MDS 3.0 RAI Manual Changes

The Resident Assessment Instrument (RAI) User's Manual has been updated to reflect changes that take effect on October 1, 2011, the manual version is 1.07 (V1.07). Providers should take extra care to ensure that materials used after October 1^st reflect this version of the RAI. Several chapters and appendices include only minor changes and edits however there are several significant changes that providers should make note of. Kris B Harmony has outlined some significant updates from Chapter 2 below and encourages clients to contact either their Kris B Harmony Consultant or the Corporate Office with any questions, including those regarding how to operationalize the changes.

Chapter 2 - Multiple changes have occurred, most signficantly related to the scheduling of PPS assessments (as a result of the final rule). Kris B Harmony strongly recommends that facility staff carefully review the updated section, including the scheduling examples that CMS has included.

Below is a bulleted list of key points from the updated Chapter 2:

• CMS clarifies that when retaining 15 months of RAIs in the active medical record, the exceptionis that demographic information (Items A0500-A1600) from the most recent admission assessment must be maintained in the active clinical record until the resident is discharged return not anticipated.
• Clarifying information was added to the Assessment Reference Date (ARD) definition and CMS stressed (in accordance with what was previously stated in the 2009 Final Rule) that the facility is required to set the ARD on the MDS form itself or in the facility software within the appropriate timeframe of the assessment type being completed.
• Clarifying information has been added to the definition of a leave of absence (LOA) as it related to discharge requirements (stating that discharge requirements do not apply to LOAs)
•  Additional examples have been provided regarding OBRA scheduling and timing, including regarding significant change examples.
• Multiple edits and clarifications have been made to the PPS Scheduling information, including the significant entries that are detailed below. 

The new PPS MDS schedule retains the current available days for the 5 day assessment with days 1 through day 8. The available dates for the 14 day assessment reflect a reduction of three days. The new window for ARD selection for the 14 day runs from day 13 through day 18. The 30, 60 and 90 day assessments have been shorten by 7 days each.  

The following ARD selection options will be effective October 1, 2011:

30 Day: 27-33

60 Day: 57-63

90 Day: 87-93 

Kris B Harmony stresses the need for clinical staff to familiarize themselves with these requirements and the many examples that CMS has provided in the updated RAI User's Manual.

• RAI Manual updates can be found at the following page:
  https://www.cms.gov/NursingHomeQualityInits/45_NHQIMDS30TrainingMaterials.asp