• Is Your State Considering PDPM Data Collection? Four Steps to Prepare

    By Jessie McGill, RN, RAC-MT, RAC-MTA - August 19, 2020

    The Centers for Medicare and Medicaid Services (CMS) gave states the option to collect Patient-Driven Payment Model (PDPM) billing codes on OBRA assessments when not combined with a Medicare PPS 5-Day assessment, beginning Oct. 1, 2020. While most of the information used to establish these codes is already on the OBRA assessments, the additional data collection will require both time to complete and training to perform correctly. Notably, the addition of completing the admission performance column for section GG (Functional Abilities) will take the most time. A lack of proper training for the staff completing this section has the potential to cause inaccuracies and confusion among direct care staff. However, the stress and workload can be mitigated with a strong preparation plan and ongoing support to direct care staff. Follow these four steps to ensure your team is ready to complete successfully the documentation and data collection for section GG on OBRA assessments:

    1.      Understand how your state is using the information and expected future implications

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  • Section GG: Assessing Usual Performance During the COVID-19 Pandemic

    By Caralyn Davis, Staff Writer - July 07, 2020

    The Centers for Medicare & Medicaid Services (CMS) makes clear in the title of MDS section GG (Usual Performance and Goals) that the assessment subitems in items GG0130 (Self-Care) and GG0170 (Mobility) are designed to capture a resident’s usual ability or usual performance. This begs the question: How can nurse assessment coordinators (NACs) and other members of the interdisciplinary team (IDT) ensure they capture usual performance in unusual times, such as in the middle of the ongoing COVID-19 pandemic?

     

    “Everyone’s nervous because nursing home residents are dealing with a new way of living, and staff are dealing with a new daily practice,” points out Melanie Tribe-Scott, BSN, RN, RAC-MTA, QCP, director of education and marketing for MDS Consultants in Medina, NY. “However, you still want to get the most complete picture of the resident possible, and you still should assess section GG the same way you always have—following the coding instructions in section GG of chapter 3 in the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual.”

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  • Q&A: If we skill a resident for nursing only related to the COVID-19 infection and therapy is not involved, how do we code section GG? How would you code goals?

    By Carol Maher, RN-BC, CPC, RAC-MT - April 21, 2020
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  • The Particulars of Coding Pre-Admission Data and PDPM

    By Jessie McGill, RN, RAC-MT, RAC-MTA - April 01, 2020

    When the nurse assessment coordinator (NAC) prepares to code the MDS, the process starts with data collected during the lookback period. However, one frequently-asked question is, “When can services that occurred prior to admission to the skilled nursing facility (SNF) be captured on the MDS?” There is no simple answer, because it depends on the coding instructions for each MDS item. Let’s take a look at the particulars of coding preadmission data, why it is collected, and how preadmission data is used under PDPM.

     

    Background

    Chapter 3 of the RAI User’s Manual contains the coding instructions for each MDS item; however, the overview of chapter 3, pages 3-1 through 3-6, are often overlooked. This brief section discusses coding conventions, which apply to all MDS items, and includes the instructions on preadmission data:

    With the exception of certain items (e.g., some items in Sections K and O), the lookback period does not extend into the preadmission period unless the item instructions state otherwise. In the case of reentry, the lookback period does not extend into time prior to the reentry, unless instructions state otherwise.

     

    MDS Item Set 1.17.1 Preadmission Data and Why It Is Collected

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  • Section GG: CMS Training Videos for GG0130H, GG0170L, GG1070P (3/20)

    By CMS - March 23, 2020

    The Centers for Medicare & Medicaid Services is releasing three short video tutorials to assist providers with coding Section GG. These videos, ranging from 5 to 10 minutes, are designed to provide targeted guidance using simulated patient scenarios. To access the videos, click on the links below:

    ·         GG0130H. Putting on/taking off footwear.

    ·         GG0170L. Walking 10 feet on uneven surfaces.

    ·         GG1070P. Picking up object.

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  • Section G: Going, Going, Almost Gone – October 2020

    By Jessie McGill, RN, RAC-MT, RAC-MTA - February 04, 2020

    The Activities of Daily Living (ADLs) in section G of the MDS are interwoven throughout the Care Area Assessments (CAAs), Quality Measures, and reimbursement—and have been for years. Yet CMS took nurse assessment coordinators (NACs) by surprise when the draft MDS item sets released in early January 2020 revealed that section G will be removed from all OBRA and PPS assessments as of October 1, 2020. In fact, section G will only appear on the Optional State Assessment (OSA) item set.

    Today, facilities must confront Section G’s future removal, an upcoming development that raises more questions than answers. Many NACs are asking how this huge change will impact the accuracy of the functional data collected, which in turn affects CAAs, care plans, Quality Measures (QMs), and possibly even Medicaid reimbursement. While we do not know how the details of how this transition will play out, we can identify how this change will impact different items and programs. We can also begin to explore how facilities can prepare for this change.

    How can section GG replace section G?

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  • Coding Section GG: A Case Study Review

    By Jessie McGill, RN, RAC-MT, RAC-MTA - November 25, 2019

    Collaboration. It is one of the key terms used to describe data collection for section GG, Functional Abilities and Goals. Collaboration among clinicians, to identify usual, and baseline conditions—these are also important terms used throughout section GG. But in a profession that is used to coding section G, Activities of Daily Living (ADLs), and calculating the Rule of 3, the process of determining usual performance for section GG holds some challenges. Does the data collected and documentation actually support how we are coding section GG? Let’s take a look at a case study of Mrs. Georgia Geoffrey and how the clinicians determined usual performance for some of the key GG tasks on her 5-Day assessment.

    Mrs. Georgia Geoffrey admitted to Happy Valley Nursing Facility following a knee replacement due to osteoarthritis. The wheelchair transport van wheeled her into the nursing home, and the nurse aide assigned to her alerted the nurse of her arrival and propelled her down the hall to her room. 

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  • CMS Section GG Training Videos: GG0130A, GG0110, GG0170C, GG0130B, Decision Tree for GG0130/GG0170 (10/19)

    By CMS - October 18, 2019

    These apply to all four QRP programs, including the SNF QRP:

    • Coding GG0130A. Eating (6:19)The Centers for Medicare & Medicaid Services is releasing a short video tutorial to assist providers with coding GG0130A. Eating. This 6-minute video is designed to provided targeted guidance using simulated patient scenarios.
    • GG0110 Prior Device Use with Information From Multiple Sources. This 4-minute video demonstrates how a caregiver can utilize information collected from multiple scenarios to accurately code GG0110. Prior Device Use. 
    • Decision Tree for Coding Section GG0130. Self-Care and GG0170. Mobility. This 12-minute video demonstrates how to apply the six-point coding scale to GG0130. Self-Care and GG0170. Mobility using GG0170D. Sit to stand as an example.
    • Coding GG0170C. Lying to sitting on side of bed This 4-minute video demonstrates how to distinguish between Code 02, Substantial/maximal assistance and Code 03, Partial/moderate assistance when coding GG0170C. Lying to sitting on side of bed.
    • Coding GG0130B. Oral HygieneThis 4-minute video demonstrates how to distinguish between Code 05, Set-up or clean-up assistance and Code 04, Supervision or touching assistance when coding GG0130B. Oral Hygiene. 
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  • SNF QRP: 2Q 2019 FAQs (10/19)

    By CMS - October 13, 2019
    A new Question and Answer (Q+A) document is now available in the "Downloads" section of the SNF Quality Reporting Program FAQs webpage. The Q+A document reflects frequently asked questions that were received by the SNF QRP Help Desk during the second quarter (Apr - Jun) of 2019.
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  • August 13 - 14 SNF QRP Training Videos and Slides With Answers (9/19)

    By CMS - September 27, 2019
    Post-training materials (includes answers to knowledge checks and interactive sessions) from the August 2019 Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Provider Training held in Baltimore, MD, on August 13 and 14, 2019 are now available.
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  • TIP: Section GG Coding and IPAs

    By AANAC - September 24, 2019
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  • Balancing Sections G and GG Requirements

    By Jessie McGill, RN, RAC-MT, RAC-MTA - July 10, 2019

    With the enormous focus on the transition from RUG-IV to PDPM, some may consider abandoning their section G Activities of Daily Living (ADLs) training materials, audits, and tools— but wait just a moment! Although section GG is stepping into the Medicare reimbursement spotlight, section G still plays a big role in other types of reimbursement and Quality Measures. To ensure success, the nurse assessment coordinator (NAC) must have a full understanding of the coding instructions, documentation requirements, impact on Quality Measures, and reimbursement for both section G and GG. Here are four key differences between the two sections and tips for successfully managing both.

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  • Section GG Web-based Training Module UPDATED (6/19)

    By CMS - June 27, 2019

    The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training course on how to properly code of Section GG. This 45-minute course is intended for providers in the following care settings: Skilled Nursing Facilities (SNFs), Long-Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), and Home Health Agencies (HHAs); and is designed to be used on demand anywhere you can access a browser. The course is divided into the following four lessons and includes interactive exercises that allow you to test your knowledge in real life scenarios:

    • Lesson 1: Importance of Section GG for Post-Acute Care

    • Lesson 2: Section GG Assessment and Coding Principles

    • Lesson 3: Coding GG0130.Self-Care Items

    • Lesson 4: Coding GG0170.Mobility Items

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  • TIP: New Section GG Training Videos

    By AANAC - June 05, 2019
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  • Q&A: Can therapy code section GG based on their clinical judgment of what the resident is capable of doing?

    By Carol Maher, RN-BC, CPC, RAC-MT - June 05, 2019
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