AGING AND DISABILITY SERVICES ADMINISTRATION

2008 NH "Dear Administrator" Letters

January 21, 2008

ADSA:  NH # 2008-001
REVISIONS TO RAI USER’S MANUAL

Dear Nursing Facility/Home Administrator:

This letter contains important information for facility staff responsible for completing the Minimum Data Set (MDS) assessments.

The Centers for Medicare and Medicaid Services (CMS) recently announced the release of the twelfth set of updates to the December 2002 revision of the Long Term Care Facility Resident Assessment Instrument User’s Manual Version 2.0.  The changes, which include clarifications of existing policy, are effective January 1, 2008.  Clarifications are provided for the following Chapter 3 Items:

• I2j: Urinary Tract Infection-definition of “Symptomatic”
• I3: Other Current Diagnoses-the window for including newly diagnosed diseases is 90 days for quarterly assessments, this is a change for Washington State as we previously looked only at the last 7 days
• K2a: Height measurement-addresses how to obtain this information for residents without lower extremities
• K3: Weight change-clarifies that this is a comparison of two distinct points in time not what occurred between those time frames.  It also removes a previous sentence directing that a 10% loss/gain within 4 months be coded here.
• L1e: Oral status-removes the word “or” before ‘rashes’ in the description of the conditions for this item
• Section M: Skin Condition-adds the following to several specific items, “Skin does not include eyes or oral mucosa”; clarifies that skin treatments in M5e include any intervention for treating skin problems that have been coded in M1, M2 and/or M4c.

The update document is 24 pages in length and includes the following:

• A two-page revision table identifying the changes
• 9 replacement pages in Chapter 3:  Item-by-item Guide to MDS Coding
• 9 replacement pages for Appendix B: State Agency Contacts
• A one-page replacement for the Title page
• 3 replacement pages for pages immediately following Title page

The revision table and revisions for Chapter 3 are available on the CMS website at

Links to the title page and Appendix B revisions are available on the ADSA Internet NH Professional page at http://www.aasa.dshs.wa.gov/Professional/MDS/Clinical/.

If you have any questions or need further information, please contact Marjorie Ray, RN, Washington State RAI Coordinator, at (360) 725-2487 or e-mail at rayma@dshs.wa.gov

Sincerely,

Joyce Pashley Stockwell, Director
Residential Care Services