June Updates from CMS

Read about recent updates from CMS related to the following topics: PBJ Data Collection; SNF Benefit Period; Advanced Beneficiary Notice new form; and MDS edit calculations.
July 9, 2020
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Updates from CMS



In response to the President’s declaration of a National Emergency, theDepartment of Health and Human Services triggered numerous waivers and liftedregulatory requirements impacting multiple aspects of long-term care.  One such waiver relieved providers of therequirement to report Payroll Based Journal information.  

CMS issued a memorandum on June 25th, 2020 indicating thewaiver related to PBJ will be ending. Providers are expected to submit staffing data for the 2ndCalendar Quarter (April - June) by August 14th. 2020.  Providers are also being encouraged to submitstaffing data from the 1st Quarter (January – March).  This information will be posted on the publicuse file; it will not impact quality measures.

In the interim, quality measures based on data collection from December31, 2019 will remain constant.  The nextupdate will occur in October 2020.



Benefit Period Waiver

On June 26th, CMS revised an MLN Matters Article regardingthe SNF Benefit Period Waiver.  TheBenefit Period Waiver for SNF refers to the renewal of SNF coverage, forbeneficiaries who exhausted their SNF benefits, without having to start a newbenefit period.  Historically, once abeneficiary exhausted their 100-day SNF benefit, they had to have 60 dayswithout receiving skilled care to renew their benefits.  The waiver removed this requirement.

The revised MLN Matters Article stresses the documentation mustdemonstrate the need to continue SNF benefits is directly related to thePublic Health Emergency.  CMS indicatesproviders should consider if a resident’s ongoing skilled care is emergencyrelated.  Compare the course of treatmentthe resident received or is receiving to what the resident would have receivedabsent the emergency.  If they are thesame, the waiver does not apply.  If itis different, then treatment was affected by the emergency.


The Department of Health and Human Services(HHS) has indicated the Public Health Emergency will be extended another 90days from July 24th.



CMS has updated the Advanced Beneficiary Notice (ABN).  There are no significant changes to the contentof the form; however, the expiration date has been updated to June 30th,2023.  CMS has indicated providers mustconvert to utilizing the new ABN forms by August, 2020.  A link to the new forms is provided below.




CMS posted an update to the MDS 3.0 Data specifications on June 18th,2020.  The updated errata identifies thecorrection of two issues.  The editsallow the calculation of a PDPM HIPPS code on OBRA assessments for statesutilizing this calculation.