• Get Ready: Oct. 1, 2018, Will Bring MDS/RAI Changes

    By Caralyn Davis, Staff Writer - February 14, 2018

    The Centers for Medicare & Medicaid Services (CMS) has released two additional pieces of the puzzle to help nurse assessment coordinators (NACs) understand what MDS and other RAI changes will be implemented on Oct. 1, 2018. In November 2017, CMS posted the draft MDS item sets v1.16.0. Now the agency has released the draft MDS submission specs v2.02.0 and the MDS 3.0 care area trigger (CAT) specifications v1.03.0.

    The picture will remain somewhat fuzzy until CMS releases the corresponding update to the RAI Manual, which will include the all-important coding instructions. However, taken together, the available documentation offers critical information about what’s coming, including MDS item changes, CAT changes, and new error messages for MDS submissions to the QIES ASAP system.


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  • Section GG Web-based Training Module (1/18)

    By CMS - January 02, 2018
    The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training module to address questions submitted by providers during trainings between November 2015 and August 2016 related to Section GG across the Skilled Nursing Facility (SNF), Long-Term Care Hospital (LTCH), Inpatient Rehabilitation Facility (IRF), and Home Health (HH) care settings.  This training is designed to be used on demand anywhere you can access a browser and includes interactive exercises that allow you to test your knowledge in real life scenarios.
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  • It’s Not Just a Desk Job: Improving Person-Centered Care Through the RAI Process

    By Emily Royalty-Bachelor, Staff Writer - November 14, 2017

    There is no one right or wrong way to be a nurse assessment coordinator. The role often varies by state, by facility, and by the individual filling the role.

     

    But, suffice it to say, there are certain elements of the job that are applicable across the board—like, say, completing the MDS, or scheduling assessments.

     

    Tasks like these usually require the quiet solitude of an office with a closed door, or at least a computer to access software. So it’s understandable why many people might associate the role of a NAC with a desk job.

     

    But the truth is, the RAI process is not something that can be completed from your work chair. And if you’re spending the majority of your workday sitting at a desk, you’re missing out on key elements of your roles and responsibilities. The role of the NAC involves a lot of face-to-face interaction, both with the interdisciplinary team and—especially—with the residents.

     

    NACs, like every other member of the facility staff, are in the business of providing person-centered care. The operative word here is “person.” If you’re not interacting with the people, how can you ensure they’re at the center of the care you’re delivering?

     

    The RAI process, just like every component of care provided at the facility, needs to incorporate the resident’s voice and resident’s choice. Here’s how to make sure you’re doing just that:

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  • Section GG: Three RAI Manual Updates NACs Should Review

    By Caralyn Davis, Staff Writer - November 01, 2017
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  • Q&A: How should I code toileting on the MDS if the resident was independent ten times, but had one to two episodes at limited, extensive, and total dependence?

    By Jennifer LaBay, RN, RAC-MT, RAC-CT - November 01, 2017
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  • Q&A: Is a Part A PPS Discharge assessment required for an unplanned discharge from the facility or an unplanned discharge to an acute hospital?

    By Scott Heichel, RN, DNS-CT, RAC-MT - October 16, 2017
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  • PPS Discharge Assessment: RAI Manual v1.15 Clarifies Unplanned Discharges

    By Caralyn Davis, Staff Writer - October 05, 2017
    In the year since its implementation, the Part A PPS Discharge (NPE) assessment has caused a few headaches for nurse assessment coordinators (NACs) across the country, due in part to coding example errors involving unplanned discharges in v1.14 of the RAI Manual. “Knowing when to complete this assessment—and how to appropriately code Section A (Identification Information) and Section GG (Functional Abilities and Goals)—is critical to having accurate reporting for the Skilled Nursing Facility Quality Reporting Program (SNF QRP),” says Robin Hillier, CPA, STNA, LNHA, RAC-MT, president of RLH Consulting in Westerville, OH. “It’s helpful that the revised manual updates both of these sections to clarify when a PPS Discharge assessment should be coded and when Section GG should be completed for that assessment.”
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  • CMS Releases MDS Rules

    By Caralyn Davis, Staff Writer - September 07, 2017

    The initial resident pool that surveyors will review in the new survey process effective Nov. 28, 2017, to determine the final sample for in-depth investigations will be 70 percent preselected offsite from MDS data, according to the New Long-term Care Survey Process—Slide Deck and Speaker Notes released by the Centers for Medicare & Medicaid Services (CMS) earlier this year. Since surveyors will have the ability to replace a resident selected offsite with a resident they identified onsite, testing showed that the offsite/onsite split of the final sample tends to be about 50/50. But whether it’s 50 percent or the full 70 percent, the MDS will play a starring role in residents chosen for investigation during survey going forward.

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  • RAI Manual v1.15 Gets Survey Ready

    By Caralyn Davis, Staff Writer - September 07, 2017

    The initial resident pool that surveyors will review in the new survey process effective Nov. 28, 2017, to determine the final sample for in-depth investigations will be 70 percent preselected offsite from MDS data, according to the New Long-term Care Survey Process—Slide Deck and Speaker Notes released by the Centers for Medicare & Medicaid Services (CMS) earlier this year. Since surveyors will have the ability to replace a resident selected offsite with a resident they identified onsite, testing showed that the offsite/onsite split of the final sample tends to be about 50/50. But whether it’s 50 percent or the full 70 percent, the MDS will play a starring role in residents chosen for investigation during survey going forward.

     

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  • Q&A: What assessments are needed when a resident is picked back up on Medicare Part A in their 30-day window? Is section GG required again?

    By Scott Heichel RN, DNS-CT, RAC-CT - September 05, 2017
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  • FLYING HIGH: The 10,000-Foot-Level Review of the Updates to the October 1, 2017, RAI Manual

    By Jane Belt RN, MS, RAC-MT, RAC-CT, QCP - September 01, 2017

    CMS came through and posted the updates for the October 1, 2017, RAI manual, allowing us at AANAC some time to take a quick look, briefly summarize the MDS changes heading our way, take a deep breath, enjoy the holiday, and then provide our members with an in-depth article in next week’s LTC Leader (September 7). And I would be remiss if I did not mention keeping folks in Texas and Louisiana in our thoughts and prayers.

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  • CMS Dials Back Fear Factor Over Standardized MDS Data in October 2018

    By Caralyn Davis, Staff Writer - August 02, 2017
    Speaking up can make all the difference. In the Fiscal Year (FY) 2018 Skilled Nursing Facility Prospective Payment System (SNF PPS) Proposed Rule, the Centers for Medicare & Medicaid Services (CMS) had proposed that SNFs be required to report a significant amount of new standardized resident assessment data (typically on both the 5-day PPS MDS and the Part A PPS Discharge assessment) beginning Oct. 1, 2018, for the FY 2020 Skilled Nursing Facility Quality Reporting Program (SNF QRP). CMS proposed these standardized resident assessment data elements for five categories designated by the IMPACT Act:
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  • Q&A: When a resident under traditional Medicare Part A is discharged to hospital (unplanned), is it necessary to combine an NPE with the OBRA discharge RA?

    By Scott Heichel RN, DNS-CT, RAC-CT - June 06, 2017
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  • Final Notice: Meet June 1 SNF QRP Data Submission Deadline or Lose Part A $

    By Caralyn Davis, Staff Writer - May 24, 2017
    Skilled nursing facilities that participate in the skilled nursing facility prospective payment system (SNF PPS) have until 11:59 p.m. Pacific standard time on June 1, 2017, to correct and/or submit their MDS quality data for Oct. 1 – Dec. 31, 2016, to fulfill the requirements for the Skilled Nursing Facility Quality Reporting Program (SNF QRP) fiscal year (FY) 2018 payment determination. Some providers have been confused by the upcoming release of the SNF QRP Review and Correct Reports, thinking those reports would allow them to identify corrections they need to make to meet the 80 percent threshold. However, the Review and Correct reports relate specifically to the calculation of the SNF QRP quality measures (QMs), not to meeting the required data threshold for payment.
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  • SNF QRP: Color-Code MDS Items You Should Avoid Dashing

    By Caralyn Davis, Staff Writer - May 09, 2017
    The Centers for Medicare & Medicaid Services (CMS) requires that skilled nursing facilities (SNFs) meet a completion threshold for reporting data to avoid financial penalties under the Skilled Nursing Facility Quality Reporting Program (SNF QRP). Specifically, SNFs will be subject to a 2 percent reduction to their market basket update in the SNF prospective payment system (PPS) for fiscal year (FY) 2018 beginning Oct. 1, 2017, and subsequent years if 80 percent of all MDS assessments submitted don’t contain 100 percent of all data items necessary to calculate the SNF QRP quality measures (QMs), according to the FY 2017 SNF PPS Final Rule.
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