The Centers for Medicare & Medicaid Services (CMS) was set to release the Minimum Data Set (MDS) 3.0 version 1.18.1 on October 1, 2020. However, the COVID-19 public health emergency upended that plan.
Prior to the pandemic, CMS intended to eliminate Section G along with making some changes to other sections of the MDS. Then in March, as part of the blanket 1135 waiver, the regulatory agency delayed the release of the planned version of the MDS to give skilled nursing facilities more flexibility in their response to COVID-19.
With a new scaled-down MDS 3.0 going into effect on October 1, it’s crucial for facilities to understand the impact of the changes and take the necessary steps to manage Medicaid revenue for FY 2021.
Understanding the impact
The interim MDS 3.0 version 1.17.2 is designed to facilitate the calculation of Patient Driven Payment Model (PDPM) payments on all Omnibus Budget Reconciliation Act (OBRA) assessments.
Each state has the option of requiring PDPM data on OBRA comprehensive and quarterly assessments. New item sets include section GG, item I0020B ICD-10 for the primary medical condition and J2100 recent surgery requiring active SNF care.
The key takeaway here is knowing where your state has landed regarding the collection of PDPM data on the OBRA assessments, and if you will be required to complete an Optional State Assessment (OSA).
Tips for success
First and foremost, there’s no need to panic. While your state may require PDPM data beginning October 1, your payments on that data will not be affected. Keep in mind that the purpose of these changes is to inform future Medicaid models.
Here are several steps your facility can take to adapt to the new MDS for FY 2021:
- Contact the RAI Coordinator for your state to find out the new requirements
- Educate your team on how to accurately code for the new section and items on MDS version 1.17.2
- Make sure your Electronic Health Record (EHR) is updated to align with the October 1 changes
- Implement a robust process for collecting PDPM data across all payers
How ABILITY can help
ABILITY CAREWATCH equips you with software tools that will enable your facility to be ready for any quality management changes coming its way. With updated logics, you can create real-time reports to closely monitor quality and revenue and comply with state and federal requirements.
Specific to MDS 3.0, you’ll have access to:
- An MDS Detail Report and ADL Report to improve data accuracy on Sections GG and J
- Diagnosis Watch and PDPM tools to help manage Section I and boost reimbursement
- Restorative Watch to improve resident outcomes via a robust restorative nursing program
Discover firsthand how to put this application to work for your facility by requesting a demo today.
“MDS 3.0 Technical Information,” CMS, accessed September 21, 2020, https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation
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