October 1 not only introduces new MDS areas, it also places SNFs into a data collection window from October 1-December 31, 2018, which will impact their FY 2020 annual payment update.
SNFs that do not submit the required measure data may receive a 2% REDUCTION to their annual payment update for the applicable payment year with 80% of assessments needing to have 100% of the data related to the following areas: Drug Regimen Review; Changes in skin integrity post-acute care: pressure ulcer/injury; Change in Self Care Score; Change in Mobility Score; Discharge Self Care Score; Discharge Mobility Score.
For the SNF Quality Reporting Program, a minimum of one self-care or mobility discharge goal must be coded.
4. My team is trying to determine how to account for differences in how an individual performs in therapy versus with the nursing assistants. Can you provide a reminder on the definition of Usual Performance?
Per the RAI Usual Performance is defined as: A resident’s functional status which can be impacted by the environment or situations encountered at the facility. Observing the resident’s interactions with others in different locations and circumstances is important for a comprehensive understanding of the resident’s functional status.
If the resident’s functional status varies, record the resident’s usual ability to perform each activity. Do not record the resident’s best performance and do not record the resident’s worst performance, but rather record the resident’s usual performance.
5. What do I need to know related to GG0100. Prior Functioning: Everyday Activities?
The item rationale for this area includes knowledge of the resident’s functioning prior to the current illness, exacerbation, or injury may inform treatment goals. The area is assessed by asking the resident or his or her family about, or review the resident’s medical records describing, the resident’s prior functioning with everyday activities.
The areas assessed include: Self-Care; Indoor Mobility; Self-Care; and Functional Cognition
6. What items are included in GG0110, Prior Device Use?
Manual wheelchair; motorized wheelchair and/or scooter; mechanical lift; walker; and orthotics/prosthetics
7. When coding for GG0130A, Eating what do we consider for a resident receiving tube feedings or total parenteral nutrition?
When impacted by a new onset medical condition:
If the resident does not eat or drink by mouth and relies solely on nutrition and liquids through tube feedings or TPN because of a new (recent-onset) medical condition, code GG0130A as 88, Not attempted due to medical condition or safety concerns. Assistance with tube feedings or TPN is not considered when coding Eating.
When not impacted by a new onset medical condition:
If the resident does not eat or drink by mouth at the time of the assessment, and the resident did not eat or drink by mouth prior to the current illness, injury, or exacerbation, code GG0130A as 09, Not applicable – Not attempted and the resident did not perform this activity prior to the current illness, exacerbation, or injury. Assistance with tube feedings or TPN is not considered when coding Eating.
When partial oral intake occurs:
If the resident eats and drinks by mouth, and relies partially on obtaining nutrition and liquids via tube feedings or TPN, code Eating based on the amount of assistance the resident requires to eat and drink by mouth. Assistance with tube feedings or TPN is not considered when coding Eating.
8. What is included and excluded when coding GG0130E, Shower/bathe self?
Set up considerations: If the resident bathes himself or herself and a helper sets up materials for bathing/showering, then code as 05, Setup or clean-up assistance.
9. What items should be considered a piece of clothing when coding the dressing items?
If donning and doffing an elastic bandage, elastic stockings, or an orthosis or prosthesis occurs while the resident is dressing/undressing, then count the elastic bandage/elastic stocking/orthotic/prosthesis as a piece of clothing when determining the amount of assistance the resident needs when coding the dressing item.
10. How do you code wheelchair items when wheelchair is used for transport?
Renee Kinder, MS, CCC-SLP, RAC-CT, is Director of Clinical Education for Encore Rehabilitation and is the Silver Award winner in the 2018 American Society of Business Publishing Editors competition for the Upper Midwest Region in the Service/How To Blogs category. Additionally, she serves as Gerontology Professional Development Manager for the American Speech Language Hearing Association’s (ASHA) gerontology special interest group, is a member of the University of Kentucky College of Medicine community faculty, and is an advisor to the American Medical Association’s Relative Value Update Committee (RUC) Health Care Professionals Advisory Committee (HCPAC).
