Congrats, you survived Oct. 2019! October has been quite an eventful month. After what felt like a lifetime of anticipation, we said goodbye to RUGs and hello to PDPM, ushering in the largest change to skilled nursing since the implementation of MDS 3.0 in 2010.
With that transition, we experienced new PDPM-related deadlines. We also saw drastic CMS changes including the addition of an alert icon, the removal of quality measures, and more.
Read on for a breakdown of the significant CMS changes by date.
Timeline of important Oct. changes
First day of the Patient-Driven Payment Model (PDPM). CMS made changes to the request dialogue found on the QRP CASPER reports.
CMS announced they will add an alert icon on Nursing Home Compare effective Oct. 23 to indicate which facilities have been cited for abuse and neglect.
CMS posted an updated QM manual version 12.1. CMS also published updates to the Five-Star Technical Users’ Guide stating that SNFs receiving the abuse icon will have their health inspection rating capped at a maximum of two stars.
In addition, CMS removed the following two quality measures related to pain from the Five-Star Quality Rating System:
- Percentage of short-stay residents who report moderate to severe pain
- Percentage of long-stay residents who report moderate to severe pain
CMS implemented several changes mentioned on Oct. 7 and Oct. 8 to the Nursing Home Compare website and the Five-Star Quality Rating System. These changes affected the health inspection and quality measure (QM) domains for SNFs.
Health Inspection changes
The new alert icon was added to the Nursing Home Compare website for facilities cited on inspection reports for one or both of the following:
- Abuse that led to harm of a resident within the past year
- Abuse that could have potentially led to harm of a resident in each of the last two years
Quality Measure changes
As a result of dropping the two quality measures related to pain, the cut-points for the long-stay, short-stay and overall QM ratings changed. The new cut-points are shown in the table below:
SimpleAnalyzer™ users: The removal of the two pain-related quality measures may have affected your predictive quality measure ratings.
Continue to expect the unexpected from CMS
When it comes to CMS, always expect the unexpected. Leverage all your internal resources and analytics to take a proactive look at your QM results.
At SimpleLTC, though we can’t predict when CMS will make changes, we’ll help you prepare for them with continuously updated SimpleAnalyzer™ features that will help you maximize your Five-Star results.