President Biden to End COVID-19 Emergencies on May 11, 2023  

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare “President Joe Biden informed Congress on Monday that he will end the twin national emergencies for addressing COVID-19 on May 11, as most of the world has returned closer to normalcy nearly three years after they were first declared. The move to end the national emergency…… Continue reading President Biden to End COVID-19 Emergencies on May 11, 2023  

CMS Issues Final Rule to Protect Medicare, Strengthen Medicare Advantage and Hold Insurers Accountable   

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare Today (January 30, 2023), the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized the policies for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program, which is CMS’s primary audit and oversight tool of MA…… Continue reading CMS Issues Final Rule to Protect Medicare, Strengthen Medicare Advantage and Hold Insurers Accountable   

Revisions to Hospice-Appendix M of the State Operations Manual and the Hospice Basic Surveyor Training

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare Today, January 17, 2023, CMS posted QSO-23-08-HOSPICE with the same title as this blog. This Memorandum is 196 pages in length, with the actual revised Appendix M starting on page 25.  There are 3 Attachments with Attachment III being the Transmittal – Advanced Copy: There’s a…… Continue reading Revisions to Hospice-Appendix M of the State Operations Manual and the Hospice Basic Surveyor Training

Latest CMS, CDC and NHSN COVID-19 Nursing Home Data 

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare CMS has posted the nursing home COVID-19 data for the week ending January 15, 2023. Comparing the January 15, 2023 data to the January 8, 2023 data shows these changes: Resident primary vaccination completion rate decreased another 0.1% this past week; Residents up to date with vaccines…… Continue reading Latest CMS, CDC and NHSN COVID-19 Nursing Home Data 

Home Health Changes for Disaster Claims and Certain Adjustments

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare CMS has posted MLN Matters Number: MM13020 (3 pages) relating to Change Request 13020.  When disaster conditions (such as hurricane or wildfire) make submission of OASIS assessments impossible, Medicare may issue a waiver indicating OASIS submission is waived. In this case, HHAs should report condition code…… Continue reading Home Health Changes for Disaster Claims and Certain Adjustments

Numerous Additional LTC Data Sets Updated

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare If you love data and analyzing data, the last couple of days have been a goldmine for you!  January 2023: Data have been refreshed for January 2023. Because of COVID-19 reporting exceptions, the claims-based measures were calculated excluding Q1 and Q2 2020.  For additional information, visit the…… Continue reading Numerous Additional LTC Data Sets Updated

PBJ (Payroll-Based Journal) Data Sets Updated   

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The Payroll Based Journal (PBJ) Nurse Staffing and Non-Nurse Staffing datasets provide information submitted by nursing homes including rehabilitation services on a quarterly basis. The View Data link above includes the hours staff are paid to work each day, for each facility, aggregated by staff reporting…… Continue reading PBJ (Payroll-Based Journal) Data Sets Updated   

Full Text of Statements of Deficiencies – Updated January 25, 2023     

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare These Excel filescontain the full texts (diagnoses, medications and similar items have been removed to protect resident identity and confidentiality) of each nursing home deficiency that Survey Agencies cited on the CMS Form 2567 (Statements of Deficiencies). Due to the size of these files, they are…… Continue reading Full Text of Statements of Deficiencies – Updated January 25, 2023     

Five-Star Technical User’s Guide Updated – January 2023    

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare Effective with the January 2023 refresh, CMS will be conducting audits of schizophrenia coding in the Minimum Data Set (MDS) data. Facilities that have coding inaccuracies identified through the schizophrenia MDS audit will have their Quality Measure (QM) ratings adjusted as follows: • The overall QM…… Continue reading Five-Star Technical User’s Guide Updated – January 2023    

Five-Star State Level Cut Point Table – January 2023    

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare This document – Five Star Quality Rating System Technical Users’ Guide: State Level Health Inspection Cut Point Table – provides the data for the state-level cut points for the star ratings included in the health inspection domain. Cut points for the staffing ratings and for the…… Continue reading Five-Star State Level Cut Point Table – January 2023