MDS 3.0 RUGIII to RUGIV Medicare PPS Transition

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Specializes in ER CCU MICU SICU LTC/SNF.

If you complete a Medicare PPS assm't with a payment that will overlap from September to October using the MDS 2.0, the RUGIII payment will only be good until September 30th. In order to receive payment for the remaining days from October 1st onward, you will need to complete the same PPS assm't type using the MDS 3.0 w/ ARD of 10/1.

Example: You did an MDS 2.0 30-day PPS in September which you expect to be paid for 30 days from September 15 - October 14.

-->The MDS 2.0 30-Day RUGIII score will be paid from September 15-30.

-->The MDS 3.0 30-Day (ARD 10/1) RUGIV score will be paid from October 1-14.

If the MDS 3.0 is not done, you will be paid the default rate from October 1-14.

For further details go to Spotlight Skilled Nursing Facilities PPS and download these 2 files...

--> RUG-III to RUG-IV transition for the August 24, 2010 audio-conference

--> August 24, 2010 National Provider Call Training Presentation Slides

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Specializes in LTC, Hospice, Case Management.

For crying out loud... I can't believe we are bearing down on October 1st & they are still giving us new directives!

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Specializes in Assessment coordinator.

Oh, yeah... friday my company had a webinar and gave us a spread sheet of exactly which "option" to use for every date of admission since July whatever that will be 100 days by Oct. 1st. Then after wasting an hour and a half of our time, we were told that the regional mds person will tell us which option to use. What, you designed and distributed a spread sheet with exact directions and then assume my tiny little lizard brain won't be able to use it? AND you are going to have people deciding this for me that haven't actually done an MDS in the last ten years, or maybe EVER? Thank you so much, medium sized company, for the vote of confidence. My skilled census for Sept is nearing 30, and I will have to do an MDS on every single one of them in the first week of October, I'll bet, even if they understand the coverage back to the 1st from the first MDS done in the month. In the mean time, I have Social Services and Activities practicing their new interviews and turning them in to me, and our new laptop computer stands have come in, but not the computers themselves. The software isn't functional yet, and the designated wound documentor doesn't even have software access yet. This does not have to be this hard.

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Specializes in LTC, Hospice, Case Management.

I think my company is just doomed with the whole transition. I think it's gonna be every man/woman for themselves as I don't see coorporate giving us near the support we need. No idea when the software for the 3.0 will be available to look at, have had no mention of when our version of caretracker will be up and running for training purposes, have not seen any new wound care documentation forms...and the list goes on!

Thank goodness for allnurses & Talino. I had to email the divisional consultant to ask about the whole transition process when Oct 1 comes. I wasn't sure I was really understanding it right (unfortunately I was :crying2:). The consultant emailed me back & confirmed I was right about re-doing Med A MDS's come Oct 1 but said they did not have a plan as of yet to give us any direction. Yikes - do they not know how quick this is coming!?!

Meanwhile, my ED informed me last week that she is taking me out of my ADON role at the end of September & putting me back into MDS thru Oct. :chair:

Good luck to all of us...I don't think this is going to be much fun

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Specializes in Long term care.

As of a couple days ago, the MDS Coordinator at my facility didn't know anything about having to 'redo' the Med A MDS assessments that have ARD's that cover both September and October. But, I tried to mention it to her, and she didn't listen to me very much. When she asked what gave me that idea, I didn't bother telling her that I heard that information on this website -- figured she wouldn't believe it. I'm still not quite sure I understand it, but at least I know something about it, and where to find the information to read it again.

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Specializes in ER CCU MICU SICU LTC/SNF.
When she asked what gave me that idea, I didn't bother telling her that I heard that information on this website -- figured she wouldn't believe it. I'm still not quite sure I understand it, but at least I know something about it, and where to find the information to read it again.

You don't have to mention seeing it here but it would be prudent to cite the official CMS reference. If you have 10 PPS residents with an average 10 days paid at default because MDS 3.0 was not done, that's a minimum $20,000.00 loss to the facility.

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Specializes in LTC, Hospice, Case Management.

Having a wonderful Labor Day wkend. Have just spent 3 hours reading the RAI & trying to figure all of this out since we are not really getting any direction/support from the powers that be...guess that leaves it up to me. I have a question for anyone who has attended more training than I have.

Entry Assessment. I am reading that this is done for every single admission, due by day 7 and transmitted by day 14.

Is this able to be combined with 5day PPS &/or admission assessment (which would really be pushing the admission assessment so not sure if that would be a good idea even if it was "legal"). That entry assessment is a pretty extensive document just in itself. I'm assuming this is going to add quite a time burden with just this one piece.

Thanks in advance.

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Specializes in ER CCU MICU SICU LTC/SNF.

The Entry tracking is a stand-alone assm't and may not be combined w/ a PPS or OBRA assm't. This is similar to 2.0's ReEntry tracking, containing demographic and administrative info., except it's done on new admits also. The items in the Entry tracking assm't can be found in Appendix F, from F-3, under Column T.

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Specializes in MDS/Office.

My Corporation has given us "Next to Nothing" 3.0 Training.

I'm so fed up.

If I knew that I had to Train myself, I would have started long ago.

Then they have the nerve to tell us, "We're all in this together."

Yeah, I'll remember that one when when all @#$% breaks loose October 1. :o

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Specializes in LTC, Hospice, Case Management.
My Corporation has given us "Next to Nothing" 3.0 Training.

I'm so fed up.

If I knew that I had to Train myself, I would have started long ago.

Then they have the nerve to tell us, "We're all in this together."

Yeah, I'll remember that one when when all @#$% breaks loose October 1. :o

Yep, I'm right there with you. Makes me wonder if we are dealing with the same company but I don't wish to post mine online.

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Specializes in medsurg, everything in LTC.

same here, on our own, but let something go wrong, guess whose fault is it?

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Specializes in Long term care.

We're in the same boat @ my facility. The interviews haven't been assigned to anyone in any of the departments yet, so no one has been able to practice doing their interviews, or had the chance to review the RAI manual about their interview and the 'rules' for each interview area.

Nobody has done anything to prepare for this until now.

After our 3.0 software seminar today, we reminded the 'higher ups' that we will be doing assessments that are 25+ pages long, and higher - so our current storage system for the MDS won't work for the new one.

I think the 2 of us that are doing the MDS' are going to have nervous breakdowns before this is all over.

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