Stay up to date on the Patient Driven Payment Model and standardized protocols in the MDS 3.0 RAI
This course is only available as a “CPE Additional Certificate”. There is no hard copy book – the link to the CMS Minimum Data Set (MDS) 3.0 RAI Manual is included in the course document.
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This course is based on The Centers for Medicare and Medicaid Services’ (CMS) Minimum Data Set (MDS) 3.0 Resident Assessment Instruments (RAI) Manual (v1.17 October 1, 2019 revision) which is a document used for implementing standardized assessment for facility care management in nursing homes and non-critical access hospital swing beds. The purpose of the manual is to offer clear guidance about how to use the RAI correctly and effectively for providing appropriate care, which in term will be used in creating and individualized care plan. It also assists in tracking changes in the resident’s status, evaluating goals, and revising their care plan.
The RAI provides assessments for each long-term care facility resident in functional capabilities and helps staff to identify health problems. The assessment is performed on every resident in a Medicare and/or Medicaid-certified long-term care facility. The MDS 3.0 tool includes residents in the assessment process and focuses on standardized protocols. The care plan is a resident’s path toward maintaining or achieving their highest level of well-being. The RAI manual is composed of three areas: The Minimum Data Set (MDS) Version, the Care Area Assessment (CAA) process and the RAI Utilization Guidelines.
The MDS Assessment data is used to calculate the resident’s Patient Drive Payment Model (PDPM) classification for payment. The PDPM case-mix adjusted groups is determined using extensive information on the resident’s therapy and nursing needs including ADL status, cognitive status, behavioral problems and medical diagnoses. Coding Section K accurately will affect the PDPM score including parenteral IV feeding and fluids and tube feedings. This is covered under the PDPM non-therapy ancillary (NTA) services category. Malnutrition also is captured using this system under NTA comorbidity score calculation.