A Summary of the Jan. 19 Open Door Forum
On the Jan. 19, 2012, Skilled Nursing Facility (SNF)/Long Term Care (LTC) Open Door Forum, the Centers for Medicare and Medicaid Services (CMS) discussed developments with MDS 3.0, nursing home quality measures, Medicare claims processing and other issues.
An encore audio recording of this call will be available at: 1-855-859-2056 (Conference ID #27214166) for 10 business days following the call.
An audio-only archive stream is also available for 90 days.
Summary of the January 19 SNF Open Door Forum
- CMS transition to the CMSNet connectivity from AT&T to Verizon: Conversion to Verizon is currently under way and the majority of the states have already converted, with the remaining of the states to be completed in the next 2 weeks.
All Swing Bed providers should have been transitioned by now. If you are still an AT&T user, the ID will be cut off very soon, so in order to continue to submit your MDS records, providers must install Verizon. For the detailed installation guide, access the QTSO.
- MDS 3.0:
- March MDS 3.0 Provider Training: The volume of registration has exceeded registration accommodations. CMS will be making available all training material from the conference after the conference ends.
- MDS 3.0 Manual Update: The latest updates to the RAI Manual item sets that will be effective April 1, 2012, is in the process of being reviewed. CMS has the revised manual, and will likely make it available early next week. All revisions will be labeled as “MDS 3.0 RAI Version 1.08, effective April 1, 2012.” Only the pages with actual changes will be updated, identified by the new label above.
- Planned and Unplanned Discharge Updates: The unplanned discharge will no longer require the BIMS and PHQ-9, and have decreased in length from the current 111 maximum questions to a length of 72 questions maximum (without considering skip patterns, and carried-over items from assessment to assessment).
- MDS Interviews: CMS continues to receive many questions about the interviews. When completing the interviews, facilities should follow the instructions as provided in the RAI manual. For example, if the look back period is 7 days, then that’s how the statement should be phrased to the resident. With the updates effective April 1, for unplanned discharge, CMS has removed the requirement for BIMS and PHQ-9 interviews. CMS stated that, during site visits, they have received some reports that have identified some facilities that are not completing interviews when residents are capable. SNF providers need to be aware that this is not acceptable and they will be sited.
- Clarification on COT OMRA: CMS has received questions re: setting the ARD for the COT OMRA. Most cases involved the ARD for the COT is not set on the appropriate day and what this would mean in terms of being a missed/late assessment. Although CMS has issued clarification documents dating September and November of 2011 to clarify some of those question, many questions still remain unanswered. CMS recognizes the need for more clarifications and is in the process of developing short term and long term solutions for these issues that have not yet been clarified.
- Quality Measure (QM) Update: CMS is still on track to post the quality measures on April 19. Providers will get an early preview of their scores sometime in the end of January through the CASPER mailbox. These reports will not be made public. CMS has not yet made a decision about which quality measures will be used for the 5-star nursing home quality rating system, but CMS expects to make a decision by April 2012.
- Claims Processing Update:
- For about a year, facilities have been hearing issues concerning reason code 31742, relating to assessment reference date reporting issues, along with code 50. As of a few weeks ago, CMS issued work-arounds for contractors to resolve some incorrect returns of SNF claims, so facilities should no longer be having any more problems. Please contact Jason Kerr, JKerr3@cms.hhs.gov, if you continue to have problems.