Long-Term Care

Tip of the week: Understanding MDS basics for non-skilled residents

Contemporary Long-Term Care Weekly, January 14, 2010

The Minimum Data Set (MDS) drives all billing, including consolidated billing. It is a federal Omnibus Budget Reconciliation Act of 1987 (OBRA) requirement that must be performed on all residents, regardless of whether they are skilled under Part A. Therefore, although administrators do not have to be experts on MDS, they must have a basic understanding and be conversant on MDS, so as to hire people who are qualified to carry out the MDS and who understand the importance of MDS coding.

The MDS process is a very intricate coding process that requires professionals who are meticulous and who code with the utmost scrutiny. All residents must have an MDS completed regularly. For those residents who are not skilled under Part A, the particulars are as follows:

  • An initial comprehensive assessment is still necessary and must be completed no later than 14 days after their arrival
  • Care plans need to be completed no later than seven days after the initial comprehensive MDS
  • A quarterly MDS assessment, not to exceed 92 days from the previous assessment, is required
  • Each year a comprehensive MDS assessment, not to exceed 366 days from the last annual assessment, is required
  • Whenever there is a significant change in a resident’s condition, an MDS is required

This is an excerpt from HCPro’s book, The Long-Term Care Administrator’s Field Guide, by Brian Garavaglia, PhD.

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