1. 0 MDS 3.0 UPDATE Presentation to: Long Term Care Providers Presented by: Lena E. Bain, R.N., M.P.A. Healthcare Facility Regulation Division April 2012

2. 1 MDS 3.0 UPDATE Effective April 1, 2012

3. 2 MDS 3.0 Our Journey Continues

4. 3 MDS 3.0 Looking Forward

5. 4 Focus Changes effective April 1st, 2012 –The emphasis is on changes to the assessment process. –Will not include typographical or formatting errors –Only pages with actual changes have been updated & is indicated by the footer “April 2012” Global Item Set Changes –Term “Mental Retardation (MR)” changed to “Intellectual Disability (ID)”. This change is reflected throughout the instrument.

6. 5 Helpful Websites MDS 3.0 RAI Manual Page http://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment- Instruments/nursingHomeQualityInits/MDS30RAIManual.ht ml MDS 3.0 Training Materials http://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment- Instruments/NursingHomeQualityInits/NHQIMDS30Training Materials.html

7. 6 Helpful Websites Cont’d MDS Technical Information http://www.cms.gov/Medicare/Quality-Initiatives- Patient-Assessment- Instruments/NursingHomeQualityInits/NHQIMDS30 TechnicalInformation.html SNF PPS Main Site http://www.cms.gov/Medicare/Medicare-Fee-for- Service-Payment/SNFPPS/index.html

8. 7 Materials Needed April 2012 MDS 3.0 RAI Manual MDS 3.0 RAI Manual (v1.08) Errata (v.3 & v.4) documents. These documents have been posted under the download section of the MDS 3.0 RAI Manual page. It contains identified issues and resolutions and also contains the replacement pages. Change tables are not needed

9. 8 Contact Information Lena E. Bain, R.N, M.P.A. 404-657-5854 RAI/MDS Coordinator  lebain@dhr.state.ga.us lebain@dhr.state.ga.us For RAI process, MDS coding, validation reports, or other information Kenni Sue Keller 404-657-5861 Automation Coordinator  kskeller@dhr.state.ga.us kskeller@dhr.state.ga.us For trouble shooting with software vendors, transmission problems and for technical assistance.

10. 9 Chapter 2 Page 2-50 4 th bullet Under PPS Unscheduled Assessments for a Medicare Part A stay there was a change in the instructions in the Change of Therapy OMRA.

11. 10 Chapter 2 Section 2.9 page 2-51 Under Coding Tips and Special Populations Unscheduled Assessment Interviews - when coding a standalone unscheduled PPS assessment (COT, EOT, SOT), the interview items may be coded using the responses provided by the resident on a previous assessment, only if the DATE of the interview responses from the previous assessment (as documented in item Z0400) were obtained no more than 14 days prior to the DATE of completion for the interview items on the unscheduled assessment (as document in item Z0400) for which those responses will be used.

12. 11 Chapter 2 Section 2.10 page 2-54 PPS Scheduled Assessment and Change of Therapy OMRA

13. 12 Chapter 3 Section A, page A-1, A-7, A-18, A21, & A23 Identification Information -Added the following; A0050—Type of Record, replaces X0100—Type of Record; A0310G— Planned or Unplanned Discharge; A1510-Level II Preadmission Screening and resident Review (PASRR) Conditions; -A1800—Entered From; A2100— Discharge Status added option “09—Long Term Care Hospital (LTCH)

14. 13 Chapter 3 Section A page A-24 Under Coding Instructions Code 09 long term care hospital (LTCH)

15. 14 Chapter 3 Section I—Active Diagnoses, page I-2 Item Set Changes I18000 Additional Active Diagnoses (where ICD codes can be entered)— Removed the check box

16. 15 Chapter 3 Section I, page I-3 The term “new normal” has been removed. Determine whether diagnoses are active.

17. 16 Chapter 3 Section K—Swallowing & Nutritional Status Item Set Changes -Added K0310: Weight Gain, page K-8 -Added K0510: Nutritional Approaches, page K-10

18. 17 Chapter 3 Section K, page K-16, K0500B next to Coding has been amended. Under Coding Instructions –Coding & Rational

19. 18 Chapter 3 Section M—Skin Conditions pages M-22 Item Set Changes M0700— Most Severe Tissue Type for Any Pressure Ulcer, added option “9” – None of the Above

20. 19 Chapter 3 Section M, pages M-29, M-31 & M-32 Replaced screen shot for item M1040 Under coding instructions for Other Ulcers, Wounds & Skin Problems, added and defined: M1040G- Skin Tears M1040 H- Moisture Associated Skin Damage (MASD) (i.e., incontinence (IAD), perspiration, drainage)

21. 20 Chapter 3 Section N, pages N-5 and N-6 Coding Instructions have been amended. Enter the number of days each of the medications listed were received in the last 7 days in item N0410.

22. 21 Chapter 3 Section Q, page Q-12 & Q-18 Added items Q0490- Resident’s Preference to Avoid Being Asked Question Q0500B. Added Q0550- Resident’s Preference to Avoid Being Asked Question Q0500B again.

23. 22 Chapter 3 Section X, page X-1 The 5 th paragraph has been amended. An Inactivation request…..

24. 23 Chapter 3 Section X, page X-5 Under Coding Instructions for X0600A -2 nd bullet, reason for assessment has been amended. X0600B Under Coding Instructions for X0600B –2 nd bullet, PPS Assessment has been amended. X0600C Under Coding instructions for X0600C 2 nd bullet, PPS Other Medicare Required Assessment- OMRA has been amended.

25. 24 Chapter 3 Section X, pages X-5 & X-6 Under Coding Instructions, for X0600D, Is this a Swing Bed clinical change assessment? –4 th bullet has been amended. Coding Instructions for X0600F, “Entry/discharge reporting”, has been amended. 2 nd bullet

26. 25 Chapter 3 Section X, page X-7 Coding Instructions for X0700A, Assessment Reference Date – Complete Only if X0600F=99 –This bullet has been amended. –2 nd bullet,

27. 26 Chapter 3 Section X, page X-7 Coding Instructions for 0700B, Discharge Date- Complete Only if X0600F=10, 11, or 12. –2 nd bullet has been amended.

28. 27 Chapter 3 Section X, page X-7 Coding instructions for X0700C, Entry Date- Complete Only if X0600F=01. 2 nd bullet has been amended.

29. 28 Chapter 3 Section X, page X-9 Coding Instructions for X0900D, Item Coding Error. (for exceptions when certain items may not be modified, see chapter 5) –2nd bullet has been amended.

30. 29 Chapter 3 Section X, page X-9 Coding Instructions for X0900E, End of Therapy- Resumption (EOT-R) date. –1 st bullet has been amended.

31. 30 Chapter 5 Inactivation Requests, page 5-12 Under Inactivation Requests, new paragraphs added If the ARD or Type of Assessment…. Inactivations should be rare…. In such instances a new ARD date must……

32. 31 Appendix B Page B-1 The hyperlink to the State RAI/MDS contacts has been amended as follows: https://www.cms.gov/NursingHomeQualityInits/20_MD S30RAIManual.asp#TopOfPage

33. 32 Appendix E Page E-7 Example 2 computation in step #2 has been amended. See bullet 5 on page E-5 for calculation of multiplier

34. 33 Appendix E Page E-7 Example 3, computation in step #2 has been amended. See bullet 6 on page E-5 for calculation of multiplier.

35. 34 Other CMS Websites For Free Automatic Open Door Forum (ODF) Schedule Updates and E-Mailing List Registration: http://www.cms.hhs.gov/OpenDoorForums/25_ODF_SNFL TS.asp#TopOfPage For Technical MDS 3.0 Version Information: http://www.cms.gov/NursingHomeQualityInits/30_NHQIMD STechnicalInformation.asp#TopOfPage For MDS 3.0 Quality Measures (QM) Manual: http://www.cms.gov/NursingHomeQualityInits/Downloads/M DS30QM-Manual.pdf

36. 35 Survey –Please complete the survey located at the following website. -http://www.surveymonkey.com/s/ondemandevaluationhttp://www.surveymonkey.com/s/ondemandevaluation Thank you for viewing this presentation.