Welcome to the HealthPRO Heritage Blog

Are You Ready for the Upcoming October MDS Changes?

CMS recently announced the proposed Patient-Driven Payment Model (PDPM) and it was a flurry of, “what happened to the RCS-1 proposal?” Add this to ongoing MDS RAI Manual updates and CMS appears to be in lockstep with refining the way it collects and analyzes clinical data through the completion of the MDS assessment, and how this will implicate provider reimbursement.

How will CMS accomplish this?
With the changes to MDS Section I set to go into effect October 1, 2018, we have a glimpse into how diagnostic categorizations outlined upon admission will frame this payment model moving forward.  Specifically, we as providers will indicate the resident's primary medical condition category that best describes the primary reason for admission. This data ultimately will have a direct impact on the reimbursement associated with the resident in question.

What’s the takeaway?
The time to ensure ICD-10 coding accuracy is now!

How can you participate?
Encourage your MDS Coordinators to participate in this important Open Door Forum Webinar on July 26, 2018 at 12:30 PM EDT.

We will address the upcoming MDS 3.0 RAI Manual Updates specific to Section I0020 & I0020A, including its impact on SNF Quality Reporting Program requirements, implications when looking ahead to the proposed PDPM, and recommended next steps to prepare for these changes.

Take a deeper dive!
Check out the recording of our recent webinar hosted on April 26 regarding the upcoming MDS Section GG changes through this link: HealthPRO® Heritage MDS Open Door Forum Recording – Upcoming Section GG Changes

Don’t forget…
CMS will be changing more than just Section GG and Section I. You can find further details on all proposed RAI Manual changes online at MDS 3.0 Data Specifications Draft V2.02.0 published 1/25/18. Here’s a quick glance:

  • Section A Item A0600B Medicare Beneficiary Indicator
  • Section C Delirium Item C1310 Signs and Symptoms of Delirium
  • Section GG Functional Abilities and Goals
  • Section I Active Diagnoses Item I0020 Indicate the resident’s primary medical condition category
  • Section J Health Conditions Item J2000 Prior Surgery
  • Section M Skin Conditions
  • Section N Medications Item N2001 Drug Regimen Review, Item N2003 Medication Follow-Up, and Item N2005 Medication Intervention
  • Section O Special Treatments, Procedures, and Programs Item O0100F Invasive Mechanical Ventilator (ventilator or respirator) & Item O0100G Non-Invasive Mechanical Ventilator (BiPAP/CPAP)

Coming in July: Look forward to hosting the training on Section I Changes.

Information based on Proposed Rule released by CMS on April 27, 2018.

Written by: Tony Barger, MS, OTR/L, RAC-CT,  Senior Vice President of Quality Assurance & Compliance

Tags: CMS Update 2018, Section GG, MDS Changes, Patient-Driven Payment Model, PDPM