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Note: The formula has been updated to reflect the CMS Assessment Schedule effective 10/1/2011
There is a mandated schedule for PPS assessments. This schedule is driven by the need to periodically identify resource utilization to set payment accordingly.
Unlike the OBRA-required assessment schedule, the PPS assessment schedule is based on the days of the Medicare stay.
Medicare benefit days are not always the same as the days of stay in the facility. "...it is not the admission date per se that determines the start of the Medicare assessment schedule, but rather, the commencement of Medicare-covered care in the SNF."
(Federal Register/Vol. 64, No. 146/Friday, July 30, 1999/Rules and Regulations, pg. 41659).
The first day of the Medicare Part A coverage for the current stay is considered Day 1 for PPS assessment scheduling purposes.
PPS assessments, which are listed in MDS Item A0310B, are based on the schedule from the RAI Manual (CMS, 2010, p. 2-41 through 2-69), and the guidelines for SNF PPS Assessments from the RAI Manual (CMS, 2010, p. 6-1 through 6-46).
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All MDS items must be signed and dated as completed at Z0500B within 14 days of the ARD. Finally, assessments must be electronically transmitted no later than 14 days after their completion date (Z0500B).
In addition to completing the assessments required under OBRA and PPS, Discharge Assessments and Reentry Tracking Forms must also be completed and submitted as mandated to track any discharges and reentries to the facility after the original admission entry.
The Medicare-required standard assessment schedule includes 5-day, 14-day, 30-day, 60-day, and 90-day scheduled assessments, each with a predetermined time period for setting the ARD for that assessment. (CMS, 2010, p. 2-41)
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Robintek is not new to the MDS/Careplan software market. Company founder, lead developer, and President Gary Jorgenson has been a Registered Nurse in Long Term Care since 1987 and is responsible for several Healthcare software applications. He and his team have developed every version of the Minimum Data Set since its inception.
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