Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD) and Supporting Regulations
Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD) and Supporting Regulations
This PRA package proposes to add Prospective Payment System (PPS)-related Item O0420 to the Minimum Data Set (MDS) 3.0 form to capture the number of distinct calendar days a SNF resident has received therapy in a seven-day look-back period. The new PPS-Item (O0420) would be added to allow the Resource Utilization Group (RUG)-IV grouper software to accurately calculate the number of distinct calendar therapy days a SNF resident has received in order to place him or her into the correct RUG-IV payment group.
We are requesting revision of resident assessment information that SNFs are required to submit as described at 42 CFR 413.343 and 483.20 in the manner necessary to administer the payment rate methodology described in 42 CFR 413.337.
US Code:
42 USC 1395yy(e)
Name of Law: Payment to Skilled Nursing Facilities for Routine Costs
PL:
Pub.L. 105 - 33 4432(a)
Name of Law: Prospective Payment for Skilled Nursing Facilities
While we are proposing to add Item O0420 to the MDS 3.0 form, we do not believe this action will cause any measurable adjustments to our burden estimates.
As required under Section 1888(e)(7) of the Act, skilled nursing facilities must be reimbursed under the SNF PPS. We have updated the MDS burden estimates on skilled nursing facilities by making this revision to include the PPS Item Set (NP), The Start of Therapy (NS), the COT/EOT OMRA combined with Discharge (NOD), and the Start of Therapy combined with Discharge (NSD) under the OMB Control Number that was approved for the COT/EOT OMRA (NO/SO) in FY2011. The hourly burden estimate for each assessment has not changed. However, because the rest of the PPS Item Sets are used more frequently than the COT/EOT OMRA item set (NO/SO), we have updated the burden and cost estimates to account for the frequency with which the rest of the assessment Item Sets are completed . Furthermore, the original frequency estimates utilized to calculate burden for the COT OMRA were estimated since the COT OMRA had not been in effect at the time of the burden calculation. We have used FY2012 data to calculate the actual frequency and numbers of assessments completed. Although the total number of items between the various item sets used for PPS assessments, which are listed above, may vary, the NO/NS item set contains the maximum number of payment related items. The NP and NOD item sets include the same number of payment items as the NO/NS item set and the NS and NSD item sets include fewer items since the assessment determines payment for a smaller subset of payment groups. Additionally, the non-payment items used for quality and care planning purposes vary between item sets. Quality or care planning items are exempt from PRA consideration pursuant to sections 4204(b) and 4214(d) of OBRA 1987 and therefore the hourly burden estimate for all of the PPS item sets are the same and only the frequency at which they are required for completion varies.
Any burden estimate changes from FY 2011 and now reflect the frequency with which the assessments are completed. This includes all of the updated wage and SNF demographic data.
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Form CMS-R-250 MDS 3.0 PPS Item Sets Preparation, Encoding, and Transmission Time
Crosswalk for Change to MDS 3_PRA_FY2014.docx
MDS 3.0 PPS Item Sets Preparation, Encoding, and Transmission Time