The federal government waived several reporting requirements for nursing homes during the COVID-19 pandemic, and while they have since been reinstated, the temporary pause will continue to have ripple effects on public data over the coming years.
The Centers for Medicare & Medicaid Services (CMS) this week released an updated tip sheet explaining the agency’s strategy for resuming the inclusion of quality data on the consumer-facing Nursing Home Compare website.
CMS in March announced that reporting fourth-quarter 2019 data for the Skilled Nursing Facility Quality Reporting Program (QRP) and the Value-Based Purchasing Program (SNF VBP) would be optional, with no submissions required for the first and second quarters of 2020.
At the time, the agency positioned the move as an emergency measure to allow health care providers to focus solely on care during the early days of the COVID-19 pandemic.
“In granting these exceptions and extensions, CMS is supporting clinicians fighting coronavirus on the front lines,” CMS administrator Seema Verma said in a statement at the time. “The Trump administration is cutting bureaucratic red tape so the health care delivery system can direct its time and resources toward caring for patients.”
That waiver expired on July 1, with quality and Minimum Data Set (MDS) reporting resuming as usual. But because so much of CMS’s public data lags behind the present by several quarters, the pause will have a long-lasting impact on Nursing Home Compare.
“The missing data for Q1 2020 and Q2 2020 will impact what is displayed on Nursing Home Compare; therefore, CMS developed a strategy to accommodate these excepted quarters of data,” CMS observed in the tip sheet.
Enough providers voluntarily reported Q4 2019 data to include that information in the October refresh, which will also see the public unveiling of six new quality measures:
- Changes in Skin Integrity Post-Acute Care: Pressure Ulcer/Injury
- Drug Regimen Review Conducted with Follow-Up for Identified Issues – PAC SNF QRP
- Application of IRF Functional Outcome Measure: Change in Self-Care (NQF #2633)
- Application of IRF Functional Outcome Measure: Change in Mobility (NQF #2634)
- Application of IRF Functional Outcome Measure: Discharge Self-Care Score (NQF #2635)
- Application of IRF Functional Outcome Measure: Discharge Mobility Score (NQF #2636)
The October 2020 data will then remain constant until public reporting resumes in January 2022, with the next normal Nursing Home Compare refresh scheduled for April 2022.
Should CMS change its methodology for calculating measures before January 2022, the agency will follow normal rulemaking procedures with notice and comment periods.
The agency also acknowledged that the resumption of data reporting requirements on July 1 may have created data mismatches — for example, a resident who does not have an admission record in the MDS because it occurred during the pause.
“CMS will make adjustments on its end to accommodate any records with missing admissions,” the agency noted. “These mismatched sets of records will not be counted or included in your SNF data calculations for Nursing Home Compare.”