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  2017 Pulse
CMS Releases Final MDS 3.0 RAI Manual Updates
On August 31, 2017, the Centers for Medicare and Medicaid Services (CMS) released the final revisions to the MDS 3.0 RAI Manual v1.15 effective October 1, 2017.
SNF Value-Based Purchasing Program
On July 31, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule outlining fiscal year (FY) 2018 Medicare payment rates and quality programs for skilled nursing facilities (SNFs).
CMS Issues FY 2018 SNF PPS Final Rule
On July 31, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule outlining Fiscal Year (FY) 2018 Medicare payment rates and quality programs for skilled nursing facilities (SNFs).
CMS Releases Revised State Operations Manual, Appendix PP
The Centers for Medicare and Medicaid Services (CMS) released a new Survey & Certification memo on June 30, 2017, detailing revisions to the State Operations Manual (SOM) Appendix PP for Phase 2, F-Tag revisions, and related issues. The revisions will be effective on November 28, 2017.
Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems
The bacterium Legionella can cause a serious type of pneumonia called Legionnaires Disease (LD) in persons at risk. Those at risk include persons who are at least 50 years old, smokers, or those with underlying medical conditions such as chronic lung disease or immunosuppression.
SNF Elements of Emergency Preparedness
On September 16, 2016, the final rule on Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers was published.
Skilled Nursing Facility Quality Reporting Data Submission Deadline
The IMPACT Act of 2014 mandated the establishment of the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP).
SPECIAL EDITION: FY 2018 SNF PPS Proposed Rule
On April 27, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule outlining the Fiscal Year (FY) 2018 Medicare payment rates and quality programs for skilled nursing facilities (SNFs).
The Core Elements of Antibiotic Stewardship for Nursing Homes
On October 4, 2016, The Centers for Medicare and Medicaid Services (CMS) published a Final Rule to revise Medicare and Medicaid participation requirements for nursing facilities. The Final Rule requires that facilities establish an Antibiotic Stewardship Program as part of the Infection Prevention and Control Program (IPCP) by November 28, 2017.
2017 Onsite HIPAA Audits
The Health Insurance Portability and Accountability Act (HIPAA) Privacy regulations require health care providers and organizations, as well as their business associates, develop and follow procedures that ensure the confidentiality and security of protected health information (PHI) when it is transferred, received, handled, or shared.
OIG Issues Final Rule On Exclusion Authority
On January 11, 2017, the U.S. Department of Health and Human Services Office of Inspector General (OIG) published its Final Rule establishing new standards for excluding individuals and entities from participation in federal health care programs.
  2016 Pulse
CY 2017 New Therapy Evaluation Codes
For CY 2017, the Physician Fee Schedule final rule includes a new 3- tiered current procedural terminology (CPT) code system to replace the current single code that covered all therapist evaluations.
Office of Inspector General Publishes FY 2017 OIG Work Plan
The office of Inspector General (OIG) Work Plan for Fiscal Year (FY) 2017 provides brief descriptions of activities that the OIG plans to initiate or continue in FY 2017.
CMS Publishes Reform of Requirements for Long-Term Care Facilities Final Rule
The Centers for Medicare & Medicaid Services (CMS) released the final rule “Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities” on September 28, 2016.
CMS Establishes Emergency Preparedness Requirements for Healthcare Providers
The Centers for Medicare & Medicaid Services (CMS) finalized a rule to establish consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and man-made disasters.
CMS Releases Final MDS 3.0 RAI Manual Update
On August 26, 2016 the Centers for Medicare and Medicaid Services (CMS) released the final revisions to the MDS 3.0 RAI Manual v1.14 effective October 1, 2016.
CMS Issues FY 2017 SNF PPS Final Rule
On July 29, 2016, the Centers for Medicare & Medicaid Services (CMS) issued the SNF PPS final rule outlining fiscal year (FY) 2017 Medicare payment policies and rates for the Skilled Nursing Facility Prospective
Payment System (SNF PPS), the SNF Quality Reporting Program (SNF QRP), and the SNF Value-Based Purchasing (SNF VBP) Program.
New Quality Measures Impact Five-Star Quality Ratings System
The Centers for Medicare & Medicaid Services (CMS) announced that five of the six new quality measures for skilled nursing facilities will be phased into the Five-Star Quality Ratings system on July 27, 2016.
OIG FY 2016 Mid-Year Work Plan
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) Published the fiscal year (FY) 2016 Mid-Year Work Plan Update, summarizing new and ongoing reviews and activities that OIG plans to pursue with respect to HHS programs and operations during the current fiscal year and beyond.
CMS Publishes Draft MDS 3.0 RAI Manual
CMS released a draft copy of the Minimum Data Set (MDS) 3.0 RAI User’s Manual v1.14, which details the requirements for the upcoming October 1, 2016, changes to the MDS.
Fiscal Year 2017 SNF PPS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) released the Skilled Nursing Facilities proposed rule on April 21, 2016, which outlines Medicare payment rates and policy changes for Fiscal Year (FY) 2017. CMS proposes a positive payment update of 2.1% for skilled nursing facilities (SNFs).
New Quality Measures Coming to Nursing Home Compare, Five-Star Rating
New quality measures for skilled nursing facilities will be introduced in April 2016 the Centers for Medicare & Medicaid Services (CMS) officials announced during an Open Door Forum on March 3, 2016.
CMS Increases Site Visits to Medicare Providers
The Affordable Care Act (ACA) provided tools to enhance the Centers for Medicare & Medicaid Services’ (CMS) ability to screen providers and suppliers upon enrollment and identify those that may be at risk for committing fraud, including the use of risk-based screening of providers and suppliers.
CMS Launches Infection Control Pilot Program
The Centers for Medicare and Medicaid Services (CMS) has begun a three-year pilot project to improve infection control and prevention
assessments for nursing homes, hospitals and care transitions between the two.
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