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CMS | Long-Term Care Hospital (LTCH) Quality Reporting (QRP)

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Long-Term Care Hospital (LTCH) Quality Reporting (QRP)


What is the Long-Term Care Hospital (LTCH) Quality Reporting Program (QRP)?

The purpose of this page is to provide users with important announcements and updates regarding the LTCH QRP. This page is updated periodically whenever an important update needs to be communicated to LTCH providers regarding the LTCH QRP. Please refer to this page when seeking information on upcoming trainings, approaching data submission deadlines, updates to training materials or measures, reminders, and other useful communications.

The LTCH QRP, mandated by Section 3004(a) of the Patient Protection and Affordable Care Act of 2010, creates LTCH quality reporting requirements. Every year, by October 1, we publish the quality measures LTCHs must report. Section 3004(a) of the Affordable Care Act (ACA) amends section 1886(m)(5) of the Social Security Act(SSA) to direct the Secretary to establish quality reporting requirements for long-term care hospitals (LTCHs).

The Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act), LTCHs also requires LTCHs to submit standardized patient assessment data with regard to quality measures, resource use, and other measures. It further specifies that the data [elements] “… be standardized and interoperable so as to allow for the exchange of such data among such post-acute care providers and other providers and the use by such providers of such data that has been so exchanged, including by using common standards and definitions in order to provide access to longitudinal information for such providers to facilitate coordinated care and improved Medicare beneficiary outcomes …”.

Learn more about Affordable Care Act (ACA) Section 3004 (Quality Reporting for Long-Term Care Hospitals (LTCH), Inpatient Rehabilitation Facilities (IRF), and Hospice Programs). Please note the link below for P.L. Public Law No: 111-148, the Patient Protection and Affordable Care Act (H.R.3590 Health Care Law). https://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf

Learn more about the Improving Medicare Post-acute Care Transformation (IMPACT) Act of 2014 which requires the submission of standardized data by Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Home Health Agencies (HHAs) and Inpatient Rehabilitation Facilities (IRFs). https://www.gpo.gov/fdsys/pkg/PLAW-113publ185/pdf/PLAW-113publ185.pdf

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The Medicare SNF Resident Classification System (RCS-I) By Marc Zimmet

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The Medicare SNF Resident Classification System (RCS-I)
A Rational Discussion on Payment Reform
By Marc Zimmet

Zimmet Healthcare Services

Nearly five months have passed since the Centers for Medicare & Medicaid Services (CMS)
formally announced its intention to fundamentally reform the skilled nursing facility (SNF)
Medicare Part A payment system. The May 4, 2017 Advanced Notice of Proposed Rulemaking (file
code CMS-1686-ANPRM) targets October 1, 2018 as the date providers would transition to the new
Resident Classification System (RCS).

Since then, quite a bit has transpired. Zimmet Healthcare has extensively studied and modeled the
financial and operational impact of RCS on our clients. We have had in-depth discussions with
national & state trade associations and industry thought leaders. We have also closely followed
reaction to the rule, and it seems that every day, more “fake news” (sorry, I couldn’t resist) is
propagated by anxious stakeholders.

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McKnight’s Long Term Care News | RCS-1 says goodbye to rehab? Yes & No

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RCS-1 says goodbye to rehab? Yes & No

McKnight's Logo

The Centers for Medicare & Medicaid Services is proposing to radically change how they pay skilled nursing facilities to care for Medicare patients after hospital stays. Today, under the RUG IV rule and formula, the economic engine of the facility is the rehab department and the fuel for that engine is the volume of minutes of therapy provided by physical, occupational, and speech therapists.

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Florida governor signs law that will change nursing home reimbursement

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Florida nursing homes will be moving to a prospective payment system for reimbursement following Gov. Rick Scott’s (R) signing of legislation Friday.
The Florida Health Care Association had advocated for healthcare bill SB 2514, saying it improves cost-based nursing center reimbursement and puts money into direct care.
“The Prospective Payment System will put the focus on quality care and quality of life for Florida’s nursing center residents, and, for the first time in Florida’s Medicaid history, will link nursing center reimbursement to quality outcomes,” said FHCA Executive Director Emmett Reed in a statement. “On behalf of the thousands of long-term caregivers working in our member centers, we commend Governor Scott for supporting the PPS so they can achieve their goals of providing exceptional care and services to our state’s seniors and people with disabilities.”

see more at http://www.mcknights.com/news/florida-governor-signs-law-that-will-change-nursing-home-reimbursement/article/669981/

“Super SNF” Symphony PAN using RTMS Analytics

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“Being able to track data such as hospitalization rates is becoming table stakes for skilled nursing providers in an increasingly integrated health care marketplace, in which they’re being asked to demonstrate their value to hospitals and other referral partners.

Symphony also is implementing analytics tools such as Real Time Medical Systems, which integrates with and scours the PointClickCare electronic medical record for information in order to flag particular patients for attention.”

Source: http://skillednursingnews.com/2017/06/symphony-shares-secrets-super-snf/


Real Time became a Kairos Health Systems Preferred Provider in December of 2015

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Real Time Medical Systems (RTMS) became a Kairos Health Systems Preferred Provider in December of 2015. Below is a link to their website www.realtimemed.com and how their clinical support tools can support skilled nursing facilities.


PITTSBURGH, Pa., (January 1, 2016) – Real Time Medical Systems RTMS’ main product suite, TranSights™, receives key resident information from any electronic medical record (EMR) and delivers specific clinical and financial insights to skilled nursing decision makers to maximize reimbursements, reduce hospital readmissions, lower the cost of care, and improve regulatory compliance.

TranSights’ clinical decision support tools analyze each resident’s health data, providing clinicians customized clinical alerts and specific intervention recommendations to improve quality outcomes. TranSights also analyzes real-time Activities of Daily Living (ADL) metrics to ensure residents are properly categorized to capture appropriate reimbursement amounts.

RTMS is celebrating the sustained success of their first customer, HCF Management, Inc. After two years of using RTMS’ real-time clinical and financial analytics across 25 skilled nursing facilities, HCF continues to see gains in financial performance and clinical outcomes.

RTMS has more healthcare analytics innovations planned for release in 2016. Current developments include access to hospital re-admission information, along with insights into the 48 episodes included under the Bundled Payments for Care Improvements (BPCI) initiative for higher quality care at a lower cost to Medicare.

To learn more about RTMS, visit realtimemed.com or call (888) 546-9786.  Or feel free to contact them directly at contactus@realtimemed.com or Jennifer Wimer at jwimer@kairoshealthsystems.com


Data Mining Software Strikes Gold

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Data Mining Software Strikes Gold

Mid-Atlantic Health Care creates Gold-winning system – McKnight’s Long Term Care News

Mid-Atlantic founder Scott Rifkin, M.D., said Transight’s ease of use has improved the company’s bottom line.

Quality of Care Flows from the Quality of Data

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Predictive Analytics for Skilled Nursing Facilities

  • Is your facility struggling with a high Return to Hospitalization rate?
  • Is your facility being reimbursed LESS than the rate appropriate for the time and resources it spends with your residents?
  • Would it be valuable to your clinicians and administration to know its Quality Measures instantaneously of the entire facility, and compared to state and national averages?

If your answer is “YES” to any of these questions, allow us to help you.

TranSights is a web-based clinical outcome management tool that works directly with your EMR. It does not require an interface and extracts data from your EMR, not your MDS. This assures real time accuracy!

We then present dashboards to your team on important changes in resident condition, Quality Measures and ADL snapshots in real time for your staff. We deliver these dashboards automatically to your team, and they can access them on any laptop, computer or tablet device!

Our clients are seeing the following results:

·        3% increase in Medicare Reimbursement

·        2 point increase in Medicaid Reimbursement

·        50% reduction in Return to Hospital (RTA)

·        Labor savings in report generation and consolidation

(855) 571-4140


Proposed Changes to Nursing Home Rules: Biggest Changes in 24 Years

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Are you ready to show your data-driven QAPI program?  Let us help you!

Quality Assurance and Performance Improvement (QAPI)

The long-awaited QAPI regulations are spelled out in this proposed rule. Facility staff will be required to present a comprehensive QAPI plan to the state agency surveyors at the first annual recertification survey that occurs after the effective date of this regulation, annually at the recertification survey, and upon request (§483.75). The rules specify that “each LTC facility, including a facility that is part of a multi-unit chain, must develop, implement, and maintain an effective, comprehensive, data-driven QAPI program that focuses on indicators of the outcomes of care and quality of life” (§483.75; all quotations and paraphrases used in this article are from the proposed rule).