Joint Commission Survey

Specialties MDS

Published

Specializes in Trauma, Med/surg, CM, UM,.

Yup, I know JC isn't something you normally see discussed on the MDS board since MDS is LTC specific. BUT... I work at a SNF hospital that is licensed under the same 'umbrella' as the Acute care/trauma hospital about a half mile away. Both are owned and run by same. JC is due we think any day and if they chose a patient to follow from the acute facility that happens to come here for skilled care... well you see where I am going. My problem is that I am being asked for reports that I have no idea about, unfortunately neither does the Director here since we are both pretty new to LTC and MDS. These reports are being requested in preperation for the anticipated JC survey. The reports are called (I think) Facility Quality Measure/Quality Indicator Report and the Resident Level QM/QI Roster Report. I say 'I think' because the emailed request we received is not entirely clear and when we called the person to clarify she basically said she doesn't know any more about it than we do, **sigh**. I am unclear as to where to find these reports. Can anyone shed some light on it please? Did not see these in my vendors MDS application, tried the CMS site but basically did not understand WHERE to find them or how to go about getting them.

Thank you so much for any help!

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Specializes in LTC, Nursing Management, WCC.

Those reports are in our software program under MDS 3.0. I don't think QI/QM is set in stone yet since the 3.0. Or it isn't in my state, from what I am told. I don't know where you would find them in your facility. They probably are going to ask for a roster matrix that will have all the residents listed and certain problems they have.

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Would that be in the Casper Reports? In Casper Reports there is a link MDS 3.0 QI/QM Reports-Under Construction. I saw that a few moments ago while printing my Validation Report, but it was blank.

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Specializes in Geriatrics, WCC.

THe QI/QM and Casper are not back up and running yet since the change to MDS 3.0. It is a federal thing and out of your control. Your software should let you run a census and Condition and Roster Matrix though.

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MDS 3.0 QM Reports will not be available until April 2012 according to CMS.

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