CMS: OMRA Modification

Lisa Volk and Nancy Leveille in Clinical & Quality

The OMRA's from the MDS version 1.14 beginning 10/1/16 have not been populating the SNFQRP data from these types of assessments. Therefore, facilities will need to resubmit these assessments to CMS through the usual QIES portal.

In consultation with some fo our MDS experts, the correct procedure is to re-open (use the modification reason, select other) then simply resubmit these assessments with your next batch. Nothing inside the MDS assessment needs to be changed. But since the MDS was already accepted, the only way to re-send it back is through the modification process. Keep in mind, this ONLY effects the stand-alone SOT, COT, EOT and EOT-R. An OMRA that was combined with a OBRA or PPS type of assessment is fine and does NOT need to be resubmitted.

Facilities should review all MDSs submitted from 10/1/16-11/4/16 to identify those MDSs that fit the criteria of a stand-alone OMRA. Once identified create a system to flag and track those that need to be resubmitted. Penalty for NOT submitting data on SNFQRP has been announced by CMS as a 2% reduction in your 10/1/17 Medicare Part A PPS rates. Therefore, failure to resubmit these MDS assessments could have a significant effect on next year’s PPS rates. 

NYSHFA CONTACT:

Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Nancy Leveille, RN, MS
Sr. Director, Member Operational Support
518-462-4800 x20