Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare CMS posted the updated Five-Star Quality Rating System Technical Users Guide (29-pages) this past week.  The updated State-Level Health Inspection Cut Point Table (4-pages) was also posted. July 2020 Revisions: Temporary Changes due to COVID-19 Staffing Rating Changes: Under the COVID-19 Emergency Declaration Blanket Waivers for…… Continue reading Five-Star Quality Rating System: Technical Users’ Guide Updated July 29, 2020

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare “On July 31, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule [CMS-1737-F] for Fiscal Year (FY) 2021 that updates the Medicare payment rates and the value-based purchasing program for skilled nursing facilities (SNFs). CMS is publishing this final rule consistent with…… Continue reading Breaking News: Fiscal Year 2021 Payment and Policy Changes for Medicare SNFs Final Rule Issued

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The July 2020 Nursing Home Compare refresh (last update was July 29, 2020), including quality measure results based on SNF QRP data submitted to CMS, is now available. For this refresh SNF QRP assessment-based measures performance scores will be based upon data submitted to CMS between Q4…… Continue reading Nursing Home Compare Quarterly Refresh with SNF Quality Reporting Program Data

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The Q4FY19 release of the Skilled Nursing Facility (SNF) Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2019 is now available for download through the PEPPER Resources Portal. To obtain your SNF PEPPER, the Chief Executive Officer, President, Administrator, Compliance Officer, or Quality…… Continue reading Skilled Nursing Facility PEPPER Now Available

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The U.S. House of Representatives’ Ways and Means Committee released Under-Enforced and Over-Prescribed: The Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes on July 27, 2020.  This is a 53-page report that merits your attention.  These are excerpts from the Executive Summary to whet your interest (bolding…… Continue reading Antipsychotic Drug Epidemic Ravaging America’s Nursing Homes

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare A new issue is affecting some inpatient hospital and Skilled Nursing Facility (SNF) claims when an interrupted stay is billed at the end of the month. The system incorrectly assigns edits U5601-U5608 (overlapping a hospital claim). If you billed the interrupted stay correctly, and your claim…… Continue reading SNF Patient Driven Payment Model Interrupted Stay Issue

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare In case you forgot about your annual PEPPER report, CMS has not.  CMS has directed the PEPPER team to resume distribution of PEPPER reports to all post-acute facilities. The SNF Q4FY report will be delivered on July 29, 2020.  It was originally scheduled for release on…… Continue reading SNF PEPPER Reports Are Coming

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare The state of Arizona has posted this Disaster Ready Behavioral Care Tool Kit which can be used beyond Arizona although some things are specific to AZ.  This is a 128-page guide was developed as a result of the Disaster Ready Behavioral Care Pilot conducted in 2018/2019.…… Continue reading Disaster Ready Behavioral Care Tool Kit

Mary Madison, RN, RAC-CT, CDPClinical Consultant – Briggs Healthcare CMS posted an updated Appendix B of the RAI Manual on July 8, 2020.  The document is dated June 26, 2020. Download and save this update to access if you need to contact your state RAI or MDS Automation Coordinator or CMS Regional Office.