IL MDS 3.0 Section S October 2016 Changes: What You Need to Know

On October 1, 2016, the new changes to Section S of the MDS (Minimum Data Set) for the State of Illinois will go into effect. These updates are significant changes and, unlike the prior Section S, this new item set will require corroboration between social services and the clinical team. If you haven’t already, now is the time to establish a process to accurately fulfill this requirement: compliance in this area will eventually be reported, enforced, and impact Medicaid reimbursement.

Section S is a State defined Section of the MDS 3.0 and is required for each MDS submitted to the national repository and ultimately the Illinois Department of Healthcare and Family Services (HFS).

The following Items have been added to Section S:

1. Resident has a disease process or condition that has been reported to the appropriate local/state health department since the last assessment.
2. Resident has an active diagnosis of Traumatic Brain Injury (TBI) and meets the care and service requirements and is eligible for the TBI add-on.
3. Resident received therapy services during the 7 day look back and these services were billed to Medicare Part A, Medicare Part B, Managed Care Entity, Medicaid, Other, (private pay, private insurance, etc.), or None of the above.
4. Resident has an active diagnosis of chronic obstructive pulmonary disease (COPD) and received one or more of the following during the 7 day look back: Oxygen, Inhaler/Nebulizer, Acute monitoring of respiratory status, Medications for treatment of COPD or related respiratory symptoms, Other (i.e. hospital/ER visit related to COPD symptoms, CXR, or other medical interventions, or None of the above.
5. Residents requires isolation procedures and was assigned a private room and did not leave the room except for medical treatments/procedures: If yes is answered there must be a start and end date.
6. Is the resident currently receiving an antipsychotic medication?
• Has an attempt been made to reduce the total amount of antipsychotic medication the resident receives since the Assessment Reference Date (ARD) of the last OBRA assessment or if this is an admission assessment, since the entry date (A1600).
• Was the reduction in the total amount of antipsychotic medication that the resident received maintained?

You may view the revised Section S Form and State-Defined Section S Reference Manual on the HFS Long Term Services and Supports (LTSS) webpage.

It is critical that whomever is completing this section on the MDS, understand how the active disease and services are defined.

Marcum healthcare professionals have extensive experience with MDS and can provide on-site audits, staff training and education of the MDS to help your facility ensure compliance and accuracy with this new item set.