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 CMS Modifies MDS 3.0 To Ease Burdens

 

 Managing Editor

Nearly 18 months after implementation of the minimum data set (MDS) 3.0, changes and clarifications are being made to the assessment tool in an effort to ease concerns about the burden it has placed on providers and residents. The changes, which were announced March 7 by the Centers for Medicare & Medicaid Services (CMS) during a training conference in St. Louis, will take effect April 1, 2012.

The modifications include:
■ Section Q will now require fewer questions about a resident’s preference to avoid being asked repeatedly about return to the community, among other changes.
■ An unplanned discharge has been defined as an “acute-care transfer of the resident to a hospital or an emergency department in order to either stabilize a condition or determine if an acute-care admission is required, based on emergency department evaluation.” Unplanned discharges can also be defined as a resident who unexpectedly leaves the facility against medical advice.
■ Providers may now carry forward patient interview coding from scheduled PPS assessments to stand-alone unscheduled assessments (COT, SOT, and EOT), provided that the most recent scheduled assessment interviews were performed no more than 14 days prior.
■ The RAI manual and MDS changes will take place less frequently. CMS plans to release errata documents on only those pages where changes and modifications are made, making it easier for providers to maintain the manual. After the next release in October 2012, future updates will occur only once per year.

“We are pleased that CMS has taken these steps to reduce the burden of MDS on patients and care providers,” said David Gifford, MD, senior vice president of quality, regulatory affairs, and research at the American Health Care Association.

According to an MDS expert who attended the conference, “Providers are happy about some of the changes,” says Rena Shephard, MHA, RN, RAC-MT, C-NE, executive editor of the American Association of Nurse Assessment Coordination. She notes that among the most significant changes were those made to discharge assessments.

CMS has determined that if it is an unplanned discharge, then there is an abbreviated discharge assessment required, and it does not include the direct resident interview. “That’s the big thing,” Shephard says.

“They really did try to hear what providers were saying to them,” she says.

Changes related to the frequency of resident interviews were applauded, says Shephard. “The way it is now, any time you do an assessment, you have to redo the resident interview,” Shephard says.

To alleviate this burden, CMS said that as of April 1 when coding an unscheduled prospective payment system (PPS) assessment, the interview items can be coded using responses provided by the resident on a previous scheduled assessment, but only if those interview responses from the scheduled assessment were obtained no more than 14 days before the completion date of unscheduled assessment, Shephard says.

“That’s a really big deal, that’s a really big change,” she says.

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