| Resident Assessment Instrument
(RAI) and
Minimum Data Set (MDS) Automation
PDF Version of BQA 00-047
(PDF, 17 KB)
Date: June 28, 2000 -- DSL-BQA-00-047
To: Nursing Homes NH-25,
Hospitals HOSP- 21, Hospices HSPCE-18
From: Jan Eakins, Chief, Provider Regulation &
Quality Improvement Section
via: Susan Schroeder, Director, Bureau of Quality Assurance
This memo addresses the current status of Minimum Data Set (MDS) automation and
the Resident Assessment Instrument (RAI). If you have any further questions regarding
these issues, please contact Billie March, RAI Education Coordinator, at (608) 266-7188,
or Chris Benesh, MDS/OASIS Automation Coordinator, at (608) 266-1718.
New Draft MDS 2.0
The Draft August 2000 updated MDS 2.0 forms are available under the
Bulletins area of the Wisconsin MDS Welcome Page. A formal attestation statement
certifying accuracy has been developed and added to all MDS forms (Assessment Forms,
Tracking Forms, and the Correction Request Form). The new forms are targeted for
implementation on August 1, 2000. At that time, facilities must adopt all of the MDS
August 2000 forms. A document that identifies revisions made to the Draft August 2000
forms, compared to the 1/30/98 version, can also be found under the Bulletins area of the
MDS Welcome Page.
Revised Facility User's Manual
The HCFA has released a new version of the MDS Long Term Care Facility
User's Manual. This manual is dated 04/30/2000 and can be found under the Bulletins area
of the MDS Welcome Page. The Facility User's Manual was revised to include information on
accessing the State MDS System through the MDCN, updated system messages and descriptions,
and information on new reports that are now available online. This manual includes
information on the content of these reports and how to request these reports through the
State MDS System. Some of the new reports that have been added include:
-
Roster Report
-
Error Detail by Facility Report
-
Monthly Submission Statistics
-
Resident Discharged Without Return
-
MDS Missing Assessment Report
A Report Viewer Plug-In must be downloaded from the State MDS System before Online Web
Reports can be requested. Follow the instructions on the MDS Online Reports page to
download the plug-in file.
It is recommended that the Facility User's Manual be printed and made available for
staff that complete MDS submissions to the State. It is a valuable reference guide for
trouble shooting problems with MDS automation.
Encryption
On June 27, 2000 the HCFA activated 40-bit encryption of MDS data
transmitted to the WI State MDS System. Encryption will further protect the
confidentiality of personal identifiable information. The next time nursing homes access
the State MDS System they will receive a message to accept an encryption certificate.
Nursing homes should accept the certificate by following the screen prompts provided.
Nursing homes will not be able to access the MDS System if the encryption certificate is
denied.
In the future, 128-bit encryption will be used. This will require nursing homes to
upgrade their web browsers (i.e., Internet Explorer or Netscape) to a version that
provides 128-bit strong encryption.
MDCN
Congratulations! Wisconsin nursing homes have migrated to the Medicare
Data Communications Network and Global Network Dialer software for accessing the State MDS
System for MDS record submission and requesting QI Reports. Some nursing homes have
experienced problems with using the MDCN. Most problems are related to user passwords. The
following lists information for maintaining the MDCN user password:
-
MDCN user passwords expire every 60 days. You will be alerted to type in a new password
when your current password has expired. A new password must begin with an alphabetic
character and cannot be the same as the three previous passwords.
-
If the wrong MDCN user password is entered more than three times, the User ID is
revoked. Contact the MDCN Help Line at 800-905-2069 to have the password reset.
-
MDCN has recently modified their voice mail system to expedite service. When contacting
the MDCN Help Line, press 3 on your telephone pad to have a MDCN user password reset. You
will be prompted to leave your name and MDCN user ID. Your MDCN user ID starts with H@ and
contains 5 additional characters. Your password will be reset to your user ID within 24
hours after leaving a message requesting a password to be reset. You will not receive a
call back from the MDCN. Simply dial-in and enter your user ID as your password and you
will then be prompted to enter a new password.
Periodically the Global Network Dialer software will make updates to your software by
downloading updated files at the time of connection. When this occurs, do not be alarmed.
Allow the download to be completed, click OK, then continue with the connection process.
FAQs
Q. We have not been able to upgrade our internal MDS software program
to be compliant with the new 1.10 version of the MDS data specifications. Can we still
submit?
A. Yes, you should continue to submit MDS records even if your nursing home's software
program has not yet been updated. Nursing homes should upgrade their MDS software as soon
as possible to take advantage of the new automated correction request process and also to
have new edits applied to assessment records before they are submitted to the State MDS
System.
Q. Since the implementation of the MDS Spring release on 5/25/2000, many assessments
are rejected by message number -29 indicating an invalid data value in AB and AC MDS
items. How can we correct these assessments so that they will be accepted by the State?
A. Message -29 is appearing when only some of the MDS items in Sections AB and AC are
completed but not all items in these sections are completed. The items in Sections AB and
AC must meet the all or none rule for most assessment types. The all or none rule requires
that if any items in Sections AB and AC are completed, then all items in AB and AC must be
completed. The only two exceptions are:
-
Admission assessments (AA8a=01) which require that all items in AB and AC (AB1 through
AC1y) be completed, and
-
Discharge prior to initial assessment (AA8a=08) which require that AB1 and AB2 must be
completed, but items AB3 through AC1y are optional. However, if any of those items are
submitted optionally, then all items must be completed.
Using these guidelines, nursing homes should make the appropriate corrections to the
rejected record and resubmit. Nursing homes may need to contact their software vendor to
resolve these errors.
Q. What do I need to do when I receive message -81 Internal Facility ID has been
updated?
A. The State MDS System includes a Resident table that stores the most current resident
identifiers for each person in the State MDS database. Resident identifiers include
information such as last name, first name, middle initial, date of birth, gender, SSN,
Medicare and Medicaid numbers, date of death, and current facility ID. Every time the
State MDS System accepts a new record it compares the resident identifiers in the
submitted record to the data in the Resident table. If the State MDS System finds that
most of the resident identifiers submitted in an MDS record match a record in the Resident
table, it updates the Resident table with the most current information being submitted.
For instance, if the last name for a resident was submitted on an admission record as
Schmidt and on a subsequent quarterly assessment the last name was submitted as Schmitt, a
message -81 would be listed on the Final Validation report indicating, Field Update:
Above field updated on resident table. The Resident table would be updated to reflect
the last name as Schmitt. However, all previous MDS records will still show the last name
as Schmidt. A modification Correction Request form would need to be submitted to correct
each MDS record where the last name was incorrect.
The Resident table also retains the ID of the nursing home or home health agency that
was last associated with an individual. All nursing homes and home health agencies are
assigned an internal facility ID by the State System. Nursing homes do not need to know or
use this number. A message -81 will be listed on the Final Validation Report when the
internal facility ID is updated by the State MDS System. This reflects the fact that the
resident for whom this message was generated was formerly a resident or patient of a
different nursing home or home health agency.
When a message -81 is received, nursing homes should verify that the New
information is correct. If it is, no further action is necessary. If the submitted
information is incorrect and the record is accepted by the State System, a Correction
Request is necessary to correct the erroneous information. Refer to the Draft Provider
Instructions for Making Automated Corrections dated March 2000 for guidance on correcting
MDS assessments containing errors. This document was sent to all Wisconsin nursing homes
under BQA memo 00-037 dated April 27, 2000.
State Help
Questions related to MDS data encoding and submission (feedback reports,
error messages and data corrections) should be directed to either:
- Cindy Symons, MDS Technical Analyst [no longer available, contact Chris Benesh]
- or Chris Benesh, MDS Automation Coordinator,
(608) 266-1718
benesce@dhfs.state.wi.us
Questions related to the RAI/MDS process (clinical issues) should be directed to:
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