MDS Alert

Look for the Section W-driven immunization quality measures to be posted this fall. The Centers for Medicare & Medicaid Services has set a target date to publish the measures on the Nursing Home Compare Web site in September/October 2006, according to the agency's Sheila Lambowitz in a presentation at the March 2006 American Association of Nurse Assessment Coordinators' conference in Las Vegas. CMS is considering developing a similar measure for staff immunizations.

The Part B rehab therapy cap doesn't have to put the lid on residents receiving the care they need. Find out more about automatic exceptions and the process for requesting and documenting manual exceptions by reviewing the CMS Web site at: www.cms.hhs.gov/Manuals/IOM/list.asp#TopOfPage. Change Request 4364 also spells out specifics; you can access the transmittal at www.cms.hhs.gov/Transmittals/2006Trans/list.asp#TopOfPage. In addition, CMS has posted a Medlearn Matters article on the topic at www.cms.hhs.gov/MedlearnMattersArticles/downloads/MM4364.pdf. The exceptions process for Part B rehabilitation therapy is "fairly broad and allows you to continue to provide therapy for most conditions" a resident would require, noted CMS' Sheila Lambowitz in addressing AANAC conferees in Las Vegas in March. But if CMS finds abuses, it could tighten it up, she said. 

Ready for an integrated post-acute payment system? CMS is "actively working" toward a patient-centered system that would pay based on the bundle of services a beneficiary needs rather on the setting where care is provided, according to a presentation at the recent AANAC conference. The agency is developing a demonstration to look at the most appropriate settings for post-hospital care and cost variations across settings, according to CMS' Sheila Lambowitz. The settings include SNFs, home health, inpatient rehabilitation facilities (IRFs) and long-term care hospitals.