On Friday, November 27, the National Quality Forum released a list of 133 Measures Under Consideration (MUC) for future rule-making in 2016, 12 of which are specific to the Skilled Nursing Facility (SNF) setting. This is a critical step in the CMS annual process which requires review and voting by the NQF Measure Applications Partnership (MAP) to arrive at a set of measures recommended for use in federal pay for performance and public reporting programs. The IMPACT Act of 2014 requires NQF's recommendation as the next step in the process CMS must follow before including measures in rulemaking. CMS has the ability to disregard NQF decisions and proceed to include measures in rulemaking, however in that case they are required to provide an explanation of their rationale for doing so in the course of the rulemaking process. We expect the inclusion of the following measures on the MUC list is a strong indication that they are likely to appear in the SNF PPS proposed rule for use in public reporting and/or in future payment programs (e.g. Value Based Purchasing). This step in the process involves only the specification of the measures themselves. At this point, the intended use of most of the measures has not been detailed. The exception to this is the SNF Potentially [...]
The Center for Medicare and Medicaid Services is seeking public comment on CMS' Development of a Discharge to Community Quality Measure, a mandate of the IMPACT Act. Comments are due by November 23rd and the call for public comment can be found on CMS' public comment web page. Additional information on specifications of the measure can be located on the page and will help to inform your comments.
CMS' proposed Revisions to Requirements for Discharge Planning for Hospitals, if adopted, will require hospitals to share Nursing Home Compare and Home Health Compare data with patients as part of discharge planning. This would continue until the impending resource use measures and revised patient assessment measures are finalized. Because the proposed rule would require medication reconciliation as part of the discharge process, it includes several resources on the subject of medication reconciliation. Centers may find it beneficial to review the MATCH Toolkit for Medication Reconciliation and consider potential process changes to enhance this area of care.
Recently, the GAO released results from a study of Hospital Value-Based Purchasing program (HVBP). The GAO report indicated results show modest effects on Medicare payments and no apparent change in quality-of-Care trends. The GAO's analysis found no apparent shift in existing trends in hospitals' performance on the quality measures included in the HVBP program during the program's initial years. However, the GAO clarifies this could shift as the HBVP continues to evolve.
It’s that time of year again and year end is quickly approaching. The renewal process is now open for Registered Nurses. Please ensure nurses have verified their license expiration date and, if set to expire at year end, licensure renewal is initiated in a timely manner. Effective January 31, 2016, all registered nurses will be required to verify continuing education/competency requirements as a condition of licensure renewal. Additional information related to these requirements can be found HERE.
Thanks to GHCA’s very own President / CEO, Tony Marshall, for calculating the Part B Fee Schedules needed for 2016. Tony has furnished these schedules to AHCA for many years. Click HERE for the 2016 GA Fee Schedules effective January 1, 2016 and HERE for the 2016 GA MPPR Fee Schedules effective January 1, 2016. Please remember that you will need both of them, as the final rule continues the multiple procedure payment reduction (MPPR) policy for “always therapy” services. The MPPR policy required a 50 percent reduction to be applied to the practice expense component of payment for the second and subsequent “always therapy” service(s) that are furnished to a single patient by a single provider on one date of service (including services furnished in different sessions or in different therapy disciplines).
As you may know, on February 12, 2014, President Obama signed Executive Order 13658, Establishing a Minimum Wage for Contractors. The Executive Order raises the hourly minimum wage paid by contractors to workers performing on covered Federal contracts to: (i) $10.10 per hour, beginning January 1, 2015; and (ii) beginning January 1, 2016, and annually thereafter, an amount determined by the Secretary of the Department of Labor (DOL) in accordance with the Order. On October 1, 2014, DOL published the final rule implementing the provisions of Executive Order 13658. DOL announced earlier this year that the minimum wage for certain federal contracts will increase to $10.15 per hour beginning January 1, 2016. The DOL notice on this increase can be found here. Should your current VA contract be up in the near future, be sure to carefully review and read your new VA contract before signing it for any new additions that could be in the contract that were not in your previous contract. Medicare (Parts A and B) or Medicaid providers are not considered to be federal contractors. However, if a provider currently has VA patients and a VA contract, they are considered to be a federal contractor. Since VA contracts are covered by the Service Contract Act, this Executive Order applies to such [...]
The cost of liability continues to increase for the long term care profession, according to the findings of an analysis recently released by the American Health Care Association (AHCA) and Aon Global Risk Consulting. The overall national long term care loss rate is expected to grow by 5 percent annually, with claim frequency driving the increase at an expected 3 percent growth rate. In August of this year, at the direction of GHCA Board leadership, GHCA staff convened a group of legal and provider stakeholder in an attempt to craft legislation aimed at liability relief for Georgia providers. An early draft has been prepared and GHCA staff is currently working with legal and legislative stakeholders to build consensus as we move towards the 2016 legislative session. Please click here for a recent article summarizing the full report.
At the November 17th Board Meeting in Stockbridge, the full GHCA Board unanimously approved the priorities for upcoming Legislative Session set to being January 11, 2016. The two motions heard by the full GHCA Board arose from a joint meeting of the GHCA Legislative and Reimbursement Committees held earlier in the day. The priorities instruct GHCA staff and leadership to pursue both updated reimbursement mechanisms (current cost report with inflation, updated fair rental value system appropriations and a potential liability insurance pass through) and legislation designed to address troubling trends in provider liability costs. GHCA staff and leadership began discussions with both the Governor’s Office and legislative leaders in October and continue to work all relevant committee members in the weeks leading up to the 2016 session.
Minimum Criteria for Submission of Application Participate in the Georgia Quality Improvement Program Must meet minimum points on Quality Incentive Report for quarters ending: 9/30/14, 12/31/14, 3/31/15, 6/30/15 Note: Failure to attach all required data will result in disqualification. Must be below the Georgia (State) average calculation points for cited deficiencies for the period of July 1, 2012 – June 30, 2015 Clinical Quality Quantitative data to be considered will be: Must be at or below the State average on 8 of 11 Quality Measures, using this criteria for all quarters Immunization rates for flu and pneumonia for these specified quarters needs to be at 80% or above for each quarter. Data from CMS will be used for this award year's reporting period – 9/30/14, 12/31/14, 3/31/15, 6/30/15 Long Stay composite score measures to be included are– Percent of residents with one or more falls with major injury Percent of residents with a UTI Percent of residents who self-report moderate to severe pain Percent of high-risk residents with pressure ulcer Percent of low-risk residents with loss of bowels or bladder Percent of residents with catheter inserted or left in bladder Percent of residents physically restrained Percent of residents whose need for help with ADL has increased Percent of residents who lose too much weight Percent [...]