MDS draft sends sector, states scrambling to assess effects

by | Sep 7, 2022 | CMS & OIG, In the News

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Joe Bush | Sept 7, 2022 | McKnights

Long-term care facilities, staff and more than half the states in the US should start preparing immediately for extensive changes to the Minimum Data Set, resident assessment experts said this week.

The Centers for Medicare & Medicaid Services last week released a draft of long-awaited update to MDS 3.0. Section G, used by many states to determine Medicaid reimbursement, is gone. Added were additional intake questions and a need for more robust documentation from hospitals referring residents. The changes, pending public comment and final draft reactions, will be official in October 2023.

Gloria Brent, president and CEO of MDS Consultants, called it a “bombshell” that A 0300 A, Optional State Assessment, was removed in the new draft. It’s a tool needed by states that still calculate RUG scores for payment purposes. The draft makes it no longer available.

“Without Section G, they don’t have a score,” said Brent. “If you take away the opportunity for the software to put in Section G, which would be A 0300, the OSA, what are the states going to do to generate an algorithm that calculates a score for the nursing homes to get reimbursed by Medicaid using Case Mix Index methodologies?

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