The fourth quarter fiscal year 2020 Program for Evaluating Payment Patterns Electronic Reports (PEPPER) are now available for skilled nursing facilities (SNFs) to download through the PEPPER Resources Portal. These reports summarize provider-specific data for Medicare services that may be at risk for improper payments. This data can be used to support internal auditing and monitoring activities.

To obtain your SNF PEPPER report, please follow the following steps:

  1. Visit the PEPPER Resources Portal
  2. Complete all the fields; and
  3. Download your PEPPER report

Click here to visit the PEPPER Resources Portal.

On April 12. 2021, the Indiana Department of Health, Division of LTC will resume federal and state health surveys for both nursing homes an residential care facilities. All surveyors have been updated with the Long-term Care Survey Process (LTCSP) Procedure Guide that was effective February 6, 2021. Surveyors will review facility information 12 months prior to the survey entrance date, unless there is a need related to complaint or other concerns that would require information past the 12-month time frame.

Click Here for More Details on Nursing Home Surveys.

On April 9, 2021, CMS issued a new Memo to State Survey Agencies (QSO-21-17-NH) resulting in an end to a few waivers which were granted under the PHE.

The below flexibilities will end effective 5/10/2021:

  • The emergency blanket waivers related to notification of resident room or roommate changes, and transfer and discharge notification requirements
  • The emergency blanket waiver for certain care planning requirements for residents transferred or discharged for cohorting purpose
  • The emergency blanket waiver of the timeframe requirements for completing and transmitting resident assessment information Minimum Data Set (MDS)

Changes in QSO-21-17-NH were updated on April 8, 2021 and made available to providers via this link: COVID-19 Emergency Declaration Blanket Waivers for Health care Providers. Please note, waivers that will end effective 5/10/2021 are found on pages 18-19 of the linked document are in red, strikethrough font

On April 8, 2021, CMS released the new Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Proposed Rule which, once finalized, is effective October 1, 2021. This proposed rule updates Medicare payment policies for facilities under SNF PPS for fiscal year 2022. The proposed rule also includes information for the SNF Quality Reporting Program (QRP) and SNF Value-Based Program (VBP) for FY 2022.

See below for the most significant areas of updates:

  1. FY 2022 updates to the SNF payment rates
  2. Methodology for recalibrating the PDPM parity adjustment
  3. Rebase and revision of the SNF market basket to improve payment accuracy under the SNF PPS
  4. New Blood Clotting Factor Exclusion from SNF Consolidating Billing
  5. Changes in PDPM ICD-10 Code Mappings – The ICD-10 code mappings and lists used under PDPM are available on the PDPM Website at: https://www.cms.gov/Medicare/MedicareFee-for-Service-Payment/SNFPPS/PDPM
  6. SNF QRP update – modification to the public reporting SNF quality measures
  7. SNF VBP Program proposal to suppress the SNF readmission measure

For more information on this proposed rule, please visit the Federal Register’s Public Inspection Desk under “Special Filings,” at http://www.federalregister.gov/inspection.aspx.