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Medicare Compliance & Reimbursement

Long-term Care:

Revamped Nursing Home Compare Coming Soon

Published on Sun Nov 21, 2004

Feds promise many more clarifications at upcoming November meeting.

Heads up, long-term care facilities: There are two new regulatory changes to get up to speed on. Nursing Home Compare is introducing a new quality measure this month, and the feds are also rolling out new survey interpretive guidelines for pressure ulcers.
 
The Centers for Medicare & Medicaid Services confirmed the timeframe for the new changes at the Skilled Nursing Facility/Long-Term Care Open Door Forum held Oct. 28.The quality-monitoring shifts mean you must quickly contend with two important changes sure to affect how consumers (and trial lawyers) view the services you provide.
 
Both developments are big news, suggests Leah Klusch, president of The Alliance Training Center, a consulting firm in Alliance, OH.

Learn From These Top Stories

 

  • Weight loss quality measure. Consumers interested in checking out a facility's quality of care will be able to scope out how many residents triggered the newest addition to the QM arsenal: "percentage of residents who lose too much weight," explained an official speaking on behalf of CMS' Office of Clinical Standards and Quality.
     
    How should SNFs respond? They should first preview their new Nursing Home Compare data as soon as possible, ideally before it is posted publicly later this month. CMS says it plans to make that process easier in the coming months. In the meantime, the best route is to visit the Web site of the Nursing Home Quality Initiative at     www.cms.hhs.gov/nhqi.
     
    "We also encourage providers to contact their [quality improvement organization] with any questions about any posted or pending information they find on Nursing Home Compare," instructed CMS.
     
    And remember: If a facility's QMs leave something to be desired, its QIO can offer resources to help take quality improvement processes to the next level.

     

  • New survey guidelines for pressure ulcers. Providers can expect the new guidance within the next month, pledged Simmons. In addition, a revised tag related to incontinence is in the clearance process at CMS. Officials expect its release no later than early 2005.

     

  • Consolidated billing help. CMS remains on the case of clearer policies and better training for SNF consolidated billing.
     Providers can tap into Power Point slides that CMS presented at two recent teleconferences with fiscal intermediaries at     www.cms.hhs.gov/medlearn/cmsinit.asp. "Providers can use the information to see what we are doing with contractors," advises one official.
     
    Hot off the e-presses: CMS expects to have issued its annual consolidated billing update by early November. For more information, go to     www.cms.hhs.gov/manuals/transmittals/comm_date_dsc.asp.
     
    Don't Miss Future Clarifications

    At the October meeting, CMS also issued a clarification regarding the use of electronic signatures on clinical records. If a facility submits its Minimum Data Set information electronically, it can sign electronically, notes CMS official Joan Simmons.

    Don't be fooled: At September's Open Door Forum, officials hinted incorrectly that only facilities that kept the complete medical record electronically would be permitted to sign the MDS electronically. CMS officials say they plan to clarify the agency's policy in writing this month.
     
    Keep in mind that, most likely, you still have to have hard copies of MDS records available to surveyors upon their request. The requirement that providers maintain and provide access to 15 months' worth of records hasn't changed, offers Simmons. 
     
    Also on the agenda for that meeting:

     

  • An update on the fine points of billing for blood glucose monitoring in SNFs.
     
  • Feedback on CMS' view of the practice of securing physician certification and recertification for skilled care by phone.
     
  • A wage index clarification.

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