The Academy of Senior Health Sciences, Inc. (formerly The Ohio Academy of Nursing Homes, Inc.) seeks to provide public education and awareness initiatives to the long-term care community in Ohio. Our membership represents a true cross-section of the skilled nursing facility profession, from small sole proprietorships to larger Ohio-based multi-facility companies, as well as those businesses that service our industry. Through our public education and awareness efforts, the Academy brings the collective influences of the members together into a single voice on vital issues affecting our profession.
Founded in 1966, the Academy then identified one of its core purposes as "To foster a spirit of goodwill among those persons engaged in the nursing home industry, to promote ethical practices in their relationships with each other, their employees, and the general public to the end that all interests may be served fairly..." Though the organization has undergone several transformations over the years, most notably in 2011, its dedication and commitment to Ohio's most frail and elderly remains the same.
| The Academy Weekly Headlines from 2 Weeks Ago|
ODM provides more guidance on CMI freeze
The Ohio Debarment of Medicaid provided more information regarding the decision for SNF providers to choose to freeze their CMI score at the March 2023 level or continue using the RUGs system and corresponding Optional State Assessment.
Providers are also reminded that the September 1 guidance regarding billing is correct: "If a new or existing resident groups into the PDPM PA1 or PA2 group, then the flat rate must be billed for the time that MDS is current, whether or not the facility case mix is frozen. If a new or existing resident groups into a higher acuity category while the facility case mix score is frozen, the rate will be the frozen rate. The freeze relates to the facility case mix score, not the case mix score of the individual residents."
- CHOPs and CMI choice: The entering provider has to keep the exiting provider’s choice, since statute mandates decisions are made by October 1. 2023.
- PDPM or OSA for PA1/2: During this biennium, those providers who have opted to continue with RUGS will use the RUGs information to determine PA1-2s. They will not be required to use both PDPM and RUGs criteria to identify the PA1-2s. Those providers who opt to freeze their case mix must rely on PDPM results to identify PA1-2s.
- Exception reviews and "frozen" providers: Providers who have frozen their case mix as of March 2023 will not be subject to Exception Reviews during this biennium.
CMS issues memo on QMs during MDS change
During the last national stakeholder call, CMS noted that the removal of Section G on the MDS would impact four quality measures (QMs) and the adjusted staffing measure. CMS has issued a QSO Memo that addresses that issue. (QSO-23-21-NH).
For the staffing measure, beginning in April 2024, CMS will freeze (i.e., hold constant) the staffing measures for three months while we make this transition. In July 2024, CMS will post nursing home staffing measures based on the new PDPM methodology. To minimize the potential disruption associated with the implementation of the new case-mix adjustment methodology, CMS will revise the staffing rating thresholds to maintain the same overall distribution of points for affected staffing measures.
For the QMs (Percentage of Residents Who Made Improvements in Function (short stay); Percent of Residents Whose Need for Help with Activities of Daily Living Has Increased (long-stay); Percent of Residents Whose Ability to Move Independently Worsened (long stay); Percent of High-Risk Residents with Pressure Ulcers (long stay)), starting in April 2024, CMS will freeze (hold constant) these four measures on Nursing Home Care Compare. In October 2024, CMS will replace the short-stay functionality QM with the new cross-setting functionality QM, which is used in the SNF Quality Reporting Program (QRP). The remaining three measures will continue to be frozen until January 2025 while the data for the equivalent measures are collected.
Please see the memo for more information.
CMS created cue cards for interview sections
The Centers for Medicare & Medicaid Services (CMS) is offering cue cards to assist providers in conducting the Brief Interview for Mental Status (BIMS) in writing, the Resident Mood Interview (PHQ-2 to 9), the Pain Assessment Interview, and the Interview for Daily and Activity Preferences, as referenced in the MDS 3.0 RAI v1.18.11 coding guidance. This resource is intended to be utilized as a supplemental communication tool that provides a visual reference for residents. More detailed instructions regarding the use of cue cards and the administration of the BIMS in writing can be found in the MDS 3.0 RAI v1.18.11 Manual. The cue cards can be viewed or printed and are available in the Downloads section of the SNF QRP Training page. If you have questions about accessing the resources or feedback regarding the trainings, please email the PAC Training Mailbox. Content-related questions should be submitted to the SNF QRP Help Desk.
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