What We Know About CMS’ CoreQ Requirement and How it Impacts SNFs
In April, the Centers for Medicare and Medicaid Services (CMS) proposed a Quality Reporting Program (QRP) rule regarding CoreQ surveys for skilled nursing facilities (SNFs). The proposed rule would require qualifying SNFs to adopt CoreQ surveys as a QRP measure for fiscal year 2026. That means SNFs will have to begin collecting CoreQ data in 2024.
In this article, we’ll explore what we know about the QRP rule proposal, why it’s being proposed, who it applies to, when each phase is projected to roll out, why SNFs should get ahead of the game, and what they should look for in a vendor.
Let’s begin by reviewing the present before venturing into the future state of CoreQ.
The Current CoreQ Landscape
CoreQ surveys are a set of standardized questions that are used to assess the experiences of residents and their families in several areas, including communication with staff, quality of care, and resident safety.
There are currently five different CoreQ surveys available to SNFs and ALFs:
SNF Short Stay Discharge – Resident
SNF Long Stay – Resident
SNF Long Stay – Family
AL – Resident
AL – Family
While none of these surveys are currently required nationwide, several states including New Jersey, Tennessee, and Georgia have incorporated the CoreQ into their Medicaid quality incentive programs. Oregon has adopted the AL surveys as part of a statewide Quality Measurement Program for Residential Care and Assisted Living.
Which CoreQ Surveys will be Required Under the QRP Rule?
Under the proposed rule, CMS will adopt the SNF Short Stay Discharge (SS DC) survey for residents as a national Medicare QRP measure. This survey calculates the percentage of residents discharged in a six-month period from a SNF, within 100 days of admission, who are satisfied with their SNF stay.
Why is CMS Considering a CoreQ Requirement?
CMS’ goal in establishing the CoreQ SNF Short Stay Discharge survey as a requirement is to create “person-centered” care and improved transparency in SNF satisfaction performance to allow for better care and apples-to-apples comparisons for patients, residents, and families when considering a skilled nursing facility.
According to the official CMS CoreQ rule proposal, “Person-centered care is achieved when healthcare providers work collaboratively with individuals to do what is best for the health and well-being of individuals receiving healthcare services, and allows individuals to make informed decisions about their treatment that align with their preferences and values, such as including more choice in medication times, dining options, and sleeping times.”
The proposal goes on to state, “There is currently no national standardized satisfaction questionnaire that measures a resident’s satisfaction with the quality of care received by SNFs. We identified resident satisfaction with the quality of care received by SNFs as a measurement gap in the SNF QRP.”
CMS’ asserts later in the document that mandating CoreQ could help to fill that gap.
Proposed CoreQ Requirement Timeline
Following is the proposed timeline for the CoreQ requirement under the QRP rule:
January 1-June 30, 2024: SNFs will have to participate in a "dry run" of the CoreQ survey by participating in at least one week of surveys during this time period.
July 1, 2024: Regular CoreQ surveys begin. SNFs will need to contract with a vendor and participate to avoid a Medicare rate reduction.
August 15, 2024: Data submission deadline for Q1 2024. This is the first time vendors will submit CoreQ survey result data to CMS. Vendors will continue to submit data each quarter after this.
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Why Should SNFs Implement CoreQ Now?
Getting ahead of the rule implementation provides SNFs a number of benefits:
Meeting Compliance, Avoiding Penalties
The proposed QRP rule would require SNFs with 60+ annual discharges to participate in the CoreQ survey program. SNFs are set to receive a 3.7% Medicare rate increase in 2024, part of which is designated to help offset the cost of conducting the surveys. Facilities that do not comply with the rule will face a 2% Medicare reduction rate penalty. By adopting CoreQ surveys now, SNFs can ensure compliance with future regulatory requirements and avoid that penalty.
Ironing Out the Kinks and Avoiding the Rush
Shopping for a vendor, implementing their solution, and understanding how it works takes time. There also stands to be a long waiting line for the best vendors as the compliance deadline approaches. In addition to getting these burdens out of the way, implementing CoreQ now provides a facility the intel to identify what they’re doing well and where improvements can be made before the rule goes into effect and scores become public.
“Implementing CoreQ now provides a facility the intel to identify what they’re doing well and where improvements can be made before the rule goes into effect and scores become public. ”
Improving and Maintaining Satisfaction Scores
CoreQ surveys provide valuable feedback from residents and their families, which can help SNFs identify areas of improvement and enhance the quality of care they provide. By listening to the needs and preferences of their residents, SNFs can improve the overall satisfaction of their residents and their families, leading to better health outcomes and a more positive reputation for the facility.
Per the CMS proposal, “Currently the SNF QRP includes measures of processes and outcomes that illustrate whether interventions are working to improve delivery of healthcare services. However, we believe that measuring resident satisfaction would provide clinical teams compelling information to use when examining the results of their clinical care, and can help SNFs identify deficiencies that other quality metrics may struggle to identify.”
Enhancing Communication and Transparency
The COVID-19 pandemic highlighted the importance of communication and transparency between SNFs and residents' families. CoreQ surveys can help SNFs foster better communication with residents and their families, providing opportunities for feedback and collaboration to improve the quality of care. By adopting CoreQ surveys now, SNFs can demonstrate their commitment to transparency and accountability, building trust with residents and their families, and improving overall outcomes for everyone involved.
Tips for Choosing a CoreQ Vendor
CoreQ vendors should deliver a combination of experience, expertise, convenience, excellent support, and peace of mind. Specifically, your CoreQ vendor should deliver the following:
Ease of Implementation: Ease of implementation is a must-have. Providers will need to send patient data out of their EHR to their vendor weekly, so a solution that integrates seamlessly with their EHR can save a lot of time.
Proven Results: Choosing a partner with a proven track record provides peace of mind that surveys will be administered properly, achieve minimum sample size and response rates, be submitted on time, and obtain the most valuable information.
Industry Experience: Look for certified vendors that have been in the game for a while and have industry-specific expertise. Knowledge of the skilled nursing industry is essential for identifying satisfaction drivers and proven recommendations for fixing any shortcomings.
Solutions and Support: A superior vendor also goes beyond survey collection and submission. According to Chris Magleby, Chief Strategy Officer at HCP, “A quality vendor adds tools and support beyond the basics. If your scores need a lift, or there are any alarming trends, they can help you pinpoint areas of opportunity and equip your team with the training and education to get your marks where they need to be.”
Time moves extremely fast in the Skilled Nursing industry. Getting CoreQ surveys in place now allows proactive SNFs to hit the ground running in the new year while competitors are scrambling to meet proposed compliance deadlines and avoid penalties for failing to do so.
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