Nursing Home July 2021 MDS Collection
- Webinar is also available in Portable Document Format (PDF)
(July 1, 2021, Rate Effective Date)
July 07, 2021
Agenda
New Regulations
New Regulation
The regulation governing MDS has been updated; please see following link.
Highlights from New Regulation
- The January and July census dates have been eliminated.
- The 5% constraint on case mix index changes from one period to the next has been eliminated.
- The Case Mix Index (CMI) calculation will be based on an average of all Medicaid assessment for a six-month period.
- The July 21 CMI will include ALL assessments submitted to CMS from October 1, 2020, through March 31, 2021.
- The MDS Certification form has been amended and continues to be required.
- Failure to submit or to certify may result in penalties of up to $2,000 per day as per Public Health Law §12
Previous MDS Collections
Previous MDS Process
- The MDS collection was based on a specific census date in January and July.
- The MDS data included ONLY assessments with an ARD:
- within 92 days prior to the census date
- and within 13 days post census date.
- DOH extracted and scored assessment data from CMS
- DOH posted ONLY the assessment closest to the census date on the HCS.
- NHs were required to review their data on HCS for completeness.
- NHs could:
- view and change certain data prior to matching.
- make and save changes to HCS data prior to matching.
- select and match residents on the HCS.
- Matching and correcting residents´ information was done in one step.
- NHs were required to certify to the data matched on the HCS.
July 2021 MDS Process
July 2021 MDS Process
- ALL Medicaid assessments within a 6-month period will be used.
- The case mix index will be calculated using an average of ALL valid assessments for the period.
- NHs must ensure all assessments are submitted to CMS timely and accurately.
- There will no longer be a reminder to submit data to CMS prior to the extraction.
- Once extracted, the data will be scored and then posted on the HCS for facilities to review.
- The facility specific Case Mix Index will be calculated the same way it has been in the past, except now there are more data points.
- The sum of all MEDICAID RUG weights for a facility
- Divided by the number of assessments
July 2021 Case Mix Index
Example for Facility Case Mix Index Calculation
- Resident 1 - 1.07
- Resident 1 - 1.13
- Resident 1 - 0.88
- Resident 2 - 1.01
- Resident 2 - 1.71
- RUG total is 1.07+1.13+0.88+1.01+1.71=5.8
- Facility Specific Case Mix Index is 5.8 / 5 = 1.16
- If there are no changes, the facility can immediately press the "Submit" button.
- If there are changes, facilities will be able to modify the BMI, TBI, and Dementia categories as well as payor source and approved specialty programs, and then press the "Submit" button.
- Once the HCS file is submitted, consistent with prior practice, the facility is required to submit certification.
- Effective with the July 2021 rates, there will no longer be a 5% constraint on case mix index changes.
July 2021 MDS Process Timeline
July 2021 MDS Timeline
Tasks | Time | Date |
---|---|---|
|
1 Day | July 8, 2021 |
|
15 Days | July 8, 2021, to July 23, 2021 |
|
July 30, 2021 |
July 2021 MDS Process Instructions
Instructions to View/Update HCS File
Steps to review DOH File on HCS:
- Login to the MDS for NF Reimbursement section of the HCS
- Click on View /Submit MDS Census Records
- Select the NH opcert
- (where applicable - if a NH only have access to one facility it will be visible. If the NH have access to more than one facility you will need to select a facility)
- Click Continue
- Select Assessment Period: 2021-1 Open
- Click Next
- The steps listed above are consistent with previous collections, the steps that follows are new beginning with this MDS Census Collection.
- Click on the View/Match Residents to view the list of ALL residents
![](/facilities/long_term_care/reimbursement/images/residents.jpg)
- DOH NH File Will Open.
- HCS will show all resident with an ARD between October 1, 2020, and March 31, 2021.
- NH will review the data.
- NHs will be able to update payer source, Dementia, BMI and the specialty indicator before or after submitting their file.
- After review is complete press the “Back To Top" button at the end of the page.
- Select “Save Changes" button
- NHs MUSTsubmit the file by pressing the “Submit" button.
HCS Data Includes All Assessments
There will be multiple assessments for each resident, as shown here.
![table of multiple assessments for each resident](/facilities/long_term_care/reimbursement/images/assessments.jpg)
Updating Payer and Specialty Data
Check the update box in far-right column and save changes
![MDS for - INH Reimbursement](/facilities/long_term_care/reimbursement/images/data2.jpg)
Contacting DOH
Contact the Department at MDSBRHCR@health.ny.gov If secure communication is required (i.e.: Protected Health information), please use secure communication (guidance below):
- Log into the Health Commerce System
- Under the My Applications (left side if the page) select Secure File Transfer 2.0
- Select Launch Secure File Transfer 2.0
- Select Send Package
- In the TO: box enter BLTCRMDS Group
- Complete the SUBJECT box
- In the NOTE: box please describe the issue
- Attach any file you feel is needed for clarity.
- Select SEND