COVID-19 (coronavirus) Tools

In this difficult time, MDS Consultants is here for you with reimbursement guidance and can help with MDS completions when needed.

Our team keeps an up-to-date list of links and resources at MDS Expert 

COVID-19 (coronavirus) Updates

Novel Coronavirus 2019, or COVID-19, is causing a crisis in our healthcare system. Do not let COVID-19 create a reimbursement crisis for you and your team. We all recognize there is a lot of conflicting information on the internet and social media, and reimbursement and MDS are no different.

MDS Consultants has vetted the following source documents and links to help you maintain clarity in the confusion.

  • CMS published COVID-19 Emergency Declaration Health Care Providers Fact Sheet on March 13. During a national emergency, CMS was empowered to take proactive steps through 1135 waivers that include waiving a 3-day hospital stay and spell of illness requirement for Medicare part A. The 1135 waiver for the hospital stay is only for beneficiaries who experience dislocations or are otherwise affected by the emergency. While the waiver for “spell of illness” only applies for beneficiaries who have been delayed or prevented by the emergency itself from commencing or completing the process of ending their current benefit period and renewing their SNF benefits that would have occurred under normal circumstances. In other words, the waivers would apply to those beneficiaries that have been affected directly or indirectly by the current state of emergency.
  • CMS QIES Technical Support Office released a statement regarding Minimum Data Set 3.0 v1.18.1 set to be implemented on October 1st will be delayed. The delay includes the removal of section G. This is a relief for case-mix states.
  • CDC released the Official Coding Guidance for Coronavirus on February 20. This document provides official diagnosis coding (ICD-10) guidance for health care. Guidance in this document will be valid until March 31st. The new ICD-10-CM code for the COVID-19 will be U07.01 effective April 1st. (Stay tuned for more information)

We recommend providers also turn to CMS, CDC, and their state for further guidance. If you and your team would like assistance or have questions, please reach out to our experts at MDS Consultants at (954) MDS-3-ADL or email us at mdsoffice@mds-consultants.com

Explore More Posts from MDS Consultants

Reimbursement Concerns

Maximizing Case Mix with Special Programs: Respiratory Therapy and Restorative Nursing

Case mix is essential in skilled nursing facilities as it impacts both reimbursement and the care provided. Two key programs that significantly impact case mix scores when properly implemented and documented are Respiratory Therapy and Restorative Nursing. Both...

Strategic Admissions: The Path to Optimized Medicaid Reimbursement

Medicaid reimbursement plays a significant role in the financial health of long-term care facilities, particularly those serving a high percentage of Medicaid residents. While it may not be the sole source of revenue, it is an important component that supports the...

Interim Payment Assessment (IPA) – To do or not to do?

The Patient-Driven Payment Model took effect in October of 2019. Along with this change came the optional IPA. We are now five years into this change and questions still arise on when to complete an IPA. The decision of when to complete lies with the team at the...

Resident Interviews – What are you doing to capture the data?

Effective October 1, 2023, several resident interviews were added to or updated on the MDS. Interview items in Section A and changes to the interviews in Section D, J, and Q have been implemented. Each of the interviews can be a great steppingstone in your path to...

Social Determinants of Health (SDOH) – A Global Initiative Important to Skilled Nursing Providers

The Centers for Medicare & Medicaid Services’ (CMS) Office of Mental Health report CMS Framework for Health Equity 2022 and 2032 states that health equity is defined by the attainment of the highest level of health for all people, where everyone has a fair and...

Read more on Toolbox Essentials

SNF Physician Certifications for Medical Review

One of the requirements of payment is a valid Physicians Certification for Medicare part A services. If SNF certifications and re-certifications are not completed and signed following CMS regulations, then the facility is at risk of losing payment for an entire claim...

Focused Infection Control Surveys and Directed Plan of Correction

It's a dreary Monday morning, and the state surveyors walk into your facility to conduct a Focused Infection Control survey. You and your team have been trying your hardest to comply with infection control procedures throughout the pandemic. At the end of the survey,...

New Advanced Beneficiary Notice

Is your facility using the proper ABN form? The Centers for Medicare & Medicaid Services (CMS) recently updated the Advanced Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131. The new ABN will be mandatory for use on 1/1/2021, but the new form can be...

Covid-19 and Skilled Status

In late June, CMS addressed two issues and posted MDS 3.0 Final Item Sets (V1.17.2).  The two edits were changes to facilitate the calculation of Patient-Driven Payment Model payment codes on OBRA assessments for states that wish to have this calculation performed. ...

Mind Your PHQs

Some skilled nursing facilities (SNFs) are concerned about accurate payment when a resident unexpectedly discharges and the Brief Interview for Mental Status (BIMS) has not yet been completed.However, they should be just as concerned about the PHQ-9. The PHQ-9...

MORE from MDS Experts

A Significant Change in Status Assessment – There are Options

The Resident Assessment Instrument (RAI) system includes a significant change in status assessment (SCSA). What might be forgotten is the State Operation Manual (SOM), Appendix PP, includes information that mirrors the RAI manual at 42 CFR §483.20(b)(2)(ii), F637 -...

Interim Payment Assessment (IPA) – To do or not to do?

The Patient-Driven Payment Model took effect in October of 2019. Along with this change came the optional IPA. We are now five years into this change and questions still arise on when to complete an IPA. The decision of when to complete lies with the team at the...

Resident Interviews – What are you doing to capture the data?

Effective October 1, 2023, several resident interviews were added to or updated on the MDS. Interview items in Section A and changes to the interviews in Section D, J, and Q have been implemented. Each of the interviews can be a great steppingstone in your path to...

Section GG Documentation – Questions Still Abound

Section GG remains a popular discussion topic among the Nurse Assessment Coordinator (NAC) and other members of the interdisciplinary team (IDT). Many have questioned their own practices and processes, designed to support coding this section of the MDS. CMS states in...

Social Determinants of Health (SDOH) – A Global Initiative Important to Skilled Nursing Providers

The Centers for Medicare & Medicaid Services’ (CMS) Office of Mental Health report CMS Framework for Health Equity 2022 and 2032 states that health equity is defined by the attainment of the highest level of health for all people, where everyone has a fair and...