AGING AND DISABILITY SERVICES ADMINISTRATION
2005 NH "Dear Administrator " Letters
March 31, 2005
ADSA NH #2005-008
Resident Assessments and Item AA7 Medicaid Number
Dear Nursing Facility/Home Administrator:
This is to follow up on the “Dear Administrator” letter NH #2004-037 dated December 30, 2004 entitled, Resident Assessments and Medicaid Resident DaysADSA. The following is the link to that letter on the ADSA Internet site:
http://www.aasa.dshs.wa.gov/professional/letters/nh/2004/04-037.htm
The purpose of this letter is to emphasize again that when completing Section AA identification information Item AA7 on a resident’s assessment, you should enter correctly the recipient’s Medicaid Number.
Effective with the Third Quarter 2005 Facility RUG reports that cover the assessment dates of July 1, 2005 to September 30 2005, ADSA has established for section AA7 an edit that will result in the resident being classified as “other” when an invalid Medicaid number is entered in section AA7 (e.g., any entry with all zeros, alphabetical characters with numbers, or any numbers that are too long or too short). When a resident is classified as “other”, the resident’s days will not be counted as Medicaid for use in computing the Medicaid Case Mix Index.
Action Requested:
To ensure that all of your Medicaid residents are used in calculating your quarterly Medicaid Case Mix Index, please take the following actions:
- Effective immediately, please verify the AA7 field before you submit any MDS assessments and correct all invalid Washington State Medicaid Client ID numbers. This number is found in the footer of the resident’s Medicaid award letter.
- In July 2005, please review the Second Quarter 2005 Preliminary RUG Report. Re-evaluate all residents designated as “Other” to make sure that they are not Medicaid recipients. If any Medicaid recipients show up as ‘Other’, please look at the AA7 field on the most recent assessment.
When it is an OBRA assessment, make sure that the A7A field (Medicaid per diem) has a checkmark. Submit a MDS modification with the correct Medicaid number in AA7 before August 2, 2005, which is the final RUG Report cut-off date for the Second Quarter 2005 RUG Report. - In October 2005, please review the Third Quarter 2005 Preliminary RUG Report. Re-evaluate all residents designated as “Other” to make sure that they are not Medicaid recipients. If any Medicaid recipients show up as ‘Other’, please look at the AA7 field on the most recent assessment.
When it is an OBRA assessment, make sure that the A7A field (Medicaid per diem) has a checkmark. Submit a MDS modification with the correct Medicaid number in AA7 before November 2, 2005, which is the final RUG Report cut-off date for the Third Quarter 2005 RUG Report.
Note on Timing: Second quarter runs from 4/1/05 to 6/30/05 and the Preliminary RUG Report will be mailed on July 18, 2005. Third quarter runs from 7/1/05 to 9/30/05 and the Preliminary RUG Report will be mailed on October 17, 2005.
See the enclosure for some examples on correctly completing the AA7 field.
Other Information and Contacts:
- If your MDS software vendor is interested in adding front-end edits to the AA7 field for Washington State nursing homes, please refer them to the newly revised Washington State vendor link: http://www.aasa.dshs.wa.gov/Professional/MDS/Automation/vendor.htm. The federal MDS data specifications are at: http://www.cms.hhs.gov/medicaid/mds20/mdssoftw.asp
- If you have problems determining what a valid/invalid Medicaid No. is or how to find the number on a DSHS award letter, please feel free to contact Shirley Stirling, MDS Automation Coordinator at (360) 725-2620 or e-mail at STIRLSA@dshs.wa.gov for assistance.
- If you have questions regarding rate implications, please contact Ken Callaghan, Manager, Nursing Home Rates Section at (360) 725-2469 or e-mail at callakd@dshs.wa.gov.
Sincerely,
Tom Kearns, Chief
Office of Rates Management
Aging and Disability Services Administration
