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MDS Data Verification Process Underway

Nursing homes have until May 7th to review data posted on the Health Commerce System (HCS) to ensure that each resident in the home on July 29, 2020 is matched to the correct Minimum Data Set (MDS) assessment. This process will be used to calculate Case Mix Index (CMI) adjustments for January 2021 nursing home Medicaid rates. Please note that this process does not apply to specialty facilities and units, since case mix updates are not currently being made to specialty rates.

Please consult the Dear Administrator Letter (DAL) for a complete timeline for the process. The slides from the Department of Health’s (DOH) June webinar describing the data verification and correction process are available here, and the full archived webinar is here. (Please note that while the information in the presentation is correct, the dates shown on the slides are not updated and still indicate the schedule from a prior collection period.)

Providers have from April 8th through May 7th to verify that the correct MDS assessment is being matched to each resident and “set the match.” While providers are required to do this for all residents in house on the picture date, regardless of payer, DOH will only use Medicaid residents (Medicaid, Medicaid Pending, Medicaid Managed Care, Managed Long Term Care (MLTC), Program of All-Inclusive Care for the Elderly (PACE), Medicaid Advantage Plus (MAP)) when calculating the CMI.

If the system selects the incorrect MDS assessment or does not list all residents who should be listed, please contact DOH at MDSBRHCR@health.ny.gov. We remind members that the secure transfer application should be used if a message contains any resident-identifying information. Instructions for using the secure transfer function of the HCS are provided on page 22 of the webinar slides.

The final step in the process is the submission of the Operator Certification. Although the deadline for the certification is May 14th, DOH requests that members not delay and submit that form as soon as they have set the match. The certification should be submitted by email to MDSBRHCR@health.ny.gov with "2020-2 MDS Certification" in the subject line.

Please let us know if you encounter any difficulties.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841