MHA News Now

Nursing Homes Have a Year to Comply with New MDS 3.0 Assessment

The Centers for Medicare & Medicaid Services released the much anticipated final Minimum Data Set, Version 3.0, on October 29, giving nursing homes approximately one year to prepare for implementation of this redesigned resident assessment instrument.

Read more here.

LTCH leaders urge Congress to oppose Medicare cuts

More than 40 long-term care hospital leaders on June 23 urged Congress to oppose Medicare cuts to hospitals to pay for health care reform, and to support the Medicare Long-term Care Hospital Improvement Act. The American Hospital Association-backed bill (H.R. 2124/S. 935) would extend for two years the congressional hold on payment cuts for certain short-stay cases and full implementation of the 25% Rule, which imposes a payment reduction for LTCH referrals that exceed 25% from a single source.

Speaking at the AHA Advocacy Day, Ellen Smith, president and CEO of Houston-based Dubois Health System, which operates 16 LTCHs, said the legislation would provide more time to develop “very clear guidelines to make sure that we have the right patients in the right setting.” Without congressional action, the moratorium on the so-called 25% Rule will expire Dec. 29, 2010.

Revised guidance for F309

On January 23, CMS provided long-term care surveyors with revised guidance on F309, quality of care, including a new general investigative protocol and new pain management investigative protocol. CMS hopes the revisions will help clarify some areas of confusion regarding F309, such as assessment, care planning, and interventions, while the new investigative protocols will aide surveyors in their investigations. 

Although the revised guidance for F309 and new investigative protocols have an effective date of March 31, 2009, CMS officials say the changes are still being reviewed. Stay tuned for more information regarding F309 revisions.

[ via CLTC Weekly ]

CMS implements the Five Star Quality Rating System

During a December 11 SNF open door forum held by CMS, Thomas Hamilton, director of CMS’ survey and certification group, announced that the agency will implement the Five Star Quality Rating System for nursing homes on December 18. Two days prior to the implementation date, nursing homes across the nation began receiving previews of their individual ratings through electronic connections to their state’s server.

Facility ratings, which will appear on the Nursing Home Compare website, are based on the following three types of performance measures:

• Health inspections
• Staffing
• Quality measures

[ via CLTC Weekly ]

OIG releases report from roundtable session

HHS' inspector general's said it will consider additional opportunities for government-industry dialogue after it released a joint report highlighting the results of a recent discussion about how long-term-care organizations evaluate quality-of-care issues, according to Jessica Zigmond in Modern Healthcare's Daily Dose. Together with the Health Care Compliance Association, the office co-sponsored a government industry roundtable discussion—called Driving for Quality in Long-Term Care: A Board of Directors Dashboard—on Dec. 6.

The purpose was for long-term-care leaders to discuss the most pressing issues that governing boards at long-term-care organizations face in addressing quality-of-care issues. More than 10 government representatives and 35 long-term-care professionals—including administrators, clinicians, compliance officers and others from for-profit, not-for-profit, national and local organizations—attended the event. In breakout sessions, participants discussed commitment to quality; processes related to monitoring and improving quality of care; outcome measures for quality of care; and challenges and opportunities in using a "quality-of-care dashboard." The inspector general's office defines the dashboard as a management tool to assess and oversee performance on quality-of-care issues.

"A consistent theme in the commitment discussion groups was that a commitment to quality needs to be communicated and demonstrated from the top-the board of directors and management," the report noted. Read the report.

OIG requests comments on compliance program guidance revisions

Recently, the Federal Register posted a notice seeking comments from nursing homes in regards to the Office of Inspector General's (OIG) revision to the compliance program guidance (CPG) for nursing homes. Nursing homes who receive Medicare, Medicaid, and federal health care program funding are especially urged to submit comments. Since the CPG was first published in March 2000, nursing homes have experienced a number of changes in the area of compliance.

If you would like to submit suggestions to the OIG, go to http://www.regulations.gov.

[ via CLTC Weekly ]

CMS releases new F-tag for paid feeding assistants

The Centers for Medicare & Medicaid Services (CMS) released draft guidance recently for F-tag #373, which covers nursing home use of paid feeding assistants and takes effect September 28. The agency's initial guidance on paid feeding assistants for SNFs arrived in September 2003, when CMS published a final rule indicating SNFs could use paid feeding assistants if state law allowed.

Under F-tag #373, surveyors will determine noncompliance in any of the following cases:

* The feeding assistant has not completed a state-approved training program
* The feeding assistant isn't properly supervised
* The facility has not selected an appropriate resident to receive paid feeding assistance
* The facility has not maintained records indicating all paid feeding assistants have completed a training course

To read the full draft guidance, click here and reference S&C-07-30.

[ via CLTC Weekly ]

Rule would require automatic sprinkler systems in long-term care facilities

The Centers for Medicare & Medicaid Services on Oct. 27 released a proposed rule that would require all long-term care facilities to be equipped with automatic sprinkler systems to improve fire safety. Citing two long-term care facility fires in 2003 in Nashville and Hartford that resulted in 31 deaths, CMS said that automatic sprinkler systems would limit the scope of a developing fire and prevent the fire from spreading beyond the area where it started.

The agency estimates the cost to long-term care facilities would be $47.8-$69.9 million, $73.5-107.5 million, and $107.7-157.6 million based on phase-in periods of ten years, seven years and five years, respectively. The agency is especially interested in receiving comments about the phase-in period for installing automatic sprinkler systems. Comments on the proposed rule are due Dec. 26.

[ via AHA News Now ]

Group kicks off initiative to improve long-term care

A public-private campaign to improve long-term care is asking nursing homes and other elder-care providers to pick three out of a list of eight quality and performance measures to focus their efforts on. Work on the voluntary program, Advancing Excellence in America's Nursing Homes, began about a year ago. Led by the CMS and several industry groups, the group kicked off a participation drive on Sept. 29.

The eight areas are: reducing high-risk pressure ulcers; reducing use of physical restraints; improving pain management for short- and long-term residents; setting specific targets for quality improvement; assessing resident and family satisfaction; increasing staff retention; and making staff assignments more consistent. The group plans to track participants' progress, but it won't publicly report individual providers' data.

[ via Modern Healthcare's Daily Dose ]

The next big difficulty for nursing homes: Obesity

With the baby boomer generation beginning its retirement years, the demand for nursing home beds is expected to increase sharply. One major concern on the horizon is how the already beleaguered U.S. nursing home industry will deal with millions of overweight boomers set to enter SNFs, according to USA Today. The Obesity Society and the American Society for Nutrition both confirm that more Americans than ever are obese—one third of the adult population, in fact—and the number of obesity-related disabilities among adults in their 30s, 40s, and 50s has increased dramatically over the past two decades. What this means for nursing homes is that, as staffing shortages continue to be a problem, their populations will increase another 10 to 25% over current projections, USA Today reported.

[ via LTC Liability Monitor ]