The Measures Applications Partnerships (MAP) Post Acute Care/Long Term Care Workgroup met to review Measures Under Consideration (MUC) for the SNF Quality Reporting Program (QRP) and SNF Value-Based Purchasing VBP program. LeadingAge is one of roughly 18 members of the work group. The work group reviews the proposed MUC list, public comments on the measures, asks for clarification on elements of each measure and ultimately votes on whether to support the National Quality Forum (NQF) staff recommendations that the measure be advanced for rulemaking or be considered for rulemaking under certain conditions. LeadingAge supported the CoreQ patient experience measure and the Discharge to Community measure for rulemaking without conditions under the SNF VBP program and both were approved by the work group. However, 4 other measures were approved over LeadingAge and other organizational representatives objections and concerns:
- Influenza Vaccination Coverage among Healthcare Personnel – approved for future rulemaking for inclusion in the SNF QRP following NQF endorsement
- NHSN Healthcare associated C. Difficile Infection outcome measure approved for future rulemaking for inclusion in the SNF QRP following NQF endorsement
- SNF Healthcare Acquired Infections Requiring Hospitalization – approved for future rulemaking for inclusion in the SNF VBP following NQF endorsement
- Total Nursing Hours Per Day – approved for inclusion in the SNF VBP following NQF endorsement.
LeadingAge and others raised numerous concerns with the administrative burden of measures that must be reported through NHSN and concerns about adding staffing measures in the current environment where providers have little ability to affect these numbers in a staffing crisis. There are more steps in the process before these measures ultimately become part of the SNF VBP and QRP programs. Most importantly, NQF endorsement and the actual proposal of rules to add these measures. Making the earliest implementation likely not until 2024. In addition, CMS can opt to not move forward with the measures and did say they heard the concerns about the staffing measure in the current environment. Nonetheless there was broad support among the various stakeholder organizations on the work group for considering more staffing measures in the future. More news as it develops.
