CMS Updates

Last week, the Centers for Medicare and Medicaid Services (CMS) provided the American Health Care Association (AHCA) with a series of updates on the following topics important to SNFs and NFs.

  1. Abt Associates is working with CMS on further development of QAPI (Quality Assurance Performance Improvement).  Several Technical Expert Panels will be making recommendations about how plans of correction can be aligned with a QAPI approach, how to help surveyors and others reconcile the tension between the overall survey/regulatory process (including regulations and guidance) and QAPI, and how to involve patients and families with QAPI.  AHCA will provide updates as they become available.
  2. CMS continues to analyze information obtained since implementation of the CMP (Civil Monetary Penalties) Analytic Tool in April 2013.   They report a slight uptick in per-day versus per - instance CMPs, and a slight uptick in the total number of CMPs imposed.  CMS believes the tool needs additional work related to how facility culpability is factored into the amount of a CMP that is imposed and  how to refine the tool to create more consistency related to the start date of a CMP (primarily in cases of past noncompliance).
  3. In March 2012 CMS requested AHCA to provide comments on a draft S&C Memo intended to “clarify issues related to the Federal requirements for abuse, neglect, mistreatment and misappropriation of resident property for nursing homes.”   Because of serious concerns with elements of the draft and following discussion with members, AHCA submitted extensive comments to CMS.  AHCA is hopeful that their comments will result in an S&C Memo that is more reasonable than the initial draft. The S&C memo has now been cleared by the CMS and is expected to be issued soon.
  4. CMS continues to work on implementing Federal electronic plans of correction.  The initial phase-in is occurring in several states and regional offices.  
  5. CMS is developing an S&C Memo that will provide additional guidance related to “egg safety” in nursing centers.  The issue date of this Memo is uncertain.