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There’s a lot on the line when it comes to accurately reporting wounds. Not only will the Quality Measure (QM) NQF #0678, “New or Worsened Pressure Ulcers,” negatively impact public reporting and payment, dashing M0300 B, C, and D could also negatively impact payment as part of the Quality Reporting Program (QRP) for Medicare stays.
NQF #0678 looks strictly at the number of worsened pressure ulcers at M0800. The QRP measure will look at the Part A PPS Discharge assessment to determine whether a higher number of pressure ulcers are reported than were coded as present on admission, indicating new pressure ulcers developed at the facility or pressure ulcers that have worsened to a deeper anatomical stage since admission. Pressure ulcers are notoriously misreported, according to Jessie McGill, RN, RAC-MT, AANAC curriculum development specialist. She advises properly training staff to avoid the following pitfalls and ensure correct data reporting.
The Five Star (5 Star) Preview Reports are available as of July 18, 2017. Nursing Home Compare will update with June's Five Star data on July 26, 2017. The 5 Star Help line (800-839-9290) will be available July 24, 2017 through July 28, 2017.
CMS provided notifications to facilities that were determined to be non-compliant with Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) requirements for Quarter 4 of CY 2016, which will affect their FY 2018 annual payment update (APU). Notifications of non-compliance were placed into facilities’ Quality Improvement and Evaluation Systems (QIES) - Certification and Survey Provider Enhanced Reporting (CASPER) system on July 14, 2017 and also mailed directly to providers. Providers that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59pm PST, August 13, 2017.
In October 2016, CMS finalized improvements in care, safety, and consumer protections for long-term care facility residents. Revisions mark first major rewrite of the conditions of participation (CoP) for long-term care facilities since 1991. In July 2017, the agency published some corrections.
Fiscal Year 2018 and After Payments to Skilled Nursing Facilities That Do Not Submit Required Quality Data. SUMMARY OF CHANGES: This is a new Change Request (CR) to pub. 100-22, Medicare Quality Reporting Incentive Programs, Chapter 80, to reflect changes to the payment reduction reconsideration process.
There can be quite a bit of confusion around Medicare skip days. What exactly constitutes a skip day? How does it affect your Medicare billable days? How does it affect scheduled and unscheduled assessments, assessment reference date (ARD) windows, and observation periods? What happens if you don’t track it correctly?
Not to worry. We’re here to help with this complete guide to skip days—what exactly they are, how to adjust for them, and how to plan your assessments when your resident has one. So without skipping a beat, let’s get started.
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