MDS 3.0 RUGIII to RUGIV Medicare PPS Transition

[Talino]

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

[rukiddingme]

We, too, are going to be doing many extra assessments on Oct. 1, in order to keep our rates up. Our company will not let us take default rates. We're getting things ready and plan to implement the new 3.0 interviews & paperwork starting Monday for all the Oct. 1 assessments we'll need to do.

[evalesco]

I am preparing to have no life come October!!

[returnexpected]

I'd like to thank you all for posting such helpful insight and information in regards to the transitions that will need to be done. The information from CMS and LSN (teleconferences) were clear as mud! LOL Thanks to the info here, I was able to review the PPS assessments I would have due or have done in mid to late Sept to see what transitions I will need to do and how to proceed. I was also able to utilize grace days for some and move them into October to avoid the transition assessments....saved our team a ton of work, thank you!

[sls73]

I only have 6 on Med A case load at this time, so we are also completing the duplicate assessments in October. Actually we only have to complete 4 of the 6 because of how the dates fell with two admissions. At this point it is a doable work load. If I receive any admissions next week- I may look at substituing those. Also, my facility would not be happy with a default rate. I also like to play it safe and make sure I am covered.

[fulzgold]

In August, I moved all the routine OBRA assessments due in october, up to September and spread them out through the month. That was rough, but that way we have plenty of time to focus on the PPS. We are choosing the no option. We will be doing repeat assessments in 3.0 version for any PPS who's payment was split between September and October. I'm glad we did it that way for now. My RAI manual is still not here yet, had to download one from CMS. My SS person had refused to attend any seminars and now says "I'm not doing this". Sheesh! Other team members have taken it pretty well. We are trying to change over some of our assessments to reflect the 3.0 items, that's not done yet. CNA's still need inserviced on ADL grids, Admin turned in his resignation!! AAAAnd, it's monthly change overs!. It's too much to do and not enough time. I've been putting in 12 hour days for over 2 weeks and 3.0 hasn't really started yet.

[NurseMomDori]

I would like to hear back any comments on the worksheet I sent to some of you. Is it helpful in your world? I used it on a few, but wonder how it could be better. Any out there who are trying it out? Thanks, Dori.

[mdecastronp]

I agree on the AANAC training. I attended the training in Las Vegas from AANAC, and 2 others from our company and felt that it did not meet its goal. I spoke with other nurses who went to the same training, and was told they had to attend and pay for other training. Another nurse said it was a waste of money and it only confused her!

[Medfordguy12]

I read a good article today on the RUG-IV to Hybrid RUG-III Analysis and the effects on reimbursement. Might be useful

RUG-IV to Hybrid RUG-III Analysis