MDS Alert
MDS & Compliance News:
CMS has issued a survey & cert memo instructing surveyors to cut nursing homes some slack for MDS transmission delays. Spurred by CMS-related MDS transmission problems for three weeks or so following MDS 3.0 implementation, the memo says surveyors should "accept the ASAP system's date stamp indicating the MDS file has been received as an indication of MDS 3.0 assessment transmission." The directive applies to MDSs transmitted between Oct. 1 and Dec. 31 of this year. If surveyors do cite a deficiency at F287 (which requires MDSs to be transmitted within 14 days after completion), they should clearly document the rationale in the statement of deficiencies, CMS advises surveyors in the memo. Facilities can be cited at F287 for late MDS transmissions that aren't the ASAP system's fault. But during the Oct. 1 through Dec. 31 period, the survey team should issue a level one deficiency, CMS instructs. "The determination of scope will depend on the number of assessments that were not transmitted in a timely manner," states the memo. Wondering why the change to 14 days? CMS implemented the 14-day submission requirement for the MDS 3.0 because it was aligning with what many swing beds were doing already, said CMS' Christina Stillwell- Deaner during a Nov. 9 agency-sponsored webinar on the MDS 3.0 and RUG-IV. And the data showed that many nursing facilities were also already submitting their MDSs within that timeframe, she added. Read the memo at www.cms.gov/Surveycertificationgeninfo/downloads/SCLetter11_02.pdf. Looking for some help with MDS 3.0 submission? The QIES Technical Support Office (QTSO) has posted a document titled, "MDS 3.0 Submission Status and Final Validation Report Helpful Hints." Among other instructions, the document lists the "most common severe errors that are occurring in MDS 3.0 file processing. When these errors are encountered, the ASAP system cannot produce a system-generated MDS 3.0 NH (or SB) Final Validation report. You will not find an MDS 3.0 NH (or SB) Final Validation report in your facility's VR folder. These errors will only be displayed on the MDS 3.0 Submitter Validation Reports," states the document. The list of errors, according to the document, includes the following: -- Sanders adds. "In the review, OIG will be looking at services that hospices provide to nursing home residents on hospice, including services provided by hospice home health aides." She notes the "OIG is looking for coordination of care and identification of services and payment arrangements." Also: The OIG work plan points out that MedPAC "has noted that hospices and nursing facilities have incentives to admit patients likely to have long stays." Proactive strategy: Hospices should beware sending aides or nurses to "help out" at the nursing facility, cautions Robert Markette Jr. in his Home Care Law Blog. Editor's note: For a look at scenarios where you can simultaneously cover a resident for both Part A SNF care and hospice services, see the next MDS Alert.
MDS Alert
- MDS 3.0 Coding:
Get the Latest Lowdown on Pressure Ulcers, Isolation, and More
CMS official explains rationale for coding stance on POA pressure ulcers. A resident with a [...] - Compliance Trends:
Beware Audits Targeting Part A Rehab RUGs
If you get notice of a ZPIC audit, make sure to do this. What auditors [...] - MACs/Intermediaries Won't Field ZPIC Questions
They will take your ZPIC appeals. To get an idea of how the FIs and [...] - Payment:
Keep Your Eye on Medicare SNF Part A Fee-For-Service Requirements
Expect the 'practical matter' requirement to be a bigger focus, says expert. Reviewing the Medicare [...] - What Do You Think?
Can a Facility Maintain MDSs Electronically if It Doesn't Use Electronic Signatures? Answer: Facilities have [...] - MDS 3.0 Coding Quizzer:
Section I: Would You Code This Resident's Previous Hip Fracture at I3900 Due to His Residual Impairment?
The answer may surprise you. Scenario: "Mr. J fell and fractured his hip 2 years [...] - Quality of Care:
These MDS Indicators Could Augment Mood Assessment in Section D
Find out which behavioral symptom has the strongest association with risk for a new depression [...] - Quality Improvement:
Find Out How Nursing Homes and Hospitals Are Collaborating to Combat Pressure Ulcers
This simple strategy can alert providers in both settings to patients at risk. A number [...] - Quality Assurance:
Identify Quality Concerns During the MDS 3.0 QM Blackout
Make sure your MDS coding is on the mark. To stay on top of quality [...] - MDS & Compliance News:
CMS has issued a survey & cert memo instructing surveyors to cut nursing homes some [...] - CODING QUIZZER ANSWER (see question on page 139).
Answer: Don't check the hip fracture item (I3900) on the MDS. Rationale: "Although the resident [...]
