MDS Items O0600 (Physician Examinations) and O0700 (Physician Orders)
As of 10-1-17, Version 1.15 of the RAI Manual went into effect. The RAI Manual now states CMS does not require completion of items O0600 or O0700, however, some States continue to require the completion of these items. The RAI Manual states if the State does not require the completion of these items, use the standard “no information” code (a dash, “–”).
Missouri does not require completion of items O0600 and O0700; staff in Missouri facilities may dash these items as the RAI Manual directs.
If you have any questions concerning this information, please contact Stacey Bryan, the State RAI Coordinator, at 573-751-6308 or Stacey.Bryan@health.mo.gov.
SNF QRP Confidential Feedback Reports for Claims-Based Measures
The SNF QRP Confidential Feedback Reports containing the claims-based IMPACT Act measures are now available via the CASPER Reporting System.
For more information on these reports, please refer to the September 28, 2017 presentation and audio and transcript on the SNF QRP Training website.
Please note that these reports only contain information for the following claims-based quality measures:
- Total Estimated Medicare Spending Per Beneficiary Measure
- Discharge to Community-Post Acute Care– SNF QRP
- Potentially Preventable 30-Day Post Discharge Readmission Measure
The full Confidential Feedback Reports or Quality Measure reports containing all SNF QRP quality measures (claims-based and assessment-based) will be released later this year and further training will be forthcoming.
If you have questions about the information contained in your report, please contact the SNF QRP Help Desk at SNFQualityQuestions@cms.hhs.gov.
Update: SNF QRP Review and Correct Reports & Confidential Feedback Reports Issues
We recently SNF providers that all data for assessment-based measures required for the SNF QRP in CY2017 would remain open to modifications until May 15, 2018, and that you would be notified when the Q1 2017 data that was “frozen” as of August 15, 2017 would be open and subject to updates again.
Please be advised that the submission deadline for Q3 2017 data has been modified to May 15, 2018. The SNF Review and Correct Report has been updated to reflect that both Q1 and Q2 2017 are “Open”. Data for all measures for Q1 2017 have been recalculated for any assessment records that have been received since the original Q1 2017 submission deadline of August 15, 2017.
The SNF Review and Correct report is available in the SNF Quality Reporting Program report category in the CASPER Reporting application. Providers are encouraged to request the report to view updated measure results. The updated report should replace versions of the report previously requested.
Note that when the report is run for more than one quarter, the Reporting Quarters are now displaying in random order, rather than being displayed in descending order (newest Reporting Quarter to oldest Reporting Quarter). The Start and End Dates, Data Correction Deadline Date, Date Correction Period as of Report Run Date and the quality measure data results associated to the Reporting Quarters are all correct. The issue is simply the way in which the Reporting Quarters are displayed in the table. This will be corrected in early December.
The remaining issue, affecting the calculation of the Application of Percent of LTCH Patients with Admission and Discharge Functional Assessment and a Care Plan that Addresses Function, is still being corrected and tested. You will be notified once this issue has been resolved in early December. At that time, the data for this measure will be recalculated and the updated results will be available on the Review and Correct Report.
View previous updates on the SNF Quality Reporting Program Data Submission Deadlines webpage.
If you have questions concerning this information, please contact the QTSO Help Desk at firstname.lastname@example.org or 1 (800) 339-9313.
CMS PowerPoint Presentation: 2017 RAI User’s Manual Provider Updates
A PowerPoint presentation that highlights the major changes to the October 1, 2017 version of the RAI Manual has been posted to the CMS MDS webpage at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html. The presentation can be found as #6 in the Related Links section at the bottom of this webpage. Please note that the presentation provides an overview of the major changes but not all of the changes to the manual. Providers should also review the RAI Manual Change Tables and the manual itself to understand all of the changes.
New MDS 3.0 RAI Manual Posted
CMS posted the MDS 3.0 RAI Manual v1.15 on their website on 8/31/17, which will be effective October 1, 2017. The new Manual can be found in the Related Links Section at the bottom of the following CMS website www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments/NursingHomeQualityInits/MDS30RAIManual.html
The Related Links section at the bottom of this page contains:
- MDS 3.0 RAI Manual v1.15 October 1, 2017
- A Single PDF file of the entire RAI manual for use as an electronic version with bookmarks that you can click on to take you to each section of the manual.
- MDS 3.0 RAI Manual v1.15 and Change Tables October 1, 2017
- Traditional zip files of the RAI manual and the change tables that crosswalk the changes made to this year’s manual. Note: This is the same material as the first item above, except there are separate files for each chapter or subchapter.
- MDS 3.0 RAI Manual v1.15 Replacement Manual Pages and Change Tables October 1, 2017
- Replacement pages for this year’s manual changes for those that want to just update their existing paper based manual with the pages that have changed. It also includes the change tables that crosswalk the changes made to this year’s manual.
- MDS Forms (Item Sets) v1.15.1 October 1, 2017
- Two folders separate the v1.15.1 MDS forms (MDS item sets) into those used in long term care facilities (SNFs and NFs) and those used in swing bed facilities.
MDS 3.0 Section M in Advances in Skin & Wound Care
Elizabeth Ayello has published an article on the MDS 3.0 Section M in Advances in Skin & Wound Care, September 2017 – Volume 30 – Issue 9. This is a free access article, which means anyone can read the article free of charge. There is also an option for CEUs. Elizabeth’s article is available on the Advances in Skin & Wound Care website at journals.lww.com/aswcjournal/Pages/currenttoc.aspx, in the Clinical Management Section, and is titled: CMS MDS 3.0 Section M Skin Conditions in Long-term Care: Pressure Ulcers, Skin Tears, and Moisture-Associated Skin Damage Data Update.
SNF QRP Review and Correct Reports & Confidential Feedback Reports
SNF providers were recently notified of two issues affecting the SNF QRP Review and Correct Reports & Confidential Feedback Reports.
An issue was identified within the SNF Review and Correct Report, if one or more modification records are submitted for a patient stay, the most recent submitted assessment, which was accepted by the ASAP system on or prior to the submission deadline for Q1 and Q2 of CY2017, was not being used in the measure calculation.
All quality measure data has been recalculated and is now available in the SNF Quality Reporting Program report category in the CASPER Reporting application. Providers are encouraged to request the report to view updated measure results. The updated report should replace versions of the report requested prior to the issue notification.
The second issue that was identified in the technical coding, which affected our calculation of one measure contained in the SNF Review and Correct Report related to the measure Application of Percent of LTCH Patients with Admission and Discharge Functional Assessment and a Care Plan that Addresses Function, also affected the SNF QRP Confidential Feedback Report (SNF Quality Reporting Program (QRP) Quality Measure Report) is still being resolved and further guidance is forthcoming.
As a reminder, all data for assessment-based measures required in the SNF QRP in CY2017 will remain open to modifications until May 15, 2018. We anticipate that the data currently “frozen” as of August 15, 2017 to be subject to updates as of mid-September. Another notice will be issued once the Review and Correct Report Q1 2017 SNF QRP data is open again.
Further guidance and timelines has been posted to the SNF Quality Reporting Program Data Submission Deadlines webpage.
All facilities will receive an email blast notifying them of the above. We will continue to send follow-up announcements as further guidance can be given.
If you have any questions concerning this information, please contact the QTSO Help Desk at email@example.com or 1 (888) 477-7876.
You don’t have to be an MDS Coordinator to attend
Often, the topics discussed are beneficial not only for MDS Coordinators but also for floor nurses, Social Services staff, DONs, ADONS and Administrators. You can find a schedule of meetings and topics by going to the Nursing Home Help website found at www.nursinghomehelp.org/supgr.html. Some past topics have included Quality Measures, QRP requirements, Phase 1 and 2 Regulation Implementation, discussions with the State RAI Coordinator and State Surveyors, PPS Scheduling, CAA documentation, Care Plans, MDS Review for Social Workers, Wounds, Section GG Coding, Behavior Documentation and ICD-10 Coding. You are welcome to attend any meeting anywhere in the state, no RSVP needed.
The State RAI Coordinator is coming to a QIPMO MDS Support Group Meeting Near You!
Stacey Bryan, the State RAI Coordinator will be presenting at Support Group Meetings across the state to discuss MDS Coding, new MDS items to be implemented 10/1/17, Phase 1 (implemented 11/28/16) and Phase 2 (to be implemented on 10/28/17) regulation updates/changes and much more. You don’t have to be an MDS Coordinator to attend, other staff that may find the information helpful include Social Services staff, ADONS, DONS and the Administrator. Don’t be blind-sided by the recent and upcoming changes, be in the know now! Visit the Nursing Home Help website at http://www.nursinghomehelp.org/supgr.html to see the specific location of where Stacey Bryan will be at the following meetings:
- June 7th, 2017 from 1:00 P.M. to 3:00 P.M. in Willow Springs
- June 8th 2017 from 11:00 A.M. to 12:30 PM. in Poplar Bluff
- June 9th, 2017 from 9:30 A.M. to 11:30 AM. in Cape Girardeau
- June 14th, 2017 from 1:00 P.M. to 3:00 PM. in Jefferson City
- June 16th, 2017 from 9:00 A.M. to 11:00 A.M. in Kansas City
- June 22nd, 2017 from 9:00 A.M. to 11:00 A.M. in St. Peters
- June 23rd, 2017 from 9:00 A.M. to 11:00 A.M. in St. Louis
- July 11th, 2017 from 9:00 A.M. to 11:00 A.M. in St. Joseph
- July 17th, 2017 from 9:00 A.M. to 11:00 A.M. in Ozark
- August 15th, 2017 from 9:00 A.M. to 11:00 A.M. in Springfield
Have you been to a QIPMO MDS Support Group Meeting lately??? You don’t have to be an MDS Coordinator to attend
Often, the topics discussed are beneficial not only for MDS Coordinators but also for floor nurses, Social Services staff, DONs, ADONS and Administrators. You can find a schedule of meetings and topics by going to the Nursing Home Help website found at http://www.nursinghomehelp.org/supgr.html. Some past topics have included Quality Measures, QRP requirements, Phase 1 and 2 Regulation Implementation, discussions with the State RAI Coordinator and State Surveyors, PPS Scheduling, CAA documentation, Care Plans, MDS Review for Social Workers, Wounds, Section GG Coding, Behavior Documentation and ICD-10 Coding. You are welcome to attend any meeting anywhere in the state, no RSVP needed.
IRF, LTCH, SNF QRP: Registration Open for Review and Correct Reports Provider Training – Live Webcast on May 2, 2017
CMS is hosting a live webcast for Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs), and Skilled Nursing Facilities (SNFs) on Tuesday, May 2, 2017, from 2:00 to 3:30 p.m. ET.
This training will assist providers in better understanding how Review and Correct Reports fit within the overall Quality Reporting Programs. Additionally, the training will provide information about re-submitting data to correct errors prior to the quarterly submission deadlines to ensure the accuracy of the data which will ultimately be publicly displayed.
Visit the following webpages for more information and to register:
IRF Quality Reporting Training: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/IRF-Quality-Reporting/IRF-Quality-Reporting-Training.html
LTCH Quality Reporting Training webpage
SNF Quality Reporting Training webpage
A Quick Reference Guide for Skilled Nursing Facilities (SNFs) is now available. This guide include frequently asked questions, information on QRP help desks, and helpful links to additional resources for the QRP.
QRP – MDS Submission
The submission deadline for the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) is approaching. Minimum Data Set (MDS) assessment data for October-December (Q4) of calendar year (CY) 2016 are due with this submission deadline. All data must be submitted no later than 11:59 p.m. Pacific Standard Time on May 15, 2017.
View the list of measures required for this deadline on the SNF Quality Reporting Program 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.html.
As a reminder, it is recommended that providers run the applicable CMS CASPER validation reports prior to each quarterly reporting deadline to ensure that all required data has been submitted. Providers are also encouraged to verify all facility information prior to submission, including their CCN and facility name. Only successful submissions will count toward your Annual Payment Update requirement.
For more information, view https://www.qtso.com/download/mds/MDS_3.0_Helpful_Hints.pdf
New QIPMO Newsletter – February 2017
The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 4, Issue 2.
Please visit QIPMO’s website here for this and other previous newsletters.
Staffing Data Submission Reminder
Staffing Data Submission Reminder: As of July 1, 2016, electronic submission of staffing data through the Payroll-Based Journal (PBJ) is mandatory for all Long Term Care Facilities. You have up to 45 days after the end of the quarter to submit data for Federal Fiscal Quarter 1 (October 1, 2016-December 31, 2016.) The final submission file for this quarter is due on February 14, 2017. Submit early to avoid system delays.
Please note that an updated policy manual and FAQ are now posted on the PBJ website.
For questions related to software or technical requirements, please email NursingHomePBJTechIssues@cms.hhs.gov
For questions related to PBJ policies, please email NHstaffing@cms.hhs.gov
PBJ website link: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html
MDS Trainings 2017
RAI Process from Start to Finish
- January 24-25, 2017: Columbia
- April 4-5, 2017: Kansas City
- June 20-21, 2017: St. Louis
- August 8-9, 2017: Columbia
- October 18-19, 2017: Springfield
This workshop will look at the RAI process from beginning to end. The MDS is used for both a clinical assessment and a financial assessment and this workshop will discuss the rules on scheduling these assessments and meeting the requirements individually and combined. Item-by-item coding will be reviewed. From coding the MDS, we will then look at the CAA to care plan process. Finally, we will review how to stay up-to-date in this ever-changing world of MDS 3.0.
Medicare from Start to Finish
- March 20, 2107: Columbia
- May 23, 2017: Springfield
- July 18, 2017: Kansas City
- September 19, 2017: St. Louis
- November 13, 2017: Columbia
This one-day workshop will begin with how to gain access to and read the MDS reports from CASPER in order to self-audit your RAI process. The completion of the MDS is becoming more and more difficult and confusing. This workshop will help the MDS Coordinator and other members of the interdisciplinary team to understand the admitting criteria and the ongoing documentation needs of the Medicare resident. The RAI process in relationship to Medicare is also confusing and errors can be a financial nightmare for facilities. This workshop will help clear up the confusion surrounding the process.
MDS Section M Training Video for Surveyors Available to Providers
An interactive training video on Section M: Skin Conditions is now available: http://surveyortraining.cms.hhs.gov/Courses/126/SectionMVideo/SectionMVideo.html.
New QIPMO Newsletter – October 2016
The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 4, Issue 1.
Please visit QIPMO’s website here for this and other previous newsletters.