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MDS 3.0 Implementation Plans



Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Robert Connolly

Presented at the National Academy for State Health Policy's 20th Annual State Health Policy Conference in Denver, Colorado. Author: Robert Connolly



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    MDS 3.0 Implementation Plans MDS 3.0 Implementation Plans Presentation Transcript

    • MDS 3.0 Implementation Plans 1
    • MDS 3.0 Goals of MDS • Clinical Goals – Make MDS more clinically relevant, while still achieving the federal payment mandates and quality initiatives • Technology Goals – Improve technology to facilitate a decrease in provider burden • NH’s access to CMS via a secure internet • Standardize MDS terminology & scales • Link to Other CMS Initiatives (CARE, STRIVE, etc.) 2
    • New MDS Self-Report Interview Items Cognitive, Pain, Depression & Customary & Routine • Many assessments based on direct interview • Most significant advance in this revision – Create resident centered assessment – More accurate – Feasible – More efficient – Been tested – Open up discussions about important topics 3
    • Other Improvements in Efficiency • More consistency in look back • Many MDS 2.0 items unchanged or improved wording changes • Eliminate items where ever possible • Retain items needed for RUGs and Quality Measures • Consistency in form and instructions 4
    • Other Improvements in Accuracy • Pressure Ulcer – Separates out Stages 2, 3 & 4 for the Quality Measurement – Embeds NPUAP’s PUSH tool & Measurement – Measures length and width of the wound • Return to the Community – Identifies residents desiring to return to the community who can benefit from Money Follows the Person State resources • Identifies potential residents for State MFP Staff 5
    • Staff Time and Resource Intensity Verification (STRIVE) Background Review • National nursing home time study – Two phases • 1. Data Collection – Spring ’06 – Summer ‘07 – Time » Nursing (48 hours), therapy (7 days), and ancillary staff (48 hours) time » Personal digital assistants (PDAs) (95%), paper tool (5%) » Types of time: resident specific time, non-resident specific time, non-study time, meals and breaks – Assessment data » Full MDS 2.0 with one-third grayed out » STRIVE MDS addendum • 2. Analysis – Analysis of entire data set starts in Fall 2007 6
    • STRIVE Background Review • Goals – Enhance accuracy and efficiency of nursing home reimbursement systems • Last time studies in 1990, 1995 and 1997; basis for RUGs • Industry practices may have changed – Incentives of the skilled nursing facility (SNF) and other prospective payment systems – Public reporting of nursing home quality measures – Changes in technology and practice – Alternatives to nursing homes (assisted living, expanded state waiver programs) – Compare and contrast Medicare and Medicaid populations – Explore relationships between payment and quality – Generate data needed to better align payment and quality incentives 7
    • MDS 3.0 Implementation Plans and Timeline Date Task MDS 3.0 Announcement 10/07 Revised Draft MDS 3.0 Posted on CMS Web 12/31/07 MDS 3.0 Town Hall Meeting 1/08 STRIVE Data Analysis Through 2009 FY2009 SNF Payment Update Federal Register Notice 7/31/08 Draft MDS 3.0 Specifications Fall 2008 Final MDS 3.0 Specifications (Includes STRIVE changes) February 2009 MDS 3.0 RAI & Technical Conferences and Satellite Fall/Winter 2008/2009 FY 2010 SNF Payment Update Federal Register Notice 7/31/09 For use starting Deploy MDS 3.0 October 1, 2009 8
    • Key State Information • CASE MIX – Considering having a standardized list of original MDS 2.0 case mix items in Section S so that States can transition to MDS 3.0 case mix items more easily. • Information Technology – Expands current IT platform without major changes to the existing file submission format. • Providers and vendors will have specifications 9-12 months in advance of the implementation date • Training – Since interview items require training, train-the-trainer materials and MDS 3.0 Manual will be made available to States and later stakeholder organizations • Training Subcommittee requires RAI Coordinators and Medicaid Case Mix staff representatives 9
    • Final Thoughts 1. MDS 3.0 analytic findings available in Fall/Winter 2007/2008 - Town Hall meeting 1/08 and Final Report 3/31/08 2. STRIVE analysis is underway – Final analysis complete in early 2009 – CARE Demo results available in 2011 3. CMS developing Roadmap to Address the Future - CMS developing the strategic vision for CARE, MDS, OASIS, Swing Bed and Inpatient Rehabilitation Instruments, IT infrastructure, Payment, Survey, Quality, Policy, etc. 10
    • Thank You Contact Information robert.connolly@cms.hhs.gov MDS30Comments@cms.hhs.gov Additional Information Nursing Home and MDS http://www.cms.hhs.gov/NursingHomeQualityInits/ STRIVE https://www.qtso.com/strive.html 11