MDS 3.0 is now here and many work flow processes must be reviewed and considered as facilities move forward to understand and complete all the assessments that are now either required. Education of staff who will be completing the MDS 3.0 fields is critical to accuracy and will impact resident quality of care as well as reimbursement management.
Q: What do you feel are the most important steps for my facility to take in order to prepare for October 1, 2010 and the MDS 3.0 process?
A: First of all, determine which individuals in your facility will be completing portions of the MDS 3.0 just as you did for MDS 2.0 and assure that they have received adequate education in these areas.
Assure that those individuals that are going to be completing the four interviews (Brief Interview for Mental Status (BIMS), Resident Mood Interview (PHQ-9), Preferences for Customary Routine and Activities, and Pain) have practiced these interviews on each other prior to completing the interviews on their residents. I would encourage that all of these individual watch the VIVE video from CMS so that the interviews run smoothly and accurate information is obtained. The Video can be ordered from CMS at the following website: productordering.cms.hhs.gov with CMS product number 11479-CD.
To assist in workflow as of October 1, 2010 and allow a little time to learn the process, I would encourage that each facility consider moving any quarterly and annual OBRA assessments forward over the next few weeks. You can always move these OBRA assessments forward, you just can’t be late. This will give the interdisciplinary team members a little more time to grasp the MDS 3.0 process in October.
Work to organize the interview process. Be sure to plan for the interviews. Anyone trained in the interview process can complete the resident interviews. Calendar the interviews and invite the resident to attend. Make sure facility staff knows when interviews are taking place to reduce or restrict interruptions. Make a placard for the door to the resident’s room or office that you are using that states “do not disturb, interview in process”. Since one of the interviews measures cognitive status, interruptions may lead to false scoring.
Review your resident’s current active diagnosis. Since almost everyone does a recapitulation once a month, and this is your last month prior to MDS 3.0 launch, this is a perfect opportunity to clean up your physician orders and help with accuracy in coding section I, disease process, on the MDS 3.0 document.
MDS 3.0 and RUGS IV are bringing many changes to facility operations including many that specifically impact financial viability. We’re here to help you navigate these changes and provide advice from industry experts.
The CAAs as I understand, are not required w/ OBRA quarterlies, OBRA DC assessments or PPS Medicare assessments. They are not required w/ PPS medicare assessments for the 5 day or the 14 day(?) , unless that assessment is dually coded as an OBRA admission or annual assessment, SCSA or SCPA. How do you distinguish /what is the criteria for the PPS /skilled res to avoid doing an OBRA assessment. I thought we had to dually code one of either the 5 day or the 14 day as an OBRA and PPS? Why. please explain.
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