On May 12, 2017, the Centers for Medicare & Medicaid Services (CMS) announced that “due to extenuating circumstances,” the reporting deadline for the fiscal year (FY) 2018 Skilled Nursing Facility Quality Reporting Program (SNF QRP) payment determination has been extended from May 15, 2017, to June 1, 2017.
Several facilities throughout the U.S. received a mass email from CMS contractor CORMAC stating, “It appears not all Medicare MDS assessments have been completed and transmitted to the data base, etc. …”
While the email was sent in error, it was a reminder to all SNFs that minimum data set (MDS) assessment data related to the SNF QRP need to be verified as accurate and having been submitted and accepted into the CMS database. SNFs that don’t have 100 percent of the required MDS assessment data on 80 percent of the Medicare assessments they’ve submitted will receive a 2 percent reduction to the annual payment update for FY 2018. SNF QRP measures for the FY 2018 reporting period include:
- Application of percent of residents experiencing one or more falls with major injury (long stay)
- Percent of patients or residents with new or worsened pressure ulcers
- Application of percent of long-term care hospital patients with an admission and discharge functional assessment and a care plan that addresses function
This reprieve is a great opportunity for SNFs to check that all Medicare MDS assessment data related to the SNF QRP has been submitted and accepted into the Quality Improvement Evaluation System (QIES). The data is taken from the Medicare Prospective Payment System five-day and SNF Part A discharge assessments. The data used for the FY 2018 payment determination are those assessments submitted and accepted between October 1, 2016, and December 31, 2016.
SNFs should review all Final Validation reports for error messages to ensure all data was accurately submitted and accepted into the CMS database. Providers should review the following to determine if assessments comply with SNF QRP reporting:
- SNF Part A discharge assessments were appropriately completed as a standalone assessment or combined with an Omnibus Budget Reconciliation Act discharge assessment when a Part A resident discharged from services.
- Five-day and SNF Part A discharge assessments are free dashes in Section GG, height/weight or other MDS items used to calculate the SNF QRP measures. Modifications should be made as needed.
- At least one discharge goal has been completed on all five-day assessments in Section GG.
- Non-Medicare five-day assessments were not submitted in error. SNFs only can transmit traditional or original Medicare assessments to QIES. If combined with an admission assessment, the assessment must be modified to remove the five-day, but only after printing a hard copy of the five-day for the medical record.
Contact your BKD advisor if you have any questions.