A revision to the PDPM DLL Package (V1.0003 FINAL) was posted, and the previous version (V1.0002 FINAL) was removed. This version corrects four bugs that were identified after the V1.0002 release. The package contains updated test files and documentation.

QTSO Memo #2019-065 (dated October 4, 2019) contained information related to issues with version 1.0002 (FINAL) of the PDPM DLL Package, and noted that an updated version would be released today (Monday, October 7, 2019).

Version 1.0003 of the PDPM DLL package is now available on the CMS MDS Webpage at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation.html.

If you have any questions concerning this information, please do not contact the QTSO Help Desk:

• For questions regarding PDPM, send inquiries to pdpm@cms.hhs.gov.
• For information technology questions, send emails to MDSTechIssues@cms.hhs.gov.

CMS is aware of issues with the latest PDPM DLL Package (V1.0002 FINAL). We are targeting to release an updated version on Monday, October 7, 2019, which corrects the identified grouper discrepancies.  SNF providers should continue to follow the Resident Assessment Instrument (RAI) requirements which include, but are not limited to, establishing assessment reference dates for OBRA or PPS assessments that are required/scheduled, including the PDPM Transitional Interim Payment Assessments, assessing residents, and coding the applicable MDS assessments.  As per the RAI requirements, assessments should be completed within 14 days and recorded in Z0500. Late submission payment penalties do not apply under the SNF PPS.  We will work with providers to ensure that timely payments are made. We will continue to share updates as they become available. In the meantime, providers should not hesitate to contact us.  For questions regarding PDPM please send inquiries to pdpm@cms.hhs.gov  for information technology questions please send emails to MDSTechIssues@cms.hhs.gov.  Please contact your state Medicaid agency for questions related to the Other State Assessment (OSA) and Medicaid payment.

CMS posted the following information to their MDS 3.0 Technical Information webpage on 10/2/19:

• A new version of RUG-IV has been applied to the MDS ASAP system. Effective Sunday, September 29, 2019, the ASAP will evaluate all RUG-IV HIPPS codes using version 1.04. This version is backward compatible and will evaluate assessments with all target dates before or after October 1, 2019. To avoid receiving the ASAP system warning message -3616b, please update the RUG-IV version number to “1.04” to submit your HIPPS code.

CMS is providing notifications to facilities that were determined to be out of compliance with the quality reporting requirements for the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP), which will affect their FY 2020 Annual Payment Update (APU).

Non-compliance notifications were sent to the Medicare Administrative Contractors (MACs) and placed into facilities’ CASPER folders in QIES on July 16, 2019. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm PST, August 15, 2019.

Instructions for the reconsideration process are in the non-compliance letter and available on the SNF Quality Reporting Reconsideration and Exception & Extension webpage.

The submission deadline for the SNF Quality Reporting Programs (QRP) is approaching. MDS data for January 1 – March 31 (Q1) of calendar year (CY) 2019 must be submitted no later than 11:59 p.m. Pacific Standard Time on August 15, 2019.

As a reminder, it is recommended that providers run applicable validation/analysis reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

CORMAC sends informational messages to IRFs, LTCHs, and SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@cormac-corp.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

August 13-14, 2019: SNF QRP Provider In-Person Training
Location: Four Seasons Hotel, Baltimore, MD

The Centers for Medicare & Medicaid Services (CMS) will be hosting a 2-day Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) in-person ‘Train the Trainer’ event for providers on August 13 and 14, 2019 at the Four Seasons Hotel, 200 International Drive, Baltimore, MD 21202. This event will be open to all SNF providers, associations, and organizations.

Like the May 2019 SNF QRP Provider Training, the primary focus of this ‘Train-the-Trainer’ event will be to provide those responsible for training staff at SNFs with information about:

• The transition to the Patient Driven Payment Model (PDPM), which becomes effective on October 1, 2019.
• A review of SNF QRP changes and updates to the Minimum Data Set (MDS) 3.0 Version 1.16.0, which became effective October 1, 2018.
• An overview of the eleven SNF QRP Quality Measures.
• An interactive session on the use of reports to identify opportunities for process improvement and utilize information contained in reports available via the Certification And Survey Provider Enhanced Reports (CASPER) system to develop quality improvement plans.

During this event, presenters will incorporate additional information into their presentations based on questions received from participants during the May training.

More information including the agenda and registration can be found at the link above.

On 5-20-19, CMS posted the MDS 3.0 RAI Manual v1.17, which will be implemented on 10-1-19. The MDS 3.0 RAI Manual v1.17 contains many updates including information related to the Patient Driven Payment Model (PDPM). You can find the new manual at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html. It is  at the bottom of the page in the Related Links section. Please check back prior to October 1, 2019 for a final posting which may contain additional updates.

The submission deadline for PBJ is approaching. PBJ data for 1/1/19 through 3/31/19 is due on May 15, 2019. CMS uses PBJ data to determine each facility’s staffing measure on the Nursing Home Compare tool on Medicare.gov website, and calculate the staffing rating used in the Nursing Home Five Star Quality Rating System.

More information about PBJ can be found on the CMS webpage www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html.

The submission deadline for the SNF Quality Reporting Programs (QRP) is approaching. MDS data for October 1 – December 31 (Q4) of calendar year (CY) 2018 are due with this submission deadline. All data must be submitted no later than 11:59 p.m. Pacific Standard Time on May 15, 2019.

As a reminder, it is recommended that providers run applicable validation/analysis reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

CORMAC sends informational messages to IRFs, LTCHs, and SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@cormac-corp.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

The submission deadline for the SNF Quality Reporting Programs (QRP) is approaching. MDS data for July 1 – September 30 (Q3) of calendar year (CY) 2018 are due with this submission deadline. All data must be submitted no later than 11:59 p.m. Pacific Standard Time on February 15, 2019.

As a reminder, it is recommended that providers run applicable validation/analysis reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

CORMAC sends informational messages to IRFs, LTCHs, and SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@cormac-corp.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.