Expect the Unexpected: This week’s top newsmakers in quality and regulatory affairs
Expect the Unexpected: This week's top newsmakers in quality and regulatory affairsCMS Announces Change Package to Prevent Harm in Nursing Homes
One-third of SNF residents experience an adverse or temporary harm event, and the majority of those are preventable. As part of CMS's focus on raising awareness of nursing home safety and to support safer nursing home care across the nation, CMS and the Quality Innovation Network National Coordinating Center released a new resource: a Change Package to prevent all cause harm in nursing homes. The Change Package is a compendium of successful practices of high-performing nursing homes, illustrating how they prevent harm while honoring each resident's rights and preferences.
Please join CMS on Thursday, January 24 at 3:00pm Eastern time to learn more about the development of the Change Package and how you can use it to improve the quality of life and quality of care for those living in nursing homes and other long-term care settings.
Date: Thursday, January 24, 2019 Time: 3:00pm-4:00pm ET Location: WebEx
REGISTER for the event: https://qualitynet.webex.com/qualitynet/onstage/g.php?MTID=efe52a812df425e04d326423a2bae4cb7
CMS finalized a rule with new requirements for accountable care organizations (ACO)
Last week, CMS announced new rules that would reduce the amount of time an ACO is allowed to stay in the program without assuming risk and expanding the three-day stay waivers for nursing homes. “Most Medicare ACOs do not currently face financial consequences when costs increase, but a review of the data on ACO performance shows that over time those ACOs that take accountability for costs perform better than those that do not,” said CMS administrator Seema Verma in a blog post dated December 21, 2018. Other key elements of the rule include the following:
· The time an ACO is allowed to remain in the program without taking accountability for healthcare spending;
· Physicians are encouraged to form their own ACOs;
· Increases flexibility for certain performance-based risk ACOs;
· The shared savings rate for ACOs not assuming risk for healthcare costs is set at 40%;
· ACOs must provide beneficiaries in an ACO with a written notice in person or electronically through email or a patient portal that they are participating;
· Allows risk-based ACOs to offer new incentive payments to beneficiaries for taking steps to achieve good health;
· Incorporates regional spending factors in establishing an ACO's target spending during all agreement periods.
CASPER Should be Used to Identify Areas for improving Quality of Care
Who has the ability to read and interpret your CASPER reports? In most facilities this responsibility lies with the MDS coordinator but these reports can and should be used with your QAPI efforts. The Certification and Survey Provider Enhancement Reports (CASPER) quality measures (QM) reports should be used to identify areas of opportunity for improving quality of care. Your QAPI teams should know what these reports look like and how to interpret the, as the state surveyors access each of these reports online in the Quality Improvement and Evaluation System (QIES) prior to and during your state survey. Each facility has the ability to designate 2 individual login accounts. The site can be found at www.qtso.com/providers/cmsnet-submission-access. The reports are generated through the Centers for Medicare & Medicaid (CMS) CASPER reporting system. It is important for facilities to become familiar with CASPER QM reports, because surveyors review the data in these reports to assess the quality of the facility's care to residents. If you need assistance with interpretation of these reports please contact MHCA to set up a time to review.
McKnight's chronicles the seven stories that resonated most with readers in 2018.
Not surprisingly, most of these stories focus on reimbursement payment models and financial solvency of facilities. It would be nice if quality of care and life stories are what resonates most to readers in the New Year!
Director of Quality Improvement & Regulatory Affairs