Therapy Management & Consulting Services Blog

Tips for Your Facility to Help with the MDS Subset Changes

As a Skilled Nursing Facility, you have had to prepare for the changes in the MDS forms and coding directions effective April 1, 2012.  If you are not prepared for the MDS 3.0 changes that occurred, most experts agree that the consequences could be very expensive.

Below are some tips for your facility to help with the MDS subset changes.

  • Ensure that you have an updated RAI manual in your facility.
  • Immediate communication should occur (verbal , via e-mail, or written) to the MDS Coordinator any time a resident is in jeopardy(need)of an EOT or COT. 
  • Daily meetings and notifications should continue to be held to discuss immediate ARD changes, any potential EOTs and potential COTs to avoid default rates. 
  • MDS Coordinator should notify the Rehab Director of any inactivated MDS's and any ARDs that are different than those provided by therapy. 
  • Communication should occur in writing IF an inactivated MDS/ARD occurs. 
  • Once completed, edited, submitted and accepted, you may not inactivate and change an assessment without penalty. 
  • STRATEGY: Must have a pre-transmission process in place to review- ARD date and Type of Assessment BEFORE any and all submissions are sent. These changes are able to be made during the accepted encoding period before submission. High risk situations for default days- early COT, Late COT, late EOT- the total number of days the assessment is out of compliance including the late ARD date. Default days need only apply until the next assessment is in effect. 
  • Report suggestions for software include:  Recent utilization report with ARD dates highlighted, and OMRA analysis to review EOT, COT, and SOT dates and scores. 
  • Unscheduled assessments must be set in the system within 2 daysof the MDS window for that assessment  Early and Late Unscheduled assessments – ARD dates must be set for the window of the date the miss/error was discovered and default days apply.
    • STRATEGY: Consider opening all possible books in advance and editing or deleting books that are not needed. This applies especially to COTs during and assessment that may become active due to acute hospital transfers, COTs on Fridays for weekends and possibly for Fridays and Saturdays over holiday weekends.
      • COT window: 2 days after the 7th day.
      • EOT window: 2 days after the applicable ARD, which is 1-3 days after the 3rd missed day of therapy, so this window is available for 5 days. Please remember that EOT assessments do not apply to index maximized nursing scores.
      • SC window: 14 days after the change was noticed+ 2 days to open the assessment, when completed as an unscheduled PPS assessment.

Tags: nursing home operations, skilled nursing facility