Did you hear what CMS said? One of the big nuggets derived from the CMS SNF Quality Reporting call conducted July 12th was that payment for FY 2017 will be based on data collected between October 1, 2016 – December 31, 2016. Yes, you are reading this correctly, you have approximately two months to get your ducks in a row with your QMs to stay ahead of the curve for your anticipated reimbursement for FY 2017. This may not be new information for you or your team, yet the time is nearing when MDS data and claims data culled from your facility will impact your facility’s future payment rates. The overview provided by CMS during the call detailed some key points from the IMPACT Act for applicable PAC settings. The speakers discussed the SNF Quality Reporting Program with regards to the PPS FY2016 Final Rule.
There are two basic take-aways for SNF providers to glean for the immediate future.
- It is imperative to meet the expectation of minimally 80% of MDS submissions containing the quality data.
- Systems for accurate data coding must be in place prior to October 1, 2016 as payments beginning October 1, 2017 are determined by this data.
Beware – avoid dash filling MDS sections to allow accurate reporting of all data and proper reimbursement inclusive of the 2% rate increase. For example: A measure cannot be calculated when a dash is coded indicating a facility is unable to complete a pressure ulcer assessment.
Training for data collection and coding of Section GG is of utmost importance at this time. The additional MDS submission of the Part A PPS discharge assessment is vital in FY2017 for the SNF success in FY2018.
In summary data collection time lines to flag on your calendar are as follows:
- Data Collection Period: October 1, 2016 through December 31, 2016
- Data Submission Deadline: May 15, 2017
- Payment Determination Affected: October 1, 2017 (FY2018)
Beyond reimbursement, this data will be publically available beginning in the Fall of 2018.
Clinical considerations for the interdisciplinary team
- Falls with Major Injury
- New or worsening Pressure Ulcers
- Goals for Function upon SNF Admission and Discharge outcomes
***Section G and Section GG
SNF Plan of Action should be as follows:
If you have questions or concerns about the latest CMS SNF Quality Reporting call, please contact Harmony Healthcare International by clicking here or calling our office at 1.800.530.4413.
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