Regulations for nursing home ethics programs and QAPI still in the works, administrators say

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National Quality Forum supports quality measures in bill to standardize post-acute assessments
National Quality Forum supports quality measures in bill to standardize post-acute assessments

The Centers for Medicare & Medicaid Services is still working on the regulations for ethics and compliance programs that nursing homes were supposed to have implemented this month, CMS administrators admitted in an Open Door Forum call Thursday.

“Facilities should feel free to set up the program,” said Diane Corning*, health insurance specialist, CMS Office of Clinical Standards and Quality. However, details on how surveyors will evaluate these programs are still being worked out. While it is CMS's “intention to get those out,” the agency will not issue instructions until the regulations have been promulgated, Corning said.

The official Quality Assessment and Performance Improvement (QAPI) regulations are also still in process, said Debra Lyons, RN, CMS project officer. She said providers should refer to the following website for updates: www.reginfo.gov/public/do/eAgendaMain.

The final version of the QAPI At-A-Glance document will be released “imminently,” Lyons said. The final release will be accompanied by PDF versions of the four accompanying tools. After the final version is released, providers can request these documents in Microsoft Word format by emailing Nhqapi (at) cms.hhs.gov.

CMS currently has no directions to give facilities related to Medicare billing for maintenance therapy, following the settlement in Jimmo v. Sebelius, said officials on the call.

In a separate call, CMS announced that seniors have saved $6 billion in out-of-pocket costs thanks to the Affordable Care Act policies to close the so-called prescription drug “donut hole.” The Acting Principal Deputy Administrator and Director, Center for Medicare, Jonathan Blum said lower costs have led to better medication compliance, saving the Medicare program money and reducing hospital costs.

“SNFs' use of the Medicare program is linked to hospital stays,” Blum said, noting a positive impact for long-term care. He said CMS will continue to monitor the “growing research” in this area.

*The article originally stated this information was provided by Jeanette Kranacs, director of the Division of Institutional Post-Acute Care. The speaker was Diane Corning, as the updated version reflects.

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