First SNF Quality Reporting due May 15 – 2% of Medicare Rate At-Risk

Regulation | April 20, 2017 | by Nicole Fallon

Skilled Nursing Facilities (SNFs) must complete their first required MDS data submissions to CMS under the Quality Reporting Program (QRP) by May 15, 2017 or be at risk to lose 2 percent off their FY2018 Medicare rates as a penalty for failure to report.

CMS established the QRP for SNFs and other post-acute care providers based upon the requirements of the 2014 IMPACT Act. The main objective is to begin collecting common quality and patient data across post-acute providers. The SNF QRP will evaluate SNF performance on three defined quality measures derived from MDS:

  • % of patients experiencing a fall with major injury;

  • % with new or worsening pressure ulcers; and

  • % with an admission and discharge functional assessment, and a care plan that addresses function

For more information and to ask questions on the reporting, CMS will be hosting a webinar May 2 from 2 – 3:30 ET entitled, “ Review and Correct Reports Provider Training – Live Webcast.”  Click here to register for CMS webinar.

What must be reported?

SNFs must complete (and make any necessary changes to) the MDS for all Medicare Part A admissions that occurred on and after 10/1/2016 and were discharged from the SNF up to and including 12/31/2016. This includes a new section of the MDS, Section GG related to SNF Part A PPS Discharge Assessment.

SNF QRP data is submitted through MDS 3.0 via the Quality Improvement and Evaluation System (QIES) Assessment Submission and Processing (ASAP) system. The implementation of the SNF QRP will not change requirements related to the submission of MDS 3.0 data through CMS’ QIES ASAP system. For an overview of the steps required to submit an MDS 3.0 file, verify its submission status and obtain a Final Validation report, go to: https://www.qtso.com/download/mds/MDS_3.0_Helpful_Hints.pdf

To meet the reporting requirement, at least 80% of the MDS assessments submitted must contain all data necessary to calculate the above SNF QRP measures. In other words, an MDS assessment including Section GG (new) must be completed and filed. However, SNFs must also, confirm each MDS’ submission status and obtain a Final Validation report.

Please also note that for swing beds, only non-Critical Access Hospital swing beds must comply with the SNF QRP reporting requirements.

 

For further information on the QRP program and reporting requirements: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/SNF-QRP-Requirements-for-FY18-Reporting-Year-Fact-Sheet_updated.pdf