The Centers for Medicare & Medicaid Services (CMS) recently released its Fiscal Year 2024 Mission and Priorities Document (MPD). This important document helps guide CMS, the Quality, Safety & Oversight Group (QSOG), the Survey & Operations Group (SOG), and State Survey Agencies (SAs) to ensure healthcare providers meet safety and quality standards. For healthcare providers and public sector planners, staying up to date on CMS priorities is key to maintaining compliance and being prepared for changes.
Here’s a breakdown of the main points from the FY2024 MPD and how they might affect your healthcare operations.
What is the MPD?
The MPD outlines how CMS will prioritize its efforts during the upcoming fiscal year. It includes updates on regulations, new programs, budget changes, and legal requirements, all designed to make sure people receiving care through Medicare or Medicaid get safe, high-quality treatment.
The FY2024 MPD is divided into three main sections:
- New program updates since last year.
- Ongoing policies that remain constant.
- Priority tiers for survey and certification activities.
Key Areas of Focus
CMS organizes its survey activities into four priority tiers, helping Survey Agencies (SAs) focus on the most critical areas of patient care. These tiers allow CMS to allocate resources effectively.
The Four Priority Tiers:
- Tier 1: Providers with immediate access-to-care issues.
- Tier 2: Providers with Medicare applications pending for more than 150 days.
- Tier 3: All other initial certifications not in Tiers 1 or 2.
- Tier 4: Less urgent activities.
One of the significant changes this year is that initial surveys for home health and hospice providers, previously categorized under Tier 4, have been moved up to Tier 1 or 2 due to the increased demand for these services.
Updates for Home Health and Hospice Providers
Home health and hospice care are receiving extra attention in FY2024. CMS has introduced stricter enforcement measures, such as fines, suspension of payments for new patients, and management changes at facilities that fail to meet quality standards. These updates will be included in the State Operations Manual (SOM) Chapter 10, although the exact release date has not been announced yet.
Hospice care is also getting special attention through the new Hospice Special Focus Program (SFP). This program targets underperforming hospice providers, pushing for improved care standards.
Post-Pandemic Healthcare Guidance
With the end of the COVID-19 Public Health Emergency (PHE) in May 2023, CMS is returning to pre-pandemic practices. This includes ending staff vaccination requirements and resuming standard survey and certification activities. One of the main goals for FY2024 is addressing the backlog of surveys delayed by the pandemic, especially those related to patient harm.
Long-Term Care and End-Stage Renal Disease Updates
CMS continues its efforts to improve care in nursing homes and long-term care facilities by streamlining the complaint investigation process. CMS will also revise how dialysis services are handled in nursing homes, paying closer attention to facilities with poor clinical outcomes. This includes:
- New investigation policies for complaints and facility-reported incidents.
- Streamlining the long-term care (LTC) survey process to enhance efficiency.
For end-stage renal disease (ESRD) facilities, CMS has revised its survey processes to improve oversight of dialysis services provided in nursing homes. CMS-approved accrediting organizations will now handle the Tier 2 surveys for ESRD facilities with poor clinical outcomes, alleviating the burden on state agencies. CMS is also paying closer attention to dialysis services provided in nursing homes. In FY2024, CMS-approved accrediting organizations will conduct surveys of facilities with poor clinical outcomes, based on set measures.
Rural Health Clinics and Federally Qualified Health Centers
Rural health clinics and federally qualified health centers will see changes in how CMS assesses their services. These revisions focus on outpatient services rather than primary care and respond to the way the U.S. Census has redefined urban areas. The most recent revisions will impact how these healthcare centers are classified and how they qualify for Medicare funding.
Training and Education for Surveyors
Surveyors responsible for inspecting healthcare facilities will undergo competency assessments as part of the surveyor skills review. For FY 2024, this review will focus on several provider types, including hospitals, home health agencies, and long-term care facilities.
This ongoing education aims to ensure that surveyors are equipped to handle the complexities of modern healthcare and enforce CMS’s strict safety and quality standards.
Funding and Resources
Since 2015, CMS’s Survey & Certification (S&C) program has not received additional funding despite an increased workload. With more patient complaints and no budget growth, CMS must carefully prioritize how it uses its resources. The top three priorities for FY2024 are:
- Investigating patient complaints that pose immediate safety concerns.
- Surveying and certifying critical healthcare facilities, such as nursing homes, home health agencies, and hospices.
- Certifying other facilities as time and budget allow.
How BOLDplanning Can Help
Navigating these changing priorities and ensuring compliance can be challenging for healthcare organizations, especially with the added pressure of limited resources. BOLDplanning’s expertise in continuity planning can help healthcare providers stay prepared. Whether it’s developing updated plans to meet new CMS requirements or managing the impact of survey backlogs, BOLDplanning’s solutions offer the tools you need to keep operations running smoothly and maintain compliance.
Conclusion
Understanding CMS’s FY2024 Mission and Priorities Document is crucial for healthcare providers working with Medicare and Medicaid. The document outlines key changes in survey priorities, enforcement policies, and certification processes. By staying informed and adapting to these updates, healthcare organizations can continue delivering high-quality care while ensuring compliance with evolving regulations. And with the right planning and preparation, you can meet these challenges head-on.
BOLDplanning is here to help guide your organization through these updates, ensuring that your continuity plans are aligned with CMS’s evolving expectations.
