Ask the payment expert: when to start training for MDS 3.0 and RUGs IV

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When should we start training our staff for the new MDS 3.0 and RUGs IV systems?

The final MDS 3.0 is due to be published next month. As soon as that is available, you should begin training your staff. The changes are significant from the MDS 2.0 and your staff can begin to implement some of the standardized tools now.  That will assist them in the transition to the MDS 3.0.

Some of the tools included are the PHQ-9 for depression, the CAM for delirium and the PUSH tool for skin. All of these can help support your coding today. In addition, you will see a shift from Resident Assessment Protocols (RAPs) to Care Area Triggers (CATs).

The difference between the CATs and the RAPs is that the RAPs give you specific guidelines you must follow. The CATs give you a list of resources to choose from to work your CATs. You as a long-term care facility need to determine what resource you want to use and then develop your own process internally. This could present some challenges for you and your employees.

At the same time that your staff is learning the new MDS 3.0, they also need to learn the new RUGs IV system. It has 66 RUG categories and many changes in which RUG groups items are placed in. Also, “look-back” periods have changed. A major impact for nursing facilities will be the movement of the IV medications from Extensive Services to Clinically Complex and the inability to capture that data from the hospital stay.

ADL coding is another big change.  The industry has had a significant focus on training CNAs in ADL coding, so the training for this aspect needs to involve all nursing staff.  Training for all the MDS 3.0 and RUGs changes must occur for the entire interdisciplinary team. You need to be ready for a challenging year in 2010!