RAI/MDS 3.0 Information
This web page provides links to information pertaining to the Resident
Assessment Instrument (RAI) and Minimum Data Set (MDS) 3.0. Many of the links on this web page
will exit the Wisconsin Department of Health Services website.
MDS 3.0 will apply to MDS assessments with Assessment Reference Dates (ARD)
of 10/1/2010 or later, entry records with an entry date of 10/1/2010 or
later, and discharge/death in facility records with a discharge date of
10/1/2010 or later.
RAI/MDS Items
CMS has posted a revised MDS 3.0 RAI Manual (V1.08) that will be effective
April 1, 2012. The RAI
Manual is available as a zip file and contains the complete manual and is available under
the Downloads area of
the CMS MDS 3.0 Training Materials website located at:
http://www.cms.gov/NursingHomeQualityInits/45_NHQIMDS30TrainingMaterials.asp (exit
DHS).
The Wisconsin
Department of Health Services is sponsoring MDS 3.0 basic training in
several locations around the state in April and May, 2012. Please
see the MDS-Basic 2012 training brochure for
information about this program including training dates and locations, and
how to register.
RAI Panel
Q&As
The RAI Panel consists of several State RAI Education Coordinators that
provide consultation to CMS and answer questions related to RAI/MDS
issues.
RAI Panel Q&As for August, 2011 (PDF,56 KB)
RAI Panel Q&As for July, 2011 (PDF,75 KB)
RAI Panel Q&As for June, 2011 (PDF,122 KB)
9/29/2010
CMS Clarification R/T: Initial resident Interviews
CMS requires facilities to attempt the resident interviews (BIMs, PHQ9,
Preferences, and Pain) on all residents at least one time. These
interviews should be attempted, even if facility staff code B0700 = '3'
'rarely/never understood'. CMS acknowledges that residents may be able to
successfully complete one or more interviews, but not all interviews. This
initial attempt at interviewing each resident should give additional
information to support accurate coding of B0700. It is advised that the
residents' response to the interview attempts be thoroughly documented in
the clinical record.
VIVE - Video on Interviewing Vulnerable Elders was funded by the
Picker Institute and produced by the UCLA/JH Borun Center. The VIVE
video can be accessed on the Picker Institute website at http://pickerinstitute.org/vive/ (exit
DHS).
Instructions for staging in
Section M (8/12/2010) Clarification has come from CMS regarding the
staging of pressure ulcers in Section M of the RAI manual.
There is no reverse staging on MDS 3.0. Once the initial numerical
staging of a pressure ulcer or the initial numerical staging of a pressure
ulcer after it is debrided is identified, the pressure ulcer remains at
that stage until it heals, worsens or becomes unstageable (and would then
have to be debrided to be staged again). If a PU worsens, the staging
would change to reflect the worsening, and the PU would remain at that
stage until healed, or worsens further (e.g. stage 1 to stage 2, stage 2
to stage 3, or stage 3 to stage 4). As pressure ulcers heal they are never
reverse staged on the MDS. Healing is captured in a separate item. (M0900)
Pressure ulcers captured on the MDS either heal, worsen or become
unstageable. They are never reverse staged. For the most part the RAI
manual Section M- July 2010 reflects this information. Minor revisions may
be coming in the future.
Section Q
DQA/DLTC Joint Memo# 11-007
MDS Section Q Referral to Local Contact Agency Process, issued
02/28/11
Section
Q Implementation Questions and Answers updated
December 22, 2010 (PDF,149 KB)
CMS
Section Q Brochure (exit DHS)(PDF,97 KB)
CMS
Community Living Initiative and additional Section Q resources/information
(exit DHS)
Section S and State Optional Items
Wisconsin will NOT have a Section S for MDS 3.0 and will not be adding
State Optional items to any of the item sets.
MDS 3.0 Survey Forms
CMS 672 -
Resident Census and Conditions of Residents (exit
DHS)(PDF,431 KB)
CMS 802 -
Roster Sample Matrix Form (exit DHS)(PDF,153 KB)
CMS 802P -
Roster Sample Matrix Provider Instructions (exit
DHS)(PDF, 312 KB)
Provider Educational Opportunities
The Wisconsin Department of Health
Services is sponsoring MDS 3.0 basic training in several locations around
the state in April and May, 2012. Please see the MDS-Basic
2012 training brochure for information about this program including
training dates and locations, and how to register.
CMS has made
available YouTube Training Videos for MDS 3.0 on the CMS
MDS 3.0 Training Materials web page.(exit
DHS)
Technical Resources
Wisconsin Change from AT&T to Verizon begins November 28, 2011
CMS is changing vendors for connecting nursing homes and home health
agencies to the MDS and OASIS Systems. Starting November 28, 2011,
Wisconsin providers should following the Installation Guide instructions
to change their access to Verizon. The Installation Guide and a FAQ
Transition guide are available at: https://www.qtso.com/cmsnet.html
(exit
DHS).
Read the FAQ Transition from AT&T to Verizon guide before
attempting to login with Verizon. It is important to have
Administrative Rights on your computer to be able to install required
software.
It is important to change to Verizon as soon as possible because the
AT&T client software may be discontinued 30 days after November 28th.
Only OBRA and Medicare PPS Assessments Allowed to be Submitted
On the
January, 2011, SNF Open Door Forum conference call, CMS explained only MDS
3.0 assessments that are OBRA assessments or Medicare Part A PPS
assessments should be submitted to the QIES ASAP MDS System. Assessments
completed for Medicare Advantage Plans or for other insurance purposes
should not be submitted. CMS acknowledged this is a change from MDS 2.0,
which allowed submission of all MDS assessments. Note: OBRA assessments
are required to be completed and submitted for all residents regardless of
payer source.
Change in MDS Correction Policy
Effective
with submissions on April 1, 2011, CMS will no longer allow facilities to
modify the MDS 3.0 reason for assessment items, assessment reference date
(ARD), discharge date, and entry date. If a modification record is
submitted attempting to change any of these items, the record will be
rejected. These MDS items must be corrected by inactivating the old record
and submitting a new record. Chapter 5 of the RAI manual will be revised
to reflect this change.
Microsoft Internet Explorer TLS/ Security Certificate
Updates
Effective November 21, 2010, Web Browser Update Required for QIES National
Systems Access and Security Certificate Update. Please refer to
instructions contained in the following QTSO Memorandums:
Submission Information
CMS has developed a MDS 3.0 Submission,
Submission Status, and Final Validation Reports Helpful Hints (PDF,
798 KB) document that provides information for how to:
-
Submit MDS 3.0 files after using the link on the MDS
3.0 Welcome Page
-
Obtaining submission acknowledgement message including
the Submission ID
-
Use Submission Status to determine if the submission
file was processed successfully
-
How to obtain Final Validation reports in the Folders
tab of CASPER
-
How and when to use the MDS 3.0 Submitter Final
Validation Report for instances when a normal Final Validation is not
generate or if records in a submitted file are not included in a Final
Validation report.
QIES Technical Support Office (QTSO) Website
The MDS Provider User's Guide
is available under the MDS 3.0 link on the QIES
Technical Support Office website (exit DHS). This guide provides detailed information for the submission of MDS
3.0 records by nursing home and swing bed providers. The Error Messages
are located in Chapter 5 of the MDS Provider User's Guide. The QTSO website also includes a link for RAVEN
(exit DHS) software and there is also a webpage
for Vendor MDS Information
(exit DHS) including Question and Answer
documents from CMS/Vendor teleconferences.
MDS Personal Login ID Requirement
A MDS Individual Login ID is required in order to access the MDS
Submission System and CASPER Reports. In order to acquire an Individual Login
ID, a request must be submitted to the QIES Technical Support Office using
the MDS Individual User Account Request Form available on the QTSO
website at https://www.qtso.com/accessmds.html
(exit DHS).
A facility is allowed to have a maximum of two Personal Login IDs. It is the facility’s responsibility to revoke access for any users
who no longer require access to facility data. Revoking the account
of a user who no longer requires access to facility data permits you to
request a personal login ID for an additional user.
Personal Login Passwords
A user selects their own personal login password when they register for
a MDS personal login account. The password must meet stringent
password rules that are available to view on the password web page.
Passwords are set to expire in 60 days. Users must enter a new
password when they are prompted to change their password or they may use
the QIES User Maintenance application that is available on the MDS Welcome
Page to change their password at any time prior to the 60 day expiration
date.
Forgot Personal Login Password and Inactivated Accounts
If the incorrect personal login password is entered too many times, a personal login account will be
made inactive. If the user does not log into CASPER reports within 90 days, their account will also be made
inactive. Inactive accounts will not be able to submit MDS
assessments.
One indication of an inactive account or an expired password: after
attempting to login the following message appears, "Authorization
Required", indicating the server can't verify the appropriate access
credentials.
To reactivate a MDS personal account, follow these steps:
- On the State MDS Welcome page select the QIES User Maintenance link.
- Select "Forgot your password or Inactive
Account?".
- Enter your Personal Login ID and answer the three security questions and
follow the directions provided.
Providing answers to the security questions were part of the process
for registering for an individual MDS account. Users will have
three attempts to correctly answer the security questions, after that,
they are locked out and must contact the QIES Help Desk to reset their
account, 800-339-9313.
To avoid getting locked out be sure to log into CASPER or the QIES User
Maintenance application at
least once every 90 days.
Quality Improvement Information
During the transition from MDS 2.0 to MDS 3.0 there will be a period of
time where QMs that are reported will not be updated. CMS will be
evaluating and testing the data and once comfortable with the accuracy of
the MDS 3.0 data it will be publicly reported.
A draft MDS
3.0 Quality Measure Technical User's Manual is available on the CMS
MDS 3.0 Technical Information web page (exit
DHS)
Medicare Nursing Home
Compare
(exit DHS)
CMS
Five
Star Rating System information (exit DHS)
CMS Nursing
Home
Quality Initiatives (exit DHS)
Advancing
Excellence in America's Nursing Homes (exit
DHS)
Metastar - Wisconsin's Quality
Improvement Organization
Medicare Payment Information
CMS
SNF
PPS FY12 Policies effective October 1, 2011 Transition for Implementation
web page includes November 3, 2011, and August 23, 2011 Nation Provider Call slides, audio,
written transcripts, follow-up clarification documents, and a transition policy
memo. (exit
DHS).
CMS SNF PPS (exit DHS)
CMS
RUG IV Education and Training - information on transition from RUG-III to RUG-IV (exit DHS)
Medicare
Benefit Policy Manual (exit DHS)
National
Government Services (exit DHS)- Medicare claims
Medicaid Payment Information
Effective
October 1, 2010, nursing home providers will begin using the MDS 3.0/RUGS
IV-48 classification system for Medicaid residents. The new system does
not affect Medicaid Fee for Service billing or rates in the current rate
period of July 1, 2010 - June 30, 2011. The first picture date that
will reflect this change will be December 31, 2010, and the first fee for
service rates based on RUGS IV-48 will be July 1, 2011.
MDS 3.0 Section Z
items Z0200 and Z0250 are not required to be coded and may be left blank.
Refer to Wisconsin Nursing Home Medicaid
Information (PDF, 28.5 KB) for additional information on case mix and "picture
dates", and CMIs are identified in the RUGIV_Grouperspecs
spreadsheet (Excel, 28.5 KB).
Wisconsin Clinical Resource Center
The Wisconsin
Clinical Resource Center (WCRC) (exit DHS)
project is jointly sponsored by the Wisconsin Health Care Association (WHCA)
and Wisconsin Association of Homes and Services for the Aging (WAHSA),
through funding from the Wisconsin Division of Quality Assurance (DQA).
The WCRC Advisory Group serves to identify, guide and review content
provided in the website and training, along with representation from DQA.
Development support is provided by the Center for Health Systems Research
& Analysis (CHSRA).
The WCRC website is designed as a user-friendly resource
to provide key information about eight care areas to include pressure
ulcers. The WCRC
Pressure Ulcer Module (exit DHS) includes
tools, guidelines, regulations and additional resources for learning.
Note: Nursing home staff that need assistance with the
login information for the WCRC website should contact CHSRA
(exit DHS).
Additional CMS Resources
Skilled Nursing
Facility Center (exit DHS)
SNF/Long
Term Care Open Door Forum (exit DHS)
Nursing
Home Certification and Compliance (exit DHS)
Medicare
Learning Network (exit DHS)
Nursing
Home Value Based Purchasing (exit DHS)
CMS Medicare (exit DHS)
Related Resources
Nursing Home
Pressure Ulcer Information
DQA
E-Mail Subscription Service (Listserv)
DQA Contacts
For questions on the RAI, coding MDS items, or clinically related
contact:
Margaret Katz, RN,
RAI Education Coordinator
(715) 836-6748
For questions related to submitting MDS records to the CMS/State MDS
System, interrupting Validation reports, and accessing CASPER to obtain QI/QM
reports and other MDS related reports contact:
Chris Benesh, MDS
Automation Coordinator
(608) 266-1718
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Last Updated: February 03, 2012 |
