Countdown to MDS ’23

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Oct 01 2023

Achieving Accurate ADLs with the OSA

Section G of the MDS 3.0 was retired October 1, 2023, yet the MDS nurse may still need to use the knowledge of accurately coding ADLs with an assessment called the Optional State Assessment (OSA).  State-Optioned OSA Although the option to choose an OSA from the federally-mandated MDS assessment was similarly retired in October, some states have opted to require SNFs complete an OSA for Medicaid reimbursement. The OSA is now a separate optional MDS assessment that is completed at the...
May 13 2023

MDS 2023 Countdown Wrap-Up

This post is part of the MDS 2023 Countdown series.  Disclaimer: Current as of May 13, 2023.   What You Can Expect to See CMS released the first MDS draft item set (v1.18.11) in September 2022, which generated many questions for the long-term care community. Both the final item sets and the draft MDS 3.0 v1.18.11 User's Manual were released in April 2023. The updated User's Manual includes updates to section intent, coding instructions, definitions, and tips - and totals nearly 400 more...
May 13 2023

Rx Reconciliation – New SNF QRP and QMs

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See The reconciled medication list will have a new documentation requirement that will go into effect with the October 1, 2023 changes to the MDS 3.0.  This new requirement will have an impact on a facility's Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) and Quality Measure (QM) item. What Is Changing This measure will assess the transfer of the reconciled...
May 13 2023

Away with Q0300 and in with Q0310 – New Section Q Changes

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of May 13, 2023 What You Can Expect to See This new Section Q update presents a key change to the wording: GOAL vs expectation. The Cambridge American Dictionary defines expectation as "the feeling or belief that something will or should happen," while goal is defined as "an aim or purpose." In the clinical setting, we are trained to create goals that are attainable. Asking the resident for a personalized goal...
Apr 08 2023

Updated Entered From and Discharge Status options

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 Section A1800 "Entered From" and A2100 "Discharged Status" have Changed One of the changes you will see when coding section A of the MDS this October 1, 2023, is found with A1805 - Entered From, and A2105- Discharge Status. A1805 was previously A1800 and A2105 was previously A2100. In the 'Entered From' section, you will notice that the list has expanded from 10 options to 13. Hospice will now be...
Apr 01 2023

Transportation – New Item A1250

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See An additional item we will see in the upcoming MDS 3.0 v.1.18.11 in October 2023 is A1250 - Transportation. This is included in a new subset of criteria known as 'Social Determinants of Health' (SDOH). A1250 will appear at the start of the Medicare A stay and at the end of the Medicare A stay with a planned discharge; A0310B = 1 -or- A0310G = 1 and A0310H = 1. What Is...
MDS 2023 3 Day Lookback
Mar 24 2023

New 3-day Lookbacks | Assessment Periods

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of March 24, 2023 What You Can Expect to See New 3-day lookback/assessment periods are coming to the MDS world. There are different sections of the MDS that the Nurse Assessment Coordinators are going to have to code that require the 3 day lookback/assessment periods. Communication and coordination between hospitals, nursing homes and discharge planning will be even more imperative. Facilities need to ensure ALL of the...
MDS 2023 Section J Pain
Feb 22 2023

New Pain Interview in Section J

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of February 22, 2023 What You Can Expect to See The most noticeable changes to Section J are evident in the pain interview, specifically questions J0510, J0520 and J0530. The RAI Manual has long cited the Pain Interview in Section J as a means of "hearing the resident's voice." With these changes, we will be able to identify the residents' pain as it applies to sleep and therapy activities by frequency. Previously this...
MDS 2023 Section B
Feb 15 2023

Section B – Hearing, Speech and Vision Changes

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See Section B on the MDS is a component of the Standardized Patient Assessment Data Elements (SPADEs), which is utilized across post-acute care settings (PACs) including inpatient rehabilitation facilities (IRFs), long-term care hospitals (LTCHs), skilled nursing facilities (SNFs), and home health agencies (HHAs). Section B contains items of the Data Element for the Assessment...
MDS 2023 Section A Race and Ethnicity
Feb 07 2023

Race and Ethnicity – Changes in Section A

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See Section A, Identification Information for Race/Ethnicity has expanded. One of the major changes is the deletion of section A1000 Race/Ethnicity. Section A1000 is set to expand and be replaced with Section A1005 Ethnicity and A1010 Race. When you look at Section A1000 Race/Ethnicity, you find a checklist with items A through F. These Items are part of the common uniform...
MDS 2023 Section N Prescriptions
Dec 23 2022

The New Section N: Use and Indication of High-risk Drug Classes

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 23, 2022 WHAT YOU CAN EXPECT TO SEE We will see changes in Section N of the MDS 3.0 effective on October 1, 2023.  Section N0410 (Medications Received) has been eliminated and is being replaced with Section N0415 (High Risk Drug Classes: Use and Indication). The updated version expands the medication list to include antiplatelets and hypoglycemics including insulin. Also, the new section adds a column...
MDS 2023 Physician Examinations
Dec 16 2022

Where did Physician Examinations and Orders Go?

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 16, 2023 WHAT YOU CAN EXPECT TO SEE CMS does not require the completion of the physician examinations and orders, but they remain a requirement for some states for reimbursement with case mix. However, CMS provides a convincing perspective of their benefit for enhancing quality of life and planning for care. CMS communicates to us in the RAI Manual: O0600: Physician Examinations Item Rationale...
MDS 2023 Section O
Dec 09 2022

What’s New in Section O – Special Treatments, Procedures, Programs?

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 9, 2023 WHAT YOU CAN EXPECT TO SEE What is Changing with Section O? When you first look at the draft of section O item O0110 special treatments, procedures, and programs, there are three columns instead of the familiar and long-standing two columns.  Coding for section O0110A1-M2 items will no longer be broken down by, "While NOT a Resident" and/or "While a Resident." The proposed columns for section O0110...
MDS 2023 What to Expect Section GG
Dec 02 2022

What to Expect in Section GG

  This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 2, 2022 WHAT YOU CAN EXPECT TO SEE What is Changing with Section GG? One of the major changes is the deletion of section G (Functional Status). What does that mean for section GG (Functional Abilities and Goals) and what should you expect to see? The Functional Abilities and Goals Admission (Start of PPS stay) title will change to Functional Abilities and Goals. The assessment period is the first...
MDS 2023 Section D
Nov 25 2022

The New and Improved Section D

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of November 25, 2022 WHAT YOU CAN EXPECT TO SEE What is Changing with Section D? Many of us may have skipped over some changes in our rush to see what happened to section G.  But Section D also has some notable changes! When reviewing this section, we see right away that the PHQ-2 has been added to supplement the PHQ-9 in gathering mood data.  This may save time because you do not necessarily have to proceed to the...
MDS 2023 Changes Section G
Nov 18 2022

Section G is Missing

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of February 7, 2023 WHAT YOU CAN EXPECT TO SEE What is Changing with Section G? MDS 3.0 changes for October 2023 removed section G completely. This leaves many questions yet to be answered, including: How will the quality measures be affected? How will reimbursement rates be calculated? What are the criteria for the ADL function CAA worksheet? Will all these things change and be adjusted to section GG, or will some be...

Recent Blogs in All Topics

Trauma and the MDS – A Sneak Peak

Trauma informed care has become an area of focus for Post Acute Care providers and survey agencies. Organizations are required to provide trauma-informed care that meets “professional standards of practice and accounting for residents’ experiences...

New Year….Same MDS Obstacle Course

As we ring in 2024, long term care professionals are still struggling to implement the October 2023 updates to the MDS. CMS is already talking about more changes in 2024, and the anticipation continues to create anxiety amongst PAC members. While...

Schizophrenia Diagnosis Audits

On January 18th, 2023, CMS announced they will be conducting off-site audits in nursing homes for assessment accuracy and coding of residents with a diagnosis of Schizophrenia. Along with auditing for appropriate diagnosis, the audits will review...

OSA or PDPM? A State-Level Decision

As of Oct. 1, 2023, the Centers for Medicare & Medicaid Services (CMS) has retired the A0300 Optional State Assessment (OSA) from the federally required MDS 3.0 v1.18.11 that is submitted by nursing facilities. The OSA is now a separate...

The Physician and “I”

The physician’s role in the nursing facility is essential to delivering skilled, quality care for Skilled and Long-Term Care residents. Physicians are our lead in providing clinical decision making and properly defining, clarifying, and verifying...

Coding UTIs on the MDS 3.0

Urinary Tract Infections (UTIs) are a commonly miscoded data element on the MDS. Are you over coding UTIs? Are you not coding them at all? Should you? Shouldn’t you? The MDS has historically left data collectors asking themselves these questions....

Achieving Accurate ADLs with the OSA

Section G of the MDS 3.0 was retired October 1, 2023, yet the MDS nurse may still need to use the knowledge of accurately coding ADLs with an assessment called the Optional State Assessment (OSA).  State-Optioned OSA Although the option to choose...

What Is an MDS Coordinator?

It’s a bit odd that when asked what you do for a living most MDS coordinators struggle to come up with an answer. Who struggles to explain what they do every day? The reality is that MDS Coordinators fully understand what this multifaceted job...

MDS 2023 Countdown Wrap-Up

This post is part of the MDS 2023 Countdown series.  Disclaimer: Current as of May 13, 2023.   What You Can Expect to See CMS released the first MDS draft item set (v1.18.11) in September 2022, which generated many questions for the long-term...

Rx Reconciliation – New SNF QRP and QMs

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See The reconciled medication list will have a new documentation requirement that will go into effect with the October 1, 2023...

Away with Q0300 and in with Q0310 – New Section Q Changes

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of May 13, 2023 What You Can Expect to See This new Section Q update presents a key change to the wording: GOAL vs expectation. The Cambridge American Dictionary defines...

Updated Entered From and Discharge Status options

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 Section A1800 "Entered From" and A2100 "Discharged Status" have Changed One of the changes you will see when coding section A of the MDS this October 1,...

Transportation – New Item A1250

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See An additional item we will see in the upcoming MDS 3.0 v.1.18.11 in October 2023 is A1250 - Transportation. This is included...

New 3-day Lookbacks | Assessment Periods

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of March 24, 2023 What You Can Expect to See New 3-day lookback/assessment periods are coming to the MDS world. There are different sections of the MDS that the Nurse...

New Pain Interview in Section J

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of February 22, 2023 What You Can Expect to See The most noticeable changes to Section J are evident in the pain interview, specifically questions J0510, J0520 and J0530....

Section B – Hearing, Speech and Vision Changes

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See Section B on the MDS is a component of the Standardized Patient Assessment Data Elements (SPADEs), which is utilized across...

Race and Ethnicity – Changes in Section A

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of October 1, 2023 What You Can Expect to See Section A, Identification Information for Race/Ethnicity has expanded. One of the major changes is the deletion of section...

The New Section N: Use and Indication of High-risk Drug Classes

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 23, 2022 WHAT YOU CAN EXPECT TO SEE We will see changes in Section N of the MDS 3.0 effective on October 1, 2023.  Section N0410 (Medications Received) has been...

Where did Physician Examinations and Orders Go?

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 16, 2023 WHAT YOU CAN EXPECT TO SEE CMS does not require the completion of the physician examinations and orders, but they remain a requirement for some states...

What’s New in Section O – Special Treatments, Procedures, Programs?

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 9, 2023 WHAT YOU CAN EXPECT TO SEE What is Changing with Section O? When you first look at the draft of section O item O0110 special treatments, procedures, and...

What to Expect in Section GG

  This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of December 2, 2022 WHAT YOU CAN EXPECT TO SEE What is Changing with Section GG? One of the major changes is the deletion of section G (Functional Status). What does...

The New and Improved Section D

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of November 25, 2022 WHAT YOU CAN EXPECT TO SEE What is Changing with Section D? Many of us may have skipped over some changes in our rush to see what happened to section...

Section G is Missing

This post is part of the MDS 2023 Countdown series.  Disclaimer. Current as of February 7, 2023 WHAT YOU CAN EXPECT TO SEE What is Changing with Section G? MDS 3.0 changes for October 2023 removed section G completely. This leaves many questions...

Pillars of Care

Reviewing the Behavioral Health Pillars The US Department of Health and Human Services (HHS) developed a roadmap for behavioral health integration to address a national mental health crisis.  The current Administration's strategy is based on three...

MDS surprises fill new draft

Joe Bush | Oct 7, 2022 | Excerpted from McKnights Long-term care facilities, staff and more than half the states should prepare immediately for changes to the Minimum Data Set, experts said in early September. The Centers for Medicare &...

Section I and Schizophrenia

Changes to Section I and Schizophrenia In July 2022, CMS released an erratum to the RAI (Resident Assessment Instrument) Manual that included more detailed guidance on the use of diagnoses for section I, including the schizophrenia diagnoses that...

Achieving Accurate ADL’s

Achieving Accurate ADLs The MDS nurse faces challenges when ADL documentation is sparse or even conflicting.  Everyone wants accurate ADL’s, but how often do we fall short?  How have pandemic staffing issues affected ADL accuracy? The “Rule of...

MDS draft sends sector, states scrambling to assess effects

Joe Bush | Sept 7, 2022 | McKnights Long-term care facilities, staff and more than half the states in the US should start preparing immediately for extensive changes to the Minimum Data Set, resident assessment experts said this week. The Centers...

MDS Changes Raise Medicaid Payment Questions

Tim Mullaney | September 7, 2022 | Excerpted from Skilled Nursing News The removal of a key section from the Minimum Data Set (MDS) will have massive repercussions, particularly for the future of nursing home reimbursements by states. ... The fate...

Stars for Staffing

Updates to the Staffing Five Star CMS released revisions to the staffing methodology in July through an updated Design for Care Compare Nursing Home Five-Star Quality Rating System: Technical Users’ Guide July 2022. The staffing star rating...

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