Ask the payment expert: explaining the changes in the new Section Q of the MDS

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Ask the payment expert
Ask the payment expert

Can you explain the changes in the new Section Q of the MDS?

The significance of Section Q of the MDS 3.0 has grown, and the Centers for Medicare & Medicaid Services wants to make sure facilities know about it.

Now discharge is nothing new, but with the implementation of the MDS 3.0, CMS has written guidance on how this should be accomplished. Q0500B of the MDS asks the resident, “Do you want to talk to someone about the possibility of returning to the community?” If the resident answers yes, the facility is obligated to refer that resident to the Local Contact Agency (LCA) within 10 days and then the LCA is required to respond to that request within a specified period of time.

The LCA and nursing home should then work together to find the best placement or services for the resident. CMS says that each state should work with providers to build a collaborative process and that process must be in place by Oct. 1, 2010.

What does this mean for you? First, you need to be aware that all residents will be asked this question on admission, quarterly, annually and with a significant condition change. So, this is not for your short-term residents. For the most part, these residents already have arrangements made for their return home and may not need additional assistance.

Secondly, you may want to inform your families and responsible parties of this change so they are not upset when the resident tells them they are getting information on returning to the community. Do we expect that this will result in lots of residents being discharged? No. However, you need to make sure your social service/discharge planning staff understand these new guidelines, and that you know your state process and you develop your own internal processes to meet this change.