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National MDS 3.0 training call recap

August 25, 2011
by Tracy Montag, RN, BSN
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Wow, we are closing in on one year of using the MDS 3.0 and are finally getting the “hang of it” with all the changes that occurred with its implementation. After all these months, MDS coordinators have grown accustomed to getting the interdisciplinary team to complete the interviews within the allowable timeframes, addressing all new items on the assessment and coordinating the different data sets. Actually, many MDS coordinators will now admit that the MDS 3.0 assessment, although 38 pages long, is “really not that bad.”

 

Tracy Burger Montag, RN, BSN, RAC-CT

Then, just like the earthquake that interrupted Tuesday’s national provider training call on MDS 3.0 and RUG-IV updates for FY2012, CMS shakes us with multiple process and MDS changes that will become effective on October 1, 2011.

The MDS Assessment schedule for PPS assessments is changing. The 5-day assessment is the only one that maintains an Assessment Reference Date (ARD) selection choice of day one through day five with three allowable grace days. After that assessment, all of the other of ARD selection choices for the 14-, 30-, 60- and 90-day assessments will be different. CMS is implementing this change to avoid capturing the same assessment data on more than one assessment.

(Really, if you think about it, information for the 5- and 14-day assessments can be and often is the same. Facilities are getting reimbursed for days 15 through 30 of the resident stay at RUG-IV levels for the 14-day assessment based on events that occurred as early as day five of a resident’s stay.)

Group therapy minutes, a modality that gained much popularity over the past 10 months, will now be allocated. A group therapy session is defined as no more or no less than four residents who are performing the same or similar activities. The total number of minutes a resident spends in group therapy will be entered on the MDS, and beginning October 1, those minutes will be divided by four for calculation of the RUG-IV classification. Initially considered a positive change, therapy students will no longer be required to be under line-of-sight supervision when providing treatment but the guidelines for the supervising therapists do not really ease the supervision burden. (Therapy student supervision guidelines are outlined here on the SNF PPS website.)

The confusion over whether a center is a 5-, 6- or 7-day provider of therapy services will be resolved once and for all. As a senior living services consultant, I can’t count how many times I have had the discussion with therapy managers on the determination of how many days they provide therapy a week. Beginning October 1, an End of Therapy OMRA must be completed whenever therapy is not provided for three consecutive days regardless of the reason.

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