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CMS Shares NF Policies with LeadingAge

LeadingAge shared the results of their January call with the nursing home policy staff from the Centers for Medicare & Medicaid Services (CMS), where they discussed updates on interpretive guidance, anticipated survey focus areas for 2020, and the phase-out of Section G, among other topics. A summary of the meeting is below:  

Interpretive Guidance. CMS confirmed that they are still on track to release phase 3 interpretive guidance in Q2 2020 but were unable to narrow down the timeframe any further. They were also unable to give a time frame for the release of guidance related to facility-reported incidents (as alluded to in the FY 2020 Mission & Priorities Document) other than to say that it will not be available in Q1 2020. 

Focused surveys. Schizophrenia surveys will be the priority for 2020, and providers may also see dementia-focused surveys. Both come out of the National Partnership to Improve Dementia Care in Nursing Homes initiative and examine antipsychotic usage, appropriateness of schizophrenia diagnoses, and care and services for residents diagnosed with dementia. 

Late Adopters. CMS has not yet finalized goals for 2020 for this program. The 2019 goal was a 15% reduction in anti-psychotic usage among late adopters. 

Removal of Section G from MDS (Implemented October 2020). Section G is out, Section GG is in for all residents, regardless of payer source or length of stay. CMS has not yet announced a plan for how case-mix adjustments for staffing and quality measures that presently incorporate data from Section G will be updated with the removal of Section G. 

Falls. CMS and Congress have been keeping an eye on falls and falls reporting. Providers need to ensure accurate reporting on the MDS of falls and injuries related to falls that occur both in the nursing home and prior to nursing home admission. This includes correcting discharge assessments to accurately reflect diagnoses for residents who are transferred to the emergency room following a fall. 

Standing Topics: Infection Control & Abuse. CMS reiterated previous messages on standing topics. Regarding infection control, CMS shared that hand hygiene is still the biggest issue. They noted the continued underuse of alcohol-based hand rubs. Abuse: This will continue to be a hot topic. Watch for “red flags” like a history of behaviors and take appropriate steps to protect other residents from those behaviors. 

We will continue to update LeadingAge Ohio members on CMS guidance. For specific questions, please reach out to Stephanie DeWees at

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Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.