One MDS change in Proposed Final Rule FY14

There are no new OMRAs or other big MDS changes in the FY 14 proposed final rule.  There is a change in how one qualifies for Rehab Medium and Rehab Low (+extensive).  Since the implementation of PPS,  one could qualify for Rehab Medium with 5 treatment days, not 5 calendar days.   One could also qualify for Rehab Low with 3 treatment days, not 3 calendar days.  Example:  One day with OT, PT and ST, and another day with OT and PT is five treatment days.  If the total RTM for those 5 treatment days is at least 150,  the MDS qualified for Rehab Medium.

CMS is proposing to add block O0420 to the MDS on October 1st that will collect distinct calendar days of therapy.   CMS says it was always the intent to require distinct calendar days, but the  grouper and the MDS has never been written in a manner to capture the distinct days.

There is a small rate increase.  For example, the Urban RUC is about seven dollars more.  

They discuss rebasing the rates using FY10 cost reports, and they discuss the on-going project to attempt to determine another way to reimburse therapy in a SNF.