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As COVID-19 moves to an endemic stage, the long term care industry continues to grapple with a severe staffing crisis and provider burnout, all while making strides toward financial recovery and new efficiencies to improve the quality of patient care under a value-based care framework. Add to this the upcoming regulatory changes and reporting shifts mandated by the Centers for Medicare & Medicaid Services (CMS), and the pressure senior care providers face continues to grow. Now more than ever it's important for technology vendors to be the advocate and partner their customers need in order to truly succeed in the future.    

In April 2023, CMS is moving a federally mandated process for clinical assessment in Medicare/Medicaid certified nursing homes (thee Minimum Data Set or MDS) to a new submission system called the Internet Quality Improvement Evaluation System (iQIES). These assessments are critical to reimbursement and regulatory compliance and are completed and submitted to CMS upon patient admission, discharge, regular intervals, and significant changes in care status. The intention behind the changes are to modernize current submission processes in a highly regulated environment—making the system “more reliable, scalable, secure, accessible, and cloud-based," according to CMS.

The goal of these changes is to ensure critical quality assurance and keep crucial clinical assessment information secure. In light of this, we must recognize the important role that technology vendors play in helping providers adapt to these changes so that patient care remains the most important task at hand.

Navigating Today's Protections for Medicare/Medicaid Facilities
Health care, especially health care delivery to high-need populations receiving Medicare and/or Medicaid funding, continues to evolve in step with industry changes, technological advances, and new patient needs. Adhering to even the smallest of regulatory changes and mandates can be a daunting task to say the least, with senior care providers in a position to not only educate themselves and their staff on the updates, but also strategize and put new processes in place to comply to these changes. This is why there is immense value in having a strategic partnership with your technology vendor—to both navigate these types of situations together, as well as succeed through these types of changes by leaning on their specialized expertise from education to execution and beyond.

As we experience monumental shifts in health care delivery, new regulations and reporting standards will always follow suit. The important thing to remember is that while providers are subject to these changes, they shouldn't bear the burden of adaptation in a silo. As new regulations and reporting standards enter the scene, it is everyone's responsibility to help these facilities endure changes that impact how they report on patient care. Put simply, adjusting to new CMS reporting processes—like the ones to come this April—shouldn't fall on providers alone.

Technology's Role in Upcoming Changes
Technology vendors hold a responsibility, at a very basic level, to help communicate to providers how these regulatory changes impact current workflows and how to stay compliant as industry challenges continue to impede on day-to-day operations.

On a deeper level, health care technology companies can also be active participants in their customer's regulatory and compliance journeys—for example, volunteering to submit MDS assessments on their customers' behalf's. Facilities will need to set up HARP accounts and request iQIES roles for the new submission portal.

At PointClickCare, we are encouraging each individual facility to approve us as assessment submitters, which allows us to streamline the assessment submission process for providers. This isn't something new, in fact, we've always submitted MDS 3.0 assessments on behalf of our customers, and our aim in helping our customers submit MDS assessments with ease is to ultimately lessen the manual, administrative burden so that they can focus on what matters most—quality care.

When we imagine and conceptualize the nursing home of the future, it's not that we don't imagine any headwinds or industry challenges. However, we are moving toward a new future for these facilities in which providers are able to focus more deeply on care delivery and experience more automated, efficient processes to check the box on mandatory and federally mandated reporting. This will allow providers to do what they do best.

How Providers Can Stay Nimble Ahead of Future Changes
Health care technology companies have a novel opportunity to step up to the plate and help their customers succeed—which means helping in any way possible when it comes to changes communicated from CMS—from new reporting processes to enhanced compliance standards. By working with a vendor that partners with their customers to achieve success and automatically upload and submit MDS assessments on their behalf, a new future of more efficient care can be realized.

Our goal has been, and continues to be, working hand-in-hand with our customers to maintain compliance and help them navigate what is and what has always been a highly regulated field. The end result of making these processes easier and less tedious for our customers is a win/win/win for staff, for patients, and for our industry. By serving as a true partner to the customers we serve and helping them with upcoming changes in April 2023 and beyond, our hope is that care team happiness, efficiency, and wellbeing increases tenfold and high-need patients experience better care outcomes across the board.

Bill Charnetski is executive vice president of Health System Solutions and Government Affairs for PointClickCare.