Quiz Course: The MDS For SNF Therapy Professionals – BIMS, PHQ, GG and More

1. Question

The original intent for the MDS (OBRA 1987) in the SNF was to provide a tool for nurses and clinicians to collect resident data, determine potential and actual problems and help to set up a plan of care that would promote the resident’s highest level of function.

True

False

2. Question

The OBRA MDSs are federally required and completed to assist with driving resident care. The PPS MDSs are mainly required for what reason? (Select best option)

To obtain a nursing home's 5 STAR Rating

To comply with PDPM

To establish Scores in the PT/OT, Speech, Nursing and NTA Components so Medicare knows when and how much to reimburse the facility for services

None of the above

3. Question

If an OBRA MDS is late or missing, you may have an issue on your State Survey. If a PPS MDS is late or missing, what will happen?

The resident will need to pay for all services received during that time

The facility will either be paid at a lower rate (default) or will not be paid at all (provider liable) for the dates that the late/missing MDS would have covered

There is no penalty for a late or missing PPS MDS

None of the above

4. Question

Section A of the MDS contains what important information?

The selection of the "type" of MDS assessment with corresponding links to all required questions

The ARD (Assessment Reference Date)

New resident interviews for Race and Ethnicity, part of the SPADES question set added 10/1/23

Information to determine if a reconciled medication list was provided upon discharge from the facility, either to the next provider, or to the resident if discharged home, added to the MDS 10/1/23.

All of the above

5. Question

MDS Sections C (BIMS), D (Mood), F (Customary Routine) and J (Pain) all contain different types of Resident Interviews. What do all the interviews have in common?

They have to be completed by a nurse

They can't be completed until after the ARD

They all have a "staff assessment" that you can choose to complete instead of interviewing the resident

They have to be completed on or before the ARD

None of the above

6. Question

What do RUG scores and Section G have in common?

They are both no longer supported by CMS and are not on any required OBRA assessments as of 10/1/23

The were both part of the PPS reimbursement system for 20 years.

They are still in use by some states for Medicaid and can only be found on the Optional State Assessment (OSA), which is not a Federally required assessment.

All of the above

7. Question

Section GG Self Care and Mobility has a Performance Column on all OBRA and PPS MDS assessments. If the MDS is submitted with dashes in any of these items, indicating that the item was “not assessed,” the is a potential penalty.

If enough Medicare Part A residents have a dashed item, this could lead to a 2% payment penalty for the facility, which could total $10,000 to $100,000+

If enough long term care residents have a dashed item, the facility could receive a MDS deficiency on state survey.

True or False?

True

False

8. Question

Selecting 1 Discharge Goal in Section GG has been a requirement for over 6 years. However, this is no longer required on the MDS and has been removed effective 10/1/24.

TRUE

FALSE

9. Question

Which of the following regarding the “Modes of Therapy” on the MDS is NOT true:

A resident covered under Medicare Part B can never be coded with concurrent treatment time on the MDS. Medicare Part B residents would be coded either Individual or Group.

If a resident does not have Medicare Part B, the MDS Manual states to apply the rules as if that resident has Medicare Part A (even if the resident was private pay, HMO or Medicaid)

The criteria for coding Group Therapy requires that the group was planned, it can be found in each resident's plan of care and 2-6 residents will participate in the group.

You cannot code the MDS with more than 1 Mode of Therapy for a resident per day (only 1 Mode per day is allowed)

10. Question

There is 1 question on the MDS that will impact the Case Mix Group under PDPM (Patient Driven Payment Model) for all 3 therapy disciplines: PT, OT and Speech.

What MDS Section is this question in; and what Type of question is it?

Section A; Date

Section I; Date

Section I; ICD-10 Code

Section O; Mode of Therapy

11. Question

Which statements about Section GG are TRUE?

Section GG Self Care and Mobility questions were only completed for Medicare Part A residents prior to 10/1/23. Now, Section GG is on all OBRA and PPS MDS assessments for all residents regardless of primary payor.

Section GG is coded based on the resident's "usual performance." Determining usual performance for coding on the MDS is an "assessment." This is why GG can only be coded on the MDS by a "qualified clinician."

CMS encourages GG data collection from multiple sources, including the resident report, family report, caregivers\ report, nursing observation/assessment, and therapy observation/assessment.

Data collected to code Section GG has to be collected in a "limited" window of 3 days. Each type of MDS has a different GG data collection window, making it very important for therapy to be aware of the window in which to perform GG assessments. Assessments performed outside of the designated 3-day window can't be used to code the MDS.

All of the above

12. Question

SPADES are a new group of questions added to the MDS as of 10/1/23. These exact Standardized Patient Assessment Data Element questions can also be found in other Post-Acute Care Settings. (ie: On the OASIS in the homecare setting, On the PAI in the Inpatient Rehab Setting).

Skipping these questions on the MDS for Medicare Part A residents can lead to payment penalties for the SNF.

True

False

13. Question

The Brief Interview of Mental Status (BIMS) has specific rules associated with completion. ALL of the following are TRUE about the BIMS EXCEPT WHICH ONE?

The BIMS is a scripted interview and must be administered in the proper order, with scripted language.

The RAI Manual states the BIMS completion is any day during the look-back period, though the preferred completion is "on the ARD or the day prior to the ARD."

If the resident is not able to complete the BIMS interview (ie: non-sensical answers to 4 or more questions), the Staff Assessment can be completed.

If the BIMS was not completed on or before the ARD (ie: staff was late in getting to the resident in time), the Staff Assessment can be completed to obtain a score.

14. Question

For PDPM Nursing Component scores, there are some MDS questions that work in combination, meaning, 2 separate MDS items need to be answered a certain way, and the combination of the 2 questions results in a higher Nursing Case Mix Group Score. An example of this type of combination is:

COPD from Section I and Shortness of Breath Lying Flat from Section J

Fever from Section J and Pneumonia from Section I

COPD from Section I and Oxygen from Section O

Both A and B above

15. Question

Having a student that is treating residents can greatly change the MODE of THERAPY (Individual, Concurrent and Group) that is documented and billed by both the STUDENT and SUPERVISING CLINICIAN.

The student is an extension of the therapist or assistant. When coding/billing for the student and therapist, what both were doing at the time is factored in.

Which of the following scenarios is NOT TRUE?

When the therapist and student are each treating their own Part A resident for the same time period, both must bill concurrent therapy, not individual therapy,

When a Part B resident is being treated by a student, the therapist must be present and directing the service, and not engaged in treating another resident at the same time.

Therapy students are not required to be in line-of-sight of the therapist when treating a Medicare Part A resident. However, if the supervising therapist is treating a resident at the same time, both would need to be in line-of-sight as this is a concurrent treatment situation.

Having a student will improve the productivity of the supervising therapist.

Quiz Course: The MDS For SNF Therapy Professionals – BIMS, PHQ, GG and More

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