Tags Posts tagged with "Quality Reporting Program"

Quality Reporting Program

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Late yesterday, the Centers for Medicare and Medicaid Services (CMS) issued the fiscal year (FY) 2024 inpatient rehabilitation facility prospective payment system (IRF PPS) proposed rule.

The proposed rule includes a 3.7 percent payment increase, compared to the 3.9 percent payment update that CMS finalized for FY 2023. This payment update reflects the effects of the proposed IRF market basket update for FY 2024 of 3.0 percent, which is based on the proposed IRF market basket increase factor (3.2 percent), productivity adjustment (0.2 percent), and outlier payment increase (0.7 percent).
** Please note that these figures are subject to change in the final rule if updated forecasts become available, which typically occurs.

CMS is making a number of changes to the Quality Reporting Program (QRP), including the future addition of a discharge function score measure and patient-level COVID vaccination measure as well as a modification of the current healthcare personnel COVID-19 vaccination measure to reflect the latest vaccination recommendations.

In addition, CMS is proposing to allow hospitals to open a new IRF unit and begin being paid under the IRF PPS at any time during the cost reporting period (rather than the current restrictive enrollment rules). The proposed rule does not address any of the COVID-19 PHE waivers, including the three-hour rule and virtual team conferences, nor does it include any further discussion of the expanded transfer policy (to include certain discharges under the care of home health) that was the subject of a Request for Information (RFI) in last year’s rule.

A more detailed and extensive summary of the proposed rule will be forthcoming.

The proposed rule will be published in the Federal Register for April 7, 2023. Comments on the proposed rule will be considered until 5:00 pm on June 2, 2023. For additional information, CMS also released a fact sheet.

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The Centers for Medicare and Medicaid Services (CMS) has created short videos and developed patient cue cards to assist providers with learning how to code patient assessment instruments for the following Post-Acute Care (PAC) Quality Reporting Programs (QRP):

Help LTCH, IRF, and HH patients select responses by showing them the new cue cards for:

See LTCHIRFHH, and SNF Quality Reporting Program Training for more information.

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It has been reported that the Centers for Medicare and Medicaid Services (CMS) has issued letters of non-compliance to Inpatient Rehabilitation Facilities (IRFs) specific to the IRF quality reporting program (QRP) requirements for the data collection period affecting federal fiscal year (FFY) 2019 reimbursement. IRFs that did not meet the IRF QRP reporting requirements will receive a two percent payment reduction on their IRF prospective payment system (PPS) annual increase factor in FY 2019.

IRFs found to be non-compliant should have received notification from their Medicare Administrative Contractor (MAC) and are also expected to receive a letter in their provider Certification and Survey Provider Enhanced Reporting (CASPER) folder with specific details regarding the missing quality reporting data. Additional information on the data collections requirements and submission timeframes for FY 2019 compliance determination can be found in the CMS Data Collection & Final Submissions table posted on the CMS website, as well as the CMS IRF QRP website.

IRFs that feel they have received a non-compliance notification letter in error may request CMS reconsideration of the decision. Providers have 30 days to file a reconsideration request. Detailed filing instructions can be found on the IRF Quality Reporting Reconsideration and Exception & Extension web page.

The Centers for Medicare and Medicaid Services (CMS) announced they will host an inpatient rehabilitation facility (IRF) quality reporting program (QRP) refresher training webinar. The webinar is scheduled for August 15, 2017 from 2:00 pm to 4:00 pm ET. The primary focus of the webinar is to provide additional training and guidance on correct data collection and submission procedures for the IRF PAI 1.4 and information on preliminary trends from the data analysis of new items that went into effect on October 1, 2016. A demonstration on how to access resources available on the CMS website to assist providers in better understanding the IRF QRP will also be provided. Those interested should register to participate.

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The Centers for Medicare and Medicaid Services (CMS) will be hosting a live webcast for inpatient rehabilitation facilities (IRFs) on Tuesday, May 2, 2017, from 2:00 pm to 3:30 pm. The focus of the webcast will be to provide a better understanding of how Review and Correct Reports fit within the overall Quality Reporting Program (QRP). The webcast will also provide information about re-submitting data to correct errors prior to the quarterly submission deadlines to ensure the accuracy of the data which will be publicly displayed. Registration is required to participate. Those who register will be provided with a URL to access the training immediately upon completing the registration process.The webcast will be recorded and posted to the CMS YouTube site following the event.

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As noted in the Rebaseline Timeline posted in the June 2016 National Healthcare Safety Network (NHSN) Newsletter, the Centers for Disease Control and Prevention (CDC) submitted standardized infection ratios (SIRs) to the Centers for Medicare and Medicaid Services (CMS), using the new 2015 baseline starting with 2016 Quarter 1 data. The inpatient rehabilitation facility (IRF) quality reporting program (QRP) preview reports that CMS provided on September 1, 2016, contained calendar year (CY) 2015 healthcare-associated infection (HAI) SIRs in accordance with the new NHSN baselines, based on nationally collected data from 2015. However, providers were unable to use NHSN to verify the accuracy of the HAI data contained within their preview reports for the Compare sites during the 30-day preview period established for this purpose.

As a result, CMS will begin publically displaying the NHSN data on the Compare sites for IRFs in the next quarterly refresh in spring 2017 instead of in fall 2016. Providers will have the chance to appropriately review their HAI data and inquire about data they believe to be incorrect. IRFs will receive preview reports in December 2016 for the data that will be displayed in spring 2017.

This change will affect the posting of quality performance data on the quality measure: NHSN Catheter-Associated Urinary Tract Infection (CAUTI) Outcome Measure.

When the IRF Compare website is launched in fall 2016, the following quality metrics will be displayed:

IRFs —

  • Percent of residents or patients with pressure ulcers that are new or worsened (short stay); and
  • All-cause unplanned readmission measure for 30 days post-discharge from inpatient rehabilitation facilities.

To assist IRFs in understanding the use of the rebaselined data, and how to monitor their data using the new baseline, a document has been posted in the downloads section of the IRF Quality Public Reporting web page.

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The Centers for Medicare and Medicaid Services (CMS) will be hosting a two-day, in-person training event on Tuesday, August 9 and Wednesday, August 10, 2016 on the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP) in Chicago, IL. This event will also be accessible via streaming media (registration is not required to participate via webcast). The event is scheduled to begin at 9:00 am EDT both days. This training is for IRF providers, associations, and organizations. The objective is to provide IRFs with assessment-based data collection instructions and updates associated with the changes in the October 1, 2016, release of the IRF-Patient Assessment Instrument V 1.4 and other reporting requirements of the IRF QRP. IRF preview reports and IRF Compare will also be discussed.

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As a reminder to members, inpatient rehabilitation facility (IRF) quality reporting program (QRP) data collected between April 1, 2015 and June 30, 2015 must be submitted by Sunday, November 15, 2015. Additional information, including a list of the quality measure data that is due, is available on the IRF Quality Reporting Spotlight and Announcements web page.

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The Centers for Medicare and Medicaid Services (CMS) has announced that a special open door forum for inpatient rehabilitation facilities (IRFs) will be held on Tuesday, October 20, 2015, from 2:00 to 3:00 pm. During the call, CMS will discuss the upcoming Dry Run for IRFs Provider Performance reports on All-Cause Unplanned Readmissions for 30-day post discharge from IRFs. This will also include timeline and content of facility dry run reports that will be disseminated to IRFs from November 3 through December 3, 2015.

To participate in this special open door forum call:
Dial: 1-866-402-6263
Conference ID #: 55982595

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On August 12, the Centers for Medicare and Medicaid Services (CMS) announced they were extending the deadline for the submission of data associated with the inpatient rehabilitation facility (IRF) quality reporting program (QRP) for measures reported to the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN).


This extension is being granted to provide IRFs additional time to submit data. Although the NHSN system is working, intermittent production problems have been experienced. The CDC has been working to resolve these issues and they are expected to be corrected soon.


The deadline for the Healthcare-associated Infection (HAI) data submission has been extended from August 15 to August 28 at 11:59 pm PT. Please Note: This extension only applies to the HAI data submission deadline. Data are submitted through the NHSN online.