Skilled Nursing PEPPER Reports Are Now Available Electronically

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The second annual Skilled Nursing Facility (“SNF”) Program for Evaluating Patterns and Electronic Reports (“PEPPERs”) are now available to be retrieved via the secure portal at PEPPERresources.org. These reports are accessible to a limited number of high level management personnel within your organization. The Centers for Medicare and Medicaid Services (“CMS”) contracted with TMF Health Quality Institute (“TMF”) for the development, preparation and distribution of the PEPPERs to SNFs, as well as other health care provider types. TMF has targeted six areas for SNF PEPPERs in the 2014 release of the 4th Quarter 2013 data. These six targeted areas include: 1) therapy resource assessment groups (“RUGs”) with high activities of daily living (“ADL”); 2) non-therapy RUGs with high ADLs; 3) Change of Therapy assessment; 4) Ultrahigh therapy RUGs; 5) Therapy RUGs; and 6) episodes of care lasting 90 days or more. Each facility is provided statistics regarding their care in each of these six areas with comparison to other SNFs in the state, Medicare contractor jurisdiction and the nation. These comparisons are provided in a percentile format for assessment by the SNF. If a SNFs percentiles are considered to be outliers either over the 80th percentile or under the 20th percentile, it may be indicative of either excessive billing or inadequate care delivery. PEPPER reports should be utilized be SNF organization to identify risk areas and develop action plans to address the risk areas. The risk areas should be incorporated in to the organization’s compliance plan and Quality Assessment and Performance Improvement Program (“QAPI”) to ensure ongoing oversight. PEPPER reports can be found at http://www.pepperresources.org.


DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Benesch | Attorney Advertising

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