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Mystery Solved: There Is No Secret Ingredient

The Centers for Medicare and Medicaid Services (CMS) recently released the Minimum Data Set (MDS) data elements used for the FY 2021 Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Annual Payment Update (APU) determination. An analysis of the data elements compared to current submission edits was revealing. The good news is that there are submission edits that provide an error message when using a dash for all MDS items used to calculate the QRP measures along with a few covariate items. The error codes are 3891, 3897, and 3908 and provide this warning:

Payment Reduction Warning: A dash (-) submitted in this quality measure item may result in a payment reduction for your facility of two percentage points for the affected payment determination.

Avoid using dashes on assessments by ensuring that all information needed to complete the MDS is obtained on admission. Remember to review all Final Validation Reports for the above warning codes. Another useful report is the SNF Provider Threshold Report in the Certification and Survey Provider Enhanced Reporting (CASPER) application. Providers can also sign up with CORMAC to receive notification of their threshold status.

Contact: Susan Chenail, schenail@leadingageny.org, 518-867-8383 ext. 116