March 21st SNF/LTC Open Door Forum Call-in Info (3/13)CMS

Open Door Participation Instructions:
This call will be Conference Call Only.
To participate by phone:

Dial: 1-800-837-1935 & Reference Conference ID: 78866871.
Persons participating by phone do not need 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: 78866871.
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.
For ODF schedule updates and E-Mailing List registration, visit our website at

MDS 3.0 Frequency Reports – 4Q 2012 Data Available (2/13)CMS

The MDS 3.0 Frequency Reports summarize information for residents currently residing in nursing homes.
These reports are updated quarterly.
The fourth quarter 2012 data is now available.

Access the reports here.

Full Texts of 2567 Statements of Deficiencies: CMS ZIP File for February (2/13)CMS

CMS has posted a ZIP file containing the full texts (with some deletions for privacy) of each nursing home deficiency that state survey agencies cited on CMS Form 2567 (Statement of Deficiencies). CMS appears to be updating this file on a monthly basis.
The February file can be downloaded
 This link will become inactive when the next file is made available.


Five Star Preview Reports Available, Help Line Open Feb. 18 – 22 (2/13) QTSO

The Five Star Preview Reports will be available beginning February 14th. 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 January’s Five Star data on February 21st, 2013.

Important Note: The 5 Star Help line (800-839-9290) will be available from February 18 through February 22, 2013. 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 is an alternative communication medium to direct inquiries. Notice: Five Star Preview Reports (Posted 02/13/2013)

Feds Release Nursing Home Inspections, Free of Censor’s Marks (1/13)

Charles Ornstein, ProPublica
In response to a Freedom of Information Act request by ProPublica, the federal government has released unredacted write-ups of problems found during nursing home inspections nationwide. ProPublica anticipates that the added information can make them more useful. For example, prescription information in the unredacted write-ups can help identify cases in which patients received medications such as antipsychotics that are dangerous for those with dementia. Patients and employees are not identified in either the redacted or unredacted reports.

To read the full article and to find a link to the unredacted reports, go to

Nursing Home Affordable Care Act Provisions: Implementation Progress (1/13)

Kaiser Family Foundation
ACA Provisions To Improve Nursing Home Transparency, Care Quality, and Abuse Prevention

The Kaiser Family Foundation has published an issue paper reviewing provisions in the Affordable Care Act (ACA) involving nursing homes and looking at where CMS stands in terms of implementation.

Download below.

MDS 3.0 Item A0410 Clarification From Texas DADS Could Be Useful REVISED(1/13) Texas DADS

The following notice posted by Texas DADS could prove useful to providers nationwide, Texas DADS revised the notice on Feb. 7, 2013:

Minimum Data Set (MDS) 3.0 – Item A0410 Clarification

On a Jan. 15, 2013 national conference call, the Centers for Medicare & Medicaid Services (CMS) staff reiterated that MDS 3.0 item A0410 must be coded correctly.

Coding instructions for item A0410 are on page A-9 of the MDS 3.0 RAI Manual.

In all states, item A0410 must be set to “3″ (federal required submission) when a resident is in a Medicare or Medicaid certified bed, regardless of whether or not CMS requires submission to the federal database.

In Texas, due to state reporting requirements, item A0410 must be set to “2″ if an MDS record is an OBRA assessment, entry tracking record or discharge record for a resident on a unit that is not Medicare or Medicaid certified. Otherwise, item A0410 is set to “1″ for Medicare Prospective Payment System (PPS) assessments and Other Medicare Required Assessments (OMRA) for a resident on a unit that is not Medicare or Medicaid certified.

CMS staff is aware some MDS support staff recommend setting A0410 to a “1″ when Medicare PPS MDS assessments are completed for private insurance (e.g. Medicare Advantage, Tricare, etc.). Sometimes miscoding A0410 is recommended incorrectly to comply with the requirements from page 5-1 of the MDS 3.0 RAI Manual, “Required MDS records are those assessments and tracking records that are mandated under OBRA and SNF PPS. Assessments that are completed for purposes other than OBRA and SNF PPS reasons are not to be submitted, e.g., private insurance, including but not limited to Medicare Advantage plans.” Then, if the MDS record was accidentally submitted, A0410 is set to 1 so the MDS record would be purged from the federal database.

However, CMS staff clarified that A0410 must be set based only on the bed certification status. MDS software vendors and nursing facility staff must develop a method other than miscoding A0410 to keep private insurance MDS records from being submitted to the federal MDS database.

Notice: Security Change for CMSNet Users (posted 2/1/2013)

 March 29 Security Changes for CMSNet Users – MDS submissions/reports (1/13) QTSO
A security change will be implemented on March 29th, 2013 that may impact users connecting to CMS via CMSNet. This change is required to comply with CMS security policies and will further secure user’s data and systems from outside threats while connected to CMS.
The change may affect the way users perform the file submission process and print reports. Users will no longer be able to access the internet, network printers or network folders, while connected to CMS via CMSNet.

Details regarding what steps users may take to work around this security change is available in theCMSNet Work-Around document. (Use the link or download below.)

Users interested in retaining the ability to access their network printers or folders might want to look for CMS approved vendors who may provide this service Information regarding approved Gateway Service Providers may be found on the CMS website at


DRAFT Oct. 1, 2013 MDS 3.0 Item Sets & Data Specs Posted (1/13)

From the CMS MDS 3.0 Technical Information page:

A new version (V1.13.0) of the data submission specs was posted. Documents associated with this version are dated 01/17/2013. This version is scheduled to become effective October 1, 2013. Version 1.13.0 of these specifications should be considered provisional or draft and are subject to change until the final specifications are published. Please refer to the Data Specifications Overview document for a summary of the changes that were made to this version. Details about the changes are contained in the Edit Change Report and the Item Change Report.

A new version (V1.11.0) of the MDS item sets was also posted. This version is also scheduled to become effective October 1, 2013 in conjunction with the new version of the data specs. The item sets should also be considered provisional or draft and subject to change until final item sets are published.



Skilled Maintenance Therapy: Settlement Approved in Jimmo v. Sebelius (1/13)

Center for Medicare Advocacy

The Center for Medicare Advocacy announced that the settlement in the Medicare Improvement Standard case, Jimmo v. Sebelius, was approved on January 24, 2013. Providers should anticipate that CMS will clarify the instructions in the online manual system accordingly. For more information, see the attached document.