— A message about MDS 3.0:
The Centers for Medicare & Medicaid Services (CMS) has received several inquiries regarding coding MDS 3.0 item G0110: Activities of Daily Living (ADL) Assistance, Column 1: Self Performance. Specifically, the questions regard coding scenarios in which a resident experiences more than three episodes of supervision in the look back period, as well as three or more episodes of a combination of full staff performance, weight-bearing assistance, and/or limited assistance; but not three times at any one of these levels. Because the threshold of three or more times of Supervision was met, and there were not three or more instances of a single higher level, the correct code in such a scenario would be “1” indicating Supervision.
Consider the following example: Supervision occurred five times in the look back period, while Limited Assistance occurred twice, and Extensive Assistance and Total Assistance each occurred once. In this scenario, the correct code for G01101 would be “1” indicating Supervision, because there were not three or more instances of a single higher level.
States and providers can expect clarifications, including to the ADL Algorithm on page G-6, in the May 2013 Resident Assessment Instrument (RAI) User’s Manual update.
— DADS proposed to repeal Chapter 48, Subchapter H, Eligibility, and Subchapter I, Case Management, and new Chapter 37, which contains the eligibility rules for Community Care for Aged and Disabled services by individual program. See the news alert page to download the rules in PDF for stakeholder review.
— Local authority and provider representatives will hold training on Changes in HCS Service Delivery. See the news alert page for dates and locations.
See the news page for more information about these and other alerts.