MS-March 2015.pmd - Myers and Stauffer
Contents
1. 7 How Can We Help You oaea eee ttee S Page One i Best Practices This is an article in the Medicaid Best Practices series to understand the M tal Medicaid Reports and their value to your facility in the Medicaid rate setting process The Medicaid Roster Report is generated from a database of records fi Rev that were accepted by CMS and acknowledged on a CMS Final Validation Report Providers should ensure that they evaluate that the data submitted in the following fields A1700 Type of Entry and A0700 Resident Medicaid number is in accordance with the requirements in the RAI manual shown below A1700 Type of Entry Code 1 admission when one of the following occurs 1 Resident is admitted for the first time to this facility OR gt 2 Resident is readmitted after a discharged return not anticipated e 10n S OR 3 Resident is readmitted after a discharge return anticipated when return was not within 30 days of discharge What could MDS stand for other than Minimum Data Set Code 2 reentry every time a resident 1 Is readmitted to this facility and was discharged return M Magic for making it happen anticipated from the facility AND D Determination to make it error free 2 Returned within 30 days of discharge S Stamina to stick with it Hats off to all of the dedicated MDS nurses A0700 Medicaid Number out there working hard to complete 1 Record this number if the resident is a Medicaid rec2. which would impact access to the web portal Who should I notify A An email should be sent to the Myers and Stauffer help desk at mshelpdesk mslc com Q My facility is a newly certified Medicaid provider how do we gain access to the web portal A An email should be sent to the Myers and Stauffer help desk at mshelpdesk mslc com Q I cannot access the web portal at this time how can I enter my assessment information A The input of MDS 3 0 assessment information is not entered through the web portal MDS assessments and tracking forms are ONLY submitted to the QIES ASAP CMS web site The web portal is used to provide the Medicaid Roster Report and enter bed hold information into the system for Medicaid rate setting purposes Q I used to enter Bed Hold Information into the Envision System should I continue to use it for entering Bed Hold Information A Bed hold information for Medicaid rate setting purposes is now exclusively collected from the web portal If providers do not enter the information via this route it will not be captured and their Medicaid rates will not be calculated with this information Mississippi Messenger User Guides Myers and Stauffer have recently updated the following User Guides and recommend each facility print and review these guides These guides are available on line at www mslc com mississippi by clicking on Case Mix and Related Services and selecting Review Resou
3. 2000 02 9 14 03 Bed hold H RAE 02 19 14 0223 14 5 1 000 5 000 NT 9909 0 01 0224 14 02 24 14 A1600 0224 14 NC 01 99 0 99 0302 14 HD2 02 24 14 A1600 0381 14 36 1 690 60 840 Total 50 77 400 The first bed hold period begins on the discharge date 02 14 2014 and continues until the day prior to the same day entry and discharge that was less than 24 hours in the facility 02 18 2014 The second bed hold period begins on the day of discharge 02 19 2014 until the day prior to the entry date 02 23 2014 Note It is important to note that when a resident returns and discharges the same day and is in the facility less than 24 hours that the bed hold periods must be entered twice first reflecting the beginning and end of the bed hold period prior to the second discharge and the second reflecting the bed hold period reflecting the same day entry and discharge and ending on the day prior to the return date Sl Mississippi Messenger Page Six e The Case Mix Review Tip column will be a regular feature in each issue of the alga IVI Mississippi Messenger We welcome your questions for future issues As always please refer all coding regulatory issues to your state RAI Coordinator R gt T gt When coding MDS item O0100M2 Isolation or quarantine for active evy ew D infectious disease remember that this item does not include standard precautions As stated in the RAI User s Manual page O 4 standard precautions include hand hygie
4. 7 b E f ay The Mississippi Messenger is a publication produced under contract with The Mississippi Division of Medicaid by Myers and Stauffer LC 9265 Counselors Row Suite 100 Indianapolis IN 46240 The Mississippi Messenger is published to keep all interested parties current on Mississippi Case Mix Reimbursement It is our goal to provide official information on major issues such as Clarifications changes to the Supportive Documentation Requirements Upcoming Training State RAI Coordinator 601 364 2711 Case Mix and Medicaid CMI Report Questions Myers and Stauffer LC 800 773 8609 Mississippi Messenger M Division of Medicaid M WHISSISSIPPI NVA ESSENGER Current Information on Mississippi Case Mix Reimbursement Introduction Vol 2 Issue 1 March 2015 Myers and Stauffer has now implemented web portal functionality in order to provide reports electronically to to the Medicaid providers in the state of Mississippi Wi P P rial without current login access for their a 2 0 facility will need to discuss their requests M with facility management and send an 1 email request to mshelpdesk mslc com including their name facility name facility Medicaid number and phone number Please note that this is not a secured email and no HIPAA information should be sent to this address User Forms will then be provided for completion The information requ
5. esident returns from the hospital and discharges back to the hospital in less than 24 hours Below demonstrates an example and is included in the P q updated Roster Report User Guide posted recently at www mslc com mississippi com i In this hospital 24 hour bed hold example the resident entered the facility with the following e Entry date A1600 02 10 2014 The subsequent combined Discharge PPS assessment was transmitted with the following e Discharge date A2000 02 14 2014 A0310F 11 Discharge Return Anticipated e Bed hold begin and end dates are as follows 02 14 2014 through 02 18 2014 The subsequent Entry record and Discharge assessment were transmitted with the following e Entry date A1600 02 19 2014 e Discharge date A2000 02 19 214 AO3IOF 11 Discharge Return Anticipated e Bed hold begin and end dates are as follows 02 19 2014 through 02 23 2014 The subsequent Entry record and Admission assessment were transmitted with the following e Entry date A1600 02 24 2014 e Admission assessment ARD A2300 03 02 2014 Hospital 24 Hour Bed Hold Example Begin Final Case Record Tar get RUG Begin Date End Dischar ge Mix CMI T Date Class Date Held Date Date Code Days Index Points NT 9999 0 01 02 10 14 02 10 14 A1600 02 0 14 NPO901 011 OQ AsVJ14 RAE 02 1014 A1600 02 3 14 03 4 1 650 6 600 Bed hold H RAE 02 14 14 02 1 8 14 5 1 000 5 000 NT 9949 0 01 02 9 14 02 19 14 A1600 02 9 14 NDA9 99 0 11 02 9 14 02 19 14 A
6. ipient accurate and timely MDS assessments 2 Enter one number per box beginning in the leftmost box 3 Recheck the number to make sure you have entered the digits correctly 4 Enter a in the leftmost box if the number is pending If you are notified later that the resident does have a Medicaid number just include it on the next assessment 5 If not applicable because the resident is not a Medicaid recipient enter N in the leftmost box Tips and Special Populations e To obtain the Medicaid number check the resident s Medicaid card admission or transfer records or medical record e Confirm thatthe resident s name on the MDS matches the resident s name on the Medicaid card Please also note that for Medicaid reimbursement purposes accuracy of this data in these fields is important Please see pages A 10 11 and A 22 23 and the flowchart in Chapter 2 page 38 of the RAI Manual relating to the completion of these fields These fields are used in the determination of eligible residents and associated payer source that would appear on the Medicaid Roster Report Inaccurate data submitted in these two fields continues to cause issues with the calculation of Medicaid CMIs on the report and the subsequent Medicaid rate Call your state RAI Coordinator for guidance on the completion of these fields SSS a Mississippi Messenger Page Two Medicaid reports such as Rosters are now only available from a secure
7. ired on the form will include a business related email address and a public facing IP address and instructions to identify the public facing Internet Protocol IP address will be provided New forms will be required to document changes to staff email and IP addresses Please note that if incomplete and inaccurate information is provided it will cause delays in processing and lead to delays in providers receiving their information for Medicaid Rate setting The number of users is limited to 2 per facility In order to access this new portal users The web portal contains the current quarters Roster Report and individual reports will be available for 180 days before being archived If other types of information such as newsletters etc are provided they may be archived for a shorter time frame such as 15 days In This Issue Introduction to the Web Portal Medicaid Best TrACUCES oree cet 2 Reflections Web Portal User Account Update Forms Details of the operation of the web portal can be found at www mslc com mississippi by clicking on Case Mix and Related Services selecting Review Resources and clicking on Web Portal the document is titled Mississippi Web Portal User Guide Posted 2 3 15 Web Portal FAQs User Guides Questions related to the web portal should f 24 Hour Hospital Bed Hold Reporting be directed to the Myers and Stauffer Helpdesk at 800 773 8609 Case Mix Review Tip RAT Footer DOCUMEN oserei
8. l 13th 2015 Cut off date for submitting MDS data applicable to the 2 Interim Roster Report April 17th 2015 The 2 Interim Roster Reports are copied to the portal April 20th 2015 Cut off date for submitting MDS data applicable to the 3 Interim Roster Report April 24th 2015 The 3 Interim Roster Reports are copied to the portal April 27th 2015 Cut off date for submitting MDS data applicable to the 4 Interim Roster Report May Ist 2015 The 4 Interim Roster Reports are copied to the portal May Sth 2015 Cut off date for submitting MDS data applicable to the Quarter Final Roster Report May 18th 2015 The Quarter Final Roster Reports are copied to the portal Mississippi Messenger Page Three General Questions Q Where can we find out information relating to the web portal A The Web Portal User Guide can be found at www inslc com mississippi by clicking on Case Mix and Related Services selecting Review Resources and clicking on Web Portal the documentis titled Mississippi Web Portal User Guide Posted 2 3 15 Q Will anything other than the Roster Reports be posted on the web portal A Yes the Mississippi Messenger quarterly newsletters training flyers MDS Review Summary letters and any other necessary correspondence will also be posted on the web portal Web Portal Set Up Form Questions Q I submitted an IP address that was deemed to be invalid by Myers and Stauffer Why was tha
9. ly via email to the following email address mshelpdesk mslc com Please include in your email your Name the facility you are requesting access to the previous facility you had access to Gf appropriate the facility s Medicaid numbers and your phone number A form will be returned to you for completion and will need to be returned via email to the appropriate state specific email address Q What is the time frame to be granted access to the web portal A The processing of forms can take up to 6 business days Q Is there a limit to the number of individuals that can have access to a provider s web portal account A Yes the providers web portal account is limited to 2 individuals and this limitation 1s enforced when changes are requested Q Who makes the determination of what type of staff can access the web portal A Ultimately facility management determines who will be authorized to access the web portal Keep in mind that the web portal contains protected health information PHI so facility staff authorization must be carefully determined Mississippi Messenger Page Four Web Portal FAQs Continued Web Portal Policy Questions Continued Q My facility has undergone a change of ownership name change which would impact access to the web portal Who should I notify A An email should be sent to the Myers and Stauffer help desk at mshelpdesk mslc com Q My facility has lost Medicaid certification
10. nces relating to IP addresses may require additional time to resolve Questions related to the web portal should be directed to the Myers and Stauffer Helpdesk at 800 773 8609 line ime T Q Dy Wa U a If you would ed like to be among yr the first to receive 0 seminar notifications newsletters resources etc please send an email to mshelpdesk mslc com to subscribe to our notification list When sending your message please type subscribe in the subject line In the body of the message please include your full name title phone number and facility company name Stay As always MDS 3 0 coding questions are addressed by your state RAI Coordinator If you have general questions and or comments pertaining to our website that you would like to submit to the Myers and Stauffer Help Desk send us an email at mshelpdesk mslc com Please be sure to provide all of your contact information to ensure a speedy response Remember resident information is considered Protected Health Information PHD Email is not a secure format for transmitting this type of sensitive information Please consult your HIPAA Security Officer for more information Any question that includes specific resident information for example questions relating to the Roster Report must be referred by phone to our Help Desk at 800 773 8609 Transmission amp Posting Dates For the Quarter Ending 3 31 15 e Apri
11. ne compliance glove use and additionally may include masks eye protection and gowns Examples of when the isolation criterion would not apply include urinary tract infections encapsulated pneumonia and wound infections The RAI User s Manual instructs that this item be coded only when the resident requires transmission based precautions and single room isolation because of active infection with highly transmissible or epidemiologically significant pathogens that have been acquired by physical contact or airborne or droplet transmission The following resources are being provided to help the facility interdisciplinary team determine the best method to contain and or prevent the spread of infectious disease based on the type of infection and clinical presentation of the resident related to the specific communicable disease The CDC guidelines also outline isolation precautions and go into detail regarding the different types of Transmission Based Precautions Contact Droplet and Airborne e 2007 Guideline for Isolation Precautions Preventing Transmission of Infectious Agents in Healthcare Settings http www cdc gov hicpac 2007IP 2007isolationPrecautions html e SHEA APIC Guideline Infection Prevention and Control in the Long Term Care Facility http www apic org Resource_ TinyMceFileManager Practice_Guidance id_APIC SHEA_GuidelineforICinLTCFs pdf In order to validate OO1O0M2 for the case mix review the Supportive Documentati
12. on Requirements state Does require e Documentation supporting active infectious disease 1 e symptomatic and or have a positive test and are in the contagious stage RAI Foo ter e Documentation of need for transmission based precautions Document and strict isolation alone in separate room See definition for single room isolation criteria Updated and Posted e Documentation of highly transmissible or epidemiologically significant pathogens acquired by physical contact airborne With the frequent updates and footer page or droplet transmission changes to the RAI manual Myers and Stauffer has created a guide that details every Does NOT include page in the RAI manual and its associated e Standard precautions footer date This guide is available on line e History of infectious disease e Urinary tract infections e Encapsulated pneumonia e Wound infections e Cohorting with roommate at www mslc com mississippi by clicking on Case Mix and Related Services selecting Review Resources and clicking on MDS 3 0 As CMS releases future changes to the manual this footer page guide will be updated Mississippi Messenger Page Seven How Can We Help You The Myers and Stauffer Help Desk is able to assist with many of your questions Below is a table of common issues and the best resource to provide you a quick and accurate response Common Issues Best Resource Telephone Number Case Mi
13. rces Each of these is an excellent reference and or training tool Below is a brief explanation for each guide e Mississippi Web Portal User Guide Y Once initial log in is completed this guide describes how bed hold wes PORTAL user GUIDE periods both hospital and therapeutic shall be reported and what validation steps the portal performs Numerous screen shots are available to help guide the user e RUG IV 48 Group User Guide Vv This user guide provides a step by step explanation of how each RUG classification is determined Associated case mix indices CMIs are also included with each classification e Supportive Documentation Requirements User Guide Draft v These state approved documentation requirements define what supporting documentation is needed in a case mix review All RUG MDS items are listed and include 1 MDS 3 0 item location and item description 2 RUG IV categories impacted 3 minimum documentation and review standards required within the specified observation period and 4 informational help e Case Mix Master Roster Report User Guide v This user guide describes the basic instructions on how the Roster Report displays MDS assessments and tracking forms and bed hold periods Numerous roster examples are included Page Five 24 Hour Hospital Bed Hold Reporting Protocol Effectively immediately the state has authorized the following bed hold reporting protocol for those rare occasions when a r
14. t A The requested IP address is the Public Facing IP address not the provider s internal network address Please note that the invalid IP addresses would include the following ranges e 10 0 0 0 0 10 255 255 255 255 e 172 16 0 0 172 351 295 255 e 192 168 0 0 192 168 255 255 e Any numeric value which exceeds 255 an example would be 150 2 54 258 e Any IP6 address format such as 2001 db8 0 1234 0 567 8 1 See the attached link for more information https support google com websearch answer 1696588 Q Two of my staff share the same public facing IP address Is that OK A Yes Q The form requests an email address which should be provided A The user s provider specific email account that is used for business purposes must be submitted Web Portal FAQs Web Portal Set Up Form Continued Q How do I find the resident_internal_id to enter bed hold information when the number is not shown on our Roster Report A Residents are now identified by the CMS Resident Internal ID also known as Res_ Int_Id This can be found on the CMS Final Validation report when assessments have been transmitted to CMS or the reports available from the Casper Reporting Application More information can be found in the CASPER Reporting User s Guide for MDS Providers at https www qtso com mdstrain html Web Portal Policy Questions Q How are users modified on the web portal A Requests must be made electronical
15. web portal In order to access this new portal users without Web Portal User current login access for their dew i Pos EEEE requests with facility management and send an email request to mshelpdesk mslIc com including their name facility name facility Medicaid number and phone number Please note that this is not a secured email and no HIPAA information should be sent to this address User Forms will then be provided for completion The information required on the form includes a business related email address and a public facing IP address and instructions to identify the public facing Internet Protocol IP address Itis assumed that IP addresses will not change but if this occurs and the facility owns a range of IP addresses these can be documented but will require a technical review with IT staff from both parties in order to determine the best way to provide access to users The users shown on the forms should also be employees of the facility company New forms will be required to document changes to staff email and IP addresses and will be subject to review and information confirmation Please note that if incomplete and inaccurate information is provided it will cause delays in processing and lead to delays in providers receiving their information for Medicaid rate setting The total number of users is limited to 2 per facility The goal to process returned forms is 6 business days although technical circumsta
16. x Interim and Quarter Final Myers and Stauffer Help Desk 800 773 8609 Roster Report mshelpdesk mslc com e Transmission Deadlines Related to Roster Reports e Reports Posted to Web Portal Bed Hold Issues Web Portal User Account Form e RUG IV 48 Group Assessments Classified as BC1 Medicaid Resources Myers and Stauffer Website Myers and Stauffer Seminars www mslc com mississippi e Medicaid Rates Division of Medicaid 601 359 4006 Robert Carter Accountant Auditor III e Casper Reports Lynn Cox RNIV Phone 601 364 2711 e CMS Validation Reports State RAI Coordinator Fax 601 364 5052 e Duplicate Residents Lynn Cox msdh ms gov e MDS Item Coding Training and Education Faye McGilvery Technical Support Phone 601 576 7385 e Assessment Sequencing Faye McGilvery msdh ms gov e Transmission Problems Email is preferred method of contact e Medicare RUG IV e Medicare Stay e Modification Inactivation Policy e QM Reports Case Mix Review Gail Townsend 601 359 5193 RN Nurse Administrator CMS User ID CMS User ID Passwords CMS User ID Passwords QTSO QTSO Help Desk Desk 800 800 339 9313 9313 PPS Billing Questions Your CMS Fiscal Intermediary Contact your business office e CMSNET User ID Passwords CMSNET Helpdesk 888 238 2122 e Connection Problems SSS S Se eae et Mississippi Messenger Page Eight
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