Interpretive Guidance:

CMS confirmed that they are still on track to release Phase 3 Interpretive Guidance in Q2 2020. They were unable to narrow it down any further. They were also unable to give a time frame for the release of guidance related to facility-reported incidents (as alluded to in the FY 2020 Mission & Priorities Document) other than to say we won’t see it in Q1 2020.

Focused surveys:

Schizophrenia surveys will be the priority for 2020, though providers may also see dementia-focused surveys. Both come out of the National Partnership to Improve Dementia Care in Nursing Homes initiative and examine antipsychotic usage, appropriateness of schizophrenia diagnoses, and care and services for residents diagnosed with dementia. 

Late Adopters: 
CMS has not yet finalized goals for 2020 for this program. The 2019 goal was a 15% reduction in anti-psychotic usage among late adopters.

Removal of Section G from MDS (to be implemented October 2020):
Section G is out, Section GG is in for all residents, regardless of payer source or length of stay. CMS has not yet announced a plan for how case-mix adjustments for staffing and quality measures that presently incorporate data from Section G will be updated with the removal of Section G.

Falls:
CMS and Congress have been keeping an eye on falls and falls reporting. Providers need to ensure accurate reporting on the MDS of falls and injuries related to falls that occur both in the nursing home and prior to nursing home admission. This includes correcting discharge assessments to accurately reflect diagnoses for residents who are transferred to the ER after a fall.

Standing Topics:
CMS reiterated previous messages on our standing topics. Infection control: hand hygiene is still the biggest issue. CMS noted the continued underuse of alcohol-based hand rubs. Abuse: this will continue to be a hot topic. Watch for “red flags” like a history of behaviors and take appropriate steps to protect other residents from those behaviors.

Questions? 

Laura Hofmann, MSN, RN, Director of Clinical and Nursing Facility Regulatory Services, LeadingAge Washington 
p: 253-964-8870 | c: 360.691-9281