OK, that was dramatic, but we really need your attention.  Thousands of nursing facility MDS records are in the “suspense” table in Minnesota Case Mix database.  We have rewritten code and done what we can to electronically fix this problem.  The problem, however, cannot be fixed by a computer program when items are in suspense because of miscoded and/or missing assessments and tracking records.

What does this mean?  It means that each assessment or tracking record that is in suspense needs to be analyzed by a member of the Case Mix staff.  If the staff member determines the record should not be in the suspense table, she or he will move it to active status and a Case Mix Classification Notice will be generated for that assessment.  If, however, the case mix staff member finds a problem, a call will be placed to the facility to resolve the issue.  Without resolution of the problem, a Case Mix Classification Notice cannot be issued, and you can’t bill for the resident’s stay.

DON’T CALL US, WE’LL CALL YOU

Each phone call to a facility takes several minutes of Case Mix staff time.  It is important information and we want to make sure your facility is educated when there is a problem.  We also need to resolve whatever issues put the record(s) into suspense in the first place.  If you have records in suspense and we need you to resolve the problem, we will call you.  We have more than three times as many staff working on the suspense tables as we had for MDS 2.0.

WHAT CAN YOU DO TO HELP?

Forward this information, complete with links, to the people in your facility who are responsible for completing and submitting MDS assessments and tracking records are accurately following the instructions in the manual.  Make sure their RAI and Case Mix manuals are up-to-date and that they understand the importance of submitting accurate and complete assessments and tracking records.  The RAI manual is available at this CMS website.  The MN Case Mix Manual for MDS 3.0 is available at this website:  http://www.health.state.mn.us/divs/fpc/profinfo/cms/casemix.html.

COMINGS AND GOINGS – KEEPING TRACK OF THE RESIDENT

We’ve discovered that the most common errors resulting in your MDS records going into suspense in the Minnesota Case Mix database revolve around tracking the resident’s status in the system.  There are changes in the way MDS 3.0 tracks residents in the system.

1.  Entry tracking is now required for admissions as well as for a resident who returns to the facility after discharge return was anticipated.  (See pages 2-32 through 2-34 in the manual.)  Be sure you know the difference between admissions and reentries at A1700.  (See Manual pages at A-18 and A-19.)  Entry tracking is a stand-alone record and cannot be combined with an assessment.  If your facility submitted an admission assessment without an entry tracking record, get it in ASAP even if it is late!

The entry tracking should be completed within 7 days of admission/reentry and transmitted to the database within 14 days of admission or entry.

2.  Discharge reporting is significantly changed with MDS 3.0.  There are now 2 major categories:  Discharge Assessments and Death in Facility tracking.  (See pages 2-34 through 2-36 in the manual.)  Also check the definitions of discharge and leave of absence on pages 2-9, 2-10 and 2-12 in the manual.  You don’t send discharge tracking for a leave of absence.  (Also see pages A-20 and A-21 for coding the discharge date.)  Remember, discharge has nothing to do with bedhold status.

The discharge assessment is to be completed within 14 days after the discharge date and transmitted within 14 days of the completion of the assessment.

One last comment:  Did you get e-mails when your Case Mix Classification Notices were ready for MDS 2.0 and you’re not getting them now?   Give us a call.  We can fix that.  Call 651-201-4306 to resolve this issue.

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