MDS Alert

Published on Thu Jun 26, 2014 PDF

Plus: Take a peek at surveyors’ new standards for dementia care.

On May 6, CMS published a SNF PPS and Consolidated Billing proposed rule for fiscal year (FY) 2015. And the good news for you is that CMS estimates an overall economic impact to increase aggregate payments to SNFs by $750 million.

Among other things, the proposed rule would revise policies related to the Change of Therapy (COT) Other Medicare Required Assessment (OMRA). The proposed rule discusses SNF therapy payment research that CMS is conducting and a provision involving Civil Money Penalties (CMPs) related to the Affordable Care Act (ACA).

Additionally, the rule includes a proposal to adopt the most recent Office of Management and Budget (OMB) statistical area delineations to identify a facility’s urban or rural status, reported Evvie Munley, senior health policy analyst for Washington, DC-based Leading Age, in a May 7 analysis. The purpose of doing so is to determine which set of rate tables would apply to the facility and to determine the SNF PPS wage index.

The rule would include a proposed one-year transition with a blended wage index for all providers for FY 2015, Munley added. The proposed rule contains a wide variety of other important changes. To read the proposed rule, go to www.gpo.gov/fdsys/pkg/FR-2014-05-06/pdf/2014-10319.pdf.

In other news …

What Surveyors Will Look for in Dementia Care

You have some new resources to guide you in getting an A-plus on your facility’s dementia care and services.

CMS has posted a Quality Indicator Survey checklist for surveyors to use with F309 Interpretive Guidance when reviewing care and services provided to residents with dementia. You can access the checklist at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/QIS-Dementia-Care-Checklist.pdf.

You can also take a look at the overall Quality Indicator Survey checklist, which CMS revised and posted on April 10: www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/QIS-Checklist.pdf. And CMS posted a new Fact or Fiction document at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Fact-Fiction.pdf.

Stay Updated on New CMP Guidance

On April 25, CMS released a new transmittal that revises and expands current Medicare and Medicaid guidance regarding civil money penalties (CMPs). The transmittal specifically focuses on imposing CMPs when nursing homes are not in compliance with federal participation requirements under Section 6111 of the Affordable Care Act of 2010.

Among other changes, the transmittal outlines new guidance on Independent Informal Dispute Resolution (Independent IDR). The transmittal, which displays changes in red italics, is available at www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R113SOMA.pdf. 

Summer Reading: Brush Up on Your Alzheimer’s Know-How

If you like to stay abreast of Alzheimer’s disease and how to best care for your residents who suffer from it, you can find a plethora of new eBooks from the National Institute on Aging (NIA), part of the National Institutes of Health (NIH). You can download the eBooks to your desktop computer, laptop, tablet, smartphone or Kindle.

The new eBooks are part of the NIA’s Alzheimer’s Caregiving Tips series:

Coping with Agitation and Aggression:

www.nia.nih.gov/sites/default/files/caregivingtips_agitationagression-final_7-12-12_0.pdf

Rummaging and Hiding Things:

www.nia.nih.gov/sites/default/files/caregivingtips_rummaging-final_7-20-12_0.pdf

Hallucinations, Delusions, and Paranoia:

www.nia.nih.gov/sites/default/files/caregivingtips_hallucinations-final_7-18-12_0.pdf

Sundowning:

www.nia.nih.gov/sites/default/files/caregivingtips_sundowning-final_13jun24_0.pdf.