December 23, 2020

Due to COVID-19, the U.S. Centers for Medicaid and Medicare Services waived certain reporting requirements for nursing facilities effective March 1, 2020. This includes timeframe requirements for Minimum Data Set assessments and transmission. Without NF-submitted MDS data, HHSC can’t calculate NF performance on four quality measures included in the Quality Incentive Payment Program. Details are in the COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (PDF).

To account for the lack of MDS data, HHSC is waiving the following performance requirements for QIPP. This waiver is effective Sept.1, 2020, and for the rest of state fiscal year 2021*:

  • All quality measures related to Component Three. Funds dedicated to this component will now be disbursed in monthly payments to all enrolled NFs.
  • Percent of Residents with Urinary Tract Infection (CMS ID: N024.02). Component Four will continue quarterly with two remaining quality measures.

To help relieve the administrative burden on facilities, HHSC is waiving the following reporting requirement for the program, effective Sept. 1 and for the rest of SFY 2021*:

  • Submission of monthly Quality Assurance and Performance Improvement Validation reports.

Non-state government-owned NFs must continue holding monthly QAPI meetings according to the performance requirements set forth in TAC §353.1304(d)(1). Only the reporting requirement is suspended. If a facility is randomly selected for a QA review, HHSC will require supporting documentation from all monthly meetings.

The change to the Component Three payment schedule will be reflected in the December 2020 scorecard. This includes all retroactive Component payments for September through November 2020.

* If CMS reinstates MDS reporting requirements, HHSC will reinstate QIPP MDS-related performance requirements no earlier than three months after the CMS requirements are effective.

Email QIPP with questions.