Creator: Patrick Connole
Out of Compliance with SNF QRP? CMS Starts Notifications
CMS is notifying skilled nursing facilities that were found to be out of compliance with Skilled Nursing Facility Quality Reporting Program requirements for Calendar Year 2025.
The Centers for Medicare and Medicaid Services (CMS) is notifying skilled nursing facilities that were found to be out of compliance with Skilled Nursing Facility Quality Reporting Program (SNF QRP) requirements for Calendar Year (CY) 2025, according to the agency and sector experts.
SNFs that do not meet the reporting requirements will receive a 2-percentage point reduction to their Fiscal Year (FY) 2027 Annual Payment Update (APU).
“The QRP Non-Compliance letters were released in iQIES today. Those facilities cited as being non-compliant with either the QRP Data Reporting Threshold [90 percent of the MDS assessments have 100 percent of the required data] or the two NHSN Health Care Personnel [HCP] reporting for COVID-19 and Influenza vaccines will have a 2 percent reduction in their FY 2027 APU,” said Alicia Cantinieri, managing director, clinical reimbursement and regulatory compliance, Zimmet Healthcare Services Group.
She said with an increase in Medicare Part A rates for FY 2027, those facilities will receive a 0.4 percent increase, “which is significant.”
“Although facilities can request reconsideration by Sept. 4, the reasons for reconsideration or exception are limited. Essentially, there must be an error in the finding, such as a penalty for failure to submit the HCP Vaccine; however, the facility has confirmation that the data was submitted and accepted by the deadline,” Cantinieri said.
Another reason for potential reconsideration is a disaster or other extraordinary circumstances.
Facilities that believe they received the penalty in error should visit the SNF Quality Reporting Reconsideration and Exception & Extension website for more information, she said.
Comments or questions? Contact Patrick Connole at pconnole@parkplacelive.com.
