CMS

CMS Contractor Nursing Facility Visits – Please read

In the calendar year 2023 Medicare skilled nursing facility (SNF) payment rule, CMS elevated the SNF provider enrollment risk level from “limited” to “high”. As a high risk level provider, one of the added requirements is a site visit by a CMS contractor who will visit facilities for a short period to take some photos to verify that the location exists and is operating as a SNF. Read More

Upcoming Facility Assessment Webinar - FREE to Members

Please join us for our upcoming webinar on the Facility Assessment requirement, scheduled for Thursday, August 1st at 11:00 AM CST. This webinar will provide an in-depth look at the CMS requirements for long-term care facilities to complete a Facility Assessment as outlined in F838 and the Minimum Staffing Standards Final Rule. Read More

Facility Assessment Support and Resources

CMS mandates long-term care facilities to complete a Facility Assessment as outlined in F838 and the Minimum Staffing Standards Final Rule. Pathway Health and AHCA/NCAL have resources offering insights and practical tools to enhance your facility’s assessment processes and ensure compliance with CMS requirements. Read More

Important New Resource From Pathway Health: Nursing Facility Mandatory Minimum Staffing Rule – Expanded Facility Assessment

CMS mandates long-term care facilities to complete a Facility Assessment as outlined in F838 and the Minimum Staffing Standards Final Rule. Pathway's Facility Assessment Toolkit © offers comprehensive resources, including templates, data collection tools, policy and procedure templates, recruitment and retention plan templates, person-centered staffing interactive tools, audit tools, and staff education materials. Read More

ICYMI: CMS Finalizes Additional SNF Transparency Requirements Regarding Ownership, Disclosable Parties, and Public Reporting

On November 15, the Centers for Medicare and Medicaid Services (CMS) issued a display copy of a final rule, titled Medicare and Medicaid Programs: Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers' and Suppliers' Disclosure of Private Equity Companies and Real Estate Investment Trusts. Read More

ICYMI: CMS Updates MDS Manual to Correct Errors

The Centers for Medicare and Medicaid Services (CMS) has posted errata updates to the Minimum Data Set Resident Assessment Instrument (MDS-RAI) Manual, version 1.18.11 on the MDS 3.0 RAI Manual page effective October 1, 2023. Provider MDS nurses and staff responsible for completing the specific sections of the MDS or Care Area Assessment (CAA) requirements impacted by this errata update should review and implement it as soon as possible. Read More

CMS Updates Nursing Home Care Compare Staffing and Quality Measures

This week, the federal Centers for Medicare and Medicaid Services (CMS) released guidance regarding updates to Nursing Home Care Compare to reflect changes to the Minimum Data Set which take effect on October 1, 2023 and changes in other areas.  Read more from our national affiliate, American Health Care Association, here. Read More

Proposed Federal Minimum Staffing Mandate for Nursing Homes – Call to Action

As we and our national affiliate, American Health Care Association (AHCA), have previously reported, on September 1st, CMS released its long-awaited minimum staffing rule for nursing homes. The rule contains mandatory minimum daily staffing requirement for RN’s and CNA’s as well as requiring that an RN be on site at the facility 24 hours per day/7 days per week. While there is phase in period for both of these components, at this time, over 80% of the nursing facilities across the country would not be in compliance if the rule went into effect today. In addition, at implementation, we estimate that this rule will cost over $4 billion annually. There is zero funding in the rule to pay for the mandate. We have included more detail about the rule at the end of this memorandum. Read More

DHS Issues CMI Adjustments and Interim Rate Information

The Wisconsin Department of Health Services (DHS) is announcing changes to the patient driven payment model prospective payment system case mix index (PDPM PPS CMI). This implements the parity adjustments from CMS. The parity adjustment is tied to CMS final rule 1765 and results in reduced CMIs for direct care. DHS has increased the nursing services base and other direct care supplies and services base to offset this reduction in CMIs. Read More

CMS Final Rule Removes COVID-19 Testing and Staff Vaccination Requirements

On May 31, 2023, the Centers for Medicare and Medicaid Services (CMS) announced a final rule, “Medicare and Medicaid Programs; Policy and Regulatory Changes to the Omnibus COVID-19 Health Care Staff Vaccination Requirements; Additional Policy and Regulatory Changes to the Requirements for Long-Term Care (LTC) Facilities and Intermediate Care Facilities for Individuals With Intellectual Disabilities (ICFs-IID) to Provide COVID-19 Vaccine Education and Offer Vaccinations to Residents, Clients, and Staff; Policy and Regulatory Changes to the Long Term Care Facility COVID-19 Testing Requirements.” Read More

All-SNF MAC 5-Claim Audit and Education Initiative

CMS has directed Medicare Administrative Contractors (MACs) to audit 5 Medicare claim submissions from every SNF as part of a widespread review to lower the SNF improper payment rate (likely due to unintentional increases brought forth by PDPM). This will be implemented in waves over the next year beginning June 5, 2023, so be on the lookout for these record requests. Read More

ICYMI: SNF VBP Program Webinar on May 24, 2023

On April 10, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for fiscal year (FY) 2024. Read More

ICYMI: Payroll Based Journal Reminders

​​As providers prepare​ for the May 15 Payroll Based Journal (PBJ) deadline to submit staffing hours for January 1 – March 31, 2023, they should keep the following reminders in mind. Read More

CMS Reverses Position on Employee Retention Tax Credit

Originally, CMS had informally instructed State Medicaid Agencies to offset Employee Retention Tax Credit (ERC) against cost. This position would have resulted in reductions in Medicaid rates. Several states already had begun issuing Medicaid rate letters. This guidance was completely different from CMS’ PPP and PRF guidance – those funds were to be disregarded for Medicaid rate setting. Read More