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 supporting documentation is complete within the first few days of the stay – and at the end of the stay.

What Is Changing

With section G leaving the MDS and GG taking over, will we be able to capture resident’s actual needs with ADLs in a 3-day lookback/assessment period?  This is half the time and half the information compared to the 7-day lookback. What will this change impact?

Section G was used to determine the most assistance the resident requires.  However Section GG determines the resident’s usual function.  Potential impacts include:

  • Reimbursement: If a facility does not capture the documentation correctly for section GG (due to lack of documentation or knowledge), there is a chance reimbursement will be negatively affected.
  • Lookback period: All we have known is the 7-day lookback period for ADLs. This gave facilities time to capture declines, improvements, etc. in section G.

Now that time has been cut in half what will we be missing? With just 3 days, documentation will need to be accurate to capture the “usual” function of the resident.

Also, with this change are we really capturing the accuracy of the resident’s function for long term stays? Using only the first 3 days of the stay for an admission assessment will this reflect the resident’s actual need.

More options in Section K

Nutritional approaches have expanded into four options rather than two. The facility will report if the approaches were in place upon admission, which is considered days one through three of the stay, performed while not a resident (7 days), performed within the last seven days while a resident, and at discharge (last 3 days of the stay).

What will this mean? Communication and collaboration between hospital staff, nursing home staff and discharge planning is going to be crucial for these new lookback periods.

3 -day look back periods in Section O

The 3-day lookback/assessment period on admission and discharge for SNF stay residents in section O are also being added. These new lookbacks will greatly impact SPADES (Standardized Patient Assessment Data Elements). This lookback will help show improvements and declines during their stay and care coordination upon discharge.

  • For example, was the resident on oxygen upon admission and will the resident need oxygen upon discharge? All these things are going to be a factor when looking at resident stays, assessments, CAA’s and care planning.

Recommendations from MDS Consultants

  • Gathering all the information from hospitals will be crucial to ensure nursing homes obtain the correct information for these 3-day lookback/ assessment periods upon admission to the facilities.
  • Ensure your staff is educated on the instructions for completing documentation in the 3-day lookback/assessment periods.
  • Accurate documentation is the key to success with an effective RAI system process when meeting MDS coding guidelines.
  • Set up an auditing and monitoring process as part of the facilities QAPI program to ensure that information is gathered and documented to support coding of the MDS.

These are all interesting factors that require ongoing attention through October 2023. Do not wait! The time to prepare is now.

More Resources

Explore More Posts from MDS Consultants

Reimbursement Concerns

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...

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 optional MDS assessment...

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...

Read more on Toolbox Essentials

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...

MDS in the Emergency Preparedness Plan

The COVID-19 pandemic has highlighted the need for skilled nursing facilities to have an effective Emergency Preparedness Plan - one that includes sheltering-in-place. The Centers for Medicare and Medicaid Final Rule requires that participating providers have an...

MORE from MDS Experts

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...

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 and preferences in...

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 the full...

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 appropriate use of...

Webinars & Training

Grow your knowledge with our MDS education

MDS Guides & Forms

Exclusive resources & tools we use every day

Ask an Expert Forum

Members can get 1:1 advice from our MDS experts

Let's Meet in Person

Get more info on our training & conference schedule

News for MDS Experts

Browse our blog & get news alerts on MDS changes

MDS Completion

Get your MDS' done ASAP with short-term, expert help

Remote Floater

Fill gaps on your team when & where you need

Case Mix Index

Improve your complex case mix calculations

MDS System Mgt

Best practices for MDS schedules & workflow

+ More Services

Get help on PDPM, ICD-10, quality, schizoph. audits ++