MDS Alert

Know how your flu vaccine measures are changing.

The Centers for Medicare & Medicaid Services (CMS) has been busy revising and refining certain key documents for nursing homes, namely the RAI Manual and the MDS 3.0 Quality Measure (QM) User’s Manual.Here’s what you need to know about these most recent changes.

On Sept. 15, CMS posted the updated RAI Manual v1.13, which includes the full sets of chapters, sections, appendices, and change tables. You can also access the replacement manual pages that changed from v1.12R to v1.13.

New way: In v1.13, CMS placed a footer date of October 2015 on every page and removed the Table of Contents’ listing of different version numbers for each chapter/section. The change tables also no longer list corrections to minor formatting, typo, or punctuation errors.

You might notice that Appendix C and the Chapter 3 pages with definition boxes look different in the new version, but the changes merely involve formatting corrections and do not affect the content or interpretation.

The change tables documents for the RAI Manual v1.13 are accessible at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/MDS-30-RAI-Manual-v113-Change-Tables-October-2015.zip, and the replacement manual pages are at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/MDS-30-RIA-Manual-V113-Replacement-Manual-Pages-and-Change-Tables-October-2015.zip.

CMS also posted an updated Appendix B, which includes changes to state RAI coordinators, MDS automation coordinators, RAI panel members, and regional office contacts. You can download the new Appendix B at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/MDS-RAI-Manual-Appendix-B-08-27-2015.pdf. All these documents are also accessible in the “Downloads” section at the bottom of CMS’s MDS 3.0 RAI Manual web page: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html.

On Sept. 21, CMS posted a new MDS 3.0 QM User’s Manual V9.0, which was effective Oct. 1, 2015. The new file contains two important changes:

1. A change in time period for calculation of influenza vaccine measures, as well as a change to a single calculation per year; and

2. A change to the missing values for risk-adjusted measures, such that missing values for items used to calculate coefficients result in resident assignment to the “low risk” category rather than being dropped from the calculation.

To access the QM User’s Manual, go to www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIQualityMeasures.html and scroll to the bottom of the page in the “Downloads” section, or use the direct link at www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/MDS-30-QM-Users-Manual-V90.pdf.