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CMS Reviews SNF PPS Rule Highlights, Prompts Providers to Use PBJ Reports

The Skilled Nursing Facility (SNF) Open Door Forum held on Aug. 4th featured a walk-through of the highlights of the recently adopted SNF Prospective Payment System (PPS) Final Rule, updates on Payroll-Based Journal (PBJ), and technology transition issues. The SNF PPS Rule governs Medicare Part A payments and nursing home value-based purchasing and quality reporting initiatives. Our highlights for members are available here, with a more comprehensive analysis and data tool forthcoming.

The new information shared by the Centers for Medicare and Medicaid Services (CMS) on the call revolved around technological changes that the Agency is implementing. CMS is working to transition all state agencies and CMS locations to a new, internet-based system that will consolidate and replace the Quality Improvement and Evaluation System (QIES), Certification and Survey Provider Enhanced Reports (CASPER), and Automated Survey Process Environment (ASPEN) legacy systems. The Agency will begin transitioning nursing home activities, including the Minimum Data Set (MDS), to the Internet Quality Improvement and Evaluation System (iQIES) this month and expects to have it in operation early next year.

Although no information is yet posted on the CMS QIES Technical Support Office (QTSO) webpage, staff indicated that there would be significant outreach, education, and support for providers during the transition. The first step will entail CMS reaching out to providers, by region, to request that each one select an individual to act as the Security Official for the new system. The Security Official, who will be approved by CMS, will have the responsibility of approving all iQIES users for the organization, including any vendors that may be accessing iQIES on behalf of the provider. CMS will be reaching out to providers in Regions 1 and 2 (which includes New York State) beginning Aug. 15th. Hopefully, more information will be made available shortly, but nursing home members may want to consider who they would select as potential security officers. Notably, some other provider types, including home care, have made this transition previously, so the system has been in use.

On the PBJ front, CMS staff reminded participants of the benefit and importance of submitting data early enough prior to the Aug. 14th due date to ensure sufficient time to run and review validation reports and to make any necessary corrections. Staff especially recommended that providers run reports 1702D (Individual Daily Staffing), 1702S (Staffing Summary Report), as well as the detailed or summary census report(s). More information about validation reports is available here.

The transcript and recording of the call will be available on the CMS website here later this month.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841