MDS, iQIES, QMs, and Five-Star

Caution! MDS Bumps in the Road with 10/1/2023 Transition*

With the implementation of the MDS 3.0 v1.18.11 this past Sunday, October 1st, it may not be surprising that there have been a few bumps in the road. Software vendors continue to work diligently to address issues, but here are some transitional potholes that you may want to watch out for:

• PointClickCare (PCC): PCC is experiencing an issue where the following MDS Items are enabled when they should be disabled:

  • D0500

  • GG0130 Column 2

  • GG0170 Column 2

  • GG0170J5

  • GG0170K5

  • K0710

  • O0400D2

PCC is working to resolve the issue and advises users to NOT answer MDS items that should be disabled. They will provide an update when the issue is resolved with instructions to complete the affected assessments. There have also been reports that some providers are not seeing the updated diagnosis codes within the PCC software, and that coding IV fluids is not populating the Special Care High case mix group.

• American Health Tech (AHT): When opening/scheduling an OSA, choose option 5 “other payment assessment” as the assessment type. Some providers are still having issues with the “Select other payment type” options not being updated. AHT scheduled a “Hot Fix” this past Saturday addressing the OSA and if problems persist you should call AHT technical support.

• Matrix Care: Older versions are omitting the Staff support response options on some of the late loss ADLs. Also, even when GG is not dashed, a warning code is given alerting the user that section GG cannot be dashed and not allowing the user to save and close, even when GG is not dashed.

Other considerations include:

• Diagnoses: Some diagnoses that once mapped to a PDPM Clinical Category may no longer (e.g., G20 – Parkinson’s disease). Make sure you have downloaded and are using the most recent PDPM ICD-10 Mapping

• iQIES: An issue was discovered with the iQIES Z0100 HIPPS code calculation. The system-calculated value was incorrect for some assessments submitted between 9/19/23 through 9/23/23. The iQIES system recalculates the Medicare Part A HIPPS codes for qualifying assessments and compares that value to the value that was submitted in item Z0100 on the record. If the submitted value does not match the system-calculated value, error number -3935a (Incorrect RUG/PDPM Value: The submitted value of the HIPPS/PDPM code does not match the value calculated by the iQIES System.) is returned on the Final Validation Report. These affected assessments received an error (-3935a) on the Final Validation Report. The iQIES technical team is working on correcting the issues and CMS will notify you of the next steps if you are identified as having one or more assessments affected by the issue.

*Information was provided by Proactive LTC Consulting | Oct 4, 2023 | Blog, Coding, Compliance, Documentation, MDS, Nursing