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Virginia Health Care Association | Virginia Center for Assisted Living

New MDS Data Specifications for PDPM Issued

New MDS Data Specifications for PDPM Issued

On February 5, the Centers for Medicare and Medicaid Services (CMS) posted a new draft version (V3.00.0) of the MDS 3.0 Data Specifications on its MDS 3.0 Technical Information webpage. This version is scheduled to become effective October 1, 2019, the start of the new Patient Drive Payment Model (PDPM).  

These specifications are used for software developers and vendors to update the Skilled Nursing Facility Prospective Payment System (SNF PPS) grouper, MDS, electronic health records, and billing systems to align with annual updates to the MDS-RAI (yet to be issued) and SNF PPS billing requirements.  

Note that there are many significant changes to align with the transition to the new SNF PPS from the Resource Utilization Groups, Version 4 (RUG-IV) to PDPM. These   changes include:

  • the removal of eight RUG-IV assessment item sets (NS, NSD, NO, NOD, SS, SSD, SO, SOD)
  • the addition of two new PDPM assessment item sets (IPA – Interim Payment Assessment and OSA – Optional State Assessment)
  • item additions in Sections A, GG, I, J, O and Z

See this link for the draft MDS 3.0 Item Sets v1.17 for October 1, 2019) that were issued on January 3. The MDS draft data specifications also accommodate the utilization of the PDPM grouper (not issued yet), which also begins on October 1, 2019.

In addition, a new version (V1.04.0) of the MDS 3.0 CAT Specifications was posted. This version is also scheduled to become effective October 1, 2019. The specification for CAT 12 (Nutritional Status) has been updated in accordance with the changes in V3.00.0 of the MDS 3.0 Data Specifications.