Ask Diane: Should we start training for the MDS 3.0 now?

Q: With all of the draft changes and delayed start dates, do you really recommend staff start training for the MDS 3.0, and if so how?

Diane: Given all the changes made to MDS 3.0 drafts and delays in implementation, many facilities are unsure of how to approach training. Some facilities have actually put all MDS 3.0 training on hold until we get closer to the October 2010 implementation deadline. However, holding off on training your staff is not a wise decision. Some of the items that are expected to be included in the final MDS 3.0 are significant and will require some level of training for all your staff. You’re going to need detailed training for MDS coordinators and other staff members who have direct MDS responsibility. But the MDS also impacts billing, medical records, quality, and payment. Training all facility staff members about the MDS 3.0 will require a large amount of time and it is extremely important to begin education as soon as possible.

Beginning training now is also important because the MDS 3.0 is not the only significant change facilities will experience in October 2010. CMS released a proposal on May 1 that calls for a new case-mix classification model, RUG-IV, to be implemented at the same time as the MDS 3.0. Ultimately, RUG-IV will limit the number of residents who qualify for the higher-paying RUG categories, which will decrease overall reimbursement to SNFs and dramatically alter the way facilities operate. Under RUG-IV and the MDS 3.0, facilities will have to modify the way they provide services, gather information (i.e., resident interviews), and manage their census. The best way to ensure your facility is prepared for these drastic changes is to start training staff now.

So, how should you go about training your staff for the MDS 3.0 and RUG-IV? We are currently working on a detailed training guideline that will map out what your facility should be doing from now until implementation. We hope to finish this within the next few weeks and will post it on the Resources page of the Web site as soon as it is completed.

4 Comments

  1. Bonnie

    Hi Diane,

    In your second paragraph it is stated that SNF’s will see a dramatic change in reimbursement: RUG-IV will limit the number of residents who qualify for the higher-paying RUG categories, What will these changes be?
    Also is there a change in the look back periods for rehab and/or any change in how we calculate our minutes and days?
    Thank you

  2. Below are some examples of how the RUG-IV proposal will limit the number of residents who qualify for the higher-paying RUG categories:

    1. Under the current system, services provided prior to SNF admission can be coded in Section P1a, Special Treatments, Procedures, and Programs, of the MDS 2.0 as long as they occurred within the 14-day look-back period. These services are then counted toward RUG placement. CMS proposes to alter the look-back period for these items under RUG-IV so only services provided while the person was a SNF resident will be included in the RUG classification.

    2. The RUG-IV proposal eliminates, modifies, and/or reduces the number of qualifiers for some RUG categories. For example, in order to classify into the proposed Rehab Plus Extensive group, the qualifiers will include patients who receive therapy AND either ventilator care, trach care, or who require an isolation room in the facility, along with an ADL index of 2 or greater.

    3. Under the MDS 2.0 and RUG-III, concurrent therapy (which is when a therapist treats multiple patients at the same time and the patients are performing different activities) minutes are counted as one-on-one therapy minutes. Under the MDS 3.0 and RUG-IV, therapists will have to divide concurrent therapy minutes among the residents receiving the service.

    I hope this helps. Thanks for the question!

  3. Sarah Milesi

    “We are currently working on a detailed training guideline that will map out what your facility should be doing from now until implementation. We hope to finish this within the next few weeks and will post it on the Resources page of the Web site as soon as it is completed.” Has this been posted? I cannot find it. Thank you!

  4. Mary Stafford

    I am trying to find out how to get MDS certification. I have heard there are places that I can take it in a week-end or so. I am very interested in getting this certification and if you can help me I would really appreciate it. Thank you and I hope to hear from you soon. Mary Stafford

Leave a Reply

Your email address will not be published. Required fields are marked *

*