CMS National MDS Conference Highlights

Last week the Centers for Medicare and Medicaid Services (CMS) held two back-to-back conferences for providers on MDS 30.  The two-day agenda focused on MDS item set changes scheduled for April 1, 2012, RUG IV updates and clarification, MDS 3.0 error reports, quality measures used in the survey process, Section Q changes, and care planning.  Conference highlights include:

  • Effective April 1, 2012 and when coding a standalone unscheduled PPS assessment (COT, EOT, and SOT), the interview items may be coded using the responses from the previous assessment if those responses were obtained no more than 14 days ago.  This does not apply in cases where unscheduled PPS assessment is combined with a non-PPS assessment or a scheduled PPS assessment.  Interviews will still be required on Significant Change in Condition assessments.
  • Discharge Assessments will be based on whether the discharge was planned or un-planned.  An unplanned discharge is defined as an acute-care transfer of the residents to a hospital or an emergency department in order to stabilize a condition or determine if an acute-care admission is required based on the emergency department evaluation, or, the resident unexpectedly leaves the facility against medical advice, or unexpectedly decides to go home or to another facility.  Currently, the Discharge Assessment has about 111 questions.  Starting April 1st, the Un-Planned Discharge Assessment will have 77 questions and the Planned Discharge Assessment will have 89 questions.
  • CMS will now publish RAI edits using errata documents showing only those pages where changes are made.  The next manual update will occur on October 1, 2012 and will be tied to the PPS rule.  After that, RAI Manual changes will occur once per year.
  • A number of minor edits will be made.  For example: the term “Mental Retardation (MR)” will be changed to “Intellectual Disability (ID).”
  • Refinement will be made to Section Q to help improve item questions and response.Quality measures used in surveys will now include Psychoactive Medication Used in Absence of Psychiatric or Related Conditions, Antianxiety/Hypnotic Medication Use, and Behavior Symptoms Affecting others.  The quality measures for Pneumonia and Influenza will be eliminated for the Survey CASPER Report.

CMS discussed the MDS 3.0 RUG IV clarifications and issues related to combining assessments, assessment ARD compliance and inactivating assessments.  Click here to view the MDS 3.0 and RUG IV; FY 2012 Updates and Clarifications slides. 

In general, providers expressed concern about the volume of assessments, the complexity of the rules, and increased nurse turnover directly related to the MDS 3.0.  CMS stated they are open to hearing feedback from providers and they are trying to resolve the issues that create financial liability.