The MDS 3.0 RAI Manual Version 1.14 and related item sets go into effect 10/1/16 and can be found at:
www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html.

• This version of the MDS 3.0 RAI Manual incorporates the new Section GG: Functional Abilities and Goals, the new Part A PPS Discharge assessment, and clarifications to existing coding and transmission policy; it also addresses clarifications and scenarios concerning complex areas.
  

  CMS Provider Training Regarding the new Section GG can be found on You Tube:

• Section GG Part 1: www.youtube.com/watch?v=pNgQ3OSaxYg
• Section GG Part 2: www.youtube.com/watch?v=M1JdQxjNOqE
• Section GG Part 3: www.youtube.com/watch?v=ok3U2-mQymk
• Section GG Part 4: www.youtube.com/watch?v=oRmMT_uYS8Y
• Section GG clarification from CMS can be found at:
  www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/SNF-QRP-Questions-from-Training-August-2016.pdf.

• MDS Provider Users Guide and CASPER Reporting User’s Guide updated in September 2016 can be found at:
  www.qtso.com/mdstrain.html.

• Updated HCPCS Codes for the billers can be found at:
  www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3603CP.pdf.

www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9735.pdf.

• Internet Only Manual Medicare 100-01, 02, and 04 can be found at:
  www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R101GI.pdf.

• Internet Only Manual Medicare Policy Manual can be found at:
  www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R3612CP.pdf.

If you have any questions, please feel free to contact Stacey Bryan at (573)751-6308 or Stacey.Bryan@health.mo.gov.

CMS S&C Memo 16-40-NH/HHA/CLIA:  Notice of Interim Final Rule (IFR) Agjusting Civil Monetary Penalties (CMPs)

• The Department of Health and Human Services (HHS) has published in the Federal Register on September 6, 2016 an IFR which adjusts for inflation CMP amounts authorized under the Social Security Act.  (See Adjustment of Civil Monetary Penalties for Inflation)
• The IFR establishes new section 45 CFR Part 102, which lists the new CMP amounts and ranges as adjusted by the IFR for affected regulations.  The changes made by the IFR are effective on September 6, 2016.
• The IFR addresses all applicable CMPs under the authority of HHS but we are highlighting only on those CMPs assessed for Skilled Nursing facilities (SNFs), Nursing Facilities (NFs), SNFs/NFs, Home Health Agencies (HHAs), and Clinical laboratories.
• Please see Attachment A for this S&C attached.
• For more information about this memo you may visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-40.html?DLPage=1&DLEntries=10&DLFilter=nh&DLSort=2&DLSortDir=descending.

CMS S&C Memo 16-38-ALL:  Notification of Final Rule Published-Emergency Preparedness

• Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers:  On September 8, 2016 the Federal Register posted the final rule Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers.  The regulation goes into effect on November 16, 2016.
• Health care providers and suppliers affected by this rule must comply and implement all regulations one year after the effective date, on November 16, 2017.
• For more information about this memo you may visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-38.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending.

CMS S&C Memo 16-37-ALL:  Office of Civil Rights (OCR) Clearance

• The Centers for Medicare & Medicaid Services (CMS) worked collaboratively with the OCR to revise the OCR clearance process for new providers and Changes of Ownership (CHOW).
• The new process requires that providers successfully submit electronically an attestation of compliance with the civil rights requirements to the OCR before the State Survey Agencies (SA) and Regional Offices (RO) may process requests for initial surveys or CHOWs.
• Confirmation from OCR of successful submission of the attestation will meet the requirements for OCR clearance and eliminates the need for CMS ROs to issue provisional provider agreements.
• OCR will begin receiving electronic attestations on September 1, 2016.
• Please see the attached Medicare Application Instructions.
• For more information about this memo you may visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-37.html?DLPage=1&DLEntries=10&DLSort=2&DLSortDir=descending.

• Each resident has the right to be free from all types of abuse, including mental abuse. Mental abuse includes, but is not limited to, abuse that is facilitated or caused by nursing home staff taking or using photographs or recordings in any manner that would demean or humiliate a resident(s).
• This CMS memo discusses the facility and State responsibilities related to the protection of residents

The CMS memo is available at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-16-33.pdf.

• CMS is implementing a national policy that requires the use of federal enforcement remedies when one or more residents suffer significant harm.
• This new policy is effective for all surveys completed on or after September 1, 2016.

For more information you may visit https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-31.html?DLPage=1&DLEntries=10&DLFilter=nh&DLSort=2&DLSortDir=descending.

For the past 10 years, the Centers for Medicare & Medicaid Services (CMS) and the States have used two standard survey processes that assess the quality of care and quality of life for nursing home residents.  The memo has a review of both the traditional survey and QIS processes.  CMS is continuing to make improvements to QIS to address the challenges, concerns and feedback we have received to optimize the effectiveness and efficiency of survey process.

The memo and attachment are both attached or you may visit www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-15-40.html?DLPage=4&DLEntries=10&DLSort=3&DLSortDir=descending.

15-31:  Focused Dementia Care Survey Pilot (NH – 3/27/15)

Attached to this memo is a final report that outlines the basis for the Focused Dementia Care Survey Pilot, the process utilized, conclusions gathered based upon post-pilot data analysis, as well as next steps for the future.  The CMS plans to expand upon the work of the focused survey pilot and has invited States to conduct such surveys in FY2015 on a voluntary basis.  The expansion project will involve a more intensive, targeted effort to improve surveyor effectiveness in citing poor dementia care and the overutilization of antipsychotic medications, and broaden the opportunities for quality improvement among providers.  Deficient practices noted during the surveys will result in relevant citations.  In the event that additional care concerns are identified during on-site reviews, those concerns will be investigated during the survey or will be referred to the SA as a complaint for further review.  The memo is attached here and one attachment is attached here.

15-34:  Grant Award: Reinvestment of Federal Civil Money Penalty (CMP) Funds to Benefit Nursing Home Residents (NH – 4/3/15)

The Centers for Medicare & Medicaid Services (CMS) invited proposals for a grant opportunity to utilize Federal CMP Funds for the support and further expansion of the National Partnership to Improve Dementia Care in Nursing Homes.  The Eden Alternative, Inc. was deemed to be the most eligible applicant and has been awarded a grant, in the amount of $293,129.00, for their project entitled, “Creating a Culture of Person-Directed Dementia Care.”  The memo is attached here.

15-35:  Implementation of Section 6106 of the Affordable Care Act – Collection of Staffing Data for Long Term Care Facilities (NH – 4/10/15)

In this memorandum, CMS notified States of the posting of technical specifications and related information for the electronic submission of staffing information based on payroll data.  This information is posted at: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html.  The memo is here.