CMS has alerted us to an issue within their ASAP (Assessment Submission and Processing) system that affects the calculated RUG rate of certain MDS 3.0 submissions. Here’s what you need to know.

What MDS files are affected?

All MDS submissions beginning Oct. 1, 2016 through Nov. 4, 2016 are affected. The issue impacts all NO and SO (Nursing Home and Swing Bed OMRA) assessments and may have resulted in an incorrect ASAP system-calculated RUG code for these assessments. (No other assessment record types were affected.)

Does this affect all providers?

Yes, all providers are affected, regardless of whether you use SimpleConnect™ to manage your MDS workflow or submit MDS batches directly to CMS.

What do I need to do?

You’ll need create modification records for all assessments submitted between Oct. 1 and Nov. 4 (with a target date of Oct. 1 or after), then submit them to CMS. No changes are required within the assessment; it only needs to be submitted as a modification. This will allow CMS to correctly recalculate RUG values as well as store accurate data for reporting.

Important: Do not submit the original record a second time, as it will be rejected as a duplicate.

What MDS field values were affected?

Specifically, this involves the submitted values for M0300B1, M0300C1, M0300D1, and M0300F1 for NO and SO assessment records. The values were not stored in the CMS ASAP system, despite being required for the NO and SO assessment record.  Since the data was not properly stored, related RUG calculations were affected for this time period.

The values in items A0200 and A0310A – A0310H that create the NO or So item set are as follows:

• NO = A0200=1, A0310A=99, A0310B=7, A0310C=2, A0310D=^, A0310F=99, A0310H=0
• NO = A0200=1, A0310A=99, A0310B=7, A0310C=3, A0310D=^, A0310F=99, A0310H=0
• NO = A0200=1, A0310A=99, A0310B=7, A0310C=4, A0310D=^, A0310F=99, A0310H=0
• SO = A0200=2, A0310A=99, A0310B=7, A0310C=2, A0310D=0, A0310F=99, A0310H=0
• SO = A0200=2, A0310A=99, A0310B=7, A0310C=3, A0310D=0, A0310F=99, A0310H=0
• SO = A0200=2, A0310A=99, A0310B=7, A0310C=4, A0310D=0, A0310F=99, A0310H=0

For more info

If you have any questions, contact the QTSO Help Desk at help@qtso.com or 888.477.7876.