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MDS Review Must Be Completed by Friday

The Department of Health (DOH) has posted Minimum Data Set (MDS) assessment data on the Health Commerce System (HCS) for nursing home provider review. After identifying that a significant number of assessments were not posted, DOH resolved the loading error on March 8th and notified providers that the process had reopened. Nursing homes have until March 18th to review the data and update payer, specialty bed, or special population (dementia, bariatric, traumatic brain injury (TBI)) identifiers in effect on the Assessment Reference Date (ARD) of the MDS.

The data will be used to calculate case mix index (CMI) adjustments to the January 2022 Medicaid rates. As has been the practice starting with the previous CMI update (i.e., July 2021 rates), DOH calculates CMI using all of the MDS assessments with an ARD from April 1, 2021 through Sept. 30, 2021, regardless of whether the individual is still a resident or has been discharged. All MDS assessments within the catchment period with Medicaid as the payer are used as long as they provide sufficient information to generate a Resource Utilization Group (RUG) score. The weights of the RUG scores for all assessments utilized are averaged to arrive at a facility’s CMI.

The final step of the review process is the electronic submission of the MDS Certification, which must be received by DOH by March 25th. The Dear Administrator Letter (DAL) is available here, and the Certification form is here. Please note that the verification process must be completed by March 18th and that DOH stresses that the signed, notarized certification is due seven days after the provider verifies the MDS data. It must be submitted electronically and can be emailed to MDSBRHCR@health.ny.gov.

If you encounter difficulties or have questions, please let us know and/or contact DOH at MDSBRHCR@health.ny.gov.

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