MDS Alert

Published on Fri May 23, 2014 PDF

Dementia survey goes way beyond reducing antipsychotic use.

The Centers for Medicare & Medicaid Services (CMS) is launching two focused survey pilots, set to begin in early summer. And although these are pilots, any deficient practices revealed during the survey could result in real citations. Here’s what to expect.

The two survey pilots will focus on MDS 3.0 coding practices and dementia care, reported Evvie Munley, senior health policy analyst with Washington, D.C.-based Leading Age, in an April 29 analysis. The pilots will each involve five nursing facilities in five states, conducted by state survey agencies (SAs).

What Dementia Survey Will Focus On

According to an April 18 CMS Survey & Certification memo (S&C: 14-22-NH), the dementia care survey aims to document dementia care practices in nursing homes, while the MDS survey will document MDS 3.0 coding practices and associated care planning. 

Reason: The dementia care survey stems from CMS’s 2012 launch of the National Partnership to Improve Dementia Care, which initially focused on reducing antipsychotic medication use in long-stay nursing home residents. Although nursing homes nationwide have exceeded the overall goal of a 15-percent reduction in antipsychotic use, more work remains, the memo says.

The dementia survey will evaluate additional issues, such as symptom/pain management, decision-making, caregiver stress, and others related to comprehensive dementia care in nursing homes, CMS explains in the memo. This survey also stems from the National Plan to Address Alzheimer’s Disease (http://aspe.hhs.gov/daltcp/napa/#Plan), which focuses on improving the assessment of dementia care practices across different settings.

The survey will include a detailed review of dementia care in nursing homes, including resident- and organizational-level processes, according to the memo. “CMS will identify the specific facilities to be surveyed and will work with the states to identify dementia care experts to accompany surveyors for the first survey whenever possible.”

Do This if Your Facility is Selected

The MDS-focused survey will generally address assessment accuracy and optimizing person-centered care planning. For both surveys, participating SAs will allocate two surveyors for a period of two to four weeks for onsite surveys, as well as time for required training.

Look ahead: “The focused survey processes will inform future activities to enhance dementia care and MDS 3.0 accuracy and care planning, including potentially more widespread survey activities,” Munley noted.

Beware: “Deficient practices noted during the survey will result in relevant citations,” the memo states. And SAs will investigate any additional care concerns identified in the surveys, either during the survey or after referral to the SA as a complaint for further review.

So if your facility becomes involved in either of these surveys, take them seriously. And don’t hesitate to contact CMS with questions. For the dementia care survey, the contact is Michele Laughman at dnh_behavioralhealth@cms.hhs.gov; for the MDS 3.0 survey, contact Shelly Ray or Jennifer Pettis at MDSFORSandC@cms.hhs.gov. 

Link: To view the S&C memo, go to www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-14-22.pdf.