The Centers for Medicare & Medicaid Services (CMS) have identified MDS submission issues under the Patient-driven Payment Model (PDPM), launched on October 1.
CMS provided the following update:
SNF providers should continue to follow the Resident Assessment Instrument (RAI) requirements which include, but are not limited to, establishing assessment reference dates for OBRA or PPS assessments that are required/scheduled, including the PDPM Transitional Interim Payment Assessments, assessing residents, and coding the applicable MDS assessments. As per the RAI requirements, assessments should be completed within 14 days and recorded in Z0500. Late submission payment penalties do not apply under the SNF PPS. We will work with providers to ensure that timely payments are made. We will continue to share updates as they become available. In the meantime, providers should not hesitate to contact us. For questions regarding PDPM please send inquiries to pdpm@cms.hhs.gov, and for information technology questions please send emails to MDSTechIssues@cms.hhs.gov. Please contact your state Medicaid agency for questions related to the Other State Assessment (OSA) and Medicaid payment.
CMS provided a fix to the software on October 7, 2019. As a result, the MDS validation reports should be reviewed for warning and error messages. Watch for updates from your software vendor. CMS rescinded Transmittal 2278 and replaced it with Transmittal 2299. This reflects the changes from RUG per diem rate to PDPM calculated total amount received by the SNF.
Additional guidance can be found in the updated SNF PDPM MLN Matters Article on October 11, 2019. This was revised as CMS rescinded changes that were made by the Change Request (CR) 11152 that was issued on October 4. The document is now the same as the May 6 version of the document. The CR that was rescinded included a new HIPPS code file, revised CR release date, transmittal number and web address. Refer to the CMS PDPM webpage for FAQ's, training, and resources.