Plus: Why OCR thinks you’re not connecting residents to the right referral sources.
The quality-of-care train continues to chug along into the next year, as the Centers for Medicare & Medicaid Services (CMS) has unveiled its action plan for nursing homes into 2017. Find out what CMS has in store for your quality reporting and surveys.
On May 20, CMS released a Survey & Certification (S&C) memo, “Fiscal Year (FY) 2016 to FY 2017 Nursing Home Action Plan.” The Plan outlines five
CMS has organized the Plan into the following five actionable strategies, each with sub-items:
1. Enhance Consumer Awareness and Assistance
A. Five-Star Quality Rating System
2. Strengthen Survey Processes, Standards and Training
A. Interpretive guidance to surveyors
3. Improve Enforcement Activities
A. Enforcement policies
4. Promote Quality Improvement
A. Maintenance of MDS 3.0
5. Create Strategic Approaches through Partnerships
A. Collaboration between State Agencies (SAs) and Quality Improvement Organizations (QIOs)
Link: To access the S&C memo (S&C: 16-26-NH), go to www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-16-26.pdf.
In Other News …
Take A Closer Look At Your Section Q Compliance
Beware: Your facility is falling short on properly referring residents to appropriate sources and avoiding discriminatory practices. So says a new guidance document from the HHS Office for Civil Rights (OCR).
On May 20, OCR issued new guidance to help long-term care (LTC) facilities comply with their civil rights responsibilities and obligations under Centers for Medicare & Medicaid Services (CMS) regulations. Specifically, these regulations require LTC facilities that are Medicare and/or Medicaid-certified to ensure that residents receive services in the most integrated setting appropriate to their needs.
This guidance comes as a result of OCR’s analysis of MDS data from a large sample of facilities. OCR discovered that many LTC facilities “are misinterpreting the requirements of the MDS or inadequately administering the MDS,” OCR stated in a June 23 announcement. “In particular, [LTC] facilities are not referring residents who are interested in living in the community to appropriate referral sources.”
Best practices: The guidance provides recommendations for steps you can take to ensure you’re properly using the MDS to facilitate compliance with regulations and to avoid discriminatory practices against residents. Focusing on Section Q — Participation in Assessment and Goal Setting, the major recommendations include:
1. Strong relationships with the local contact agency can help LTC facilities understand the availability of community-based services;
Link: To read the new guidance, visit www.hhs.gov/sites/default/files/mds-guidance-2016.pdf.
inter-related and coordinated approaches (or “principles of action”) for nursing home quality, aligned with CMS’s main goals.
B. Improving staffing data on the CMS website
B. Improvements to the nursing home survey processes
C. Fire Safety and Life Safety Code (LSC) in nursing homes
D. Surveyor and regional office training
E. Long-term care (LTC) surveyor training and testing
F. Complaint investigation process
G. Infection control in LTC
H. State performance standards
B. Federal Civil Money Penalty (CMP) fund
C. Monitor CMP amounts
D. Special Focus Facilities (SFF)
E. Notice of facility closure of nursing homes
B. Quality Assurance and Performance Improvement (QAPI)
C. National Partnership to Improve Dementia Care in Nursing Homes
B. Advancing Excellence in America’s Nursing Homes campaign
C. Nursing Home Convergence
D. National Background Check Program
2. Proper administration of MDS Section Q, including questions Q0400, Q0500, and Q0600, is critical in assisting residents to receive services in the most integrated setting; and
3. LTC facilities should update their policies and procedures to comply with this guidance document and provide periodic training.