DAL 08-04: Revisions to Section S Supplement-MDS 2.0

April 4, 2008

DRS/DAL # 08-04
Revisions to Section S. Supplement-MDS 2.0
(New York State 2008)

Dear Administrator:

This letter is to provide you with advance notice that a change is being made to Section S of the Minimum Data Set (MDS). The Centers for Medicare and Medicaid Services (CMS) allows each state to collect information of specific interest in Section S. New York State has requested that three new items of information be added to Section S that identify residents eligible for specialty unit/facility Medicaid rate reimbursement, identify residents eligible for enhanced Medicaid rate reimbursement add-ons for specific conditions, and identify the primary payor.

This information is required to be available from MDS assessments effective October 1, 2008 for Medicaid reimbursement purposes beginning in 2009. Pursuant to statute, during 2009 a new case mix reimbursement system for residential health care facilities will be implemented. Medicaid rates will be subject to case mix adjustments through application of the relative resource utilization groups system of patient classification (RUG-III) employed by the Federal Government for payments to skilled nursing facilities pursuant to Title XVIII of the Federal Social Security Act (Medicare). The reimbursement system will employ the MDS 2.0 or subsequent revisions as approved by the CMS. The reimbursement system will also employ the 53 Group RUG-III Classification System model version 5.20. The Department will provide additional information on the transition to the MDS for Medicaid reimbursement purposes in a Dear Administrator Letter anticipated to be sent by October 2008.

Nursing homes should inform their software vendors that Section S will need to be reprogrammed to include the additional three items by October 1, 2008. The revised form, instructions, and file specifications are accessible under MDS at the public site: www.nyhealth.gov/forms/

Nursing Homes MAY begin to submit the altered Section S on or after August 1, 2008, and MUST submit the revised Section S for all assessments with item A3 (Assessment Reference Date) on or after October 1, 2008. Once the receiving software is reprogrammed, a non-fatal warning notice will be issued on the final validation report for all assessments which do not include the additional items.

For those nursing homes using CMS Resident Assessment Validation and Entry (RAVEN) software, the revised program will be posted on the NYS MDS Submission site when it becomes available.

Any questions regarding the requirements or specifications should be directed to Kathleen Minucci, R.N., MDS RAI Coordinator, or Patricia S. Amador MDS Automation Coordinator via the MDS Help Desk at Voice: (518) 408-1658 or Fax: (518) 408-1636 or Email: mds2@health.state.ny.us.

Sincerely,

Jacqueline Pappalardi
Director of Residential Services
Office of Long Term Care

cc: NH Associations

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