CMS rule alters MDS assessment process

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CMS rule alters MDS assessment process
CMS rule alters MDS assessment process
A controversial new rule from the Centers for Medicare & Medicaid Services will recalibrate Medicare case mixes under the Resource Utilization Group (RUG) system.

The rule will, in part, eliminate a section of the Minimum Data Set and change the RUG classification for short-stay residents. Effective Oct. 1, 2010, the regulation eliminates section T of the Minimum Data Set (MDS), which helps determine RUG placement.

Section T is used to estimate the amount of therapy a resident will receive during the first 14 days of a stay in a skilled nursing facility. CMS believes that projections have been inaccurate and a large number of residents have not received the amount of therapy they were forecast to receive.

CMS will implement an optional start-of-therapy Other Medicare Required Assessment (OMRA) with an Assessment Reference Date (ARD) to be carried out five to seven days after therapy begins.

CMS said the rule will reduce payments to nursing homes by roughly $1.05 billion in fiscal year 2010.