MDS Alert

Published on Fri Jun 07, 2019 PDF

CMS is continually focusing on facilities improving resident safety and health.

If you are wondering how Resident Assessment Instrument (RAI) guidance may change with the implementation of the patient-driven payment model (PDPM), you can take a look at the 2019 version of the RAI Manual.

Additionally, the Office of the Inspector General (OIG) recently released a report analyzing trends of deficiencies in nursing facilities from 2013-2017.

Read the Preliminary RAI Manual Now

The Centers for Medicare and Medicaid (CMS) has released the preliminary version of the 2019 Resident Assessment Instrument (RAI) Manual.

“Please note this early, preliminary release is being provided in response to stakeholder feedback. The MDS 3.0 RAI Manual v1.17 contains many updates including information related to the Patient Driven Payment Model. Please check back shortly prior to October 1, 2019 for a final posting that may contain additional updates,” CMS says on its website.

You can access a zip file containing the 2019 preliminary RAI Manual here: www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/NursingHomeQualityInits/MDS30RAIManual.html.

10 States Identified as Worst Offenders

One takeaway of the OIG’s recently released report on the trends of deficiencies in nursing facilities is that providers in 10 particular states accounted for half of the deficiencies identified. However, those states did not necessarily have the most surveys, numbers-wise. The 10 worst offenders are, in order, California, Texas, Illinois, Pennsylvania, Ohio, Michigan, Indiana, Florida, Kansas, and New York.

One caveat: Kansas identified nearly three times as many deficiencies per survey as California, even though the latter state ranked number one in deficiencies, the report says. California ranked 44th of the 50 states in the average number of deficiencies per survey.

There was little overlap between the states with the highest number of deficiencies and the states with the highest average of deficiencies per survey. Those states were, in order: Alaska, Idaho, Delaware, Hawaii, Virginia, North Dakota, Montana, Utah, Wyoming, and West Virginia.

Additionally, approximately 31 percent of nursing homes had a repeat deficiency, the OIG report says. The OIG defines a “repeat deficiency” as having been cited at least five times in separate surveys, which suggests that the issues surrounding these deficiencies are especially prevalent.

You can read the entire report here on the OIG website,  here: https://oig.hhs.gov/oas/reports/region9/91802010.pdf.