The Centers for Medicare & Medicaid Services (CMS) announced that a new DRAFT version of the 2020 MDS item sets (v1.18.0) has been posted.
The most impactful change was removing Section G from all Federal item sets. This will help eliminate the coding misunderstandings between section G & GG and place ADL evaluation solely in the hands of “qualified clinicians.” However, this change leaves us with probing questions such as what will happen with ADL tracking and RUG-based case-mix payment for residents of other payer sources and quality measures associated with section G?
Items in Section A were changed to better align with the 2011 HHS race and ethnicity data standards for person-level data collection. The Patient Health Questionnaire-9 (PHQ-9) is replaced with PHQ-2 to 9 to support Post-Acute Care (PAC) alignment. Additional changes to Sections A, B, C, D, J, N, and O were made in relation to the Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long- Term Acute Care Hospital (LTCH) Prospective Payment System Final Rule CMS-1716-F. This final rule includes adoption of two new quality measures in satisfaction of the quality measure domain in the IMPACT Act pertaining to transferring health information, as well as a number of standardized patient assessment data elements (SPADE) that assess functional status, cognitive function and mental status, special services, treatments and interventions, medical conditions and comorbidities, impairments, and social determinants of health (race and ethnicity, preferred language and interpreter services, health literacy, transportation, and social isolation).
The new DRAFT version of the 2020 MDS item sets (v1.18.0) files are located in the Downloads section on the CMS website. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/NHQIMDS30TechnicalInformation
The Change Table for Proposed SNF QRP New and Modified Items – Effective Date: October 1, 2020 is located on the CMS website also. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/Downloads/Change-Table-for-Proposed-SNF-QRP-Items-Effective-October-1-2020.pdf
FY 2020 Final Rule Tables web page: https://www.cms.gov/Medicare/Medicare-Fee-for-ServicePayment/AcuteInpatientPPS/FY2020-IPPS-Final-Rule-Home-Page-Items/FY2020-IPPS-Final-RuleTables.html
Blog by Kristen Walden, MSN, RN RAC-CT, Clinical Consultant, Proactive Medical Review
Learn more about Kristen and the rest of the Proactive team.