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CMS Releases Draft MDS 3.0 Nursing Home Comprehensive (NC) Item Set – How Can Nursing Homes Start Preparing for the Changes?

On Sept. 1, 2022, the Centers for Medicare & Medicaid Services (CMS) released the draft MDS 3.0 Nursing Home Comprehensive (NC) Item Set, version 1.18.11, which is scheduled to become effective Oct. 1, 2023. Among the major changes seen in the new item set, CMS removed section G from the MDS. With the removal of section G, there will be more of an emphasis on section GG, expanding beyond Medicare reimbursement into MDS 3.0 quality measures, care area triggers, and Medicaid reimbursement. This blog will briefly cover some ways that nursing homes can start preparing for the changes ahead and will also include some AAPACN resources that can be utilized to ensure the team is ready.

How to Start Preparing

  • Open a line of communication with your state’s Medicaid department. The draft item set also eliminates the optional state assessment (OSA) option, so states will no longer have the option to utilize section G instead of GG for state Medicaid reimbursement. It’s important to start the conversation with the state Medicaid department to understand how this change will be handled. They may not have answers yet, but your team can find out how communication will be made available to facilities with this proactive approach.
    • Note: You will need to know definitively what methodology your state Medicaid payment model is going to use before training nurse aides. In addition, if your state is going to use GG, section G will continue to be coded through your state’s transition date—so education will need to be planned accordingly to prevent confusion and inaccurate coding.
  • Care plan goals can be updated and reviewed now. When completing annual MDS assessments or Significant Change in Status Assessments (SCSAs), review all functional goals. Update the goals so they can be measured using either section G, ADL Data or section GG, Functional Abilities.
    • For example, instead of having a goal to complete a task with “limited assist,” use descriptive words, such as “non-weight-bearing assist” or “contact-guard assist.” These terms can be measured using either section G or GG data.
  • Keep up with MDS-related news. Nurse leadership (especially nursing home administrators and directors of nursing services) and nurse assessment coordinators (NACs) should stay abreast of MDS-related news to ensure timely planning and education.
    • Look out for upcoming emails, webinars, podcasts, and articles from AAPACN on the changes.

AAPACN Resources to Get Ready for Oct. 1, 2023

The following resources are available free to AAPACN members to help with coding MDS section GG:

Additional courses available from AAPACN to help test your knowledge of section GG and coding the MDS:

  • Section GG Train-the-Trainer Certificate Program – Take this course to prepare to provide on-going training to direct care staff to accurately report or document the resident’s performance in the 24 different section GG self-care and mobility activities.
  • MDS Essentials – Learn the intent, rationale, and coding requirements of each MDS item set, Care Area Assessments, care plans, and scheduling.
  • RAC-CT – This certification program has long set the national standard for skilled nursing facility PPS and MDS 3.0 education. The program ensures your knowledge of clinical assessment and care planning, completion of the MDS, and the regulatory body surrounding the RAI/MDS process. It is best for post-acute care professionals with at least six months of experience with the MDS/RAI process.

AAPACN is the leading source for MDS-related news and information, and we will be keeping members informed as we learn more about these changes from CMS.

Join AAPACN to stay up to date with the latest MDS information, key changes, and resources to ensure nurse assessment coordinators can tackle their jobs with confidence and ensure compliance with the latest federal guidance and regulations.