This version is for implementation on October 1, 2012. This new version implements several changes to Section S as well as changes noted in the latest errata document for version 1.10.1.
Please note that no changes to the printable item sets are required for October, 2012. Version 1.10.4 of the printable item sets will continue to be in effect.
An updated version history document was also posted.
Note: On June 6, 2012, CMS issued an errata document for version 5.0 of the manual. The errata document includes a correction to the calculation of the ‘Prevalence of antianxiety/hypnotic use’ state surveyor measure (Appendix E) in the manual.
The finalized version 5.0 manual includes the following:
Chapter 1, QM Sample and Record Selection Methodology, includes information about definitions, selecting QM samples, short-stay record definitions, and long-stay record definitions.
Chapter 2, MDS 3.0 Quality Measures Logical Specifications, breaks down the definitions, including numerators, denominators, and potential exclusions, for the publicly reported short-stay QMs and long-stay QMs
Appendix A, Technical Details
Appendix B, Parameters Used for Each Quarter
Appendix C, Episode and Stay Determination
Appendix D, Measures Withdrawn from NQF Submission
Appendix E, Surveyor Quality Measures, defines the survey-only QMs that are not publicly reported.
Clarification and revisions to Interpretive Guidance at F Tag 492, as Part of Appendix PP, State Operations Manual (SOM) for Long Term Care (LTC) Facilities
Memo: # 12-34-NH
Posting Date: 2012-06-01
Fiscal Year: 2012
Revised Guidance for Tag F492: Current guidance in Appendix PP of the SOM for Tag F 492, 42 CFR §483.75(b) and (c) States that this tag should be cited only when the authority having jurisdiction has both made a determination of noncompliance and has taken a final adverse action as a result. There has been confusion as to whether this requirement may be cited when a facility simply does not meet a State regulation. This memorandum clarifies and revises the Centers for Medicare & Medicaid Services (CMS) guidance to Surveyors in Appendix PP of the SOM regarding citations under Tag F492.
Download the memo below.
CMS has issued the following e-mail:
From: CMS CMSProviderResource
Sent: Tuesday, May 29, 2012 10:53 AM
Subject: Skilled Nursing Facility Prospective Payment System FY2012 PC Pricer File Update
Skilled Nursing Facility Prospective Payment System FY2012 PC Pricer File Update
The FY 2012 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) PC Pricer has been posted to the SNF PPS Pricer webpage in the “Downloads” section.
The next CMS Skilled Nursing Facility (SNF)/Long-Term Care (LTC) Open Door Forum is scheduled for: Thursday, July 12, 2012
Date: Thursday, July 12, 2012;
Start Time: 2:00 PM Eastern Time (ET);
Please dial in at least 15 minutes prior to call start time.
Conference Leaders: Jeanette Kranacs, Gregory Price.
Open Door Forum Participation Instructions:
This call is Conference Call Only.
1. To participate by phone:
Dial: 1-800-837-1935 & Reference Conference ID#: 76233161.
Persons participating by phone are not required to RSVP.
TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.
Encore: 1-855-859-2056; Conference ID#: 76233161.
Encore is an audio recording of this call that can be accessed by dialing 1-855-859-2056 and entering the Conference ID. Encores for ODFs held on Thursdays can be access the following Monday or business day. The recording is available for 3 business days.
The Centers for Medicare and Medicaid Services (CMS) is expected to provide an Update Notice for the Skilled Nursing Facility Prospective Payment System (SNF PPS) for Fiscal Year (FY) 2013. This Notice, expected on or before July 31, 2012, would be issued rather than theFinal Rule which providers generally face annually. The planned issuance of this Update Notice indicates that, at this time, there are no policy changes planned that require proposed rule making, a comment period and, ultimately, a Final Rule.
CMS reports that the definitive amounts of the market basket update along with the productivity adjustment mandated by the Affordable Care Act (ACA) will not be finalized until summer and therefore cannot be confirmed at this time. In an April, 2012 communication from the American Healthcare Association (AHCA), the following was reported to be expected: “a market basket update of approximately 2.6%” combined with the mandated “productivity adjustment of 0.8%” to net providers an “approximate 1.8% SNF payment update”. Additionally, the Association reports that a Market Basket forecasting error correction is not expected for this coming fiscal year.
CMS continues to monitor the impact of certain FY 2012 policy changes on various aspects of the skilled nursing facility prospective payment system (SNF PPS). Specifically, CMS has been monitoring the impact of the following FY 2012 policy changes:
- Recalibration of the FY 2011 SNF parity adjustment to align overall payments under RUG-IV with those under RUG-III,
- Allocation of group therapy time to pay more appropriately for group therapy services based on resource utilization and cost, and
- Implementation of changes to the MDS 3.0 patient assessment instrument, most notably the introduction of the Change-of-Therapy (COT) Other Medicare Required Assessment (OMRA).
CMS has now added second-quarter data. Access the ZIP file or the individual first-quarter and second-quarter files below on the “SNF Monitoring” Link.
The CASPER Reporting User’s Guide for MDS Providers provides information and instructions pertaining to the CASPER Reporting application. This system enables users to connect electronically to the National Reporting Database. This guide is intended for use as a reference and learning tool for accessing CASPER Reports.
This user’s guide is organized into the following sections:
- Cover (updated in March 2012)
- Section 1, Introduction, provides general information about this manual, its organization and document conventions. (updated in March 2012)
- Section 2, Functionality, introduces the CASPER Reporting System and its functionality. (updated in May 2012)
- Section 3, Utility Reports, addresses surveyor, deficiency tag, report locator, and template-listing reports. (updated in May 2012)
- Sections 4 and 5 are blank as of May 2012.
- Section 6, MDS 3.0 Nursing Home Provider Reports, addresses MDS 3.0 submission, vendor, error and resident roster reports for nursing home providers. (updated in March 2012)
- Section 7, MDS 3.0 Nursing Home Final Validation Report, addresses the Final Validation Report for nursing home providers. (updated in March 2012)
- Section 8, MDS 3.0 Swing Bed Provider Reports, addresses the MDS 3.0 SB Assessment Print report for swing bed providers. (updated in March 2012)
- Section 9, MDS 3.0 Swing Bed Final Validation Report, addresses the Final Validation Report for swing bed providers (updated in March 2012)
- Section 10, MDS 3.0 Submitter Validation Report, addresses the Final Validation Report for provider, corporate and third-party submitters. (updated in March 2012)
- Section 11, MDS 3.0 Quality Measure (QM) Reports, addresses MDS 3.0 facility, resident and monthly comparison QM reports. (updated in March 2012)
- Appendix A, Quick Reference Guide to Final Validation Reports, provides instructions for accessing and viewing MDS 3.0 Final Validation reports.
The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for:
Date: Thursday, May 24, 2012
Start Time: 2:00 PM Eastern Time (ET);
Please dial-in at least 15 minutes before call start time.
**This Agenda is Subject to Change**
I. Opening Remarks
Chair – Jeanette Kranacs (CM)
Moderator- Gregory Price (OPE)
II. Announcements & Updates
1. Update of Quality Measure 802/676 forms and instructions Lori Grocholski (OCSQ)
2. Procedures for MDS Questions
3. Coding Therapy Start and End Date
4. Updated Skilled Nursing Facility Data
5. Claims Processing Update
III. Open Q&A
**Next ODF: Thursday, July 12, 2012**
Access these update and entire manul here
From the QIES Technical Support Office at https://www.qtso.com/providernh.html:
Notice: Five Star Preview Reports
The Five Star Preview Reports will be available beginning May 15th. To access these reports, select the CASPER Reporting link located at the top of your MDS State Welcome page. Once in the CASPER Reporting system, click on the ‘Folders’ button and access the Five Star Report in your ‘st LTC facid’ folder, where st is the 2-character postal code of the state in which your facility is located and facid is the state-assigned Facility ID of your facility.
Nursing Home Compare will update with April’s Five Star data on May 19th, 2012.
Important Note: The 5 Star Help line (800-839-9290) will be available from May 14th through May 18th, 2012. Provider preview reports will continue to be available on a monthly basis in advance of public posting and will include the dates and hours of helpline availability. BetterCare@cms.hhs.gov is an alternative communication medium to direct inquiries