LeadingAge is pleased to announce the release of the Staff Competency Toolkit©. Created by LeadingAge member Pathway Health Services, a national post-acute care consulting and management organization, this resource is intended to provide skilled nursing facility operational and clinical leaders with tools to address staff competency requirements of the Requirements of Participation.
The OIG analysis showed that in that five-year period, 94% of the deficiencies cited on nursing home surveys were in the "less serious" categories, which the OIG defined as F or below on the scope and severity grid. Six percent of deficiencies cited were in the G category or above.
However, the OIG also noted that 31% of nursing homes had at least one repeat deficiency during the review period. Half of these nursing homes had repeat deficiencies that were categorized as "more serious", including deficiencies causing actual harm and immediate jeopardy.
On April 19, Centers for Medicare & Medicaid Services (CMS) released the proposed rule to update fiscal year (FY) 2020 payment rates and policies for skilled nursing facilities (SNFs). This rule proposes changes to aspects of three major components of Medicare payment and quality programs: SNF prospective payment system (PPS), SNF quality reporting program (QRP), and SNF value-based purchasing (VBP) program. The rule is open for public comment with a deadline for comments by 5pm on June 18, 2019.
M0100: Determination of Pressure Ulcer/Injury Risk
This is the first item in Section M, Skin Conditions and it simply requires checking all boxes that apply in the seven-day look-back period. The choices are:
- Resident has a stage 1 or greater, a scar over a bony prominence, or a non-removable dressing / device
- Formal assessment tool (e.g. Braden, Norton, or other)
- Clinical assessment
- None of the above
Steps for Assessment
Hospice
Payment Update
The proposed payment update for FY 2020 is 2.7% based on the estimated inpatient hospital market basket update of 3.2% minus the multifactor productivity adjustment estimated at 0.5%. CMS indicates this to be a $540 million increase in payments. However, that is a simplistic overview of the payment adjustment for this rule as it affects hospice rates.
Here’s an overview of our work for you in April 2019.
As announced by CMS in March 2019, changes to the Five Star Quality Rating System will go into effect April 24, 2019. Here is a run-down of the changes by domain:
CMS issued somewhat of a manifesto via the CMS Blog on April 15 regarding a five-part plan to ensure quality care in nursing homes. The plan focuses on five key components: strengthening oversight, enhancing enforcement, increasing transparency, improving quality and reducing administrative burden (or the “Patients Over Paperwork” initiative). While many of these initiatives will come as no surprise to providers, certain allusions made by Administrator Seema Verma have us wondering what comes next.
The coding instructions for section K0300 sound simple but may not be upon closer inspection. From the MDS 3.0 RAI Manual: "This item compares the resident's weight in the current observation period with his or her weight at two snapshots in time:
- At a point closest to 30-days preceding the current weight.
- At a point closest to 180-days preceding the current weight."
As an example, an assessment reference date (ARD) is 4/22/19. Consider the list of weights below for the resident:
A new rule from EPA establishes regulations for disposing of hazardous waste pharmaceuticals. The rule applies to nursing and skilled nursing portions of life plan communities, but not to assisted living communities.
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