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IRF Quality Indicator Submission Deadline: Friday Aug 15th

Written by: Darlene D'Altorio-Jones (1959-2015) on Tuesday, August 12, 2014 Posted in: Acute Care Rehab

Don’t delay – timely submission is critical for financial viability

CMS released a notification this week alerting IRF’s of the deadline for quality submissions for the first quarter of 2014.

Remember that there are several different indicators and several different submission areas. Items that were placed on the IRF PAI are automatically made available for upload to CMS. Be certain that you complete thorough IRF PAI’s as you go and ensure there is no need for additional work other than to validate each upload on a timely basis.

On the other hand, items not present but due for submission are provided to CMS either through Quality Improvement and Evaluation System (QIES) Assessment Submission and Processing (ASAP) system or National Health Safety Network (NHSN). Be sure your assigned responsible person is aware and has completed these items as they are expected in 100 percent of the patients discharged from your program to be considered ‘complete’.

·     CMS states, “1st Quarter 2014 – IRF Care Data Set submission – Discharges from Jan. 1, 2014, through March 31, 2014, should be submitted through the Quality Improvement and Evaluation System (QIES) Assessment Submission and Processing (ASAP) system

·     National Healthcare Safety Network (NHSN) Catheter-associated Urinary Tract Infection (CAUTI) Outcome Measure (NQF #0138)

·     Percent of Residents with Pressure Ulcers That are New or Worsened (Short-Stay) (an application of NQF #0678) 1st Quarter 2014 – Healthcare-Associated Infections (HAI) data submission – Discharges from January 1, 2014 through March 31, 2014 should be submitted via the Center for Disease Control and Prevention’s National Healthcare Safety Network (NHSN)

·     NHSN Catheter-Associated Urinary Tract Infection (CAUTI) Outcome Measure

Do you know if the responsible person in your organization has set up your hospital as a separate reporting entity for quality measures? It is not acceptable for reporting IRF quality measures as a ‘subset’ or unit within the acute care. The information must be filed with the various reporting agencies using your unique Medicare provider ID so that you may get credit for participation and not be penalized in future payment years because your unit was not recognized as reporting as an IRF/U.

CMS has a website devoted to information on quality reporting.

CMS publishes these Web links. For help with the IRF Patient Assessment Instrument (IRF-PAI) data coding or IRF-PAI data submission, call 800-339-9313 FREE or email help@qtso.com.

For questions about Quality measure calculation, data submission deadlines, data items in the Quality Indicator section of the IRF-PAI, email IRF.questions@cms.hhs.gov.

For questions about CAUTI data or submission, NHSN Registration, email NHSN@cdc.gov.

Remember the reporting year affects the payment cycle in the fiscal year 2 years away. Persons who did not report 2013 quality data per the 2015 Final Rule can expect a $297 decrease in the standard payment. Standard payment for a 1.0 CMI in 2015 is $15,198. Persons that did not report quality data will receive a starting standard payment of $14,901 dollars. This is the amount that BEGINS the facility indicator standard payment FORMULA. Each facility has their own LIP, rural, wage and teaching status that also calculates into that formula. You do not want to start payment in future payment cycles at a disadvantage.

Payment margins are slim enough. With Medicare Administrative Contractors (MAC’s) and Recovery Audit Contractors (RAC’s) being severe in denials on payment requirements that align with 2010 criteria, there is really no money that can be left on the table to successfully manage and run an IRF unit/facility today.

Again, check with your responsible person for quality uploads to be certain the deadline for the first quarter is not missed and you are participating 100 percent in filing for patients on the unit according to the guidelines set by the reporting agencies.

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