1

MDSMDS 3.0 UPDATE3.0 UPDATE

Presentation to: Long Term Care Providers

Presented by: Lena E. Bain, R.N., M.P.A.

Healthcare Facility Regulation Division

April 2012

2

MDS 3.0 UPDATE

Effective April 1, 2012

3

MDS 3.0

Our Journey Continues

4

MDS 3.0

Looking Forward

5

Focus

• Changes effective April 1st, 2012 – The emphasis is on changes to the assessment process. – Will not include typographical or formatting errors– Only pages with actual changes have been updated & is

indicated by the footer “April 2012”

• Global Item Set Changes– Term “Mental Retardation (MR)” changed to “Intellectual

Disability (ID)”. This change is reflected throughout the instrument.

6

Helpful Websites

• MDS 3.0 RAI Manual Pagehttp://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/nursingHomeQualityInits/MDS30RAIManual.html

• MDS 3.0 Training Materialshttp://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TrainingMaterials.html

7

Helpful Websites Cont’d

• MDS Technical Information

http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation.html

• SNF PPS Main Site

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/SNFPPS/index.html

8

Materials Needed

• April 2012 MDS 3.0 RAI Manual• MDS 3.0 RAI Manual (v1.08) Errata (v.3 & v.4)

documents.

These documents have been posted under the download section of the MDS 3.0 RAI Manual page. It contains identified issues and resolutions and also contains the replacement pages. Change tables are not needed

9

Contact Information

Lena E. Bain, R.N, M.P.A. 404-657-5854RAI/MDS Coordinator

lebain@dhr.state.ga.usFor RAI process, MDS coding, validation reports, or other information

Kenni Sue Keller 404-657-5861Automation Coordinator

kskeller@dhr.state.ga.usFor trouble shooting with software vendors, transmission problems and for technical assistance.

10

Chapter 2

• Page 2-50 4th bullet• Under PPS Unscheduled Assessments for a

Medicare Part A stay there was a change in the instructions in the Change of Therapy OMRA.

11

Chapter 2

• Section 2.9 page 2-51• Under Coding Tips and Special Populations

• Unscheduled Assessment Interviews - when coding a standalone unscheduled PPS assessment (COT, EOT, SOT), the interview items may be coded using the responses provided by the resident on a previous assessment, only if the DATE of the interview responses from the previous assessment (as documented in item Z0400) were obtained no more than 14 days prior to the DATE of completion for the interview items on the unscheduled assessment (as document in item Z0400) for which those responses will be used.

12

Chapter 2

• Section 2.10 page 2-54 • PPS Scheduled Assessment and Change of

Therapy OMRA

13

Chapter 3

Section A, page A-1, A-7, A-18, A21, & A23Identification Information

-Added the following; A0050—Type of Record, replaces X0100—Type of Record; A0310G—Planned or Unplanned Discharge; A1510-Level II Preadmission Screening and resident Review (PASRR) Conditions; -A1800—Entered From; A2100— Discharge Status added option “09—Long Term Care Hospital (LTCH)

14

Chapter 3

• Section A page A-24 • Under Coding Instructions• Code 09 long term care hospital (LTCH)

15

Chapter 3

• Section I—Active Diagnoses, page I-2 Item Set Changes

I18000 Additional Active Diagnoses (where ICD codes can be entered)— Removed the check box

16

Chapter 3

• Section I, page I-3• The term “new normal” has been removed.• Determine whether diagnoses are active.

17

Chapter 3

• Section K—Swallowing & Nutritional StatusItem Set Changes-Added K0310: Weight Gain, page K-8-Added K0510: Nutritional Approaches, page K-10

18

Chapter 3

• Section K, page K-16, • K0500B next to Coding has been amended.• Under Coding Instructions

– Coding & Rational

19

Chapter 3

• Section M—Skin Conditions pages M-22Item Set Changes

• M0700— Most Severe Tissue Type for Any Pressure Ulcer, added option “9” – None of the Above

20

Chapter 3

• Section M, pages M-29, M-31 & M-32• Replaced screen shot for item M1040 • Under coding instructions for Other Ulcers, Wounds

& Skin Problems, added and defined:M1040G- Skin TearsM1040 H- Moisture Associated Skin Damage

(MASD) (i.e., incontinence (IAD), perspiration, drainage)

21

Chapter 3

• Section N, pages N-5 and N-6 • Coding Instructions have been amended.• Enter the number of days each of the medications

listed were received in the last 7 days in item N0410.

22

Chapter 3

• Section Q, page Q-12 & Q-18• Added items Q0490- Resident’s Preference to

Avoid Being Asked Question Q0500B.• Added Q0550- Resident’s Preference to Avoid

Being Asked Question Q0500B again.

23

Chapter 3

• Section X, page X-1• The 5th paragraph has been amended. • An Inactivation request…..

24

Chapter 3

• Section X, page X-5• Under Coding Instructions for X0600A

-2nd bullet, reason for assessment has been amended.

X0600B Under Coding Instructions for X0600B– 2nd bullet, PPS Assessment has been amended.

X0600C Under Coding instructions for X0600C• 2nd bullet, PPS Other Medicare Required Assessment-

OMRA has been amended.

25

Chapter 3

• Section X, pages X-5 & X-6• Under Coding Instructions, for X0600D, Is this a

Swing Bed clinical change assessment? – 4th bullet has been amended.

• Coding Instructions for X0600F, “Entry/discharge reporting”, has been amended.

• 2nd bullet

26

Chapter 3

• Section X, page X-7• Coding Instructions for X0700A, Assessment

Reference Date – Complete Only if X0600F=99– This bullet has been amended.– 2nd bullet,

27

Chapter 3

• Section X, page X-7• Coding Instructions for 0700B, Discharge Date-

Complete Only if X0600F=10, 11, or 12.– 2nd bullet has been amended.

28

Chapter 3

• Section X, page X-7• Coding instructions for X0700C, Entry Date-

Complete Only if X0600F=01. • 2nd bullet has been amended.

29

Chapter 3

• Section X, page X-9 • Coding Instructions for X0900D, Item Coding Error.• (for exceptions when certain items may not be

modified, see chapter 5)

– 2nd bullet has been amended.

30

Chapter 3

• Section X, page X-9• Coding Instructions for X0900E, End of Therapy-

Resumption (EOT-R) date.– 1st bullet has been amended.

31

Chapter 5

• Inactivation Requests, page 5-12• Under Inactivation Requests, new paragraphs

addedIf the ARD or Type of Assessment….Inactivations should be rare….In such instances a new ARD date must……

32

Appendix B

• Page B-1• The hyperlink to the State RAI/MDS contacts has

been amended as follows: https://www.cms.gov/NursingHomeQualityInits/20_MDS30RAIManual.asp#TopOfPage

33

Appendix E

• Page E-7• Example 2 computation in step #2 has been

amended. • See bullet 5 on page E-5 for calculation of multiplier

34

Appendix E

• Page E-7• Example 3, computation in step #2 has been

amended.• See bullet 6 on page E-5 for calculation of

multiplier.

35

Other CMS Websites

• For Free Automatic Open Door Forum (ODF) Schedule Updates and E-Mailing List Registration:

http://www.cms.hhs.gov/OpenDoorForums/25_ODF_SNFLTS.asp#TopOfPage

• For Technical MDS 3.0 Version Information: http://www.cms.gov/NursingHomeQualityInits/30_NHQIMDSTechnicalInformation.asp#TopOfPage

• For MDS 3.0 Quality Measures (QM) Manual:http://www.cms.gov/NursingHomeQualityInits/Downloads/MDS30QM-Manual.pdf

36

Survey

– Please complete the survey located at the following website.

-http://www.surveymonkey.com/s/ondemandevaluation

• Thank you for viewing this presentation.