Ask the payment expert

What changes do you anticipate in 2009 related to the assessment process?

Lots! First, we anticipate the final version of the MDS 3.0 in March 2009. Although many providers are still questioning whether the Centers for Medicare & Medicaid Services can actually implement it as anticipated on Oct. 1, 2009,  the agency, so far, is adamant it will occur.

We anticipate that lots of education will be needed to inform staff how to complete the new tool,  and how to do resident interviews and the completion of this new tool at the bedside.

Secondly, we are anticipating the final STRIVE study results to be published. As a result of that,  CMS will be realigning the RUGs groupings. Lastly, as a result of this realignment of time studies and the new MDS 3.0, we can anticipate revisions to the RUGs rates.

We heard the CMS is pulling back on implementation of the Quality Indicator Survey. Is this a good process or not? Can you help us?

Instead of pulling back, I learned that the QI Survey will begin implementation in the states of Washington and Maryland. 

In addition, Dr. Andrew Kramer (who developed the QI Survey) is also working on a Federal Validation Survey process utilizing the QI Survey process. So, it looks like the national implementation is proceeding.

As for the process, I like it. I think it is a much more objective process in Stage I and looks at all facilities equally the same. We are hearing that many states are seeing greater frequency of citations but at a lower scope and severity level.

The key to this process is understanding the methodology and how the resident voice has such a significant impact on the results.