MDS 3.0 and the RAI Process
The MDS 3.0 and the RAI (Resident Assessment Instrument) is a comprehensive nurse assessment and care planning process used by the long-term and post-acute care field as a requirement for reimbursement under Medicare and Medicaid. AAPACN nurse experts help you stay up to date on changes to the MDS with breaking news, articles, and practical tools.
- Appendix B State RAI Coordinator Contact List UpdatedThe November update of Appendix B to the RAI 3.0 User’s Manual contains changes to the list of State RAI Coordinators, MDS Automation Coordinators, RAI Panel members, and CMS locations and contacts. To ensure accurate formatting, use a …
- Errata V3.01.4 for MDS Data Specifications V3.01.1 (FINAL), FY2024 ICD-10 Codes for Item I0020B, CAT Specifications V1.06.0 Test Files, and OSA Data Specifications V3.01.0 (FINAL)Errata V3.01.4 for MDS Data Specifications V3.01.1 (FINAL) is now available for download. Six issues were added to the errata. As a result, four edits were revised, and there were several mapping changes of items …
- Schizophrenia Audit Takeaways for NACs and the IDTIn the Jan. 18, 2023, Quality, Safety, and Oversight (QSO) memo QSO-23-05-NH, the Centers for Medicare & Medicaid Services (CMS) announced plans to conduct offsite audits to assess whether nursing homes appropriately assess, document, and …
- Q&A: What is the definition for intermittent oxygen therapy? Question: What is the definition for intermittent oxygen therapy? Answer from Jeff Taylor: Item O0110C3, Intermittent oxygen therapy, is based on the amount of continuous time administered, not ordered. Greater than 0 but less than …
- Q&A: If a resident is admitted to the hospital “for observation” and returns within 24 hours, is an OBRA Discharge assessment required? Question: If a resident is admitted to the hospital “for observation” and returns within 24 hours, is an OBRA Discharge assessment required? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: I …
- Q&A: What is the section GG performance period for a Medicare 5-Day and what is the performance period for an OBRA Admission assessment?Question: What is the section GG performance period for a Medicare 5-Day and what is the performance period for an OBRA Admission assessment? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: It would …
- The Basics of Significant Change and What Has ChangedIn this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist with AAPACN, discuss some of the common concerns …
- TIP: CMS Addressed Section GG on Unplanned DischargesThe Centers for Medicare & Medicaid Services (CMS) recently released a Questions and Answers document from the Oct. 12, 2023, Skilled Nursing Facility/Long-Term Care Open Door Forum. A question was asked regarding if it was …
- PDPM Grouper UpdateThe “PDPM Grouper JAR Package V2.2001.zip” is now available. This V2.2001 release is an update to adjust the OBRA logic for target dates on or after October 1, 2023. The logic for standalone OBRA assessments will …
- OBRA Scheduling Tools for Calendar Year 2024AAPACN offers two great tools to assist nurse assessment coordinators (NACs) in scheduling OBRA assessments. Be prepared for 2024 with these two tools that are free to members: This AAPACN resource is copyright protected. AAPACN …
- The Physician and “I”: Part 1 on Diagnoses and MDS Coding RelationshipsWritten by Michelle Olear, RHIT, BSN Director of Documentation Analysis and Professional Coding Services Minimum Data Set Consultants, LLC The physician’s role in the skilled nursing facility (SNF) is essential to delivering skilled, quality care for skilled …
- Patient Health Questionnaire Completion DeterminationEffective Oct. 1, 2023, the full Patient Health Questionnaire (PHQ)-9 will only be completed if the resident responds to the gateway PHQ-2 questions in a certain way. The Patient Health Questionnaire Completion Determination chart clarifies …
- QTSO Notice: MDS Section G: Functional Status Replaced with Section GG: Functional Abilities and GoalsEffective October 1, 2023, Minimum Data Set (MDS) Section G: Functional Status was replaced with Section GG: Functional Abilities and Goals. This transition significantly impacts the specifications of the following MDS-based Quality Measures (QMs): To address the impact …
- Putting the Significant Change in Status Assessment Criteria into Clinical PracticeThe Significant Change in Status Assessment (SCSA) has been a federal requirement since the inception of the Resident Assessment Instrument (RAI) process that resulted from the Omnibus Budget Reconciliation Act of 1987. The specifications of …
- Stop and Read: Skilled Documentation Audit and Education Lessons for the NACSkilled nursing facilities (SNFs) are increasingly subject to skilled medical review audits from both fee-for-service Medicare (e.g., the SNF Five-Claim Probe and Educate initiative) and individual Medicare Advantage plans. Audit success ultimately hinges on documentation …
- Q&A: If a resident discharges from a Medicare Part A stay, but is remaining in the facility, how do we answer A2121, provision of reconciled medication list to subsequent provider? Question: If a resident discharges from a Medicare Part A stay, but is remaining in the facility, how do we answer A2121, provision of reconciled medication list to subsequent provider? Answer from Jeff Taylor: See …
- Q&A: Do we have to mark “no” on indication for use in section N just because the nurse missed updating the order with the indication even though the medical record from the hospital clearly states the indication for use?Question: Do we have to mark “no” on indication for use in section N just because the nurse missed updating the order with the indication even though the medical record from the hospital clearly states …
- Q&A: If a resident discharges home with skilled home health, how do we code the discharge status and do we provide the reconciled medication list to the home health provider or to the resident?Question: If a resident discharges home with skilled home health, how do we code the discharge status and do we provide the reconciled medication list to the home health provider or to the resident? Answer …
- TIP: CMS Released Updated Errata DocumentThe Centers for Medicare & Medicaid Services (CMS) recently released an update to the RAI User’s Manual, MDS 3.0 RAI User’s Manual (v1.18.11R) Errata (v2). The update, issued on Oct. 20, 2023, provided additional clarification …
- MDS 3.0 RAI Manual: CMS Adds a Second Errata Effective Oct. 1, 2023The PDF file labeled “MDS3.0RAIManualv1.18.11R.Errata.v2.October.20.2023” is now available. The errata document contains revisions to the MDS 3.0 RAI Manual version (v)1.18.11R to provide clarity and additional guidance in Section D and Chapter 6 to support item D0100, …
- MDS Data Collection for the NAC ToolDo you have an organized approach to collect MDS data during the 7- and 14-day look-back periods? AAPACN’s MDS Data Collection for the NAC tool provides an organized approach to gathering supporting data from the …
- UPDATED: Final MDS 3.0 Item Sets version 1.18.11 v6The final Minimum Data Set (MDS) 3.0 Item Sets version (v)1.18.11 have been updated and are now available. Changes in this version (listed below) align the item sets with the Errata V3.01.3 for MDS Data Specifications …
- The Significant Change in Status Assessment: Key Issues Related to v1.18.11 and BeyondThe Significant Change in Status Assessment (SCSA) was not a major focus of the revisions in the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.18.11. However, some of the v1.18.11 MDS coding changes …
- TIP: CMS Issued Corrections to the FY 2024 Final Rule and MDS SpecificationsThe Centers for Medicare & Medicaid Services (CMS) released two important correction notices recently. NOTE: CMS clarified on the Oct. 12, 2023, Skilled Nursing Facility/Long-Term Care Open Door Forum, that assessments that did not allow …
- OSA or PDPM? A State-Level DecisionAs of Oct. 1, 2023, the Centers for Medicare & Medicaid Services (CMS) has retired the A0300 Optional State Assessment (OSA) from the federally required MDS 3.0 v1.18.11 that is submitted by nursing facilities. The …
- Q&A: Part of the new coding instructions for section O “while a resident,” states to include services performed or received since admission OR in the last 14 days. Does this mean it includes services from before entry into the facility and within the last 14 days?Question: Part of the new coding instructions for section O “while a resident,” states to include services performed or received since admission OR in the last 14 days. Does this mean it includes services from …
- Relieving the Pressure of Coding Reopened Pressure UlcersIn the updated Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual, v1.18.11, the Centers for Medicare & Medicaid Services (CMS) added several clarifications to help ease the pressure that nurse assessment coordinators (NACs) …
- Section M Pressure Ulcer/Injury: Algorithms for Present on AdmissionProperly coding pressure ulcers or injuries can be tricky. AAPACN’s Section M Pressure Ulcer/Injury: Algorithms for Present on Admission helps guide the assessor on whether to code present on admission in variety of situations. …
- CMS iQIES Reports User Manual v2.5: MDS ReportsThis user manual provides information for CMS, Providers, Vendors, Accrediting Organizations, Contractors, and State Agencies to effectively perform Reports functions and the processes necessary to request, view, download, and save reports in iQIES. Appendix A: …
- MDS v1.18.11 Is Here: How to Double-Check Efficiency for Long-Term SuccessNow that the MDS version 1.18.11 item sets and the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.18.11 are in play, there are still steps that nurse assessment coordinators can take to ensure …
- Q&A: We completed a combined 5-Day/Admission assessment on day 15 of the stay. After submission, our system shows we are out of compliance for CAAs/MDS based on the signature/completion date. Do we need to bill default for the one day we were out of compliance?Question: We completed a combined 5-Day/Admission assessment on day 15 of the stay. After submission, our system shows we are out of compliance for CAAs/MDS based on the signature/completion date. Do we need to bill …
- What Changed from the Draft RAI User’s Manual to the Final?In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, AAPACN curriculum development specialist, discuss what changed from the draft RAI …
- 4 Essential MDS Changes Documents NACs May Have MissedThe Centers for Medicare & Medicaid Services (CMS) recently released the Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual version 1.18.11, and also a document outlining the draft-to-final changes and updated item sets …
- CMS iQIES Notice of Upcoming SNF QRP Measure Removals The Centers for Medicare & Medicaid Services (CMS) is alerting Skilled Nursing Facility (SNF) providers of upcoming measure removals from the SNF Quality Reporting Program (QRP). The following quality measures are planned for removal from …
- iQIES Resources Site UpdatediQIES is the Internet Quality Improvement and Evaluation System, which is the system that the MDS submissions system is being transferred to. The QIES Technical Support Office maintains a website with iQIES reference materials, including …
- Implement the New and Revised Resident Interviews on the MDS: How to Be Ready for Oct. 1Most of the changes in the MDS version 1.18.11 item sets and the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual v1.18.11 are resident-driven, says Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, a curriculum …
- Q&A: A resident has a catheter for urinary retention. Would this be coded as neurogenic bladder or obstructive uropathy?Question: A resident has a catheter for urinary retention. Would this be coded as neurogenic bladder or obstructive uropathy? Answer from Jeff Taylor:Neither. Retention is a symptom used when the physician hasn’t determined the cause …
- Q&A: Can I code isolation in section O for Extended Spectrum Beta-Lactamase (ESBL) of urine with contact isolation?Question: Can I code isolation in section O for Extended Spectrum Beta-Lactamase (ESBL) of urine with contact isolation? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: The RAI User’s Manual prohibits coding isolation …
- Q&A: For OBRA assessments starting Oct. 1, 2023, will section O therapies data elements be collected or is this item being removed completely?Question: For OBRA assessments starting Oct. 1, 2023, will section O therapies data elements be collected or is this item being removed completely? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Therapy minutes/days …
- CMS QSO Memo: Updates to Nursing Home Care Compare Staffing and Quality MeasuresMemo # QSO-23-21-NH Posting Date 2023-09-20 Fiscal Year 2023 Title Memorandum Summary • Adjustment to Staffing and Quality Measures: CMS will update the staffing level case-mix adjustment methodology and replace some of the Quality Measures …
- MDS 3.0 Quality Measures (QM) User’s Manual V 16.0 Effective Oct. 1, 2023The Minimum Data Set (MDS) 3.0 Quality Measures (QM) User’s Manual V16.0 is now available. The MDS 3.0 QM User’s Manual V16.0 contains detailed specifications for the MDS 3.0 quality measures and includes a Notable …
- FY 2024 ICD-10-CM Codes and Coding Guidelines Effective Oct. 1, 2023: Errata and Updated Files2024 release of ICD-10-CM October 1, 2023 release of ICD-10-CM The FY2024 ICD-10-CM codes are to be used from October 1, 2023 through September 30, 2024. Note: This replaces the FY 2023 – April 1, …
- FY 2024 PDPM ICD-10-CM Mappings File UpdatedFrom https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/patient-driven-model
- SNF QRP FAQs for FY 2024An update to the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Frequently Asked Questions (FAQs) document is now available. This document has been updated to reflect the finalized policies for the SNF QRP in …
- NACs Like a Reasonable Challenge: 2023 AAPACN NAC Work Study and Salary ReportOver the last few years, nurse assessment coordinators (NACs) are being hired with less long-term care experience, being paid more, and facing a multitude of challenges including stress and burnout, staffing shortages, and increased workloads. …
- Q&A: Can the MDS 3.0 scripted interviews be coded directly on the MDS or is additional separate documentation required? Question: Can the MDS 3.0 scripted interviews be coded directly on the MDS or is additional separate documentation required? Answer from Kim Steele RN, WCC, RAC-CT, RAC-CTA: You are not required to document the answers …
- Q&A: How do you code GG0130E, Shower/bathe self, when the resident did not have a bath scheduled during the three-day assessment period? Question: How do you code GG0130E, Shower/bathe self, when the resident did not have a bath scheduled during the three-day assessment period? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: If there was …
- Nurse Assessment Coordinator FTE Calculator Tool FY 2024AAPACN has re-released the Nurse Assessment Coordinator (NAC) FTE Calculator for SNF leaders to estimate the time needed to complete assessments as well as project how many hours the NAC needs for meetings and other …
- TIP: CMS Clarified Section GG Documentation Requirement In late August, the Centers for Medicare & Medicaid Services (CMS) released the post-event question and answer (Q&A) document from the SNF MDS 3.0 RAI v1.18.11 Guidance Training Program available in the Downloads section of …
- Most Frequently Asked Questions on Oct. 1 MDS Updates for Section GGIn this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, chief nursing officer for AAPACN, and Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, curriculum development specialist with AAPACN, discuss the answers to the most frequently …
- FY 2026 (Calendar Year 2024) SNF QRP APU Table for the MDS Data Submission ThresholdThe FY 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (88 FR 53200) revised data collection and submission requirements for the SNF Quality Reporting Program (QRP) affecting the Fiscal Year (FY) 2026 …
- FY 2025 (Calendar Year 2023) SNF QRP APU Table for the MDS Data Submission Threshold–RevisedThe FY 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (88 FR 53200) revised data collection and submission requirements for the SNF Quality Reporting Program (QRP) affecting the Fiscal Year (FY) 2025 …
- FY 2026 (Calendar 2024) SNF QRP Data Collection and Final Submission Deadlineshe FY 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (88 FR 53200) revised data collection and submission requirements for the SNF Quality Reporting Program (QRP) affecting the Fiscal Year (FY) 2026 …
- FY 2025 (Calendar 2023) SNF QRP Data Collection and Final Submission Deadlines — RevisedThe FY 2024 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Final Rule (88 FR 53200) revised data collection and submission requirements for the SNF Quality Reporting Program (QRP) affecting the Fiscal Year (FY) 2025 …
- Section GG Q&A from AAPACN’s 2023 Live Virtual Conference – MDS Updates Prep and PolishOn Aug. 23, 2023, AAPACN hosted the AAPACN 2023 Live Virtual Conference – MDS Updates Prep and Polish event, with educational sessions designed to help implement the MDS changes effective Oct. 1. This one-day event …
- How the Director of Nursing Services Can Support the MDS ProcessThe Minimum Data Set (MDS) determines Medicare and often state Medicaid reimbursement; prompts initial and MDS-assessment-based care planning; provides data that the Centers for Medicare & Medicaid Services (CMS) uses to calculate Quality Measures (QMs) …
- Section GG 3-Day Assessment Periods and AlgorithmEffective Oct. 1, 2023, section GG will be required on all OBRA and PPS assessments for all long-term care residents. This results in many different section GG assessment periods depending on the assessment type(s). The …
- Section GG Data Collection ToolAAPACN has updated the Section GG 3-Day Data Collection Tool to include all of the new self-care and mobility items effective Oct. 1, 2023. This AAPACN resource is copyright protected. AAPACN individual members may download …
- Finalized RAI User’s Manual: Eight Key Points to KnowIn preparation for the upcoming Oct. 1, 2023, implementation of the also-just-updated v1.18.11v5 MDS item sets, the Centers for Medicare & Medicaid Services (CMS) has released the final Long-Term Care Facility Resident Assessment Instrument 3.0 …
- Minimum Data Set (MDS) 3.0 Frequency Report WebsiteEffective August 21, 2023, MDS 3.0 Frequency data will be available from a new location on the data.cms.gov website (https://data.cms.gov/quality-of-care/minimum-data-set-frequency). This new website replaces the previous MDS 3.0 Frequency Report webpage which was decommissioned on …
- CMS iQIES MDS FAQsTable of Contents 1. Launch/Help Questions 1.1 Will iQIES have the same spec version at launch as QIES (version 3.00.1 including Errata Version3.00.8)? _____________________________________________ 1.2 How do I register for iQIES? 1.3 Whom can I …
- Optional State Assessment (OSA) Item Set and OSA Manual for Oct. 1, 2023 Implementation–UpdatedThe Optional State Assessment (OSA) Item Set and OSA Manual have been updated, and the updated versions are now available in the Downloads section on the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page. …
- Solving the Mystery: How to Document for Section GGSection GG, Functional Abilities and Goals, will expand to all OBRA assessments starting Oct. 1, 2023, with the retirement of the section G activities of daily living (ADL) items. This change disrupts the long-standing practices …
- RAI Manual v1.18.11 Surprises: PPS Discharges Get More ComplexNote: This is the third in a series of articles reviewing key issues in the draft v1.18.11 Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual that could prove to be disruptive for busy nurse …
- Q&A: If a resident admits to the facility with a second or third degree burn and it was documented as healed during the look-back period, would it be coded on the MDS at M1040F? Question: If a resident admits to the facility with a second or third degree burn and it was documented as healed during the look-back period, would it be coded on the MDS at M1040F? Answer …
- Q&A: We have a resident on a Medicare Advantage (MA) plan, who went out for a one-day leave of absence. Since this is covered by the MA plan, do we need to complete a discharge assessment, reentry, and set a new 5-Day assessment? Question: We have a resident on a Medicare Advantage (MA) plan, who went out for a one-day leave of absence (LOA). I understand that the discharge assessment and reentry would not be required for Medicare …
- Q&A: When will the new changes affect the MDS assessment? Is this according to the assessment reference date (ARD) or the admission date?Question: When will the new changes affect the MDS assessment? Is this according to the assessment reference date (ARD) or the admission date? For example, if the resident admitted on Sept. 28, 2023, and has …
- Q&A: Are there specific requirements for CNA documentation?Question: Are there specific requirements for CNA documentation? Answer from Alexis Roam, MSN, RN-BC, CPHQ, DNS-MT, QCP-MT: Although Appendix PP of the State Operations Manual (SOM) includes numerous references to documentation, it does not specify what …
- SNF MDS 3.0 RAI v1.18.11 Guidance Training Program: Post-Event Training Videos and Presentation Slide Decks Are UpdatedThe Centers for Medicare & Medicaid Services (CMS) is offering a virtual training program that provides instruction on the updated guidance for the Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Resident Assessment Instrument …
- Accurate PDPM Reimbursement: Four Areas of Focus to Shore Up MDS DocumentationThe Patient-Driven Payment Model (PDPM) has been the case-mix classification model used for Medicare Part A skilled nursing facility (SNF) reimbursement since October 2019. Although this payment system has been in place for nearly four …
- RAI Manual v1.18.11 Surprises: Standout Issues in Sections D and KNote: This is the second in a series of articles reviewing key issues in the draft v1.18.11 Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual that could prove to be disruptive for busy nurse …
- Q&A: This October, are the ethnicity and race items required to be asked on all assessments or can this information be carried over across each MDS assessment?Question: Has there been any additional guidance provided as to whether the questions A1005 Ethnicity and A1010 Race are required to be asked on all assessments or if this information can be carried over across …
- Q&A: What assessments are required when a resident goes out on a leave of absence (LOA)? Question: What assessments are required when a resident goes out on a leave of absence (LOA)? Answer by Jeff Taylor: No discharge is required for a leave of absence as defined in chapter 2 of …
- Q&A: If a resident admits with a UTI diagnosis from the hospital, do we need to code it on the MDS even if McGeer criteria is not met?Question: If a resident admits with a UTI diagnosis from the hospital, do we need to code it on the MDS even if McGeer criteria is not met? Answer by Carol Maher, RN-BC, RAC-MTA, RAC-MT, …
- FY 2024 SNF PPS Final Rule and Correction NoticeThe final rule and key files: Final Rule Permalink Correction Notice: https://www.federalregister.gov/documents/2023/10/04/2023-22050/medicare-program-prospective-payment-system-and-consolidated-billing-for-skilled-nursing-facilities FY 2024 PDPM ICD-1- Mapping (ZIP) (effective 10-01-2023) CMS-1779-F Wage Index Tables for FY 2024 – Final (ZIP) PDPM Case-Mix – Tables 5 and 6 …
- Q&A: We just noted that we missed a Quarterly assessment a few months ago on a resident who has now been discharged. How do we correct this?Question: We just noted that we missed a Quarterly assessment a few months ago on a resident who has now been discharged. How do we correct this? Answered from Scott Heichel, RN, RAC-MT, RAC-CTA, DNS-CT, …
- TIP: Facilities Must Update ICD-10-CM Diagnosis Codes by Oct. 1, 2023The Centers for Medicare & Medicaid Services (CMS) released the revised ICD-10-CM diagnosis codes for fiscal year 2024, which will become effective Oct. 1, 2023. Facility staff will need to review diagnosis codes for residents …
- Develop an Action Plan for CMS’s Schizophrenia MDS AuditsWritten by: Jessica Stucin, RN, BSN, LNHA, RAC-CT, Assistant Director of Education, MDS Consultants On Jan. 18, 2023, the Centers for Medicare & Medicaid Services (CMS) announced they will be conducting offsite audits in nursing …
- RAI Manual v1.18.11 Surprises: Section M and N Updates Include Course CorrectionsNote: This is the first in a series of articles reviewing key issues in the draft v1.18.11 Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual that could prove to be disruptive for busy nurse …
- Using New MDS Items Beyond the MDSSeveral new items added or revised on the Minimum Data Set (MDS) this October are considered social determinants of health (SDOHs): ethnicity, race, language, transportation, health literacy, and social isolation. SDOHs are nonmedical factors that …
- BIMS MDS Coding Video Tutorial UpdatedThe Centers for Medicare & Medicaid Services (CMS) is offering an updated video tutorial to assist providers with guidance application and interview strategies for the cognitive assessment known as the Brief Interview for Mental Status …
- DNS and IDT Must Plan Ahead for Oct. 1 MDS ChangesThe Centers for Medicare & Medicaid Services (CMS) released the draft of the Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual (RAI User’s Manual), version 1.18.11, in April 2023, noting substantial revisions. These …
- Planning Template to Operationalize Oct. 1, 2023, MDS ChangesOn April 3, 2023, the Centers for Medicare & Medicaid Services (CMS) released the draft Long-Term Care Facility Resident Assessment Instrument (RAI) User’s Manual, version 1.18.11, which will go into effect Oct. 1, 2023. The …
- TIP: Medicare Advantage PPS Assessments Are Not Submitted to iQIESThe RAI User’s Manual clarifies that PPS assessments that are completed for the purpose of insurance payment, such as with a Medicare Advantage (MA) plan, are not CMS required assessments and are not to be …
- OSA Crash Course: Keys to Navigating this Medicaid-Only Payment AssessmentIn a number of Medicaid case-mix states, the MDS v1.18.11 item sets won’t be the only MDS item sets that are implemented on Oct. 1, 2023—a fact that should temper some excitement about certain MDS …
- How Will October 2023 MDS Changes Impact PDPM and Medicare Payment?Many changes are coming to the Minimum Data Set (MDS) effective Oct. 1, 2023. The Centers for Medicare & Medicaid Services (CMS) released the draft of the Long-Term Care Resident Assessment Instrument (RAI) User’s Manual …
- Review of ICD-10-CM Changes Effective Oct. 1, 2023In this podcast, Amy Stewart, MSN, RN, DNS-MT, QCP-MT, RAC-MT, RAC-MTA, vice president of education and certification strategy for AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist with AAPACN, discuss some …
- Q&A: An ongoing pressure ulcer was initially noted by our wound nurse as unstageable related to slough and/or eschar. The most recent documentation in the look-back period states the wound is now a Stage 4. Should I continue to code it as unstageable or now code it as a Stage 4?Question: An ongoing pressure ulcer was initially noted by our wound nurse as unstageable related to slough and/or eschar. The most recent documentation in the look-back period states the wound is now a Stage 4. …
- Q&A: Our software auto-populates I0020B and I8000A with the same ICD-10 code. Is this an RAI User’s Manual requirement?Question: Our software auto-populates I0020B and I8000A with the same ICD-10 code. Is this an RAI User’s Manual requirement? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC: The primary diagnosis coded in I0020B …
- iQIES Dashboard Q&AsFrom https://qtso.cms.gov/software/iqies/reference-manuals
- Extended Q&A from the AAPACN May 18 Live Webinar on Upcoming MDS ChangesIn this podcast, Jessie McGill, RN, BSN, RAC-MT, RAC-MTA, curriculum development specialist with AAPACN, and Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, curriculum development specialist with AAPACN, discuss some of the most pressing questions about …
- Q&A: Please clarify when a device would or would not be considered a restraint?Question: Can a winged versus a concave mattress be considered a restraint if it fits the definition? Can a tilt and space wheelchair be considered a restraint? It is being explained to me that it …
- MDS Issues From the iQIES Known Issues ReportCS1963652 Resolved Reports ALL iQIES Users are currently experiencing issues generating reports in HTML or downloading them in CSV/PDF format, presenting no data or limited data to users. Team is investigating and resolving actively 05/31/2023 …
- Q&A: What staff member in a skilled nursing facility (SNF) can complete data collection and entry for section GG items?Question: What staff member in a SNF can complete data collection and entry for section GG items? Answer from Melissa Brown, OTR/L, RAC-CT, CDP, CSRS: I think what may be causing confusion here is the …
- Q&A: If a Medicare Part A resident goes on a therapeutic leave of absence (LOA) of four days for a funeral, what MDS assessments/records, if any, are required?Question: If a Medicare Part A resident goes on a therapeutic leave of absence (LOA) of four days for a funeral, what MDS assessments/records, if any, are required? Answer from Jeff Taylor: No additional MDS …
- Q&A: Can a comprehensive MDS be completed before day 14, such as on day 9 or 10, as long as it is completed by day 14?Question: Can a comprehensive MDS be completed before day 14, such as on day 9 or 10, as long as it is completed by day 14? For example, we have a 5-Day combined with an …
- MDS Item O0110: Get Ready for Multiple Look-Back Periods on the Same MDSThis Oct. 1, 2023, MDS 3.0 item O0100 (Special Treatments, Procedures, and Programs) will be retired and replaced with O0110 (Special Treatments, Procedures, and Programs) as part of the transition to the v1.18.11 MDS item …
- MDS: State Section S Items Effective October 1, 2023 OverviewThe tables list the Section S items that will be active on MDS 3.0 records with a target date on or after October 1, 2023. The active item on each item subset code (ISC) is …
- Top Attendee Questions from the May 18 AAPACN Webinar on Upcoming RAI Manual ChangesThe Centers for Medicare & Medicaid Services (CMS) recently released the draft Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User’s Manual v.1.18.11. With several changes coming this October, the American Association of Post-Acute Care …
- CMS MDS v1.18.11 Training Videos: Direct LinksDirect links: SNF Training Program Overview SNF Understanding Changes to the MDS 3.0 RAI Manual v1.18.11 Training Webinar SNF Social Determinants of Health and New Data Elements in Section A Training Webinar SNF Section C: …