Change has been the underlying theme for the last three years. Sometimes change is for the better, and sometimes, not. For those working in the long-term care sector, it has felt relentless. Facilities had to adapt to ever-changing guidance in the face of COVID-19 and now face new guideline changes with the public health emergency ending on May 11. In addition, the Minimum Data Set will have updates to its item sets that will affect changes in other areas.

COVID-19 PHE Ending

On May 11, 2023, the public health emergency for COVID-19 will end. Facilities will eventually see changes in reporting requirements and the end of the waivers that were in effect during the pandemic.

While COVID-19 will not disappear, infection control and prevention will still be necessary as testing and other COVID-19 prevention strategies will now be expected to become a part of the general infection control and prevention plan. Facilities should anticipate the guideline changes and adapt their practices and policies concerning this.

Minimum Data Set

The Minimum Data Set (MDS) is a core set of screening, clinical, and functional status elements which form the foundation of a comprehensive assessment for all residents of nursing homes certified to participate in Medicare or Medicaid. Over the years, the MDS has adapted and changed to try and not only capture resident care problems to be addressed in individualized care plans but to guide reimbursement and monitor the quality of care provided to nursing home residents.

Changes to the MDS item sets were initially to occur in October 2020, but COVID-19 came along, and those changes were postponed. The Centers for Medicare and Medicaid Services (CMS) will conduct those changes effective October 1, 2023. CMS will be providing virtual training for the item sets starting in May. Changes in MDS item sets will affect other elements of data monitoring, such as quality measures and Five Star reporting, especially with the elimination of Section G. Still, information about how these will be affected is limited at this time.

In addition, MDS assessments that are currently submitted through the Quality Improvement and Evaluation System (QIES) will transition to the Internet Quality Improvement and Evaluation System (iQIES), which will occur on April 17, 2023. Facilities should already be prepared for the transition and have access to submit MDS records. Payroll-Based Journal (PBJ) submissions will continue to be forwarded to QIES now.

FY2024 SNF Prospective Payment System Proposed Rule

The FY2024 Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule is scheduled for publication on April 10, 2023. This document proposes a 3.7% increase, or approximately $1.2 billion, in Medicare Part A payments to SNFs in FY2024 and changes to numerous quality measures that will affect both the Skilled Nursing Facility Quality Reporting Program (SNF QRP) and the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP).

Stay Ahead of Guideline Changes with The Compliance Store

The focus of The Compliance Store is to be your resource for compliance with guidelines and regulations that affect your operations and resident care. We provide numerous tools and policies to assist with your compliance efforts and keep you updated on the latest information, manuals, and other resources to ensure that you have what you need to succeed. For more information on how we can help you, contact us online or at 877-582-7347.