as drive quality. Let’s take a look at some of the moves CMS has already made towards succeeding in this strategy:
- Quality – The addition of six new Quality Measures to Nursing Home Compare that appeared in April, with five of those measures expected to be incorporated into the Five Star Quality Rating for nursing homes starting in July 2016. These measures include data from both MDS-based claims and Medicare claims-based. This new set of QMs marks the first time CMS has delved into nursing home claims data to assess the quality of care being provided.
- Staffing – A switch from self-reported staffing data during survey to quarterly electronic data submission that uses verifiable data for reported staffing levels – the Payroll Based Journal. CMS issued a reminder this week to long term care facilities that the mandatory data submission period for facilities begins on July 1, 2016 (the same month that the above-mentioned QMs will start being incorporated into your facility’s Five-Star Rating).
- Value-Based Purchasing (SNF VBP) – Authorized under the Social Security Act, VBP creates a system where skilled nursing facilities shift their focus to “quality over quantity” of services provided to residents. One of the key measurements of this program measures readmissions after discharge, which can be considered a strong indicator of the quality of care being provided in your facility.
- SNF Quality Reporting Program (SNF QRP) – This program is authorized by the IMPACT Act, and will include three claims-based measures that would impact SNF payments, as well as include a Drug Regimen Review assessment. Read this 2015 final rule for more information on the Quality Reporting Program, as well as the SNF 30 Day All-Cause Readmission Measure (SNFRM) and information on staffing.
If that doesn’t give you the idea that CMS is all about “quality, quality, quality” then stay tuned for our upcoming posts on the plans CMS has for your nursing home related to survey, Civil Monetary Penalties and additional quality improvement initiatives like the ever-looming QAPI regulation.
Should you need compliance assistance with any of these changes for nursing homes, check out an overview of CMS Compliance Group’s Nursing Home Services or contact us to discuss how we can work with your nursing home.
