Ask the payment expert: training for MDS 3.0 and preparing for a RAC review

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Ask the payment expert
Ask the payment expert

I heard that MDS 3.0 was published. What should we be doing in terms of staff training?

The MDS 3.0 is a completely different document than the MDS 2.0 and your staff has a lot to learn. I advise that you begin training now.

Your staff needs to learn how to interview residents, the rules of when to interview and when not to, as well as the changes in definitions that are included in the new RAI manual.

The other information that is expected to be published soon is the Care Area Assessments, the Assessment Scheduling and the RUGs chapters. It will take your staff several training sessions before they have all the information. Your entire interdisciplinary team needs to complete this training.

What can we do to prepare for a RAC review?

Recovery Audit Contractors (RACs) are rolling out across the country. CMS does have a Web site at that can keep you up to date on when RACs may be visiting you. The RACs are posting training sessions on their Web sites and you need to stay turned for that training in your area.

We know that the RACs only completed 2% of their reviews in nursing homes during the demonstrations. But don't sit back, thinking a RAC will not visit you. We know they are beginning to complete automated reviews.

The key to success is to have good systems in place for coding your UB04s, good supportive documentation of skilled care, and assistance in responding to any RAC review. There is a lot to this process and you want expert advice if you have a review.

Better yet, have a Medicare assessment completed now to see if all your processes are in place.