Three weeks to go until implementation of MDS 3.0 and RUGs-IV . . . ready or not!  Hopefully facilities have put into place updated software, determined the “best” transition strategy, analyzed historical therapy practices and made changes if desirable, practiced resident interviews, purchased or downloaded necessary resources, and provided training for all involved staff.

This article will look at the most recent updates provided by CMS regarding MDS 3.0, and provide links to necessary resources and training, in case the deadline has snuck up on staff or a facility.

RECENT UPDATES

August 27, 2010 Updates

On August 27, 2010, CMS updated some of the technical documents related to MDS 3.0.  These updates can be seen by clicking here.  Below is a summary of the new technical documents:

• The version numbers given for the RUG-III MDS 3.0 Mapping Specifications (V1.00.2) and the RUG-III MDS 3.0 Version Converter DLL (V1.00.1) have been corrected.
• The MDS 3.0 CATs Specifications (V1.00.3) have been updated.  The only change is the inclusion of a corrected test data file for CAT #20.  See "CAT Test Data Change Document 1_00_3 (07-29-10).pdf" in the download ZIP file.
• A new version of the RUG-IV Specifications and DLL Package (V1.00.8) is being posted to correct four coding errors, to correct 5 test data sets, to add Medicare Case Mix Indices (CMIs) to be used starting 10/1/2010, and to correct 2 CMIs in CMI Set F02.  For details of the changes, see the initial section of the "RUGIV grouper overview V1.00.8 20100817.pdf" document.

Of particular importance was the August 27th release of the RUG-IV Medicare Skilled Nursing Facility Prospective Payment System (SNF PPS) Case Mix Indices, in effect starting October 1, 2010.  These indices will be particularly important for MDS staff to make strategic decisions regarding the dates chosen to complete assessments and the MDS assessments used, in order to maximize reimbursement.  Click here to view the RUG-IV groups with case mix indices.

September 3, 2010 Updates

On September 3, 2010, CMS revised parts of Chapter 3, Sections M (Skin Conditions) instructor guide and training slides in response to feedback from the last Train-the-Trainer national conference held in August.  These updates can be seen by clicking here.  Below is a summary of the changes to the training documents:

• Chapter 3, Section M Instructor Guide (note:  this is a new document so there are no changes reflected)
• Chapter 3, Section M Revised Training Slides (V1.01)

The changes to the slide deck, Chapter 3, Section M V1.01 August 2010 are:

• Clarified Major Changes to Section M (measurement of dimensions) slide.
• Expanded on Clinician Skills Needed slide.
• Revised slide for M0100C Clinical Assessment.
• Revised M0150 Risk of Pressure Ulcers slide.
• Deleted one example from the Pressure Ulcer Quiz.
• Updated format of Pressure Ulcer Quiz to replace numbering with bullets.
• Added labeling to the graphics for M0610A Length and M0610B Width to indicate the resident's head and toe.
• Revised M0610B Width slide.
• Updated instructions for measuring depth of a pressure ulcer on M0610C Depth slide.
• Revised Section M Scenario Instructions.
• Corrected the Section M Scenario Coding for the date of the oldest known Stage 2 pressure ulcer for the first quarterly assessment.
• Deleted one example from the Wound Quiz.

RUGs-IV Rates, CBSA Codes/Wage Index, and RUGs-IV Case Mix Indices

Click here to find the RUGs-IV Rates posted on the Care Providers of Minnesota website (extracted from the July 22, 2010 Federal Register).

Click here to find the Core-Based Statistical Area (CBSA) and Wage Index codes for Minnesota posted on the Care Providers of Minnesota website (extracted from the July 22, 2010 Federal Register).

Click here to find the RUGs-IV groups with case mix indices posted on the Care Providers of Minnesota website.

MDS 3.0 MATERIALS and TRAINING RESOURCES

Hopefully all facilities and staff are fully trained and ready to roll on October 1, 2010 with MDS 3.0.  Not quite ready?  Below are links to tools, resources, and training that will be necessary for implementation of MDS 3.0:

Training

Care Providers of Minnesota has the following MDS 3.0 webinars available for purchase on our website: MDS 3.0 & RUGS IV Operational Strategies and Financial Implications, MDS 3.0 Interdisciplinary Team and System Changes, MDS 3.0 Transition Guidelines, Preparing for RUG-IV/Hybrid RUG-III.  These recorded webinars may be purchased for viewing by clicking here.

Care Providers of Minnesota will also be hosting an MDS 3.0-focused “virtual” October region meeting.  The October Region Meeting will be a 90-minute webinar, scheduled on October 7 starting at 10 a.m., where you can get answers to your MDS 3.0 questions from a panel of experts.  Even with all of the preparation for MDS 3.0 that we’ve offered you up to this point, chances are you will have questions once it is implemented on October 1, 2010.  This webinar, just like traditional Region Meetings, will be free of charge to members, and if you are unable to join us live, we will archive the webinar so you can download it after the event.  We will be answering questions submitted to us in advance, as well as responding to live email questions during the webinar.  Remember, there are no questions too basic—if you have a question, likely there are peers out there with the same question.  Registration for this free webinar will be available as the date nears; keep an eye out in your inbox and future newsletters for more information.

The Minnesota Department of Health has produced 23 on-line WebEx Presentations, all available free for new or repeat viewings:

• MDS 3.0 Section X – This presentation will focus on Correction Request – 24 minutes
• MDS 3.0 Section A – This presentation will focus on Identification Information – 52 minutes
• MDS 3.0 Chapter 5 – This presentation will focus on Submission & Correction of MDS Assessments – 36 minutes
• MDS 3.0 Section Z – This presentation will focus on Assessment – 19 minutes
• MDS 3.0 Section C Part 1 – This presentation will focus on Section C Part 1 – Resident Interview for Mental Status – 41 minutes
• MDS 3.0 Section C Part 2 – This presentation will focus on Section C Part 2 – Staff Assessment & Delirium – 37 minutes
• MDS 3.0 Chapter 1 – This presentation will focus on Chapter 1 – Resident Assessment Instrument – 25 minutes
• MDS 3.0 Section Q – This presentation will focus on Section Q – Participation in Assessment and Goal Setting – 44 minutes
• MDS 3.0 Section V – This presentation will focus on Section V – Care Area Assessment (CAA) Summary – 38 minutes
• MDS 3.0 Section O – This presentation will focus on Special Treatments, Programs and Procedures – 1 hour, 18 minutes
• MDS 3.0 Section J – This presentation will focus on Section J – Health Conditions – 1 hour
• MDS 3.0 Section G – This presentation will focus on Section G – Functional Status – 1 hour
• MDS 3.0 Section E – This presentation will focus on Section E – Behavior – 50 minutes
• MDS 3.0 Section H – This presentation will focus on Section H – Bladder and Bowel – 37 minutes
• MDS 3.0 Section I – This presentation will focus on Section I – Active Diagnoses – 17 minutes
• MDS 3.0 Section N – This presentation will focus on Section N – Medications – 17 minutes
• MDS 3.0 Section P – This presentation will focus on Section P – Restraints – 22 minutes
• MDS 3.0 Section D – This presentation will focus on Section D – Mood – 33 minutes
• MDS 3.0 Section K – This presentation will focus on Section K – Swallowing and Nutritional Status – 33 minutes
• MDS 3.0 Section F – This presentation will focus on Section F – Preferences for Customary Routines and Activities –  23 minutes
• MDS 3.0 Section L – This presentation will focus on Oral and Dental Status – 11 minutes
• MDS 3.0 Section B – This presentation focuses on Section B – Hearing, Speech and Vision – 32 minutes
• MDS 3.0 – Introduction to Chapter 3 – This is an introductory presentation to MDH training for coding Chapter 3 of the MDS 3.0 manual – 14 minutes

Each of these recorded WebEx presentations may be viewed here.

Under “Attend a Session” on the left hand side of the page, click on “Recorded Session,” then select the WebEx you wish to view.  These recorded WebEx’s should be the best topic-specific resources for both new and experienced MDS coders.

The Minnesota Department of Health is also holding a series of 8 free conference calls in an effort to respond to provider questions concerning the implementation of MDS 3.0, RUG-IV and Case Mix.

The conferences calls will begin at 10:00 a.m. and last for an hour.  They are scheduled for the following dates:

Thursday September 23, 2010
Thursday September 30, 2010
Thursday October 7, 2010
Thursday October 14, 2010
Thursday October 21, 2010
Thursday October 28, 2010
Thursday November 4, 2010
Thursday November 18, 2010

MDH will be requiring registration for the MDS 3.0 teleconferences concerning the implementation of MDS 3.0.  The first conference is scheduled for Thursday, September 23, 2010 beginning at 10:00 a.m.  Registration for the September 23, 2010 call will open Friday, September 10, 2010 and close Sunday, September 19, 2010.

To register, go to the following website:  http://www.health.state.mn.us/divs/fpc/MDS30_teleconferences.html and click on the registration link.

Facilities and organizations are reminded that each provider and organization is limited to one phone line per facility or organization.  Please do not call in on a cell phone, as this causes static that makes it difficult for others to listen to the call.

Providers are asked to submit their questions in advance to the following e-mail address: health.mds@state.mn.us.  Please enter in the subject line, “phone call question.”

Consultants and Software – Many organizations will continue to provide ongoing training and consulting options for facilities regarding MDS 3.0 and RUGs-IV.  Care Providers of Minnesota Associate Members E-Health Data Solutions, Health Dimensions Group, LarsonAllen, Pathway Health Services, PointRight, and Wipfli all provide consulting and training on MDS 3.0 and/or RUGs IV.  Care Providers of Minnesota Associate Members who provide facility software – MDI Achieve and PointClickCare – also provide software-related training.

Important Resources

CMS MDS 3.0 website (training materials, RAI manual, technical information, and updates, etc.)

MDH MDS 3.0 website (resources, RAI manual, SNF PPS Payment Transition, Educational Opportunities, MN Case Mix Information, Data Specifications, etc.)

Care Providers of Minnesota MDS 3.0 website (links to many resources and documents)

Doug Beardsley
952.851.2489
dbeardsl@careproviders.org

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