SNF QRP Measure Calculations and Reporting User’s Manual Updated

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

CMS has posted the updated SNF QRP Measure Calculations and Reporting User’s Manual_V3.0.1_Addendum_Effective 10-01-2020 (ZIP).  You’ll note this is a .zip file so you’ll find 2 items there:

The SNF QRP Measure Calculations and Reporting User’s Manual Version 3.0.1 and associated risk adjustment appendix and Hierarchical Condition Category (HCC) crosswalks are now available.

This document serves as an addendum that communicates quality measure updates to the SNF QRP Measure Calculations and Reporting User’s Manual Version 3.0. The SNF QRP Measure Calculations and Reporting User’s Manual V3.0.1 is effective on October 1, 2020 and provides information on measure-related changes in a change table format in lieu of a complete update to the overall manual. Additionally, we have included the updated Risk Adjustment Appendix File for the SNF Quality Reporting Program Measures Calculations and Reporting User’s Manual V3.0.1, which contains the risk-adjustment values used to calculate the risk-adjusted quality measures, and Crosswalks of ICD-10 codes to HCC categories used in the risk models for the Change in Self-Care, Change in Mobility, Discharge Self-Care, and Discharge Mobility measures (NQF #2633, NQF #2634, NQF #2635, and NQF #2636, respectively).

We would like to describe several changes to the quality measure specifications, including updates to the exclusion criteria for the SNF Functional Outcome and Discharge to Community measures.

Specification updates for all four SNF Functional Outcome Measures:

  1. Exclusion criteria: The age exclusion criterion for these measures has been updated from 21 years to 18 years, such that any resident younger than 18 years of age will be excluded from measure calculations.

Specification update for the SNF Discharge to Community Measure:

  1. Exclusion criteria: This measure has been updated to exclude residents who had a long-term nursing facility (NF) stay in the 180 days preceding their qualifying hospitalization and SNF stay, with no intervening community discharge between the long-term NF stay and qualifying hospitalization.