The report shows SNFs if they are meeting the 80% reporting threshold requirement on the SNF QRP measures during a calendar year.  Failure to meet this threshold can result in a SNF having its Medicare Fee-For-Service rate reduced 2% in the forthcoming fiscal year.  For this reason, SNFs should review the PTR now to see if they are below the 80% threshold on any of the measures, as they have until May 15, 2019 to make updates or corrections to their current MDS submissions for, at least, 10/1/2018 – 12/31/2018.   

LeadingAge had advocated for this report because the existing SNF QRP Provider Preview Reports did not offer any indication of whether SNFs were reporting sufficiently to avoid the 2% penalty on their Medicare FFS rates.

Also of note, CMS began tracking SNF performance on five new quality measures in the fourth quarter of 2018 related to Drug Regimen Review (DRR), as well as Self Care and Mobility scores. The SNFs reporting on these measures, even though only for the fourth quarter, is taken into account when determining if a SNF has met the 80% reporting threshold on all measures. SNFs failing to meet the threshold will see their FY2020 Medicare FFS rates reduced by 2%. Therefore, SNFs should review their PTR and especially their reporting performance on these new measures, as they can still make updates or corrections to their October 1 – December 31, 2018 MDS submissions until May 15, 2019.

CMS calculates a SNFs performance based on certain QRP measures using data from key sections of the MDS that SNFs submit on their admissions and discharges. Typically, when a SNF fails to meet the SNF QRP reporting requirement, it isn’t that the SNF did not submit MDS data; it is more likely that the relevant MDS sections were not completed at least 80% of the time. For example, last year the majority of noncompliant SNFs (penalized 2% beginning 10/1/2018) often entered dashes in section GG of the MDS and therefore, were deemed to not have reported adequately.   

For more information about which MDS items tie to the SNF QRP measures, click here.  

The QIES Technical Support Office recently sent out an email to providers about the availability of the PTR noting that providers can also access their reporting statistics for CY2019 data submission.

The PTR can be found in the “SNF Quality Reporting Program” category in the CASPER Reporting system. It is in the same folder as other items for the SNF QRP, such as the Provider Preview Reports (PPR), which just show a SNF’s performance on the quality measure.  For more information, see the CASPER Reporting User`s Guide.