New Set MDS PPS Q & As @ CMS

Specialties Geriatric

Published

Specializes in ER CCU MICU SICU LTC/SNF.

..... includes new policies effective July 1, 2002

http://www.hcfa.gov/medicaid/mds20/qa51302.pdf

Thanks Talino, I am going to print them today at work (use their ink and paper ha ha) Tex

thanks, Talino.

Talino, is your facility buying a new manuel that is suppose to be updated this summer. Do you know of any training will be provided with the use of the new shorter version of the MDS for PPS. Do you have to do raps on these residents? Please shed some light.........thanks tex

Specializes in ER CCU MICU SICU LTC/SNF.

Getting the new and revised manual would be nice but most likely the revisions will be available for download at the CMS website (afterall, I'm using the ink and paper too from work :chuckle )

Besides, your disciplines are probably akeen to the manual they already have. So just print out what's revised and add it to the old manual rather than starting with a brand new manual again (and you can tell ur bosses you save them big bucks!).

No need to undergo training for the new shortened Medicare MDS Tex. All items in there are the same except it's shortened. Better if you print out the sample form and make copies for your disciplines to familiarize themselves with it.

instructions....

http://www.hcfa.gov/medicaid/mds20/mpafopt.pdf

form...

http://www.hcfa.gov/medicaid/mds20/mpaf.pdf

Just make sure you're clear of this...

- NO RAPs section in this Medicare MDS (so no need to do RAPs).

- You can only use this new form for Medicare purposes. If you have to combine an OBRA required MDS (Initial, Quarterly, Annual, SCSA) with a Medicare MDS, you have to use the regular Full MDS version.

-the use of this shortened form is OPTIONAL. You can continue to use the full version altho some items will not be stored (since they're not required) in the database

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Talino, how do you feel about this shorter form? Tex

Specializes in ER CCU MICU SICU LTC/SNF.

Disciplines in our facility have developed a routine and seemed comfortable and content completing the current MDS.

Doing the new Medicare short form would probably saved them an average of 1-3 mins. each? WOW! Not to mention the time getting adept in using it. Well. eventually everyone will probably get used to all the different forms.

One major setback... say after certifying completion of a 30-day Medicare MDS, you noticed significant changes. You will have to redo the entire MDS using the full version form since you will need to code this 30-day as an SCSA also. Imagine asking these disciplines to redo an MDS? LOL!

I am not going to use the new short form Tex...

We usually average 10% of our population (264) on Medicare Part A. 90% of them are short-term rehab. Of this 90%, most are discharged by day 45, even earlier. The new short form definitely affords very little benefit or nothing at all.

However, if your Medicare Part A population is larger and your disciplines continue to complain about the time in completing the full version MDS, the short form is definitely worth using.

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Talino, I guess from what you have said you actually have other disciplines working as a team and filling out their sections, completed their raps and care plans. Do you have a social worker that participates? Do you have dietary discipline and an activity person? Well I fill out every section except for the nutritional part, and even then, she is an LPN that was thrown into this, she has (bless her heart) little training. She doesn't understand the time concept, of when things are do, and I can't blame her, she also does the scheduling for all the nursing/CNA's (what a nightmare) works on the floor when nurses don't show up. So I guess you could say in reality I do that part to, and care planning is not her forte. The activity director is so layed back, an excellent activity person but I end up filling her section out, she will do the care plan part, but it is shakey. Our social worker,,,,,,,,,lets just say is a waste. Now before any thoughts of getting people in to replace them or hire more, that isn't going to happen. These people have been at this facility for 10+ years, and are loyal to the owner. I do have the DON and ADON working on qtr's and significant changes/annuals they are wonderful. I in turn will supervise q 3rd week end. I do all the PPS. I do have another LPN that does MDS, but she works only 3 days a week, she has been doing this for years, but I am not sure she is as anal as I am. So What I am thinking is maybe it will save me hours upon hours of time to do the shortened form. Anyway I can on the onset of a new short term resident not have to do raps, would be a blessing for me. If you think of any other info don't hesitate to fill me in. Again thank you TEX

Specializes in ER CCU MICU SICU LTC/SNF.

Tex...

Your type of situation is such a predicament and obviously shared by many facilities. The most common pitfall of MDS is the Administration's lack of understanding how the process work, what it entails, and who is in-charge. MDS is the only tool used in an LTCF that gives you a big picture of what the resident needs are and how much revenue the facility is entitled to in caring for a particular resident. An inaccurate entry to an MDS or non-compliance to its regulation can give your facility a huge monetary loss, not to mention survey citations.

I am not suggesting to anyone that you should go down to your administration and revamp your facility practices. But here's my take...

You as an MDS Coordinator should report directly to the Administrator. You are not under the supervision of the DON nor do you work FOR the DON. You work WITH the DON as well as all other Department Heads, including your Comptroller (or financial officer). You are considered a clinical nurse accountant. When it comes to MDS, these department heads all answer to you because you are the expert of this field!

Easier said than done right? Yep... but I did it 10 years ago! No "Director" title after my name but a more purposeful function... full authority regarding all MDS aspects.

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"Unless one leads the ballgame, everyone else just takes a shot."

Right on, Talino! My facility recently re-vamped our MDS system after the model you describe, and what a difference it has made! Every discipline in the facility now has a new job description to include their own parts of each MDS / RAP / Care plan. I know for a fact that our MDS's are now more accurate, we provide better care because of it.

Specializes in MDS Coordinator, CWS.

tex, are you not a member of the AANAC? you can get so much info from this site. Diane Carter and Rena Shepard are pillars of info. It is worth the 90 bucks.

No I am not a member, the 90 bucks would be great to utilize this site, but I do not have internet use at work, just to transmit to the state. My administrator does, but right now the cost is a concern as far as She is concerned I am sure because our census is down. And I wouldn't mind putting the money into, but unfortunately I am putting my money into remodeling our home. So maybe in the future I can do it...thanks anyway Tex

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