Fasten your seatbelts as there are 6 days left (yes, only 6 days) until the Final Rule changes to the SNF PPS and RAI process go into effect. Following a historical pattern, CMS posted additional changes and updates to the MDS 3.0 RAI manual on September 20, 2011. The MDS 3.0 Training Materials web page states: Files that have changed are Chapter 2, Chapter 6, and Chapter 3, Section O. Previous files are not completely accurate and should be replaced with these immediately.
Throughout the revised chapters, there were multiple corrections of typographical errors and other minor changes. Several items that changed the intent of the directions in Chapter 2 are noted below.
- Added: An SOT OMRA is not necessary if rehabilitation services start within the ARD window (including grace days) of the 5-day assessment, since the therapy rate will be paid starting Day 1 of the SNF stay.
- If the EOT OMRA is performed because three or more consecutive days of therapy were missed, and it is determined that therapy will resume....(referring to the EOT OMRA)
- Added: The resumption of therapy date is counted as day 1 when determining Day 7 of the COT observation period.
- Revised (adding the italicized portion): If Day 7 of the COT observation period falls within the ARD window of a scheduled PPS Assessment, the SNF may choose to complete the PPS Assessment only by setting the ARD of the scheduled PPS assessment for an allowable day that is prior to Day 7 of the COT observation period. This effectively resets the COT observation period to the 7 days following that scheduled PPS Assessment ARD.
- Replaced EOT with SOT in the following sentence: If the ARD for the SOT OMRA falls within the ARD (including grace days) of a PPS scheduled assessment that has not been performed yet, the assessments MUST be combined.
The full documents can be found at the link below.
RAI Manual updates can be found at the following page:https://www.cms.gov/NursingHomeQualityInits/45_NHQIMDS30TrainingMaterials.asp