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Skilled nursing facilities to receive break on reporting staffing data

The Centers for Medicare & Medicaid Services (CMS) has extended timeline requirements for reporting direct staffing data in skilled nursing facilities. The extension is part of a series of blanket waivers to CMS requirements that is designed to relieve bureaucratic stress on SNF staff as they implement infection control programs to combat the COVID-19 outbreak and protect residents.

Under CMS regulations, skilled nursing facilities are normally required to report information on direct staff – anyone responsible for the hands-on care of residents – to the CMS in a uniform format at least quarterly. The waiver applies to data pulled and submitted electronically to CMS through the Payroll-Based Journal (PBJ) system.

The reporting requirements whose timelines are being waived include:

  • The work category for each direct-care staff member
  • Resident census data
  • Staff tenure and turnover
  • The number of care hours performed by each staff member per day
  • Designation of direct-care staff as facility employee, agency worker or independent contractor

Skilled nursing facilities that are overwhelmed by their response to COVID-19 infection or prevention do not have to submit paperwork to take advantaged of the relaxed timeline for reporting direct staffing data. Because the timeline extension was part of a blanket waiver by the agency, it automatically goes into effect for all skilled nursing facilities. The measure, which was announced on April 24, is good for 60 days. That timeframe could be extended based on the ongoing impact of the COVID-19 pandemic.

The extended deadlines for reporting staffing numbers do not apply to data that was due to CMS for its April reports. That data should have been collected before a public health emergency was declared on Jan. 31.

The timeline extension was part of a large series of blanket waivers issued by CMS to help skilled nursing facilities better address and cope with the COVID-19 crisis.

 

Source:

Director, CMS Quality Safety & Oversight Group, April 24, 2020,  memorandum to State Survey Agency Directors. https://www.cms.gov/files/document/qso-20-28-nh.pdf

 

ABILITY and design® and ABILITY® are trademarks of ABILITY Network, Inc.

CMS temporarily lifts MDS reporting timeline

Skilled nursing facilities will see the timeline requirements for reporting the Minimum Data Set (MDS) to the Centers for Medicare & Medicaid Services (CMS) extended as they work to keep residents safe during the COVID-19 pandemic. CMS announced at the end of April that it would provide a blanket waiver for MDS reporting timeline so facilities could focus their energy on infection control programs that could help slow the spread of COVID-19.

The timeline waiver applies specifically to regulations listed under 42 CFR 483.20. The MDS data under that code documents and monitors residents’ conditions by assessing cognitive patters, vision, communication, mood and behavior, psychological and social health, physical function, continence, diagnoses and condition, medication, treatments and procedures, activity and discharge planning.

Some of screenings affected by the timeline waiver include:

  • Pre-admission Level 1 and Level 2 screenings, which are typically required within the first 14 days of admittance
  • Quarterly review assessments, which are required at least once every three months
  • Annual assessments, which are required at least once every 12 months
  • Assessments that mark significant changes in a patient’s condition within 14 days of those changes

Under normal circumstances, all MDS data collected during resident assessments must be encoded within seven days and reported to CMS within 14 days.

Because the waivers were a blanket order issued by CMS, skilled nursing facilities do not have to file any additional paperwork if they will be delaying the reporting of the eligible MDS. The waiver does not apply to MDS required for CMS’s April 29 reports, as that data would have been collected before a public health emergency was declared on Jan. 31. The blanket waiver is in effect for 60 days, though there is a potential to extend the waiver.

 

Source:

Director, CMS Quality Safety & Oversight Group, April 24, 2020,  memorandum to State Survey Agency Directors. https://www.cms.gov/files/document/qso-20-28-nh.pdf

 

ABILITY and design® and ABILITY® are trademarks of ABILITY Network, Inc.

CMS issues new COVID-19 reporting requirements for SNFs

The Centers for Medicare & Medicaid Services (CMS) has declared skilled nursing facilities “ground zero” in the country’s COVID-19 outbreak. In an attempt to monitor and control the spread of the virus within SNFs, CMS this week released new reporting requirements for COVID-19 infections.

The new infection reporting protocol are based, in part, on recommendations from the American Health Care Association and Leading Age. The two industry groups had called on skilled nursing facilities to report COVID-19 infections in a more timely manner.

Under the guidelines, SNFs must:

• Inform residents, as well as their families and representatives, of any positive COVID-19 cases within the facility within 12 hours

• Inform residents, as well as their families and representatives, of any instances of 3 or more respiratory illnesses within the facility within 72 hours

• Update residents, as well as their families and representatives, of COVID-19 infections and mitigation efforts weekly

• Report cases of COVID-19 directly to the Centers for Disease Control and Prevention (CDC)

• Continue to meet requirements to report infectious diseases to state and local health departments

• Fully cooperate with all CDC efforts to monitor the spread of COVID-19

COVID-19 reporting tools

To assist skilled nursing facilities with meeting the new requirements, the CDC will provide SNFs with a reporting tool. According to CMS, the reporting tool will be an important component in collecting national COVID-19 data to monitor the spread of the virus and coordinate infection response. Any COVID-19 data collected through the new reporting program will be made publicly available by CMS.

“Nursing homes have been ground zero for COVID-19. [This] action supports CMS’ longstanding commitment to providing transparent and timely information to residents and their families,” said CMS Administrator Seema Verma. “Nursing home reporting to the CDC is a critical component of the go-forward national COVID-19 surveillance system and to efforts to reopen America.”

Improving your infection control program

Skilled nursing facilities can get additional help in monitoring COVID-19 symptoms and control efforts with ABILITY INFECTIONWATCH. This helpful application allows SNFs to enhance their infection control programs while adhering to all CMS requirements. Learn more about how ABILITY INFECTIONWATCH can help your facility monitor COVID-19 prevention efforts.

 

Source: “Trump Administration Announces New Nursing Homes COVID-19 Transparency Effort.” Centers for Medicare & Medicaid Services. April 19, 2020. https://www.cms.gov/newsroom/press-releases/trump-administration-announces-new-nursing-homes-covid-19-transparency-effort

ABILITY and design®, ABILITY® and ABILITY INFECTIONWATCH® are trademarks of ABILITY Network, Inc.

HICNs to MBIs for Medicare Eligibility: How to Handle the Switch

By now, you are probably aware that the Centers for Medicare & Medicaid Services (CMS) is no longer accepting SSN-based Health Insurance Claim Numbers (HICNs) for most transactions.

The HICNs have been replaced with randomly-generated Medicare Beneficiary Identifiers (MBIs), intended to improve the security of patients’ personal information and help prevent fraud.

Starting January 1, claims or eligibility transactions submitted without an MBI have been rejected. And since an estimated 65 percent of claim denials are never corrected and re-submitted for reimbursement*, this could result in a preventable and sizeable hit to your revenue cycle.

The long and tedious hunt for patient MBIs

Updated Medicare cards with the new MBIs were mailed to patients long before the deadline, so one might expect the transition to be simple.

However, it’s important to remember that patients are people. They are busy. They forget to bring their cards to appointments. Especially where hospitals are concerned, patient visits may be unexpected or emergent. Where does that leave you as a provider?

While patient cards may be the easiest way to get an MBI, it certainly isn’t the only way. It’s possible to use your Medicare Administrative Contractor’s MBI look-up tool, but this process relies heavily on precise patient or policyholder data, and checking numbers one-at-a-time is tedious at best.

You can also refer to historical remittance advice if you happened to treat the patient prior to January 1 and have access to the records.

If you’ve had to resort to these methods, you understand how cumbersome the process can be.

An easier way to turn HICNs into MBIs

Busy healthcare providers need practical procedures to keep things running smoothly. Automated tools can take the administrative burden off of your staff and allow them to move on to the next claim faster.

Unlike other revenue cycle management providers, ABILITY goes beyond basic MBI lookup to provide full-service eligibility processing. Not only does our enhanced eligibility service have a nearly 100 percent MBI match rate; when combined with ABILITY COMPLETE, it also offers batch Medicare eligibility checks, alerts to indicate other insurance coverage and more.

Discover how to perform real-time eligibility verification and collect MBIs all at once. Request a demo today.

* “Success in Proactive Denials Management and Prevention,” Glen Reiner, HFMA, Accessed Jan 20, 2020, https://www.hfma.org/topics/hfm/2018/september/61778.html Read more

New A/B MAC Selected for Jurisdiction J – Alabama, Georgia and Tennessee

The Centers for Medicare & Medicaid Services (CMS) has announced it will transition the A/B Medicare Administrative Contractor (MAC) for three states (Jurisdiction J) in early 2018.

Palmetto GBA will become the new MAC (replacing Cahaba GBA) in Alabama, Georgia and Tennessee, as well as for any additional out-of-jurisdiction or RHC providers who currently submit to Cahaba GBA. Transition dates are Jan. 29, 2018, for Part A providers and Feb. 26, 2018, for Part B. Read more

Medicare IDs Now Come With Medicare Beneficiary Identifiers (MBI)

Mark April 1, 2018, on your calendars – that’s when change will be coming for more than 60 million active Medicare beneficiaries, their healthcare providers and payers who work with Medicare patients. Medicare cards with new Medicare Beneficiary Identifiers (MBI) numbers could start arriving in beneficiary mailboxes and be presented beginning on that date. It will take a year for the Centers for Medicare & Medicaid Services (CMS) to mail out all of the cards, but the industry needs to ramp up now. ABILITY is currently reviewing its processes and applications to prepare to support its providers, payers and Strategic Partners during the transition and beyond. Read more

MACRA Reprieve for More Than 800,000 Physicians

A broad category of physicians who see Medicare patients – 806,879 doctors – has been relieved of reporting responsibilities for this year under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Physicians should be receiving letters outlining their status relative to the Merit-Based Incentive Payment System (MIPS) this month. Read more

Will physicians be burned by MACRA surprises?

A comprehensive 2016 study by The Physicians Foundation examined physician attitudes toward their work life and uncovered various attitudes and beliefs that are certain to affect how they respond to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). More than 17,000 physicians responded to the survey and submitted an astonishing 10,000 comments about their work life, many of which focused on ever-growing administrative work related to insurance and government reimbursement. Read more

Providers should assume status quo on MACRA

With the confirmation of Tom Price as the head of the U.S. Department of Health and Human Services seemingly imminent, healthcare providers are being advised to continue their efforts to comply with the Medicare Access and CHIP Reauthorization Act (MACRA) as currently configured. Data collected in 2017 could still affect 2019 payments, so waiting to see what happens under a new administration is probably not wise. An expert from Industry trade group Medical Group Management Association urges providers to continue with their program. Read more

Proposed CMS codes and fees align with realities for physicians

The Centers for Medicare & Medicaid Services (CMS) are bowing to the reality of all that primary care practices are asked to do these days. CMS is proposing a Medicare 2017 Physician Fee Schedule that recognizes the added complexity of these demands and the expanding role of the family physician. Read more