Centers for Medicare and Medicaid Services (CMS) SNF/LTC Open Door Forum call Summary 

CMS staff provided updates on CMS’ PDPM Website, the SNF Quality Reporting Program (QRP), and Payroll-Based Journaling (PBJ).   An important item to note from the call is that during the Q&A portion, CMS committed to publishing the revised RAI Manual sometime in May 2019 so that providers can prepare for PDPM. 

PDPM Website Update 

  • PDPM-related educational materials are posted on CMS’ website.  
  • Based on a lot of the feedback received, CMS has made a number of changes to the educational materials on the website.  Those changes have been finalized and should be going live later today.  
  • The three main updated areas include: (1) the training presentation has been replaced with the one from the National Provider Call from December 2018; (2) the classification walk-through document has also been updated; and (3) the FAQ document has also been updated. 
  • CMS is hopeful that these updates will go live by the end of the day today. 
  • For any questions or feedback related to the materials please email 


SNF QRP Updates  

  • Future Measure Development – CMS has contracted with RTI International to develop and maintain quality measures for the SNF QRP. 
  • As part of its measure development and maintenance process, CMS asks measure developers to convene groups of stakeholders and experts who contribute direction and thoughtful input to the measure developer during measure development and maintenance. 
  • RTI International is convening a Technical Expert Panel (TEP) to inform the direction and development of a claims-based measure of healthcare-associated infections (HAI) in skilled nursing facilities.  This TEP will be called the SNF QRP HAI Measure TEP 
  • Additional details about this project and the nomination materials are available at the following website: 
  • As a final reminder, if you wish to nominate yourself or other individuals for consideration, please email materials to Kelly Hughes at by the closing date tomorrow, February 15th, 2019.  


PBJ Update  

  • The PBJ staffing data due today (2/14) for Quarter 4 (10/1/18 – 12/31/18)  



  • When can we expect to receive the updated RAI Manual?  Also, when should we expect for Version 12 of the CASPER Quality Measures User’s Manual to be posted?  
  • Version 12 of the report will be posted in the next couple of months. (Did not address RAI Manual question.) 
  • Is it possible to calculate turnover rates from PBJ Data?  Is there any plan to make that happen anytime soon?  
  • The ability to capture turnover and tenure is in the law; however, CMS has not posted any info on that to date but plans to come out with additional details as the year progresses. 
  • Our facility received a notice that we did not meet the QRP requirements, but we did not receive a 2% reduction.  Is there a reason for this?  
  • The 2% Payment reductions will be applied very shortly.  There was a miscommunication with some of the MACs, but CMS sent out a new letter to the MACs and it will be retroactive. 
  • On the PDPM calculation worksheet there is a statement saying that if neither the BIMS nor staff assessment is completed, then PDPM cognitive level cannot be determined.  Does that mean that we will not be able to get a CMD for the speech component?  
  • This is a question CMS has received from a number of people, so it is something that the agency is working on.  An error message will be provided back if neither the BIMS nor staff assessment completed. 
  • When should we expect the release of a revised RAI Manual?  
  • Typically post RAI Manuals more towards August; however, the goal is to have it published sometime in May 2019 so that providers can prepare for PDPM.