The Centers for Medicare and Medicaid Services (CMS) has revised the MDS assessment used for the coding of resident data representative of care and services. This data is also used for the quality measures reports which impact the Five Star Quality Rating and for reimbursement for both skilled services through the Patient Driven Payment Model (PDPM) and Medicaid as part of the quarterly Case Mix Index (CMI) score. The MDS assessment data elements are also utilized to correlate to the person centered care plan. The revised MDS and all related item sets are now available on the CMS website and on the PANAC website at Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual | CMS and News | PANAC (paanac.net).

 

Additionally, CMS will no longer support the RUG classifications effective September 30, 2023. Pennsylvania will continue to utilize the RUG classifications for the Medicaid CMI quarterly reports for reimbursement. Thus Pennsylvania will begin using the Optional State Assessment (OSA) to collect data required to achieve the RUG classifications. The OSA will collect data in addition to the required OBRA MDS assessments. The OSA data set can also be found and reviewed on the CMS website.