Takeaways from Today’s SNF/LTC Open Door Forum

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare®

The February 14, 2019 SNF/LTC Open Door Forum – the 1st one held in 2019 – had a last minute agenda item added along with the agenda that was posted. The ODF lasted only 30 minutes. I’m providing you with the key items I heard during this call:

  • John Kane of CMS announced that the PDPM website has received lots of positive feedback from stakeholders. Later today, CMS contractors are scheduled to upload several items to this website:
    • The December 2018 National Provider Call on PDPM materials will be added
    • The 40-page Classification Walkthrough has been updated
    • New Q&A items have been added to the PDPM FAQ document found on this website
  • Questions regarding PDPM can be submitted to this mailbox: pdpm@cms.hhs.gov
  • CMS has awarded a contract to RTI to develop a future claims-based measure: healthcare-associated infections (HAI) in SNFs. Nominations for inclusion on the TEP (Technical Expert Panel) can be submitted via information found on the SNF QRP website. Nominations must be submitted before EOB on Friday, February 15, 2019.
  • CMS reminded providers that staffing data for 4th quarter 2018 must be submitted by EOB today in order to be considered timely and for inclusion on Nursing Home Compare.
  • CMS usually posts the MDS 3.0 RAI User’s Manual in August however this year they expect to post it in May, so providers can prepare for PDPM.
  • Version 12 of the Quality Measures manual has not yet been posted but Evan Shulman says they expect to post it in the next couple of months when the QMS will be in the public domain.
  • The 5-day PPS Item Set for October 1, 2019 contains the O0400 items (therapies) just as they are in the current and past Item Sets. John Kane says that they will be retained for now in addition to the new O0425 Part A Therapies items; eventually CMS will retire the O0400.
  • CMS will release information as the year progresses on turnover rates calculated from PBJ submissions.
  • Facilities notified last year that they did not meet the SNF QRP requirements and thus will face a 2% payment penalty have not seen a reduction in payments. CMS says that the payment reductions will be applied shortly, and such reductions will be retroactive to 10/1/2018. CMS cites a miscommunication with some of the MACs as a reason for the delay.

If you’d like to listen to the recording of today’s ODF, here’s that information:

Encore: 1-855-859-2056; Conference ID: 3693669.

Encore is an audio recording of this call that can be accessed by dialing 1-855-859-2056 and entering the Conference ID. Encores for ODFs held on Thursdays can be accessed the following Monday. The recording is available for 3 business days.