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Big changes are expected for the Quality Measures reported for all facilities nationwide on CMS' Nursing Home Compare Website. The National Quality Forum recently endorsed a revised list of Quality Measures for acceptance by CMS.
Nursing homes' performance on a total of 14 measures will be posted on the Website that is intended as a source of objective information for people choosing a nursing home, such as consumers and discharge planners.
The revised list of Quality Measures (QM) covers residents receiving chronic care and post-acute care separately, and adds two measures for all residents.
Two of the current chronic-care QMs have not changed: Loss of ADLs and Physical Restraints. Other QMs have the same subject as currently, but changes are proposed to the way they are calculated: chronic-care Pain and Pressure Ulcers, and post-acute Delirium and Pain.
Chronic-Care Quality Measures:
- Loss in ADLs
- Pain
- Physical Restraints
- Bedfast
- Locomotion Decline
- Urinary Tract Infection
- Depression Worsening
- Pressure Ulcers in High-Risk and Average-Risk Residents
- Bowel or Bladder Incontinence paired with Indwelling Catheter
Post Acute Quality Measures:
- Pain
- Delirium
- Pressure Ulcers
For All Facilities:
- Pneumococcal Vaccination (of residents age 65 or older)
- Influenza Vaccination
Click here to read the National Quality Forum's press release for further information.
You can also click here to visit CMS' Nursing Home Compare Website.
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For Medicare Part A beneficiaries in skilled nursing facilities, the daily co-insurance rate for longer than 20 days and up to 100 days will be $109.50 in 2004, compared with $105.00 in 2003.
Keane Care Clients: Instructions on updating the rate in the VistaKEANE Resident Account Management (RAM) and Accounts Receivable applications are in the clients-only section of the website (password required).
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Paid feeding assistants are now permitted in long-term care facilities. Assistants must successfully complete a state-approved training program. The regulation, released September 26, went into effect October 27, 2003.
They will work under the supervision of a RN or LPN to feed residents who do not have complicated feeding problems. Selection of residents would be made by the professional nursing staff.
The rules do not apply to volunteers and family members.
Speaking at the AHCA National Convention October 15, Cindy Graunke, Director, CMS Division of Nursing Homes, stated how the final rule differs from the proposed rule:
- Individual states decide whether to implement a paid feeding assistant program
- States determine the training content and how many hours (the final rule specifies at least eight hours)
- In the final rule, the requirement that a feeding assistant work under the direct supervision of a RN or LPN was changed to remove the word "direct." This change would allow assistants to feed residents in their rooms
Click here to read the final rule in the September 25, 2003, Federal Register.
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The agency responsible for protecting Medicare programs against fraud, waste, and abuse - the DHHS Office of Inspector General - has outlined the specific areas it will address in its 2004 Work Plan.
Included in the 12 activities scheduled for Medicare Nursing Homes in 2004 are examinations into these areas:
- Compliance with MDS reporting requirements, including timeliness and accuracy
- Whether the prospective payment system for SNFs has affected Medicare beneficiaries' access to care
- How Nurse Aide Registries are being use
- Trends in the proportion of beneficiaries assigned to each Resource Utilization Group (RUG)
- Prospective payments to SNFs, including those made on the day of discharge, at the default rate, while beneficiaries are hospitalized, for infusion therapy and for rehabilitation services
- SNF care provided to Medicare beneficiaries with consecutive inpatient stays
- Medicare Part B payments for SNF residents, including any duplicate Part B payments, and any unbundling, payment for inappropriate services, or aberrant billing patterns
- Any inappropriate billing for imaging and laboratory services
- Compliance with federal dietary services requirements
Click here to read the entire DHHS OIG 2004 Work Plan.
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Medicare & You 2004 handbooks have been mailed to Medicare beneficiaries. This annual publication includes information on changes made since the last handbook, including:
- New financial limits on therapy services
- How to receive your Medicare Summary Notices (MSNs) electronically (CMS is currently testing the service)
- National Coverage Determination and Local Medicare Review Policies - how payment decisions are made
- New requirement that providers bill Medicare electronically
- Medicare Specialty Plans, such as Disease Management
- A speech-recognition version of the Medicare helpline (1-800-MEDICARE) will be tested in 2004 to replace the current touch-tone system
Click here to download a copy of the 88-page handbook.
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CMS now offers nationwide information on Home Health agencies on a Home Health Compare Website. Consumers can read reports on eleven Quality Measures that indicate how well Home Health agencies provide care for some of their patients, the patients' physical and mental health and whether the patients' ability to perform basic daily activities is maintained or improved.
Click here to access the Home Health Compare Website.
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Are you losing money by undercoding ADLs on the MDS? CareTracker kiosks from Resource Systems offer a solution for this common and costly problem.
Click here to read more about it in an article in the latest online KeaneCARRIER. For additional information on CareTracker, please contact Kim Barth at 800.426.2675 or via email at Kimberly_A_Barth@keane.com.
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At the AHCA National Convention in San Diego and the AAHSA National Convention in Denver, Keane Care sponsored a drawing for a new Dell Laptop Computer.
Congratulations to:
Rick Mountz of Life Care Centers of America who was the winner from the AHCA Convention
and
Janice Cambron of Seashore Gardens Living Center who was the winner from the AAHSA Convention.
Keane Care would like to thank all who entered the drawings at both conventions.
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The Keane LTC Users' Group invites staff from all facilities using the VistaKEANE system to participate in their organization.
The mission of the Keane LTC Users' Group is to provide input to ensure all the products used by Keane Long-Term Care clients meet the ongoing requirements of the post-acute care community. The Users' Group is a self-governing body, independent of Keane.
Membership in the Users' Group is free and individuals determine their level of involvement.
Sign Up Now
Keane Care customers can visit the VistaKEANE Insider for more information and to sign up for the Keane LTC Users' Group.
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