This 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 (DHS) website.
Wisconsin RAI/MDS Contacts
Chris Benesh, MDS Automation Coordinator
- For technical/automation questions related to submitting MDS records, interrupting validation report messages, and generating CASPER reports.
Therese Van Male, RAI Education Coordinator
- For questions on the RAI, coding MDS items, or clinically related.
This information is grouped under the following categories:
- RAI/MDS Items
- Section Q
- Section S
- Provider Educational Opportunities
- Technical Resources
- Quality Measures/Quality Improvement Information
- Payment Information – Medicare & Medicaid
- Additional CMS Resources
- Related Resources
- Wisconsin Clinical Resource Center
- The MDS 3.0 RAI Manual is available under the Downloads area of the CMS MDS 3.0 RAI Manual website.
- The MDS Item Sets and Data Submission Specifications are available for download from the CMS MDS 3.0 Technical Information website.
- DQA/DLTC Joint Memo# 12-009 MDS Section Q Referral to Local Contact Agency Process and Automated Submission, issued 06/26/12
- Connection to Community Living (nursing home relocation initiative)
State Optional Items and Section S
Wisconsin does not have a Section S for MDS 3.0 and does not require the submission of State Optional items.
RAI/MDS Educational Forum
DQA sponsores a quarterly educational forum to assist in keeping nursing homes with evolving RAI/MDS information and to provide an avenue for nursing home staff to ask RAI/MDS-related questions. The RAI/MDS Educational Forum will be hosted jointly by DQA’s RAI/MDS Education and Automation Coordinators.
Next RAI/MDS Educational Forum: not yet determined.
To attend the RAI/MDS Educational Forum:
- The forum utilizes an ‘internet meeting format’ via your computer for sharing information online. It is highly recommended that you test your computer for connection compatibility prior to the day of the forum by going to: https://connect.wisconsin.gov/common/help/en/support/meeting_test.htm. The test will immediately start after accessing the test page and you may be prompted to install Flash Player.
- On the day of the forum, connect online to the free ‘virtual meeting room’ approximately 10 minutes prior to the start of the training at: https://connect.wisconsin.gov/dhsdqa-mdsforum/. You will not hear any sound until the forum is started.
- Enter the online meeting room as a ‘Guest,’ signing in with the name of your nursing home.
- If you are having difficulty hearing the presenters through your computer speakers you should run the Audio Setup Wizard which is located under Meeting on the top left-side of the menu bar in the online meeting room. Make sure your computer speakers are not on mute.
Recordings and Agendas of Previous Forums:
- August 23, 2017– Agenda (PDF)
- May 17, 2017 recording – Agenda (PDF)
- February 2, 2017 recording – Agenda (PDF)
- October 31, 2016 recording – Agenda (PDF)
- July 28, 2016 recording – Agenda (PDF)
- April 20, 2016 recording
Section GG Training
MDS Section GG was implemented October 1, 2016. CMS developed the following YouTube four part Section GG training:
CMS developed MDS 3.0 Provider Training videos for Sections I, G, M and O. These YouTube videos and additional MDS 3.0 training videos can be accessed on the CMS MDS 3.0 Training webpage.
Additional Training Resources
VIVE - Video on Interviewing Vulnerable Elders was funded by the Picker Institute and produced by the UCLA/JH Borun Center.
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. Additional information related to Transmitting MDS Data is identified in Chapter 5 of the RAI Manual.
Note: OBRA assessments are required to be completed and submitted for all residents regardless of payer source.
Change in MDS Correction Policy
CMS made changes to the MDS Correction Policy effective May 19, 2013. Changes include the ability to submit a modification to correct typographical and data entry errors for A0310: Type of Assessment (if there is no Item Set Code change) and A2300: Assessment Reference Date (if results do not change look back period). Refer to Chapter 5 of the most recent version of the RAI Manual for additional information. The RAI Manual can be downloaded from CMS MDS 3.0 RAI Manual website.
CMS PowerPoint slides identifying changes to MDS 3.0 Manual Modification/Inactivation policy, effective May 19, 2013.
CMS has developed a MDS 3.0 Submission, Submission Status, and Final Validation Reports Helpful Hints (PDF) 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 ( Final Validation reports are automatically deleted after 60 days)
- 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. 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.
User IDs/Passwords Required
Requesting access to CMS systems requires two steps to obtain two separate login IDs. A CMSNet User ID and a QIES Submission/MDS Individual login ID.
Use the CMSNet Online Registration application to request a CMSNet User ID.
The CMSNet ID is needed to access secure CMS sites (e.g., submissions pages/reports) unless an otherwise secure connection has been established.
Use the QIES online User Registration tool to obtain a QIES Submission ID. Once you have registered for a CMSNet User ID, you will receive an email from MDCN.firstname.lastname@example.org containing your login information. Using this information you will connect through the 'CMS Secure Access Service'.
Once securely connected, select the 'CMS QIES Systems for Providers' link to access the QIES online 'User Registration' tool. New users must utilize the online 'User Registration' tool to obtain a QIES Submission/MDS Individual login ID (the only exception is Corporate/Third-Party accounts).
Additional information is available on the QTSO MDS Access Information web page.
QIES Submission/MDS Individual ID Requirements
A user selects their own QIES login password when they register for their individually assigned 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.
A facility is allowed to have a maximum of two Individual MDS 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 an individual MDS ID for an additional user. To remove an account use the MDS Individual User Account Request form available on the QIES Technical Support Office (QTSO) website at https://www.qtso.com/accessmds.html.
Forgot MDS Individual Login Password and Inactivated Accounts
If the incorrect individual login password is entered too many times, the 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 CMS 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.
The MDS 3.0 Quality Measure User's Manual is available under the Downloads area of the CMS Quality Measures website.
Section 11 of the CASPER Reporting Users Manual provides provides information for how to generate the MDS 3.0 QM reports. This manual is available on the CMS MDS 3.0 System Welcome page and is also available on the QTSO MDS 3.0 User Guides and Training website.
CMS MDS 3.0 QM User's Manual - available under the Downloads area
CMS Five Star Rating System information
Metastar - Wisconsin's Quality Improvement Organization
Medicare Payment Information
CMS Clarification document to the March 2012 Provider Conference, previous clarification documents, provider call transcriptions, and additional information is available under the Downloads area of the CMS SNF PPS RUG IV Education and Training web page.
National Government Services - Medicare claims
Medicaid Payment Information
MDS 3.0 Section Z items Z0200 and Z0250 are not required to be coded and may be left blank.
Wisconsin Medicaid uses the MDS 3.0/RUGS IV-48 classification system for Medicaid residents.
Additional Wisconsin Medicaid Payment information:
- RUG IV - 48 Grouper Decision Tree (PDF)
- Medicaid Nursing Home Reimbursement web page
- CMIs are also identified in the RUGIV_Grouperspecs spreadsheet (Excel)
Forward Health Update 2017-31 Nursing Home Level of Care Process Change and New Level of Care Report (PDF)
ForwardHealth Update 2017-04 New Policy Regarding Developmentally Disabled Level of Care Assignments (PDF)
Additional CMS Resources
- Federal Register – Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities (published 10/4/16)
- Skilled Nursing Facility Center
- SNF/Long Term Care Open Door Forum
- CMS SNF Consolidated Billing
- Nursing Home Certification and Compliance
- State Operations Manual - Appendix PP Guidance to Surveyors for Long Term Care Facilities
- State Operations Manual - Appendix P Survey Protocol for LTC Facilities
- CMS Form 672 Resident Census and Conditions of Residents
- CMS Matrix with Instructions
- CMS Forms Website
- CMS Certification & Survey (S&C) Memos
- CMS Staffing Data Submission PBJ additional information on QTSO PBJ
- Medicare Learning Network
- Nursing Home Value Based Purchasing
- CMS Medicare
- Removal of SSNs from Medicare Cards – Provider Resources
Clinical Resource Center
The Clinical Resource Center (CRC) project is jointly sponsored by the Wisconsin Department of Health Services, LeadingAge Wisconsin and the Wisconsin Health Care Association (WHCA/WiCAL), through funding from the Department of Health Services. Development support is provided by staff from the Center for Health Systems Research & Analysis (CHSRA), University of Wisconsin-Madison. The CRC website was designed as a user-friendly resource to provide key information to staff working in Wisconsin nursing homes about selected care areas and training topics.
CRC Website Address: https://crc.chsra.wisc.edu/
For more information:
- Contact your nursing home association
- CRC email: email@example.com
- CRC Helpdesk: 888-300-8098.