February 28, 2012_NH "Dear Administrator" Letters

February 28, 2012

ADSA:  NH #2012-003

Dear Nursing Facility/Home Administrator:

This letter contains important information for facility staff responsible for completing the Minimum Data Set (MDS) assessments.

The Centers for Medicare and Medicaid Services (CMS) recently released the fourth set of updates to the Long Term Care Facility Resident Assessment Instrument User's Manual Version 3.0 as well as changes to the MDS Item sets (the MDS forms). Changes include updates and clarifications, some of which are minor "clean ups" such as correcting spelling, the addition of new items and some substantive changes as well.  Multiple changes have occurred in Sections A, G, H, K, M, O and Q of Chapter 3.  Portions of chapters 2, 4, 5 and 6 have also been updated. The updates are effective April 1, 2012.

One of the more significant changes is the addition of item A0310G-Type of Discharge.  This asks you to identify if the discharge was planned or unplanned for the Discharge Assessment.  When the discharge is unplanned, the assessment is abbreviated and the interviews for cognition, mood and pain have been eliminated via the use of skip patterns.  Items have also been removed from the planned discharge assessment also.  The net result is a shorter Discharge Assessment.
Another section that has been significantly updated is Section Q: Participation in Assessment and Goal Setting. Several items have been deleted and others re-worded.  Section K: Item K0510-Nutritional Approaches has also been updated to include two columns for coding whether or not the approaches were provided While a Resident and/or While Not a Resident (Mirrors the coding for the Treatments and Programs in Section O, item O0100).

The update includes "Track Changes" documents that describe the items in each chapter/section that have changed and the page number of the changes and the actual chapter/sections that have been changed.  You may choose to download the entire chapters or only the pages where changes have occurred.  Your software vendor should be updating your software package to accommodate the changes to the item sets.

To obtain the RAI Manual changes go to The CMS webpage at: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/index.html?redirect=/NursingHomeQualityInits/45_NHQIMDS30TrainingMaterials.asp

To obtain a hard copy of the changed MDS 3.0 item sets, go to: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/index.html?redirect=/NursingHomeQualityInits/30_NHQIMDS30TechnicalInformation.asp 
It is the responsibility of the individuals who complete the MDS to have the most current RAI manual instructions in order to accurately complete the required assessments.

Residential Care Services (RCS) will be providing three 1-day seminars on the updates as well some information on the upcoming return of Quality Measures.  The seminar schedule is listed below and facilities will need to pre-register the number of attendees for each session. Each session will begin at 9 am and end around 3 pm.

  • March 20 RCS Headquarters Building Blake West, Lacey
  • March 21 Criminal Justice Training Center, main auditorium, Burien
  • March 26 Sacred Heart Medical Center Providence Auditorium, Spokane

Driving directions, special instructions (parking pass, meals, etc.) can be found on our ALTSA website at: https://www.dshs.wa.gov/altsa/stakeholders/aging-and-long-term-support-a...

In addition to the above seminars related to the April 1, 2012 MDS updates, there will be 3 basic MDS sessions provided this spring.  These are 2-day courses that provide an overview of the RAI process including scheduling, significant change, coding of the MDS, error correction, and completion of tracking documents.  Pre-registration for these sessions is also required.  Each session will begin at 8 am and end around 4 pm.

  • May 8-9 RCS Headquarters Building Blake West, Lacey
  • May 22-23 RCS Headquarters Building Blake West in Lacey
  • June 20-21 Sacred Heart Medical Center, Providence Auditorium, Spokane

Driving directions, special instructions (parking pass, meals, etc.) can be found on our ALTSA website at: https://www.dshs.wa.gov/altsa/stakeholders/aging-and-long-term-support-administration-headquarters

If you have any questions or need further information, please contact Marjorie Ray, RN, Washington State RAI Coordinator, at (360) 725-2487 or e-mail at rayma@dshs.wa.gov


Joyce Pashley Stockwell, Director
Residential Care Services