CMS publishes the updates to the RAI Manual

This week CMS published the updates to the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) manual for skilled nursing facilities (SNFs). These updates will be effective October 1st, 2012. The manual contains both the updated version files (new for 2012) and earlier version (no change) files.
Change-table files are included only for sections of the manual that have changes that will be effective October 1. Sections that have been updated include: Title Page, Table of Contents, Chapter 1, Chapter 2, Chapter 3 (Introduction, Sections: C, H, I, K, M, N, and O), Chapter 4, Chapter 6, and Appendices (A, B, C, and E). Each manual page reflects the effective date of the content. Access the zip file through the following link:
RAI Manual 2012 Updates

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2 Responses to CMS publishes the updates to the RAI Manual

  1. Lashauh Kness says:

    I have a question with the new 3 day rule and the use of rehab low, if I schedule patient tue, wed, thur and they are on restorative of course, is the 3 day of no skilled therapy cause for discharge?

    • Pauline says:

      It would trigger an EOT OMRA but not necessarily discharge. So in saying that, let me qualify that statement and pose you a question.
      The new SNF regulations that are coming into effect Oct 1st require that an EOT OMRA must be done when a patient misses 3 consecutive days of therapy for any reason, this is referred to as a discontinuation of therapy not a discharge, as the patient is still expected to continue with therapy services. If the therapy resumes at the same level within 5 consecutive days from the last therapy visit, then it becomes an EOT-R OMRA. The facility would be paid at the clinical RUG for the days between the therapy treatment days.
      Now my question to you is, what is the clinical reasoning behind this schedule and, if the patient only needs 3 days of therapy then a 4 day break, why cannot this be done under Part B as the “conditions of coverage for SNF” are really not being met.

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