MDS Alert

Have you seen the latest version of the MDS 3.0? In October, the Centers for Medicare & Medicaid Services posted on its website the MDS 3.0 draft data specifications, the draft item set, and draft dictionary. "These are as complete as we have at this point," said a CMS spokesman at the October SNF/LTC Open Door Forum. CMS plans to finalize these elements next spring, he said.

CMS also says it's sticking with the Oct. 1, 2009 implementation date for MDS 3.0. "The schedule has not changed," although the agency realizes it's a tight timeline, said the CMS spokesman.

The seven-day lookback periods are back: The MDS 3.0 draft that came out of the RAND study had five-day lookbacks for most sections. But now most sections in the draft form have a seven-day lookback or none designated in some cases.

"Section O, which looks at special treatments and procedures, still has a 14-day lookback," says Ron Orth, RN, NHA, CPC, RAC-MT, president of Clinical Reimbursement Solutions LLC in Milwaukee. But it now asks you to distinguish between those services that a beneficiary received while he was a resident in the facility versus those he received when he wasn't a resident in the facility, Orth notes.

CMS also added suspected deep tissue injury (DTI) under unstageable pressure ulcers, along with ulcers that aren't stageable due to a nonremovable dressing.

Review the October 2008 version of the MDS 3.0 at www.cms.hhs.gov/NursingHomeQualityInits/downloads/MDS30DraftItemSet.pdf.

If you thought nursing homes are lagging in using electronic information systems (EIS), consider the findings of a new study. The rate of nursing homes using EIS is "considerably higher than previous estimates and compares favorably to other health care settings," according to a new report released by the American Association of Homes and Services for the Aging (AAHSA), which conducted the research.

Tapping data from the 2004 National Nursing Home Survey, AAHSA researchers, as well as those from the association's Center for Aging Services Technologies (CAST) and Institute for the Future of Aging Services (IFAS), found that nearly all U.S. nursing homes had EIS for Minimum Data Set (MDS) data collection and billing in 2004.

In addition, 43 percent of nursing homes had electronic records, says AAHSA, while only 25 percent of physician offices and 59 percent of hospitals do, as indicated in other studies. "In addition, 48 percent of nursing homes had computerized physician orders, 51 percent used electronic systems for medication orders, and 41 percent used electronic systems to manage laboratory information."

For the full report, go to www.aahsa.org/article.aspx?id=5728