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 three days of the stay, and it will be present in section A0310A (Admission) assessment and remain in section A0310B (5D PPS) Medicare assessment.

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The Functional Abilities and Goals Discharge (End of PPS stay) title will change to Functional Abilities and Goals Discharge.

The assessment period is the last three days of the resident’s stay, and it will be present in the Discharge Return Anticipated, Discharge Return Not Anticipated, and the PPS discharge assessments. The Functional Abilities and Goals Discharge will be present on planned discharges that do not include a discharge to Short-Term General Hospital (acute hospital, IPPS-Inpatient Prospective Payment System).

Section GG (Functional Abilities and Goals OBRA/Interim) is new.

The assessment period is the ARD plus the previous two days equally a 3 day look back. Section GG will be present in the OBRA quarterly assessment, annual assessment, signification change in status assessment, significant correction to prior comprehensive assessment, and significant correction to quarterly assessment. Section GG will also be present on the Interim Payment Assessment (IPA).

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Section GG will inherit Functional Limitation in Range of Motion and Mobility Devices from section G.

 The Functional Limitation in Range in Motion and Mobility Devices will remain a seven day look back.

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What do the Changes Mean?

The new MDS 3.0 changes that are predicted for next year are creating a mix of opinions from long-term care experts. The changes coming to the MDS 3.0 will be significant not only to the MDS Coordinators, but also to the IDT within a facility.  Many feel this is the most significant change since the move from MDS 2.0 to 3.0.

As an MDS Coordinator in a case mix state, there are still many questions that arise with the elimination of section G and using section GG.

Elimination of section G affects the Medicaid Reimbursement at a state level.

There are several unanswered questions still to be resolved before the effective date of October 1, 2023.  For example:

  • Will section GG be the new section G for our case mix states?
  • Will the case mix states convert to PDPM criteria?
  • Will section GG (Functional Abilities and Goals) criteria create new Quality Measures?
  • How will section GG and the loss of section G affect our 5-star Quality Rating System?

Recommendations from MDS Consultants

Nursing facilities have a year to prepare for the changes. Preparation should start now.

  • Staff training and education with documentation for section GG will make more sense than with section G, especially with the assist level of support.
  • The Safety and Quality of Performance definitions seem clearer. It was difficult for nursing assistants to differentiate between limited and extensive assist.
  • Not only with differentiating the assist level, the rule of three was difficult to understand with the ADL self-performance.

We expect that nursing facilities will have to proceed with a team approach to tackle the new updated MDS sections. The IDT in a facility will need to assist the MDS nurse with the preparations, documentation, training, and education of the MDS 2023 changes.

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