Action Required: iQIES Provider Security Official Recruitment

As previously announced, CMS is preparing to release the Internet-facing, cloud-based system, referred to as the Internet Quality Improvement and Evaluation System (iQIES) for Minimum Data Set (MDS) submission in early 2023.

Although the MDS submission functionality will not be available immediately, we strongly encourage Provider Security Officials (PSOs) to request access to iQIES as soon as possible, as doing so will allow for a smoother transition prior to the go live date. The individual designated as the PSO must work for the provider and will be responsible for approving or rejecting iQIES user access requests for their respective organizations, including vendors. A user will not be granted access unless a PSO approves the request. The first PSO for your provider will need to be approved by CMS. Once approved, PSOs can approve additional Provider Security Official role requests.

Organizations must complete the steps below to register a Provider Security Official as soon as possible:

 ***IMPORTANT: General user onboarding begins November 15, 2022. At that time, if your organization has not yet successfully registered at least one PSO, users will not be able to complete their access requests. The delay for assigning a PSO places an organization in jeopardy of a smooth transition to iQIES.***

  1. Identify at least one individual who will be the Provider Security Official (PSO). Note: At a minimum, at least one PSO needs to be selected, but CMS highly recommends at least two PSOs are designated so there is a higher likelihood that someone will be available to approve/reject iQIES access requests. The PSO must work for the provider and cannot be a vendor.
  2. Create an account in the HARP system using your corporate email address* at: https://harp.cms.gov/register. Note: HARP User IDs cannot be adjusted. As such, please refrain from using facility names or any special characters (such as # or &) when creating the HARP User ID. *If the facility handles 2 or less providers and does not have a corporate email domain, the PSO may use a personal email address.
  3. Access iQIES at: https://iqies.cms.gov/ and log in with your HARP credentials (completed in step 2 above) to request the Provider Security Official role for YOUR specific provider CMS Certification Number (CCN).
  4. Once the PSO role request has been submitted AND approved, you will receive notification via email. At this point you will be one of the designated PSOs for your CCN and have the authority to approve/reject subsequent requests for access of various role types to your provider’s CCN.

Please see iQIES Quick Reference Guide – Provider Security Official for more information to onboard the PSO Role in iQIES: https://qtso.cms.gov/software/iqies/reference-manuals

Please Note: Currently, we are only onboarding MDS. You do not need to register for a HARP/iQIES account for Payroll Based Journal (PBJ) submissions.

Resources

For more information on HARP or iQIES, please refer to the following resources:

 HARP

 iQIES

If you have questions or require assistance, please contact the iQIES Service Center at iqies@cms.hhs.gov or by phone at (800) 339-9313.

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS and NHSN data for 4/1/22 through 6/30/22 must be submitted no later than 11:59 p.m. on November 15, 2022.

The Minimum Data Set (MDS) 3.0 must be transmitted to the Centers for Medicare & Medicaid Services (CMS) through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). Data for the National Healthcare Safety Network (NHSN) measures must be submitted to the Centers for Disease Control and Prevention (CDC). No additional data submission is required for the claims-based measures.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:
CMS SNF QRP Data Submission Deadlines webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Data-Submission-Deadlines
CMS SNF QRP Help webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-QRP-Help
CMS SNF QRP Measures and Technical Information webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Measures-and-Technical-Information
CMS SNF QRP Training Webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Skilled-Nursing-Facility-Quality-Reporting-Program/SNF-Quality-Reporting-Program-Training

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 7/1/22 through 9/30/22 is due November 14, 2022.

Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline, as the Service Center will be unavailable to assist on the weekend.

More information about PBJ can be found on the following webpages:
CMS PBJ webpage – https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ
PBJ Reference Manuals – https://qtso.cms.gov/vendors/payroll-based-journal-pbj-vendors/reference-manuals
PBJ Training – https://qtso.cms.gov/training-materials/payroll-based-journal-pbj

iQIES Provider Security Officials Onboarding for MDS

CMS announced they are preparing to release the Internet Quality Improvement Evaluation System (iQIES) for Minimum Data Set (MDS) submission in early 2023. Although the MDS submission functionality will not be available immediately, CMS encourages Provider Security Officials (PSOs) to request access to iQIES as soon as possible, as doing so will allow for a smoother transition prior to the go live date. At a minimum, at least one PSO needs to be selected, but CMS highly recommends that at least two PSOs are designated so that there is a higher likelihood that there will be someone available to approve/reject iQIES access requests. Nursing homes and Swing Beds in CMS Region 7 (which includes Missouri) should onboard their Provider Security Officials October 31, 2022 through November 11, 2022. The onboarding of other nursing home and swing bed hospital staff can begin on November 15.

Onboarding Schedule for MDS Transition to iQIES:
https://qtso.cms.gov/system/files/qtso/Provider%20Security%20Officials%20Schedule%20-%20QTSO%20posting%20final%20-%20Copy.pdf

iQIES Onboarding Process Quick Reference Guide for the Provider Security Official Role:
https://qtso.cms.gov/system/files/qtso/iQIES%20Onboarding%20Process%20Quick%20Reference%20Guide%20-%20Provider%20Security%20Official.pdf

Harp Help: https://harp.cms.gov/login/help

SNF Quality Reporting Program (QRP) Submission

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS and NHSN data for 1/1/22 through 3/31/22 must be submitted no later than 11:59 p.m. on August 15, 2022.

The Minimum Data Set (MDS) 3.0 must be transmitted to the Centers for Medicare & Medicaid Services (CMS) through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). Data for the National Healthcare Safety Network (NHSN) measures must be submitted to the Centers for Disease Control and Prevention (CDC). No additional data submission is required for the claims-based measures.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 4/1/22 through 6/30/22 is due August 14, 2022.

Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline, as the Service Center will be unavailable to assist on the weekend.

More information about PBJ can be found on the following webpages:

RAI Manual Update

CMS released a PDF file labeled “MDS3.0RAIManualv1.17R.Errata.v2.July.15.2022,” available in the Downloads section of the MDS 3.0 RAI Manual webpage. This file contains revisions to pages in Chapter 3, Section I, of the MDS 3.0 RAI Manual v1.17.1R that clarifies the need for a detailed evaluation and appropriate diagnostic information to support a diagnosis, such as for a mental disorder, prior to coding the diagnosis on the MDS, and the steps that may be necessary when a resident has potentially been misdiagnosed. An example of when a diagnosis should not be coded in Section I due to lack of a detailed evaluation and appropriate diagnostic information to support the diagnosis has also been added to this section. Changed manual pages are I-12 and I-16 and are marked with the footer “October 2019 (R).”

Quality Reporting Program: Non-Compliance Letters for FY 2023 APU

CMS is providing notifications to facilities that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2021, which will affect their FY 2023 Annual Payment Update (APU). Non-compliance notifications are being distributed by the Medicare Administrative Contractors (MACs) and were placed into SNFs’ CASPER folders in QIES on July 13, 2022. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, August 11, 2022.

If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notice of non-compliance and on the SNF Quality Reporting Reconsideration and Exception & Extension webpage.

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS and NHSN data for 10/1/21 through 12/31/21 must be submitted no later than 11:59 p.m. on May 16, 2022.

The Minimum Data Set (MDS) 3.0 must be transmitted to the Centers for Medicare & Medicaid Services (CMS) through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). Data for the National Healthcare Safety Network (NHSN) measures must be submitted to the Centers for Disease Control and Prevention (CDC). No additional data submission is required for the claims-based measures.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 1/1/22 through 3/31/22 is due May 15, 2022. Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline, as the Service Center will be unavailable to assist on the weekend.

More information about PBJ can be found on the following webpages:

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS data for 7/1/21 through 6/30/21 must be submitted no later than 11:59 p.m. on February 15, 2022.

The Minimum Data Set (MDS) 3.0 must be transmitted to CMS through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). No additional reporting is required.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 10/1/21 through 12/31/21 is due February 14, 2022. Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline, as the Service Center will be unavailable to assist on the weekend. More information about PBJ can be found on the following webpages:

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS data for 4/1/21 through 6/30/21 must be submitted no later than 11:59 p.m. on November 15, 2021.

The Minimum Data Set (MDS) 3.0 must be transmitted to CMS through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). No additional reporting is required.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 7/1/21 through 9/30/21 is due November 14, 2021. Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline, as the Service Center will be unavailable to assist on the weekend. Therefore, phone and email support will be concluded as of Friday, November 12, 2021 at 8:00 p.m. (ET).More information about PBJ can be found on the following webpages:

RAI Manual Updates

CMS released a PDF file labeled “MDS 3.0RAIManualv1.17.1R.Errata.October.1.2021,” available in the Downloads section of the MDS 3.0 RAI Manual webpage. This file contains revisions to pages in Chapter 6 of the MDS 3.0 RAI Manual v1.17.1R that update the NTA Comorbidity Score Calculation table. Changed manual pages are marked with the footer “October 2019 (R).” The errata document begins with a table that lists all identified revisions and the pages to which they have been applied. Following the table are the actual corrected replacement pages for insertion into the printed manual.

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 4/1/21 through 6/30/21 is due August 14, 2021. Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

PLEASE NOTE: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center no later than the Friday before the submission deadline. The Service Center will be unable to assist on the weekend. Therefore, phone and email support will be concluded as of Friday August 13, 2021 at 8:00 p.m. (ET).

More information about PBJ can be found on the following webpages:

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS data for 1/1/21 through 3/31/21 must be submitted no later than 11:59 p.m. on August 16, 2021.

The Minimum Data Set (MDS) 3.0 must be transmitted to CMS through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). No additional reporting is required.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to IRFs, LTCHs, and SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:

Quality Reporting Program: Non-Compliance Letters for FY 2022 APU

CMS is providing notifications to facilities that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for CY 2020, which will affect their FY 2022 Annual Payment Update (APU). Non-compliance notifications are being distributed by the Medicare Administrative Contractors (MACs) and were placed into SNFs’ CASPER folders in QIES on July 14, 2021. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 pm, August 13, 2021.

If you receive a notice of non-compliance and would like to request a reconsideration, see the instructions in your notice of non-compliance and on the SNF Quality Reporting Reconsideration and Exception & Extension webpage.

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS data for October 1 – December 31 (Q4) of CY 2020 must be submitted no later than 11:59 p.m. on May 17, 2021.

The Minimum Data Set (MDS) 3.0 must be transmitted to CMS through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). No additional reporting is required.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to IRFs, LTCHs, and SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 1/1/21 through 3/31/21 is due on Saturday, May 15, 2021. Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center (1-800-339-9313) no later than the Friday before the submission deadline as the Service Center will be unavailable to assist on the weekend.

More information about PBJ can be found on the following webpages:

SNF Quality Reporting Program (QRP) Submission Deadline Reminder

SNFs are required to report data to meet the SNF QRP requirements. The submission deadline for the SNF QRP is approaching. MDS data for July 1 – September 30 (Q3) of CY 2020 must be submitted no later than 11:59 p.m. on February 16, 2021.

The Minimum Data Set (MDS) 3.0 must be transmitted to CMS through the Assessment Submission and Processing (ASAP) system to the Quality Improvement Evaluation System (QIES). No additional reporting is required.

As a reminder, it is recommended that providers run applicable CASPER reports prior to each quarterly reporting deadline, in order to ensure that all required data has been submitted.

Swingtech sends informational messages to IRFs, LTCHs, and SNFs that are not meeting APU thresholds on a quarterly basis ahead of each submission deadlines. If you need to add or change the email addresses to which these messages are sent, please email QRPHelp@swingtech.com and be sure to include your facility name and CMS Certification Number (CCN) along with any requested email updates.

More information about SNF QRP can be found on the following webpages:

Payroll-Based Journal (PBJ) Submission Deadline Reminder

Nursing homes are required to electronically submit direct care staffing information to the Payroll-Based Journal (PBJ) system. Submissions must be received by the end of the 45th calendar day (11:59 PM Eastern Standard Time) after the last day in each fiscal quarter to be considered timely. PBJ data for 10/1/20 through 12/31/20 is due on Sunday, February 14, 2021. Please submit PBJ data as soon as possible to avoid delays. CMS recommends running staffing reports in CASPER prior to the submission deadline to ensure the accuracy and completeness of submissions. Please remember, the Final File Validation Report verifies that the submission was successful.

Please note: If you need assistance with the PBJ quarterly submission and the deadline falls on a weekend, you must contact the QIES/iQIES Service Center (1-800-339-9313) no later than the Friday before the submission deadline as the Service Center will be unavailable to assist on the weekend.

More information about PBJ can be found on the following webpages:

MDS Changes for 10-1-20

Missouri opted to collect PDPM HIPPS codes on OBRA assessments with an ARD of 10/1/20 or later. This means that SNFs and NFs in Missouri need to complete additional items on OBRA assessments not combined with a Medicare assessment. Additional items include:

  • GG0130 Self-Care items;
  • GG0170 Mobility items;
  • I0020 and I0020B Primary Medical Condition items;
  • J2100 Recent Surgery item. If J2100 is checked yes, J2300-J5000 are to be completed.

Training: QIPMO provided a webinar on 9/21/20 where Stacey Bryan, Missouri’s State RAI Coordinator, went over MDS changes for 10-1-20. To view a recording of this webinar please go to https://nursinghomehelp.org/event/september-monthly-webinar/. Please note, the RAI Manual pages to review for examples of diagnoses in each medical condition category for item I0020 is I-2 and I-3, not I-12 which is referenced in the webinar.

FAQ Document: Below is a FAQ document concerning the MDS changes for Missouri this October. This document will be updated as needed. The date a question and answer is added to the document will be beneath each answer.

MDS FAQ Document for MO 10-16-20 version

If you have any questions about this information please contact Missouri’s State RAI Coordinator, Stacey Bryan, at Stacey.Bryan@health.mo.gov or 573-751-6308.

MDS Rejections related to October 2020 Changes

Missouri opted to collect PDPM HIPPS codes on OBRA assessments with an ARD of 10/1/20 or later. This means that SNFs and NFs in Missouri need to complete additional items on OBRA assessments not combined with a Medicare assessment. Additional items include:

  • GG0130 Self-Care items;
  • GG0170 Mobility items;
  • I0020 and I0020B Primary Medical Condition items;
  • J2100 Recent Surgery item. If J2100 is checked yes, J2300-J5000 are to be completed.

Multiple homes have reported their software has not incorporated the additional required items listed above for OBRA comprehensive and Quarterly assessments with an ARD of 10/1/20 or after. They report if they complete the MDS assessments without these items the assessments are rejected by the QIES ASAP system. Some homes report they are able to change a setting in their software themselves that will include these items on OBRA assessments. Some homes report they cannot change the setting in the software themselves, that they must contact their software vendor for this setting change. Most homes that encounter this issue say after their software setting is changed, they must open completely new MDS assessments because the additional items will not be added to the assessment they opened prior to the setting change.

If you are completing an OBRA comprehensive or Quarterly assessment that has an ARD on or after 10/1/20, please ensure the additional items listed above, required to calculate a PDPM HIPPS code, are NOT grayed out in your software. If you discover these items are grayed out, contact your software vendor as soon as possible before continuing with the assessment.

If you have any questions about this issue please contact Stacey Bryan at Stacey.Bryan@health.mo.gov or 573-751-6308. Thank you.