Changes to the Special Focus Facility Program
QIPP Overview
CMS Guidance for Medical Reviews after the Public Health Emergency is Over
Connecticut women convicted for creating false vaccine records
QIPP Overview
CMS Guidance for Medical Reviews after the Public Health Emergency is Over
Connecticut women convicted for creating false vaccine records
CMS has made an important policy change that will affect nursing facilities. Currently, there is an informal dispute resolution process both at the state and federal level for citations issued by the Center for Medicare & Medicaid Services (CMS), including those involving civil money penalties. These processes are referred to as IDR and IIDR. CMS has decided to publish when such citations are under informal dispute on the “Nursing Home Care Compare” and “Quality Certification and Oversight Reports” websites. This means that the public will now have notice when a nursing facility disagrees with a citation whereas this was not the case before. Moreover, CMS has decided not to include the disputed citations in the facility’s five-star rating until after the dispute is resolved.
CMS also noted an absence of comprehensive psychiatric evaluations and behavior documentation resulting in erroneous schizophrenia coding and will begin auditing facilities for compliance. Inaccuracies identified through audit will result in a star rating downgrade as detailed below:
CMS also noted an absence of comprehensive psychiatric evaluations and behavior documentation resulting in erroneous schizophrenia coding and will begin auditing facilities for compliance. Inaccuracies identified through audit will result in a star rating downgrade as detailed below:
- The Overall QM and long stay QM ratings will be downgraded to one star for six months (this drops the facility’s overall star rating by one star).
- The short stay QM rating will be suppressed for six months.
- The long stay antipsychotic QM will be suppressed for 12 months.
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