»» Good morning and welcome everyone.
It's very exciting to see so many folks join us for this two-day conference, it's very
exciting to see you.
I'm going to be giving just a brief overview of the MDS 3.0 items that you can expect to
see changing effective October 1, 2018.
I won't be spending a lot of time discussing the items in detail as over the next two days
there will be other presentations that will provide you additional information about these
items that are changing.
So let's go ahead and get started.
For your convenience and reference we've included a list of the acronyms and their definitions
in your slide presentation should you wish to refer to that.
Here are the objectives for this presentation.
Following this presentation it is our hope that you will be able to identify the new
MDS 3.0 items that are being added to the item set, that you'll be able to identify
the MDS 3.0 items that will be retired effective October 1, 2018, and that you'll be able to
identify the items that are transitioning to be state optional.
This is an important informational slide for you.
It's important to know that the new item sets in effect October 1, 2018 have a version number
of 1.16.0R.
We have included two links on this slide that will enable you to access important MDS 3.0
information on the CMS website.
The first link will take you to the MDS 3.0 technical information page.
There's a lot of information available to you on this page including the ZIP file for
the item sets that are in effect in October.
You will also be able to access things such as the data submission specifications that
coincide with the item changes, and a link that will take you to the RAI Manual page.
The second link that is listed on your slide will take you directly to the ZIP file where
you can access the item sets that are in effect on October 1st.
One important document within that ZIP file is an Item Change Report.
This Item Change Report will identify all of the item changes that are incorporated
into the item sets that you download and those changes that are in effect on October 1st.
I'm going to now summarize the changes to the sections in the MDS that you'll see in
October.
So as you can see here, there will be item changes in Section GG, I, J, M, N, and O.
Let's go ahead and take a look first at the item changes for Section GG.
The first new item that you will see is item GG0100, Prior Functioning Everyday Activities.
As you can see in this sample, the new item will collect data on the resident's ability
to do every day activities prior to their current illness, exacerbation or injury.
And the sub items for GG0100 are Self-Care, Indoor Mobility Ambulation, Stairs and Functional
Cognition.
To the left there you will see then a list of the valid values that are associated to
those new items.
The second new item then is GG0110, Prior Device Use.
This item allows you to identify the devices or aides that the resident used prior to their
injury, exacerbation or illness and admission to your facility.
Notice that this is a checklist of items.
So this allows you to select one or more of the devices that the resident would have used
prior to their admission to your facility.
If none of the items were applicable, then you would simply select the "none of the above"
option.
There have been some item definitions that have been clarified to promote alignment across
the item sets.
So for items GG0130A-C for the six-point scale you will notice that for code option 04, supervision
or touching assistance, the definition has been enhanced to include the words "contact-guard."
We added definition to Code 09, not applicable.
So you can see that the new definition is not attempted and the resident did not perform
this activity prior to the current illness, exacerbation or injury.
And finally a new code, code number 10, not attempted due to environmental limitations
has been added.
You will notice that for items GG0130 and GG0170, the Discharge Goal items now allow
you to code response options 07, 09, 10 and 88.
Here is a picture of new items GG0130E, F, G and H. As you can see, these items allow
you to identify the resident's ability to shower and bathe themselves, perform the upper
body dressing, lower body dressing, and putting on and taking off footwear.
Effective in October, the walking items, GG0170H1, does a resident walk at the time of admission,
and GG0170H3 does the resident walk at the time of discharge are being removed from the
item set.
Instead, a new skip pattern has been added to item GG0170I.
And that item GG0170I asks whether the resident can walk 10 feet.
If the answer is that the resident isn't able to walk 10-foot, then the skip pattern allows
you to skip the subsequent items.
Here's a picture of some new items that are being added to the functional abilities and
goals section.
So you can see there are three new items on this picture.
Those are GG0170A, GG0170G and GG0170I.
And as you can see in the highlighted section, the GG0170A item is roll left to right.
GG0170G addresses the car transfer item.
And GG0170I is for the walk ten feet item.
And here are a few more new items to the Section GG.
You'll see that we have new items GG0170L, M, N, O and P. As you can see on this picture,
those new items are walking 10 feet on uneven surfaces, the ability to step up and down
from one step on the curb, the ability for the resident to take four steps up and down,
twelve steps up and down, and finally picking up an object.
Here are two new items that you will see in Section I.
The first item indicates the resident's primary medical condition category at the time of
admission.
So you can see that you will have a list of conditions from which you can identify for
that resident.
You will get additional information in subsequent training about these new items as well.
Then there is a new item I0020A.
Here's new item J2000.
This question asks whether the resident had major surgery during the 100 days prior to
admission.
Now we're going to review some changes to some existing items.
Those existing items are K0510C and D. Effective October 1, 2018 CMS will no longer require
you to complete column 1, which is while the resident column for items K0510C and D. However,
some states will continue to require completion of those items.
It's very important for you to understand the requirements from your state, whether
you should be completing the column 1 section for K0510C and D. If your state does not require
you to complete that column, you would simply enter the standard "no information" response,
which is a dash.
There is a similar change to items K0710A and B. Again effective October 1 of this year,
CMS will no longer require you to submit data in Column 1 which is while the patient was
not a resident for items K0710A and B. However, some states may require that you continue
to submit data for that column 1.
So it's very important that you understand what your state requirements are.
If your state does not require you to complete that column then you would simply use the
standard "no information" code value, which is a dash.
Now we're going to move on into the Section M items which pertain to the skin conditions.
You'll notice in the list and also in the picture of the item sets that the terms "injury"
or "injuries" has been added to several of the Section M items including the heading
and the item itself.
So as you can see that pertains to Section M item M0100, M0150, M0210, and the M0300
series of items.
This slide shows you that items M0300G and M0300G1 have also been enhanced.
The term "suspected deep tissue injury in evolution" has been replaced with the words
"deep tissue injury".
Effective October 1 of this year we have several of the Section M items that are being retired.
You can see those are listed here.
Item M0300B3 which is the date of the oldest Stage 2 pressure ulcer.
M0610A-C which are the dimensions of the unhealed Stage 3 or 4 pressure ulcer or eschar.
Item M0700, which is the most severe tissue type for any pressure ulcer.
M0800A-F which are the worsening in the pressure ulcer status items.
And finally, items M0900A-D, which identify the healed pressure ulcers.
Because of the removal of these items from the item set, there have been new skip patterns
associated to the items that remain on the item set.
So you can expect to see those changes as well.
In this picture you can see that for item M01200 and M01200E the term "injury" has been
added to the label as well as to the item description itself.
Here are three new items that are being added to Section N. The first two items N2001, Drug
Regimen Review and N2003, Medication Follow-up are both going to be added to the Admission
Assessment.
Item N2005, Medication Intervention is being added to the discharge item set.
And here is a picture showing how the items will display on the item set and the code
responses that are associated to each of those items.
You will notice in Section O, Special Treatments, Procedures and Programs that there has been
an item label change for item O0100F, and O0100G.
Of course as you can expect with these item set changes there will be the corresponding
changes to the RAI or Resident Assessment Instrument Manual.
The updates that are included in the October 1, 2018 manual will be covered in upcoming
presentations to include the coding instructions and some examples of the new items.
So specifically, you can expect that the changes regarding the Self-Care and Mobility items
in Section GG, the Primary Medical Condition item in Section I, the Prior Surgery Item
in Section J, the Skin Conditions items in Section M and the Drug Regimen Review items
in Section N have all been addressed in the upcoming RAI Manual.
So to summarize, the new additions and updates to the item sets version 1.16 are in effect
October 1, 2018.
We have reviewed the items that are being retired from the MDS and those items that
are becoming state optional.
Please remember that throughout the next two days you will be receiving additional information
about these item changes.
But, I would be happy to entertain any questions you might have regarding this presentation
now if you have any.
I think there are none.
Thank you very much for your time.