CMS/MDS Updates

The MDS 3.0 RAI Manual Version 1.14 and related item sets go into effect 10/1/16 and can be found at:
www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html.

  • This version of the MDS 3.0 RAI Manual incorporates the new Section GG: Functional Abilities and Goals, the new Part A PPS Discharge assessment, and clarifications to existing coding and transmission policy; it also addresses clarifications and scenarios concerning complex areas.

    CMS Provider Training Regarding the new Section GG can be found on You Tube:

 

  • MDS Provider Users Guide and CASPER Reporting User’s Guide updated in September 2016 can be found at:
    www.qtso.com/mdstrain.html.

 

www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9735.pdf.

 

 

If you have any questions, please feel free to contact Stacey Bryan at (573)751-6308 or Stacey.Bryan@health.mo.gov.

CMS S&C Memo 16-40-NH/HHA/CLIA

CMS S&C Memo 16-40-NH/HHA/CLIA:  Notice of Interim Final Rule (IFR) Agjusting Civil Monetary Penalties (CMPs)

CMS S&C Memo 16-38-ALL

CMS S&C Memo 16-38-ALL:  Notification of Final Rule Published-Emergency Preparedness

 

CMS S&C Memo 16-37-ALL

CMS S&C Memo 16-37-ALL:  Office of Civil Rights (OCR) Clearance

LeadingAge MDS Webinar

Commonly Asked Questions on the MDS, M-Section

Webinar – November 10, 2016, 11:00 a.m. – 12:15 p.m. CT

Presenter: Pamela Scarborough,  American Medical Technologies

The purpose of this presentation is to provide education regarding commonly asked questions from clinicians about the MDS 3.0, M-Section and wounds.

 

Please find registration and more information here

RAI Manual Changes

QIPMO will be presenting two different webinars on changes to the RAI Manual that are being implemented October 1st, 2016.  One webinar will cover the new MDS Section GG and Delirium and the other webinar is on General MDS Manual Updates.  Both webinars will be presented on multiple days at different times.  There is no cost for the webinars.

To sign up for these webinars:

  • Section GG and Delirium, multiple dates and times from August 26, 2016 through September 9, 2016 visit enrollment webpage here .
  • General MDS Manual Updates, multiple dates and times from September 12 through September 28, 2016 visit enrollment webpage here.

CMS S&C Memo:16-33-NH: Protecting Resident Privacy and Prohibiting Mental Abuse Related to Photographs and Audio/Video Recordings by Nursing Home Staff

  • Each resident has the right to be free from all types of abuse, including mental abuse. Mental abuse includes, but is not limited to, abuse that is facilitated or caused by nursing home staff taking or using photographs or recordings in any manner that would demean or humiliate a resident(s).
  • This CMS memo discusses the facility and State responsibilities related to the protection of residents

The CMS memo is available at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-16-33.pdf.

CMS S&C Memo 16-31-NH: Mandatory Immediate Imposition of Federal Remedies and Assessment Factors Used to Determine the Seriousness of Deficiencies for Nursing Homes

  • CMS is implementing a national policy that requires the use of federal enforcement remedies when one or more residents suffer significant harm.
  • This new policy is effective for all surveys completed on or after September 1, 2016.

For more information you may visit https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions-Items/Survey-and-Cert-Letter-16-31.html?DLPage=1&DLEntries=10&DLFilter=nh&DLSort=2&DLSortDir=descending.

CMS has published the updated Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual and forms which will be effective 10/1/2016

Section GG Part 1: www.youtube.com/watch?v=pNgQ3OSaxYg
Section GG Part 2: www.youtube.com/watch?v=M1JdQxjNOqE
Section GG Part 3: www.youtube.com/watch?v=ok3U2-mQymk
Section GG Part 4: www.youtube.com/watch?v=oRmMT_uYS8Y

New MDS Updates

Medication Classification Resources

The DRAFT RAI Manual v1.14 posted 5-11-16 and found at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html) and S&C 16-15-NH dated 3-25-16 and found at www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-16-15.pdf include several websites CMS lists as resources for information on medications (including classification).

Page 881 of The Draft RAI Manual v1.14 includes the following medication resources:

Page 41 of S&C 16-15-NH includes the following medication resources:

If you have any questions about the above information, please contact Stacey Bryan, BSN, RN, State RAI Coordinator, Department of Health & Senior Services, Telephone 573-751-6308 or E-mail stacey.bryan@health.mo.gov.

New MDS Updates

New MDS 3.0 Quality Measure User’s Manual Available

The MDS 3.0 QM User’s Manual Version 10 was posted April 28, 2016, which includes new Quality Measures.  The MDS 3.0 QM User’s Manual v10.0 contains detailed specifications for the MDS 3.0 quality measures that are only MDS based.  The new manual can be found in the Download section at the bottom of the page at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments/NursingHomeQualityInits/NHQIQualityMeasures.html.

 

New Measures Technical Specifications

There are also now QMs that are claims based in addition to being MDS based.  The specifications for these Quality Measures can be found in the download section at the bottom of the page at www.cms.gov/Medicare/Provider-Enrollment-and-certification/CertificationandComplianc/FSQRS.html.

 

Nursing Home Compare Five-Star Rating

Beginning in July 2016, five of the new measures (all except for the antianxiety medication measure), will be used in the calculation of the Quality Measure rating.  Gradual phase-in of the new measures will occur between July 2016 and January 2017.  Prior to July, the Technical Users’ Guide, which is also available in the downloads section of the CMS website (same link as above), will be updated to reflect the changes to the Quality Measure rating calculation.

 

Payroll-based Journal (PBJ)

Beginning in July 2016, all Medicare- and Medicaid-participating nursing homes must submit staffing

data to CMS through a new electronic system called the Payroll-based Journal (PBJ).  More information about staffing data submission is available at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Staffing-Data-Submission-PBJ.html

For additional assistance with or questions related to PBJ registration process, please contact the QTSO Help Desk at 877-201-4721 or via email at help@qtso.com.

 

Draft RAI Manual v1.14

On May 11, 2016, CMS posted a new DRAFT RAI Manual v1.14 in the Related Links section at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html so that users can preview significant changes before they become effective October 1, 2016.  There are many item set changes, including the new Chapter 3, Section GG: Functional Abilities and Goals. Chapter 2 and Chapter 3, Section A provide information on the new Part A PPS Discharge assessment.  Please note that it does not include Appendices F and H or replacement pages, which will be published with the final version 1.14 in September 2016.

 

If you have any questions about the above information, please contact Stacey Bryan, BSN, RN, State RAI Coordinator, Department of Health & Senior Services, Telephone 573-751-6308 or E-mail stacey.bryan@health.mo.gov.

New MDS 3.0 Quality Measure User’s Manual Available

The MDS 3.0 QM User’s Manual Version 10 was posted April 28, 2016 which includes new Quality Measures.  The MDS 3.0 QM User’s Manual v10.0 contains detailed specifications for the MDS 3.0 quality measures.  The new manual can be found in the Download section at the bottom of the page at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments/NursingHomeQualityInits/NHQIQualityMeasures.html.

If you have any questions, please contact Stacey Bryan, BSN, RN, State RAI Coordinator, Department of Health & Senior Services, Telephone 573-751-6308 or E-mail stacey.bryan@health.mo.gov.

MDS Training

RAI Process from Start to Finish

                April 12-13, 2016:  Independence, MO
                June 28-29, 2016:  St. Louis, MO
                August 10-11, 2016:  Columbia, MO
                October 11-12, 2016:  Columbia, MO

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.

Medicare from Start to Finish

               March 22, 2016:  Columbia, MO
May 24, 2016:  Columbia, MO
July 13, 2016:  Blue Springs, MO
September 20, 2016:  St. Louis, MO
November 15, 2016:  Columbia, MO

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 this process.

Please see the brochure here for more information.

ICD-10 CM Refresher

February 8-9, 2016:  Blue Springs, MO
February 10-11, 2016:  Springfield, MO
February 15-16, 2016:  St. Louis, MO
February 17-18, 2016:  Columbia, MO
This workshop is for long-term care staff, including nursing home administrators, MDS coordinators, medical records personnel, therapists, home health nurses and others who currently assign and/or use ICD-10 codes.

Please see the brochure here for more information including registration.

Updated MDS Information – additional

On October 1, 2015 a new version of the RAI Manual became effective, Version 1.13.  Most of the changes were minor but there is one important change to point out.  Prior to the update, Significant Change MDS’s were required if a resident enrolled in or discontinued hospice.  Those rules are still in effect, but now, a Significant Change MDS is also required when a resident changes hospice providers and remains a resident at the nursing home.  This new rule is in the RAI manual in Chapter 2 on page 21.  A Significant Change MDS may also be required in situations when the hospice providing services is purchased by another hospice provider.

The new manual can be found at:  www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html.  Scroll to the bottom of the page.  The first link is the ENTIRE Manual.  The second link is just the pages that have been changed as of October 1, 2015.  You will also find a summary of the changes in the second link.

If you have any questions, you may contact Stacey Bryan, BSN, RN, State RAI Coordinator, Department of Health & Senior Services, Telephone 573-751-6308 or E-mail Stacey.bryan@health.mo.gov.

Updated MDS Information

Updated RAI Manual
On October 1, 2015, a new version of the RAI Manual became effective, Version 1.13.  The new manual can be found at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursinghomeQualityInits/MDS30RAIManual.html towards the bottom of the page.  The first link is the ENTIRE Manual.  The second link is just the pages that have been changed.  Also, there is a summary of the changes with the second link.

Updated Quality Measure Manual
On October 1, 2015, a new version of the MDS 3.0 QM User’s Manual became effective, Version 9.0.  It can be found at: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures.html towards the bottom of the page and click on the 4th download (MDS 3.0 QM User’s Manual V9.0) OR at the following address: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/MDS-30-QM-Users-Manual-V90.pdf.

Updated MDS 3.0 Provider User’s Guide
Section 1 (Introduction), Section 5 (Error Messages) and Appendix A were updated in the MDS 3.0 Provider User’s Guide in September 2015.  The updated guide can be found at www.qtso.com/mdstrain.html.

If you have any questions regarding the updates, you may contact Stacey Bryan, BSN, RN, State RAI Coordinator, Department of Health & Senior Services, Telephone 573-751-6308 or E-mail stacey.bryan@health.mo.gov.