MDH communicates important MDS information on OSA & Section S requirements

By Todd Bergstrom  |  October 6, 2023  |  SNF/NF providers

With the October 1, 2023, changes to the Minimum Data Set (MDS), including the adoption of the Optional State Assessment (OSA), the Minnesota Department of Health (MDH) recently communicated important information to for long term care facility administrators, directors of nursing, MDS coordinators, and staff who work with the MDS.

According to the MDH communication on Section S and OSA requirements:

Section S
 Section S is a new section containing three new data elements, S6060A, S6060B, and S6060C. These data elements identify whether strict isolation services were provided during the observation period. The isolation coding criteria has not changed; only strict isolation is coded on the MDS.
  • S6060A–Strict Isolation. Has the resident been in strict isolation since admission, reentry, or the prior OBRA/OSA assessment, whichever is more recent? The response is simply, Yes or No.
  • S6060B–Start Date of Strict Isolation. If the response to S6060A is Yes, enter the start date of strict isolation in this data element and proceed to S6060C.
  • S6060C–End Date of Strict Isolation. Enter the last day of strict isolation since admission, reentry, or the prior OBRA/OSA assessment, whichever is more recent. If strict isolation was ongoing after the ARD of the assessment, enter dashes.

Submission of the MDS 3.0 Optional State Assessment in Minnesota
 The use of the Optional State Assessment (OSA) enables the Minnesota Departments of Health and Human Services to establish case mix classifications for reimbursement of nursing facility care, effective October 1, 2023. These requirements are in addition to the requirements set forth in the Resident Assessment Instrument (RAI) Manual.

Requirements
Nursing facilities must submit an OSA for State Medicaid Billing beginning on October 1.
The OSA is required:
  • Each time an OBRA Admission, Annual, Significant Change in Status (SCSA), Significant Correction to Prior Comprehensive (SCPA), Quarterly, and Significant Correction to Prior Quarterly (SCQA) assessment is completed.
  • The ARD of the OBRA assessment and OSA must match.
  • The assessments must be submitted in the same batch.
  • When all therapy services have ended.
  • When isolation services have ended.

Submit the OSA with these fields:
  • A0300A must = 1 indicating the assessment is for state payment purposes only.
  • A0300B must = 2 when all therapy services have ended, if the previous OBRA assessment resulted in a rehabilitation classification. The ARD of the assessment must be set on day 8 after all therapy services have ended. This will generate a new classification notice.
  • A0300B must = 2 when all isolation services have ended if isolation was coded on the previous OBRA assessment. The ARD of the assessment must be on day 15 after isolation services have ended. This will generate a new classification notice.
  • A0300B must = 5 for an Admission, Annual, Significant Change in Status (SCSA), Significant Correction to Prior Comprehensive, Quarterly, and Significant Correction to Prior Quarterly.

Classification effective dates
 The classification effective dates are:
  • Admission date for an OSA with a corresponding Admission assessment,
  • Assessment Reference Date (ARD) for an OSA with a corresponding SCSA,
  • Assessment Reference Date for an OSA completed due to the End of Therapy (EOT) or End of Isolation (EOI), or
  • The first day of the month following the ARD for all other corresponding OBRA assessment types.

When a resident is Discharge Return Anticipated (DRA) and returns to the facility within 30 days of their discharge date the previous classification will resume unless a new assessment is completed.

Classification notices
 The OSA is submitted to CMS the same way all OBRA required assessments are submitted to CMS. Multiple classification notices may be generated during a billing period depending on the number of OSAs submitted. It is the facility's responsibility to provide the resident with the notice that contains the classification that will be used for payment purposes.

For more information, please visit the “Minnesota Case Mix Review Program” page on the MDH website.

Please contact Todd Bergstrom at the Association office if you have any questions. 


Todd Bergstrom
Todd Bergstrom  |  Director of Research and Data Analysis  |   tbergstrom@careproviders.org  |  952-851-2486