Smart Approaches to Improving the Performance of Continuing Care Organizations
www.MDS3point0.info
Are you ready for MDS 3.0? The new MDS 3.0 is scheduled to be implemented in October, 2010. This major revision of the assessment tool for categorizing care into a RUG group for both financial and quality improvement purposes will have a major impact on skilled nursing facilities. As a nursing home leader, it is important that you become familiar with the MDS 3.0, and begin to prepare your organization for its implementation. This page is dedicated to providing you with information to assist with this goal.
The new MDS 3.0 is going to have more opportunities for residents to voice their needs through resident interview. Through validation studies and the STRIVE initiative, efforts have been made to increase the accuracy of the tool and how it reflects time required for care. Initial studies show that reimbursement based on RUG IV is less than RUG III. The major impact of the implementation of MDS 3.0 is the discontinuation of a look back period into the hospital for extensive services.
MDS and RUG Changes
The look back period data collection component will be changing. The pre-admission activities, such as oxygen and IV therapy that are collected on the new MDS will be used for care planning purposes-- not for reimbursement.
Concurrent therapy time, when multiple residents receive therapy from one therapist at the same time, will be divided among the number of residents receiving therapy, and not on a one to one ratio as was the case with RUG III.
Section T, which predicts therapy to be given on the initial 5-day assessment and allowed payment based on that prediction whether or not it actually occurred, is being eliminated.
OMRA (Other than Medicare Required Assessments) will be required within 8 to 10 days following the cessation of therapy, and therapy started in the middle of a payment period does not trigger a change in payment.
CMS maintains a web site with MDS 3.0 related information. You can find this page at www.cms.hhs.gov/snfpps They also maintain a page specifically for training information, including information on the conference being scheduled for August in Las Vegas. Click here to go to that page.
The MDS 3.0 manual is now available for free download from CMS: Click Here
Congress has delayed the implementation of RUG IV until October, 2011. The new RUG categories have been expanded, and the changes in the MDS 3.0 have resulted in significant changes in how patients will be categorized by the new RUG system. The PDF file below shows a comparision to the current distribution of RUG scores, and the anticipated change after RUG IV is implemented. Of biggest significance is the tremendous decrease in Rehab with Extensive Services. This is due to the elimination of the hospital look-back for extensive services-- only allowing extensive services provided during the SNF stay to be included.
MDS 3.0 Implementation Calendar
September 2010= National Quality Forum Endorsement of MDS 3.0 based quality measures
October 1, 2010 MDS 3.0 implementation, with RUG IV based reimbursement until CMS develops a modified RUG III methodology that accomodates the changes in MDS 3.0 (e.g. no lookback for extensive services, changes to concurrent therapy rules, etc.). When this is available, it will be applied retrospectively to October 1st, and then will carry forward until RUG IV goes live on October 1, 2011.
For a free white paper covering the anticipated challenges of MDS 3.0 and RUG IV, fill and submit the form below:
Bookmark this site and check periodically for ongoing tracking and analysis of the MDS 3.0 implementation!
