QIPP Year Three

The following QIPP resources are specific to Year Three and reflect application materials, final eligibility determinations, national benchmarks and expected timelines for submissions and payments.

Benchmarks

Below are the National Average Benchmarks for the CMS Five-Star quality measures that nursing facilities participating in QIPP year three will have their improvement measured against. Be aware that these benchmarks will remain the same for the entire year (Sept. 1, 2019, through Aug. 31, 2020).

QIPP Year Three Benchmarks

Long-Stay Quality Measure High-risk residents with pressure ulcers (QM453) Residents who received an antipsychotic medication (QM419) Residents whose ability to move independently has worsened (QM 451) Residents with a urinary tract infection (QM407) Residents assessed and appropriately given the pneumococcal vaccine (QM415)*
National Average Benchmarks 7.345% 14.562% 17.716% 2.799% 93.667%

(date data pulled: 07/2019)

*The national average benchmark for QM415 is being used for the self-reported pneumococcal vaccine measure. Even though the state’s version is defined slightly differently compared to the CMS measure, performance should be directly analogous. No facility-specific benchmarks will be available for this measure.

Data Submission and Payment Timeframes

Three of the QIPP Year 3 Components rely on self-reported data, required both monthly and quarterly. All required data must be submitted to HHSC via the LTSS Webportal, which can be reached by clicking the button on the top-right of this page.

Components One and Two require monthly submissions by the deadlines printed in the tables below. Component Four requires submission of data anytime during the post-quarter reconciliation period as printed in the table below.

Component Three does not require special self-reported data; facilities have only to ensure minimum data set assessment data are reported completely and correctly to CMS by the end of the post-quarter reconciliation period as printed below.

Component One: Quality Assurance Performance Improvement Validation Reports

The table below provides participating nursing facilities with QIPP Quality Assurance Performance Improvement (QAPI) Validation Report Form submission deadlines (by close of business to HHSC) and the anticipated date they should receive payment. QAPI deadlines each month reflect the first business day of the month following the month for which data are being reported.

Monthly QIPP Submission Deadlines for QAPI Attestations and Payment Timeframes

Month Submission Deadline (Close of Business) Expected Payment Date
September 2019 Oct. 1, 2019 Oct. 31, 2019
October 2019 Nov. 1, 2019 Dec. 2, 20119
November 2019 Dec. 2, 2019 Dec. 30, 2019
December 2019 Jan. 2, 2020 Jan. 30, 2020
January 2020 Feb. 3, 2020 March 2, 2020
February 2020 March 2, 2020 March 31, 2020
March 2020 April 1, 2020 April 30, 2020
April 2020 May 1, 2020 May 31, 2020
May 2020 June 1, 2020 July 1, 2020
June 2020 July 1, 2020 July 30, 2020
July 2019 Aug. 3, 2020 Aug. 31, 2020
August 2019 Sept. 1, 2020 Sept. 30, 2020

Note: The payment dates listed in the table are only expected dates and could change if the data are not available to HHSC on the listed date.

Component Two: Workforce Development

The table below provides participating nursing facilities with QIPP Workforce Development submission deadlines (by close of business to HHSC) and the anticipated date they should receive payment. QAPI deadlines each month reflect the third business day of the month following the month for which data are being reported.

Monthly QIPP Submission Deadlines for Workforce Development Data Elements and Payment Timeframes

Month Submission Deadline (Close of Business) Expected Payment Date
September 2019 Oct. 3, 2019 Oct. 31, 2019
October 2019 Nov. 5, 2019 Dec. 2, 2019
November 2019 Dec. 4, 2019 Dec. 30, 2019
December 2019 Jan. 6, 2020 Jan. 30, 2020
January 2020 Feb. 5, 2020 March 2, 2020
February 2020 March 4, 2020 March 31, 2020
March 2020 April 3, 2020 April 30, 2020
April 2020 May 5, 2020 May 31, 2020
May 2020 June 3, 2020 July 1, 2020
June 2020 July 3, 2020 July 30, 2020
July 2019 Aug. 5, 2020 Aug. 31, 2020
August 2019 Sept. 3, 2020 Sept. 30, 2020

Component Three: Centers for Medicaid & Medicare Services Quality Measures

The table below provides participating nursing facilities with dates when HHSC will pull Centers for Medicare & Medicaid Services Quality Measure data and the anticipated date they should receive payment. HHSC pulls data after a one-month reconciliation period that follows the end of the quarter for which data are being reported.

Quarterly Payment Timeframes

Quarter Reconciliation Period Expected Data Pull Expected Payment Date
Quarter 1: Sept. 1, 2019 - Nov. 30, 2019 Dec. 2019 Jan. 2, 2019 Jan. 30, 2020
Quarter 2: Dec. 1, 2019 - Feb. 28, 2020 Mar. 2020 April 1, 2020 April 28, 2020
Quarter 3: March 1, 2020 - May 31, 2020 June 2020 July 1, 2020 July 27, 2020
Quarter 4: June 1, 2020 - Aug. 31, 2020 Sept. 2020 Oct. 1, 2020 Oct. 27, 2020

Note: The data pull and payment dates listed in the table are only expected dates and could change if the data are not available to HHSC on the listed date. The reconciliation period might be shortened by 1 day, if needed, due to CMS reporting constraints; if this occurs, facilities will be notified as early as possible.

Component Four: Infection Control

The table below provides participating nursing facilities with Infection Control self-reported data submission deadlines (by close of business to HHSC) and the anticipated date they should receive payment. Submission deadlines each month are the same as the reconciliation period for Component Three (CMS Quality Measures) and typically align with the end of the month following the quarter for which data are being reported.

Quarterly Payment Timeframes

Quarter Reconciliation Period Submission Deadline Expected Payment Date
Quarter 1: Sept. 1, 2019 - Nov. 30, 2019 Dec. 2019 Dec. 29, 2019 Jan. 30, 2020
Quarter 2: Dec. 1, 2019 - Feb. 28, 2020 Mar. 2020 Mar. 29, 2020 April 28, 2020
Quarter 3: March 1, 2020 - May 31, 2020 June 2020 June 28, 20200 July 27, 2020
Quarter 4: June 1, 2020 - Aug. 31, 2020 Sept. 2020 Sept. 27, 20200 Oct. 27, 2020

Note: The payment dates listed in the table are only expected dates and could change if the data are not available to HHSC on the listed date.