2014-2 MDS Clarification of New CMS Item

Karen Morris in Clinical & Quality

In October 2013 CMS instituted a new item to help clarify the classification criteria for rehabilitation RUGs categories which adds Item O0420, Distinct Days of Therapy, to count the calendar days of therapy needed to be classified into the Low and Medium rehab RUG categories.
The former system added together the days of therapy to determine the number of days a resident received to qualify for the Medium or Low Rehab categories.  Adding together the days of therapy was not the original intent to score residents.  Therefore in October 2013 CMS clarified the Medium and Low rehab therapies to include the use of new item O0420 to count the distinct days of therapy.
It is the Department’s policy to apply all CMS rule changes, item updates and rule interpretations and the Department has therefore applied item O0420 (Distinct Days of Therapy) to the scoring process.  This change to the scoring was included beginning January 2014 collection and will remain in effect for future collection cycles.
Questions regarding the MDS and scoring for reimbursement may be sent to PRIMail@health.ny.gov

Karen Morris

Director, Clinical & Quality Services
518-462-4800, ext. 15