MDS Modifications Needed – QTSO Request

Nationwide MDS Modifications Needed for ARD 10/1/16 through 11/4/16

Remember the big MDS update on October 1st? New questions, new item sets, Section GG and the like? Well, there was a little blip that may now need to be addressed by your MDS Coordinator due to a CMS technical error.

Below is a copy of the QTSO Memorandum that came out 11/11/16 to all facilities informing of needed changes.

Here is a summary:

Certain types of MDS assessments did not have all the questions included in calculating the value. The issue was with some of the “M” questions: skin.

These types of MDS assessments technically did not “score” with the data for the “M” questions included, so these MDS’s will need to be resubmitted. The MDS assessments can’t just be resent because there is already an assessment in the database, so the assessment has to be resubmitted as a “Modification.” The modified assessment will replace the originally submitted assessment {but nothing in the assessment will be modified}.

MDS Types Needing Modification

The assessment types that need to be “Modified” are those with ARD’s from 10/1/16 through 11/4/16 with the following item sets:

OMRA (NO) Item Set: This is the Nursing Home set of items active on a standalone end of therapy OMRA and a change of Therapy OMRA assessemnt. Standalone means not combined with other assessments.

• EOT
• EOT with SOT
• COT

OMRA (SO) Item Set: This is the Swing Bed set of items active on a standalone end of therapy OMRA and change of therapy OMRA assessment. Standalone means not combined with other assessments.

• EOT
• EOT with SOT
• COT

What if the COT and EOT is combined with other assessments, for example a 14 day COT? Well, then the “M” questions were already present in the questions of the “other” assessment, thus scoring correctly and not needing to be modified.

How Should You Tackle This?

There is no wrong way to gather your information. You know your reports and systems best, but here are a few suggestions:

• Run a report showing all your Medicare Part A assessments with RUG scores for 10/1/16 to 11/4/16. Once you have this, you have options.

1. You can use the HIPPS code (the 2 digits after the RUG score) to identify the type of assessment you are looking for. These codes can be found on your billing claims, billing reports or RUG report. If you use this method, you are looking for HIPPS that end in:

• 04 (Standalone EOT)
• 05 (EOT combined with SOT)
• 0D (Standalone COT)

2. You can use the printed assessment names (COT, EOT, EOT/SOT) from your MDS list and/or billing reports.

When completing the Modification Request, for the “reason” it is recommended that you select “other” and then use the text box to type in “QTSO Request.”

Below is the actual Memorandum with an email address and phone number to obtain more information if needed.

Be kind and share this info with your MDS Team…

Good luck!

The Montero Team

QTSO MEMORANDUM
MEMO NUMBER: 2016-125

TO: QIES State Coordinators CC: CMS Central and Regional Office Contacts FROM: Kathy Langenberg, QIES Technical Support Office

DATE: November 11, 2016

SUBJECT: Alert: MDS 3.0 ASAP Issue for NO and SO Assessment Records
An issue has been identified with MDS 3.0 assessment records submitted to the ASAP (Assessment Submission and Processing) system beginning October 1, 2016, through November 4, 2016. This issue impacts all NO and SO (Nursing Home and Swing Bed OMRA) assessment records with a target date on or after October 1, 2016, and may have resulted in an incorrect ASAP system-calculated RUG code for these assessments. No other assessment record types were affected by this issue.

This issue involves submitted MDS response values for M0300B1, M0300C1, M0300D1, and M0300F1 for NO and SO assessment records. The submitted response values were not stored in the ASAP system, despite being required for the NO and SO assessment record. Since these items were not stored, they were excluded from validation and RUG calculations that would have occurred during this time period.

All providers who submitted MDS NO and SO assessment records on or after October 1st through November 4th, with a target date of October 1, 2016 or after, must submit a modification record to the ASAP system.

No changes are required in this modification record. Providers may not submit the original record a second time as it will be rejected as a duplicate record if it was accepted into the ASAP system in the original submission. Submission of the modification record will allow the ASAP system to correctly recalculate the RUG value and have accurate data stored for reporting purposes.

An email blast containing this information will be sent to all MDS providers and vendors for whom we have email addresses.
If you have any questions concerning this information, please contact the QTSO Help Desk at [email protected] or 1 (888) 477-7876.