Date: September 15, 2020
To: Long Term Care Facilities – Nursing Facilities Only
Re: Minimum Data Set (MDS) Assessments – Changes Effective October 1, 2020
This notice informs nursing facilities that the Centers for Medicare & Medicaid Services (CMS) has updated the Minimum Data Set 3.0 (MDS 3.0) item sets (version 1.17.2) and related technical data specifications to support the calculation of Patient Driven Payment Model (PDPM) payment codes on OBRA assessments, specifically the OBRA comprehensive (NC) and OBRA quarterly (NQ) assessment item sets.
These new PDPM items will begin being collected for Medicaid providers for nursing facility MDS assessment submissions effective October 1, 2020 and after. This will allow Illinois to compare Resource Utilization Group IV (RUG-IV) payment codes to PDPM ones and thereby inform future payment models. These new items are for informational purposes only and will not impact current reimbursement rates.
Illinois nursing facilities should contact their MDS Software Vendors as soon as possible to ensure that their MDS Vendors are aware of this change and are in the process of making appropriate changes and/or updates to their products.
Questions regarding this notice may be directed to the Bureau of Long Term Care at
Interim Medicaid Administrator