Tuesday, September 29, 2015

CMS News: Focused Surveys, Nursing Home Compare, and PBJ

Lyn Bentley, MSW
On September 15, AHCA met with CMS along with other stakeholders and received numerous updates.
  • Starting in July 2015, the focus surveys (dementia, MDS and soon the adverse events – focused surveys) are not included in “complaint survey” information on Nursing Home Compare (NHC) and Five Star. They are reflected as “focus surveys” and NHC and Five Star websites will be updated soon to reflect this change.

  • Most frequent deficiency citation in MDS-focused surveys relates to inconsistency between patient MDS and care plan.

  • in 2016, two new measures will be added to Nursing Home Compare – readmission to hospital and discharge to community. Although not completely decided, it appears that CMS will use claims-based data.

  • Other quality measures are under development, consistent with the requirements for such measures across post-acute care providers specified in the IMPACT Act.  

  • In 2016, there will be a rebasing of Quality Measures in an effort by CMS to continue to “raise the bar” of quality for nursing centers.

  •  As of September 15 more than 500 nursing centers had registered for the voluntary submission of payroll and census data through the Payroll-Based Journal (PBJ).

  • The staffing and patient census data electronically submitted by nursing centers through the PBJ will not be used in Five Star until late 2017 or early 2018. CMS Forms 671 & 672 will also need to be submitted during that time. This “dual-reporting” of the data is to ensure the PBJ system is working well for providers and for CMS.

  • Following full implementation of PBJ, CMS expects there will be “an increase in the role of staffing” in calculating the overall Five Star rating due to the relationship with outcomes.

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