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COVID-19 vaccinations: ABILITY helps providers get paid

Now that COVID-19 vaccinations are available, providers across the care continuum are dealing with the same question: How will I be reimbursed for administering the vaccine?

As you likely know, the COVID-19 vaccinations are being provided at no cost to patients or providers. However, that doesn’t mean that you have to lose money for administering vaccinations. You can bill for that service. But how can you ensure that you enter these claims correctly so you can get paid without spending a lot of time on claims corrections?

Two ways to bill for COVID-19 vaccinations

Providers administering COVID-19 vaccinations are currently eligible for $16.94 reimbursement for a patient’s first shot and $28.39 for their second dose.1 According to CMS’s guidelines, you can bill for vaccine administration in one of two ways:

  1. Single claims
  2. Roster billing

Unlike previous instances in which Medicare covered the cost of patients’ medications, when submitting claims for COVID-19 vaccine administration, you should not include the vaccine codes on the claim (when vaccines are free). Also, Medicare Advantage Plan participants can submit COVID-19 vaccine administration claims to Original Medicare for all of your Medicare Advantage patients in 2020 and 2021.2

While many providers prefer single claims, others may opt to save some time with roster billing. This option allows you to submit multiple claims at once up to a certain number. Roster billing has traditionally been used for flu and pneumococcal vaccines, and CMS has announced it will be available for COVID-19 vaccines, though you will not be able to combine shot codes for different vaccines on a single roster bill.

With traditional roster billing, you can only include 10 patients per roster bill. With providers administering thousands of vaccinations per day, even roster billing can be extremely cumbersome and time-consuming.

Simplify COVID-19 vaccine billing with ABILITY

With ABILITY EASE Medicare, you can centralize and automate the billing process – whether you’re submitting single claims or roster bills. And, with ABILITY EASE All-Payer, you can automate the process for all of your payers, including Medicare and private payers.

Get more information from CMS on billing for COVID-19 vaccine administration here. Then discover how ABILITY can help you streamline the billing process for COVID-19 vaccinations and all your Medicare claims by scheduling a demo today.

 

Sources:

1. “Key Considerations for COVID-19 Vaccine Billing and Coding,” Jacqueline LaPointe, RevCycle Intelligence, December 16, 2020. Accessed January 7, 2021, https://revcycleintelligence.com/news/key-considerations-for-covid-19-vaccine-billing-and-coding

2. “Medicare Billing for COVID-19 Vaccine Shot Administration,” Centers for Medicare & Medicaid Services website, accessed January 5, 2021. https://www.cms.gov/medicare/covid-19/medicare-billing-covid-19-vaccine-shot-administration

 

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

Secure COVID-19 relief funds for your skilled nursing facility

Has your skilled nursing facility been diligent in tracking infection control and prevention during the COVID-19 pandemic? If so, your facility could be eligible for a portion of the $2 billion in relief funds being distributed by the U.S. Department of Health and Human Services (HHS). Additional details on how SNFs can receive incentive payments were recently released.

Eligibility for incentives

Previously, HHS announced that SNFs would be eligible for incentive payments based on how well they were able to control rates of COVID-19 infections, as well as COVID-19 mortality rates. HHS clarified the requirements last month, stating that facilities had to show that their rates of COVID-19 infections were lower than their counties’ rates of infection. The death rate among residents within the facility who tested positive for COVID-19 also had to be below a national performance threshold for mortality within nursing homes.

Those two measures serve as a “gateway” for participation in the incentive program. Each month, facilities must meet those two criteria to receive incentive payments. Eligible facilities will have their performances evaluated, with infection rates accounting for 80 percent of the incentive payment. Calculations will be made by dividing the facility’s number of non-admission COVID-19 infections by the total number of resident-weeks reported to the National Healthcare Safety Network (NHSN). The mortality rate will be calculated for any facility that reported at least one non-admission COVID-19 infection.

Tracking your facility’s incentive eligibility

How can you track your facility’s COVID-19 infections accurately to help qualify for relief funds? Many SNFs are turning to ABILITY INFECTIONWATCH to carefully track resident symptoms, infections and infection control measures. The application allows you to map infections within your facility and monitor data in real time to keep infection rates lower and maximize protection for residents and staff. ABILITY INFECTIONWATCH also helps administrators pull infection information and track the documentation required by NHSN.

Another application that can help SNFs qualify for COVID-19 incentives is ABILITY CAREWATCH. Facilities using ABILITY CAREWATCH to manage quality and QAPI incentives can more easily manage their Medicare and Medicaid licensing. Current licensing is required to receive incentive payments.

Staying up to date with infection reporting

COVID-19 incentive payments can help skilled nursing facilities like yours invest more in testing and PPE to keep residents and staff safe. Learn more about how ABILITY INFECTIONWATCH and ABILITY CAREWATCH can help your facility qualify for payments.

 

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

CMS audits have restarted: how skilled nursing facilities can prepare

The Centers for Medicare & Medicaid Services (CMS) resumed Recovery Audit Contractor (RAC) and Medicare Administrative Contractor (MAC) medical review audits in August.

Here’s what you need to know and how to prepare your skilled nursing facility in the event of an audit.

RACs and MACs are back

The ongoing COVID-19 public health emergency (PHE) brought considerable changes to healthcare facilities, including a temporary halt to most CMS audits on March 30, 2020. The suspension included prepayment and post-payment medical reviews conducted by MACs and RACs.

In July, CMS announced that it would be resuming medical review activities in August regardless of the status of the PHE. Audit activity ramped back up on August 17, prioritizing post-payment reviews of COVID claims submitted prior to March 1, 2020.

While CMS has not yet announced when the audits on claims submitted after March 1 will begin, they will likely commence in the coming months.

What you need to know

CMS has indicated that audits will be conducted in accordance with existing statutory and regulatory provisions, including related billing and coding requirements. However, any waivers or flexibilities that were allowed for any date of service under review will be applied in the audit.

Keep in mind that the rules changed rapidly at the onset of the PHE, which may increase the chances of audit errors as well as misapplication of rules and regulations.

If auditors are unable to make a determination on prepayment or post-payment claims review based on the information that’s been provided, they will issue an additional documentation request (ADR) to solicit supporting documentation.

While RAC and MAC audits historically have been done in person, CMS has expanded desk reviews during the pandemic. Although a remote audit may potentially be less burdensome on your organization, it will still be crucial to be organized and prepared.

Tips for audit response

CMS recognizes that many skilled nursing facilities have limited staffing and resources to respond to audits during this time. If your facility is selected for medical review, there are several actions you can take to facilitate the process.

  • Identify someone to manage the ADR and denial process
  • Promptly respond to every overpayment and audit letter (ADR)
  • Contact your auditor to discuss any COVID-19 related hardships you may be experiencing that could impact audit response timeliness
  • Avoid returning any overpayment before confirming and accepting the audit findings
  • Only send the specific information in the ADR to expedite the process
  • Make sure all documentation is legible and supports MDS coding and the UB-04

Boost audit success

Audits are disruptive even during the best of times. It’s more critical than ever to have an efficient and effective process in place to not only respond to an audit in a timely manner, but to also help you avoid one in the first place.

ABILITY CAREWATCH and ABILITY UBWATCH can help you get ahead of an audit request and potentially minimize the risk of an audit by ensuring accuracy between the MDS and UB-04. Data analytics and real-time reports give you access to:

  • Medicare roster
  • RUG 66 Watch page
  • Built-in Triple Check
  • Quality pages
  • And more!

There’s no time to waste! Get a first-hand view of how to use these applications to boost your audit response by requesting a demo today.

 

Sources:

“Coronavirus waivers & flexibilities,” CMS, accessed October 9, 2020, https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers.

“MACs Resume Medical Review on a Post-Payment Basis,” MLN Connect eNews, CMS, August 6, 2020, https://www.cms.gov/outreach-and-educationoutreachffsprovpartprogprovider-partnership-email-archive/2020-08-06-mlnc#_Toc47449031.

“CMS Announces Resumption of Routine Inspections of All Provider and Suppliers, Issues Updated Enforcement Guidance to States, and Posts Toolkit to Assist Nursing Homes,” CMS, August 17, 2020, https://www.cms.gov/newsroom/press-releases/cms-announces-resumption-routine-inspections-all-provider-and-suppliers-issues-updated-enforcement.

 

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

Study shows disconnect between CMS infection control surveys and COVID outbreaks

A recent study of data from the Centers for Medicare & Medicaid Services (CMS) by the Center for Medicare Advocacy (CMA) has shown a disconnect between the results of CMS infection control surveys and outbreaks of COVID-19 within skilled nursing facilities.

Infection control citations

In mid-March, CMS announced that inspections would focus on infection control programs – in addition to cases of immediate resident danger – to help suppress the spread of COVID-19 within SNFs. A review of CMS inspection data by CMA showed that a very small portion of infection control surveys resulted in citations. Out of 5,724 infection control surveys performed from the March announcement through June 24, only 99 resulted in citations.1

Of the citations, 93 were marked as having minimal harm or potential for minimal harm, and three were marked as having a potential for minimal harm. The remaining three were marked as putting residents’ health and safety in immediate jeopardy. Thirty-five of the citations resulted in fines.

The disconnect between citations and infections

The concern raised by CMA has been raised by officials in many states, as well as by families of afflicted nursing home residents: With the high rate of COVID-19 cases in nursing homes, the low amount of citations – which translates to 2.4 percent of surveys – seems “implausible,” according to CMA officials. Through the end of June, more than 40 percent of COVID-19 deaths in the United States were related to skilled nursing facilities.2

The CMA’s review showed that several of the CMS infection control surveys that did not result in citations took place even as SNFs were in the middle of COVID-19 outbreaks. Three days after a passing survey at one California facility, there were 68 diagnosed COVID-19 cases documented. The staff refused to return to work over concerns for their safety, and members of the California National Guard were deployed to care for residents.3

Those eyeing the survey results give different causes for the disconnect between passing surveys and COVID-19 infections. Some say SNFs lacked access to the personal protective equipment needed to keep staff and residents safe. Others called out a lack of regular testing among residents and staff. One CMS administrator said the disparity between survey results and infection rates likely shows that SNF staff demonstrated compliance during surveys but failed to follow protocols when they were not under scrutiny.

Maintaining infection control programs

Amidst the COVID-19 pandemic, maintaining infection control protocol has become more important than ever in keeping residents and staff safe. The number of SNF deaths due to the pandemic and the results of the CMA’s data review could lead to further scrutiny of infection control programs or more stringent infection control program requirements.

SNFs can stay on top of regulations, infection control protocol and patient data with ABILITY INFECTIONWATCH. The application allows for easy tracking of McGeer criteria, infection reports and infection control measures. SNFs can tighten their vigilance against infections by customizing infection thresholds; when those thresholds are reached, an alert appears on the ABILITY INFECTIONWATCH dashboard so staff won’t miss the signs of an outbreak.

 

Sources:

1. “Special Report Additional Infection Control Surveys at Nursing Facilities Show Same Results: Few Deficiencies, Most Called ‘No Harm’; Poor Ratings on Nursing Home Compare,” Miriam Edelman, July 9, 2020, https://medicareadvocacy.org/wp-content/uploads/2020/07/Report-Coronavirus-Infection-Controls-Second-Batch-.pdf?emci=0f6236c7-f5c1-ea11-9b05-00155d03bda0&emdi=526f3f5a-0dc2-ea11-9b05-00155d03bda0&ceid=7801066.

2 “More than 40 Percent of U.S. Coronavirus Deaths are to Nursing Homes,” The New York Times, July 23, 2020, https://www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html.

3 “As Coronavirus Raged Through Nursing Homes, Inspectors Found Nothing Wrong,” Jack Dolan & Brittny Mejia, June 28, 2020, https://www.latimes.com/california/story/2020-06-28/coronavirus-nursing-homes-state-inspector-covid-19.

 

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

CMS issues millions in infection control penalties to SNFs

The Centers for Medicare & Medicaid Services (CMS) has imposed more than $15 million in penalties on 3,400 skilled nursing facilities for failure to comply with infection control regulations in the midst of the COVID-19 pandemic. The announcement of the penalties comes with a warning to SNFs to stay vigilant in monitoring their infection control programs.

“Now more than ever, nursing homes must be vigilant in adhering to federal guidelines related to infection control to prevent the spread of infection disease, including COVID-19,” said CMS Administrator Seema Verma. “We will continue to hold nursing homes accountable and work with state and local leaders to protect the vulnerable population residing in America’s nursing homes.”1

Avoid CMS penalties

ABILITY INFECTIONWATCH can help your facility avoid costly CMS penalties with better infection control monitoring. This valuable application makes it easier for your facility to meet all CMS Requirements of Participation, and it allows you to quickly pull reports to meet the requests of surveyors. Using built-in national infection criteria, infection control administrators align facility data with reporting requirements consistently and efficiently.

Accurately track symptoms and infections

As COVID-19 continues to spread throughout the U.S., ABILITY INFECTIONWATCH helps you to protect against outbreaks utilizing your facility’s data. Monitor symptoms, track and report infections, oversee facility visitors and identify the sources of infections through the application. The convenient dashboard allows you to customize alerts so you are notified when your preset data points are reached.

Protect your facility

COVID-19 poses a real danger to SNF residents and staff. And never before have facilities been placed under such scrutiny. ABILITY INFECTIONWATCH provides the tools you need to protect your facility from a coronavirus outbreak. It also allows you to track, access and report the data required by CMS to reduce the risk of survey deficiencies and costly penalties.

Protect your facility from a potential outbreak – and potential financial penalties. Learn more about ABILITY INFECTIONWATCH now.

 

1. “Trump Administration Has Issued More Than $15 Million in Fines to Nursing Homes During COVID-19 Pandemic,” Centers for Medicare & Medicaid Services, August 14, 2020, https://www.cms.gov/newsroom/press-releases/trump-administration-has-issued-more-15-million-fines-nursing-homes-during-covid-19-pandemic

 

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

CDC advice for managing a staffing shortage – and how ABILITY can help

Healthcare workers across the U.S. – many who thought the worst of the COVID-19 pandemic was behind them – have been hit with a blast of harsh reality.

Hospitals in California, Texas, Florida and elsewhere are reporting shortages in equipment, drugs, beds and staff as the pandemic has spiked in some areas. Concerns abound that more waves could land in the fall, right as the annual flu season starts.

Healthcare workers on the front line, despite being more cautious and better equipped than the average citizen, are at high risk for contracting the virus. In fact, according to the Centers for Disease Control (CDC), healthcare professionals account for 106,180 cases and 552 deaths. And those numbers don’t paint the full picture because, of the data collected, healthcare personnel status was only available for 21.6% of the subjects.

The CDC warns that healthcare organizations must be prepared for staffing shortages due to exposure to COVID-19, actual illness or to care for loved ones who become ill with the virus.

In healthcare, where staffing shortages already make shift management and adequate staff-to-patient ratios a challenge, more surges are bound to leave hospitals reeling.

To help healthcare organizations, the CDC has released Strategies to Mitigate Healthcare Personnel Staffing Shortages on its website. We highly recommend you read the full article, but here are some highlights.

Understand how many employees you must have

Know the minimum number of staff you need to provide high-quality care and a safe work environment. That is the benchmark for establishing your schedule for all doctors, nurses, paramedics and support staff, including custodians and administrators.

With that as your baseline, you can then set up contingency plans in the event of a surge in your facility, for example, by:

  • Hiring additional healthcare professionals
  • Recruiting retirees, students or volunteers to be on call
  • Canceling elective procedures and visits and shifting personnel from those floors to support patient care in the ER or ICU

The goal here is to not wait until you are up against a shortage, but instead, prepare for a worst-case scenario. That starts by understanding your most basic staffing needs and having steps in place before a shortage occurs.

How do busy healthcare leaders track it all?

A previous post examined how the pandemic is complicating credential tracking, as states waive requirements and help comes from retirees, students, volunteers, ex-healthcare staff whose licenses have expired and out-of-state professionals.

COVID-19 is creating the same challenges for staffing.

Think about it: What if three ICU nurses called off sick one hour before a shift? What if several hospital custodians went on strike because they weren’t receiving adequate PPE? What if the on-call ER physician is a no-show? Or half of your ER registrars had to quarantine?

Do the managers who oversee those employees have the information they need to find replacements quickly and efficiently?

For many organizations, that is a “No.” Healthcare leaders and managers don’t have the broad visibility or context to make quick staffing decisions on a “normal” day – much less during a crisis. They can spend hours poring over spreadsheets and making calls to find replacements.

Add in an influx of on-call volunteers or new hires and the complexity grows. And if your organization has no other choice but to allow employees with suspected or confirmed COVID-19 to work, scheduling that person so that they can treat patients that meet the CDC’s criteria is a logistical nightmare. That’s a detail that you would need to consider and track as you create the schedule and fill open shifts.

ABILITY SMARTFORCE Scheduler enables you to act fast

With the deep visibility and intelligence you gain from ABILITY SMARTFORCE Scheduler, you can better meet the needs of your patients and staff now and long after you’ve recovered from the pandemic:

  • Gain instant access to schedule data – across your organization – from any device
  • Manage staff-to-patient ratios with a quick-look staffing grid through predictive analytics
  • Communicate schedule changes and shift needs to staff without picking up a phone
  • Avoid overstaffing and overtime by gaining an eagle-eye view of the hours each employee has worked with a highly intuitive dashboard
  • Pinpoint costly inefficiencies, such as scheduling over budget and paying for hours not met, with permissions-based control and visibility

Plus, check out the rest of ABILITY’s suite of mobile applications that take the work out of workforce management:

  • Allow staff to clock in from their phones, approve timecards and track staff punches with ABILITY SMARTFORCE Attendance
  • Collect, organize and track licenses and certifications with ABILITY SMARTFORCE Credentialer
  • Manage physician and clinical schedules, view open shifts and track commitments with ABILITY SMARTFORCE Physician

All our applications are affordable and easy to deploy and use. Upgrade how you manage your workforce by contacting our sales team at 888-552-4049.

 

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

The PBJ reporting waiver has ended: what you need to know

In a memorandum released on June 25, CMS announced the end of the COVID-19 emergency waiver for staffing data submissions.

Back in March, CMS had granted a series of blanket waivers to lessen administrative burden and allow nursing homes to focus on responding to the COVID-19 threat. Facilities now must resume submission of their staffing data through the payroll-based journal (PBJ) system as required by regulation.

Why it matters

A recent study published in the Journal of the American Geriatrics Society found that facilities with lower nurse staffing levels and lower scores on the Five-Star Quality Rating System before the pandemic had higher rates of COVID-19 infections and deaths. In fact, higher nurse staffing ratios were strongly correlated with fewer cases and deaths.

The authors of the study recommended that nursing home inspections should target facilities with lower RN staffing levels and quality ratings in addition to those located in areas with high infection rates.

On the heels of these findings, CMS made the announcement that nursing homes must recommence submission of their staffing data, stating that “we continue to emphasize the importance of staffing based on its relationship to quality.”

What this means for your facility

Here’s what you need to know about PBJ data submissions for 2020:

  • Staffing data for April-June is due by the usual deadline of August 14
  • You are not required to submit your staffing data for January-March
  • Nursing Home Compare is displaying the staffing star rating based on your October-December 2019 data
  • New Five-Star staffing ratings, based on your April-June data, will post at the end of October 2020
  • Facilities that received an automatic staffing downgrade to one star for the fourth quarter of 2019 will have their measures and rating temporarily suppressed and that one-star staffing rating downgrade removed

How ABILITY can help

While CMS is giving long-term care providers the opportunity to correct and improve their star rating, the agency plans to restart inspections “as soon as possible.” To protect your star ratings and ensure compliance with the PBJ reporting requirements, it is crucial to act soon. This is where ABILITY can help.

ABILITY CAREWATCH PBJ puts the right tools at your fingertips so you can efficiently collect, classify, validate and submit your facility’s direct care staffing data accurately and on-time.

To see firsthand how easy PBJ reporting can be, request a demo today.

 

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

The three priorities nursing leaders should have for the rest of the year

This year has been a roller coaster so far, with influenza and COVID-19 wreaking havoc in healthcare facilities across the country and world.

While many of us may still be in recovery – or even survival – mode it’s important to not lose sight of the longer-term goals for your team and organization.

Nurse job satisfaction

If you want high quality of care, your nurses’ overall satisfaction with their job is vital. It’s easy to see that happier nurses are going to offer a better patient experience than ones who are miserable. And the research backs it up.

The American Nurses Association’s National Database of Nursing Quality Indicators (NDNQI) collects information from U.S. hospitals to help healthcare organizations pinpoint areas for improvement. Using that data, researchers have found a direct link between nurses’ job satisfaction and patient outcomes. For example, they noted that a 25% increase in nurse job enjoyment over two years was linked to a quality of care increase between 5% and 20%.

That job satisfaction quotient may be particularly challenging right now. After months of turmoil and stress, with potentially more to come, don’t forget to check in on your nurses to find out how they’re holding up. Schedule one-on-one meetings to talk things through and evaluate how they are doing.

However, the biggest key to job satisfaction is improving staffing and nurse scheduling, especially when it to comes to nurse-patient ratios and helping nurses preserve their work/life balance. Learn how ABILITY SMARTFORCE Scheduler can help with both.

Turnover

Turnover has a direct link to job satisfaction. If nurses are unhappy, they are more likely to quit.

In 2019, we saw the turnover rate for bedside RNs decrease 1.3% and it stands at 15.9% right now, according to the 2020 NSI National Health Care Retention & RN Staffing Report. While a dip in turnover is certainly good news, it’s still too high and the cost can be devastating.

In fact, according to the same report, the average cost of turnover for a bedside RN is $44,400 and, ranges from $33,300 to $56,000. For the average hospital, we’re talking about losses in the $3.6 to $6.1 million range. Most can’t sustain that. Besides, we’re already facing a nursing shortage as it is, and you can’t afford to lose good people.

Again, after prolonged upheaval and stress, many of your nurses could be thinking about quitting or even leaving the profession altogether. Prioritizing their job satisfaction is critical to keeping them onboard.

Training and nurse development

Developing staff is one of the smartest ways to both retain nurses and attract new ones. It’s also a way to increase the overall skill sets and value of your staff. With every skill they learn, they improve your organization’s ability to provide a high quality of care.

It’s critical to provide in-house training and development programs to keep their clinical skills fresh. However, also provide training that goes beyond that. Training in communication, conflict resolution and leadership makes nurses more capable in their current roles, while also preparing them for future management and leadership roles.

The challenge is often creating the time for them to take training on top of long shifts. Still, it’s important to do so, if you want the best and brightest nurses working for you.

To see firsthand how you can improve your staffing process, request a demo of ABILITY SMARTFORCE Scheduler.

 

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

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.