The Pennsylvania Department of Health (PA DOH) presented a teleconference on 4/8/21, that briefly reviewed upcoming changes for PA-OBRA Minimum Data Set (MDS) assessments with an Assessment Reference Date (ARD) of 7/1/21, or after. MDS assessment changes are being made to collect data for the Patient-Driven Payment Model (PDPM) to evaluate use for a future state Medicaid payment model. Some key reference points that were presented:
- Any standalone OBRA assessment, excluding OBRA MDS discharge assessments, with an ARD of 7/1/21 or after, will have to have the following additional items completed:
- GG0130 Self Care and GG0170 Mobility (No goals)
- I0020 and I0020B, Primary medical condition and Primary Diagnosis
- J2100 Recent Surgery Requiring Active Skilled Nursing Facility (SNF) care
- If the assessment being completed is a standalone OBRA assessment, Pennsylvania will require the completion of Column 1 only for GG0130 and GG0170 and the assessment lookback period is the ARD and the two previous days.
- I0020 and I0020B should represent the resident’s clinical condition during the observation period and will likely be different than the reason for admission. In other words, this represents the reason that the resident continues to require long-term care.
- J2100 Recent surgery should be checked, “Yes,” only if the resident has had a surgery within a 30-day lookback of the ARD.
- Fatal errors (MDS rejections) following submission will occur if the MDS items required for Section GG are not completed (i.e. left blank/skipped). Dashes in these areas will be accepted although the use of a dash in an MDS item continues to be highly discouraged.
- There will be no changes at this time to the CMI data collection process, payment methodology, or OBRA MDS reviews.
- Though no changes to the case-mix methodology have been made at this time, it is projected that the Nursing component of the PDPM MDS assessments will be used to calculate the state case-mix in the future.
