Skilled Nursing Facilities/Long-Term Care Open Door Forum Open Door Forums

Skilled Nursing Facilities/Long-Term Care Open Door Forum


**Updated December 10, 2010- The next Skilled Nursing Facility(SNF)/Long Term Care (LTC) Open Door Forum is scheduled for Thursday, January 27, 2011 from 2pm-3pmET.If you wish to participate dial 1-800-837-1935 Conference ID 29122620. This call will be Conference Call Only. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums.


October 20, 2010 - (LTC)MDS 3.0 Assessment Submission and Processing Problem
CMS recently identified a systems problem that resulted in errors in the RUG-III and RUG-IV codes printed on facility Final Validation Reports. Since accurate RUG data is required for billing and other facility operations, the following actions are being taken to correct the MDS 3.0 Assessment Submission and Processing (ASAP) System:
Submission and Confirmation
The transmission system remains in operation. All providers can continue to submit MDS 3.0 records.
After each submission, you will receive confirmation that the MDS 3.0 file has been received. The confirmation page includes a submission ID and the date and time of the transmission. You can print the confirmation and retain it for your records.

File Editing and Final Validation Report Generation Stopped
The editing of the submission files and generation of the Final Validation Reports has been temporarily stopped pending final testing of the reprogrammed editing and validation system.

MDS 3.0 Files Submitted Since October 1, 2010
All MDS 3.0 files submitted since October 1, 2010 will be edited. Revised Final Validation Reports will be available in your CASPER shared folder.
Note: The incorrect RUG information may have appeared on any previous Final Validation Report.

Final Validation Reports Release
The release of all Final Validation Reports, including the revised reports for earlier submissions, is expected to occur by 9:00 PM EDT October 22, 2010.
If you have already submitted MDS 3.0 data and received a Final Validation Report, you will need to check your CASPER shared folder for the revised report for each MDS 3.0 file submitted. Please disregard the old Final Validation Reports and use the revised reports.
Please use the revised Final Validation Reports to verify your RUG III and RUG IV values to ensure your submitted claim for payment is correct.

Late Submissions
Providers receive only warning messages on validation reports for records submitted late. Since late submission is determined by the submission time stamp, delayed editing and validation processing does not affect whether the submission is late.
The CMS Survey and Certification group has been notified that some MDS 3.0 assessments may be delayed due to this systems problem. The Survey and Certification staff is expected to issue written policy instructions shortly.


jRAVEN-Providers using jRAVEN need to check the CMS website at http://www.cms.gov/NursingHomeQualityInits/30_NHQIMDS30TechnicalInformation.asp#TopOfPage for an updated jRAVEN, which will be available soon.
Non-jRAVEN users need to check with their vendor for software updates that address the issues identified.

Note: It's recommended that all providers continue to check for software updates on a regular basis.
If you have questions, please contact the QTSO Help Desk at (800) 339-9313 or help@qtso.com.
We appreciate your patience during this time.

**Updated October 18, 2010- Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Resource Utilization Group-Version 4 (RUG-IV) National Provider Call with Question & Answer Session is scheduled for Tuesday, November 9, 2010 2:00pm-3:30pmET.

This call is one in a series of calls designed to provide information on key aspects of the RUG-IV SNF PPS case mix system, which was put into place on an interim basis effective October 1, 2010. CMS held three previous calls, which provided details of significant changes related to the RUG-IV payment system.

In June, CMS discussed coding procedures, with emphasis on the appropriate Look-back Period to be used when coding the Minimum Data Set (MDS) 3.0 and how facility staff should separately report individual, concurrent and group therapy for accurate payment, along with changes to the ADL coding requirements and their impact on the assignment of MDS 3.0 records to a RUG-IV group. In August, CMS held a second call, where subject matter experts discussed the transition from RUG-III to RUG-IV. The third call, in September, discussed several SNF PPS policies, including Start of Therapy and End of Therapy Other Medicare Required Assessments and the SNF short stay policy.

For this call, CMS subject matter experts will review some of the significant changes associated with the RUG-IV payment system. Information on the previous calls and future information for this call will be available on the SNF PPS webpage at http://www.cms.gov/SNFPPS/03_RUGIVEdu.asp#TopOfPage.

Following the formal presentation, callers will have an opportunity to ask questions of CMS subject matter experts.

Conference call details: In order to receive the call-in information, you must register for the call. It is important to note that if you are planning to sit in with a group, only one person needs to register to receive the call-in data. This registration is solely to reserve a phone line, NOT to allow participation.
Registration will close at 2:00 p.m. ET on November 8, 2010 or when available space has been filled. No exceptions will be made, so please be sure to register prior to this time.

1. To register for the call, participants need to go to: http://www.eventsvc.com/palmettogba/110910
2. Fill in all required data.
3. Verify that your time zone is displayed correctly in the drop down box.
4. Click "Register".
5. You will be taken to the "Thank you for registering" page and will receive a confirmation email shortly thereafter. Note: Please print and save this page in the event that your server blocks the confirmation emails. If you do not receive the confirmation email, please check your spam/junk mail filter as it may have been directed there.
6. If assistance for hearing impaired services is needed, the request must be sent to medicare.ttt@palmettogba.com no later than 3 business day before the event.
For those who will be unable to attend, a transcript and MP3 audio file of the call will be available at http://www.cms.gov/SNFPPS/03_RUGIVEdu.asp#TopOfPage on the CMS website shortly after the call.

**Updated September 27, 2010- The next Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum is scheduled for Thursday, October 28, 2010 from 2-3pmET. This call is Conference Call Only. If you wish to participate dial 1-800-837-1935 Conference ID 98971679. Please see the Downloads section below for the full participation announcement. Thank you for your continued interest in the CMS Open Door Forums.

**Additional Update September 23, 2010- MDS 3.0 Training Materials Important Notice – MDS 3.0 RAI Manual Chapter 3, Section O, Page O-17 Errata Document: A formatting issue was identified on page O-17 of Section O of the latest published version of the MDS 3.0 RAI Manual (MDS_3.0_Chapter_3_-_Section_O_V1.04_Sept_2010.pdf) which may have resulted in mis-coding of item O0400 on the MDS 3.0. Please download the PDF file below labeled "MDS 3.0 Chapter 3 Section O Page O-17 Errata Document September 2010.pdf" and insert the new page O-17 in your MDS 3.0 RAI Manual.

Now Available - YouTube Training Videos for MDS 3.0:
• VIVE – Video for Interviewing Vulnerable Elders
• Gold Standard Nurses Presentation from the April National Train the Trainer Conference in Baltimore
• RAI Manual Chapter 3 Sections A, B, C, D, G, K, Q, and P

Please click on the appropriate YouTube Link under "Related Links Outside of CMS" on the CMS Nursing Home Quality Initiatives website (http://www.cms.gov/NursingHomeQualityInits/45_NHQIMDS30TrainingMaterials.asp). Additional postings to be added as they are completed. You can also visit the "CMS YouTube Channel" at www.youtube.com/cmshhsgov.
MDS 3.0 Technical Information:
• The "RUG-IV Medicare SNF PPS CMIs 10-01-2010.pdf" document in the RUG-IV package has been found to have labeling errors in the "Hierarchical Classification" column for 4 groups (CD2, CD1, CB2, and CB1). The CMI values are correct and are associated with the correct group. This document has been replaced by a new version ("RUG-IV Medicare SNF PPS CMIs 10-01-2010 V2.pdf") with the labeling errors corrected.
• A RUG-III Errata document has been posted. In three documents in the RUG-III Version 5.20 grouper package on the "MDS 2.0 Software and Specifications" page, the incorrect ADL ranges were given for groups RAB and RAB for the 34-group model. These are only documentation errors and all code (SAS, C++, or DLL) is correct.

**Updated September 23, 2010- Availability of 2010 MCPSS Results: CMS has completed the administration of the 2010 MCPSS. The results are in! Ratings reflect the percentage of provider satisfaction as distributed on the new, fully labeled, 5-point scale. A random sample of over 33,000 providers was selected to participate in this year's survey. Providers were asked to rate their satisfaction with services provided by the Fee-for-Service (FFS) contractors. Of all providers who responded, more than 69 percent stated they were satisfied or very satisfied with their contractor's overall performance. Approximately 13 percent stated they were dissatisfied or very dissatisfied with their contractor's overall performance. To view more MCPSS results, visit the CMS website at www.cms.hhs.gov/MCPSS, scroll down to the "Downloads" section of the page and click on the link corresponding to the 2010 MCPSS Public Report. If you have general questions about the MCPSS please send them to MCPSS@cms.hhs.gov . Thank you.

******

Skilled Nursing Facilities/Long Term Care Open Door Forum (ODF) Overview:

The Skilled Nursing Facilities / Long-Term Care Open Door Forum (ODF) addresses the concerns and issues of both the Medicare SNF, the Medicaid NF, and the nursing home industry generally. The types of issues that come up during this forum are often related to the Minimum Data Set, SNF Consolidated Billing, the roles and responsibilities of different SNF, NF or LTC professional staff under CMS regulations, clarifications of issues that are covered during a survey and certification process, and the many rules and requirements under which different related services can be payable. Timely announcements and clarifications regarding important rulemaking, quality program initiatives, and other related areas are also included in the forums.

Downloads
open here to download the documents:
Skilled Nursing Facilities/Long-Term Care Open Door Forum Open Door Forums