The Semi-Annual Preliminary RUG Reports Are Coming Soon

The Semi-Annual Preliminary RUG Reports Are Coming Soon

The 2022 1st Semi-Annual Preliminary RUG report will be generated during the week of 04/11/2022. It will include all MDS assessments from 10/01/2021 to 03/31/2022 that have been transmitted to CMS/QIES by 04/08/2022. This report will be emailed to the address identified to us as authorized by your facility around 04/11/2022.

The 1st Semi-Annual Preliminary report is run so you can carefully review and make corrections needed to all assessments for 2022 1st Semi-Annual Case Mix calculations. The 2022 1st Semi-Annual Preliminary report will help you predict future reimbursement rates. It includes all the same assessments and timelines used in May’s 1st Semi-Annual Report, which sets the Nursing Home rates as of July 2022.

Please transmit modifications or corrections by end of business day on Friday, April 8, 2022.  We anticipate that these changes will then be available for inclusion, leading to more accurate information for you to use.

Items that need your attention and action when reviewing previous RUG Reports:

  • Excluded Residents:  On the last page of the report is a section titled “Residents Excluded”. Reasons residents may be on the excluded list include:
    • There are two Entries in a row without an intervening Discharge, or
    • Two Discharges in a row without an intervening Entry, or
    • If the A1600 Entry Date field on a later assessment does not match the most recent Entry Tracker record the system cannot compute an accurate Stay Period.
  • Invalid Medicaid ID (A0700) Entries in MDS
    • This report lists assessments that do not have a valid Medicaid ID number in the A0700 field.
    • If the resident applied for Medicaid by the assessment reference date, and you do not have an acceptance or denial of eligibility, then modify the assessment with a “+” in the leftmost box of A0700 field. 
    • If a resident was not Medicaid or Medicaid pending, you do not have to make a correction, just enter “N” in the A0700 field on the next assessment. 

If a resident has a Medicaid number, but the number was not entered in A0700 field, then send in a modification with the correct Medicaid number in the A0700 field. (This number is found on the bottom right of the award letter or on the ProviderOne Services Card). They are not the same number, but either number will prevent the default.

If you have questions, please contact the MDSHelpdesk@dshs.wa.gov

 

 

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March 30, 2022