Further information about these requirements may be found at: http://www.hhs.gov/ocr/civilrights. . Fewer observed hospice Start Printed Page 42562services on weekends (relative to that provided on weekdays) is not itself an indication of a lack of access. If you are human user receiving this message, we can add your IP address to a set of IPs that can access FederalRegister.gov & eCFR.gov; complete the CAPTCHA (bot test) below and click "Request Access". 51. 18-04 that was issued on September 14, 2018. We appreciate commenters' concern for provider and vendor burden in implementing a new tool and encourage all key stakeholders to continue to stay informed and engaged through the HQRP Forums, Quarterly Updates, and listserv notifications. To estimate overhead salaries for each level of care, we first proposed to calculate noncapital nonbenefit overhead costs for each level of care to be equal to Worksheet B, column 18, less the sum of Worksheet B, columns 0 through 3, for line 50 (CHC), or line 51 (RHC) or line 52 (IRC) or line 53 (GIP). The commenter stated that this would better allow CMS to isolate the costs of those facilities that truly operate an inpatient unit. CMS froze CAHPS data starting with the November 2020 refresh and concluding with the November 2021 refresh. We also rebased IRC per diem rates equal to the estimated FY Start Printed Page 425322019 average costs per day, with a reduction of 5 percent to the FY 2019 average cost per day to account for coinsurance. Paragraph (b)(1) will include the existing language on the standardized set of admission and discharge items. We received seven comments on the proposed FY 2022 hospice wage index from various stakeholders including hospices, and national industry associations. Denominator: The number of beneficiaries with at least 1 day of hospice during the last 3 days of life within a reporting period. The next four quarters would be Q3 2020 and Q2, Q3, and Q4 of 2019that is, past quarters adding up to eight quarters but omitting Q1 and Q2 of 2020, which were exempt from quality reporting (please see section 10.b. To assess hospice service availability, this indicator includes minutes of care provided by skilled nurses on weekend RHC days. For CHC, we proposed to then multiply this ratio by other patient care total costs for CHC (Worksheet A-1 column 7, lines 38 through 46). However, section 1814(i)(5)(D)(ii) of the Act provides that in the case of a specified area or medical topic determined appropriate by the Secretary for which a feasible and practical measure has not been endorsed by the consensus-based entity, the Secretary may specify measures that are not endorsed, as long as due consideration is given to measures that have been endorsed or adopted by a consensus-based organization identified by the Secretary. Further, section 1814(i)(6) of the Act, as added by section 3132(a)(1)(B) of the PPACA, authorized the Secretary to collect additional data and information determined appropriate to revise payments for hospice care and other purposes. During these meetings, the discussions reflecting on the analysis generally supported the replacement of HVWDII with a claims-based HVLDL measure.
