Skilled Nursing Facilities (SNFs) can potentially avoid a 2% reduction on their Medicare Fee For Service (FFS) rates by ensuring they have submitted all necessary MDS data for admissions and discharges between October 1 – December 31 (Q4) of calendar year (CY) 2018 as part of the required reporting for the SNF Quality Reporting Program (QRP). Four new measures pose the greatest threat to SNFs not meeting the reporting requirements for CY2018
This year, SNFs can access a new SNF QRP Provider Threshold Report in the CASPER system that shows, by measure, whether the SNF is sufficiently reporting data. Just because an MDS has been submitted for an admission or discharge does not mean the appropriate fields are completed to satisfy the reporting requirements. Last year, some SNFs were cut 2% because submitted MDS data contained dashes in key Section GG fields and as such were deemed non-reporting.
As part of the SNF QRP, SNFs must report 100% of the required MDS items at least 80% of the time. Where a SNF falls below that 80% requirement for CY2018 MDS data, it is in jeopardy of having its FY2020 (begins October 1, 2019) Medicare FFS rates reduced by 2%, even in cases where a SNF only misses the reporting threshold on 1 of the 8 MDS-based measures.
LeadingAge believes SNFs are in the most jeopardy of insufficient reporting on the four new measures that CMS began tracking on October 1, 2018 (during the Q4 reporting period):
- Change in Self-Care Score (NQF#2633)*
- Change in Mobility Score (NQF#2634)*
- Discharge Self-Care Score (NQF#2635)*
- Discharge Mobility Score (NQF#2636)*
While SNFs cannot correct MDS submissions for the first three quarters of CY2018, they still have the opportunity to ensure accurate and complete reporting for the new measures as long as the Q4 MDS data is completed and submitted no later than 11:59 p.m. Pacific Standard Time on May 15, 2019 deadline.