07/02/2002 - Updated completed
July 5, 2002 - error -108 and -29 should no longer occur with
Question: I have been adding AB5a-f to my Quarterly assessments
and when I submitted the file, the quarterly assessments were
rejected with Error -108 and -29 related to AB and AC. Why
is this occurring?
Answer: This is occurring incorrectly. When a facility
submits a record with only AB5a-f in the following record
types ( Rec_types Y, YM, YO, Q, QO, D=06, 07, 08; and R),
the record will be rejected. Per the Data Specs v1.20, this
is acceptable, however, the edit is presently not allowing
it and these records are being rejected. We recommend, until
the fix is completed, that the facility send all of the face
sheet or none of the face sheet items. Do not send just AB5a-f
on these rec_types.
07/01/2002 - Updated completed
July 5, 2002 - error -397 should no longer occur with this situation.
Question: I submitted an Admission/PPS assessment and a discharge
(06) assessment within the first 14 days of the Resident being
admitted to the facility and I am receiving a warning error,
Error -397. The resident had an AB1 date of June 24 and was
discharged on June 29. Should this error occur?
Answer:No, this error should not occur in this situation.
An enhancement to the code will be completed. Until that time
continue to code and submit your assessments, as they are
accepted. You will receive the warning message -397 on your
final validation report.
06/26/2002 - Updated completed
July 5, 2002 - error -306 and -307 should no longer occur with
Question: Our state requires calculation of Medicaid RUG's
and when I submit a Medicare (PPS) only assessment, I am receiving
warning errors related to T3STATE, Error -306 and -307. Is
Answer: No. With the release on June 24, 2002, the MPAF
assessment form replaced the full assessment form as the required
fields for a PPS only assessment (AA8a=00, AA8b=1,2,3,4,5,7,8).
T3STATE is not a required field on the MPAF form. However,
when your state requires calculation of Medicaid RUG's, the
RUG's procedure will calculate T3STATE. Because the PPS only
assessment edits the required MPAF fields only and T3STATE
is not required on this assessment, the RUG's calculation
views T3STATE as blank and gives the error messages of -306
and -307. This will be corrected as soon as possible. You
can continue to submit, as this is a warning message only
and the record will be accepted. Medicaid RUG's(T3STATE) are
not required for PPS only assessments.
Question: I received fatal file message -29 for Medicare
number (AA5b). The resident doesn't have a medicare number
so I entered a C as I have in the past. Why is it getting
Answer: The edits for AA5b were tightened in the Spring
2001 Release. C alone is not a valid character for AA5b. Valid
Medicare numbers and a C entered as the beginning character
with a railroad number following the C will be accepted, twelve
blanks or twelve dashes are also valid values.
Question: I submitted an annual assessment that was within
366 days of the last annual assessment. On the Final Validation
Report, I received message number -70, "Assessment completed
late: The submitted R2b date was greater than 92 days after
the R2b date submitted previously. The report indicated that
R2b was the field in error. I thought timing for 92 days from
R2b date was for quarterly assessments. Why did I receive
this message on an annual assessment?
Answer: An annual assessment must meet two timing requirements.
Date R2b must be within 92 days from the prior assessment
and the VB2 must be within 366 days from the last full assessment
MDS record timing data specifications state, "A standard
MDS assessment (comprehensive or quarterly) is due every quarter
unless the resident is no longer in the facility." Every record
coded AA8a = 01, 02, 03, 04, 05, or 10 is expected to be followed
by a record coded AA8a = 01, 02, 03, 04, 05, or 10 within
92 days if the resident is still in the facility at that time.
Date R2b from the previous assessment is expected to be within
92 days of date R2b from the subsequent assessment.
MDS record timing data specifications also state, "A full
assessment with RAPs is due every year unless the resident
is no longer in the facility." Every full assessment with
RAPs (AA8a = 01, 02, or 04) is expected to be followed by
another full assessment with RAPs (AA8a = 01, 02, or 04) if
the resident is still in the facility at that time. Date VB2
from the previous full assessment with RAPs is expected to
be within 366 days of date VB2 from the subsequent full assessment
Question: I submitted an assessment with the assessment reference
date (A3a) less than 7 days after Admission. The instructions
for O4 are: "Record the number of days that the resident received
each type of medication listed in the past 7 days." I do not
know the medications this resident received during the days
prior to admission, so I entered the 'unknown' (-) response
in O4a, O4b, and O4c. My software calculated RAP 17 (Psychotropic
Drug) as 'unknown' (-), but the State System rejected the
record and indicated the calculation should have been zero
(not triggered). I am sure the 'unknown' (-) response is correct.
Is there a problem with the State System calculation of RAP
Answer: A problem has been discovered with calculation
of the RAP trigger for the Psychotropic Drug RAP (RAP17).
In some very unusual cases, the standard MDS system at the
State will incorrectly determine RAP17 as not triggered (value
'0') when the correct value actually should be "unable to
determine" (value '-'). When this problem occurs, an MDS assessment
with a correct RAP 17 value of '-' will be rejected.
Analysis has indicated that this is an exceedingly rare
problem limited to RAP17. There is a reasonable work-around
when the problem occurs. The problem will be fixed in the
standard system with the next scheduled update in April 2001.
Further details concerning the nature of the problem, frequency
of occurrence, and recommended work-around are presented below.
Nature of the Problem: This RAP 17 problem will only occur
when the responses on the MDS assessment meet all of the following
- There is an "unable to determine" response on one or more
of 3 MDS psychotropic medication items (O4a, O4b, and O4c).
O4a addresses antipsychotic medication; O4b, antianxiety
medication; and O4c, antidepressant medication. The response
for each of these items is the number of days (of the last
7 days) that the medication was given.
- None of these 3 psychotropic medication items (O4a, O4b,
and O4c) is recorded as having been received for 1 or more
- A zero value ('0') does not occur for all of the possible
side-effect items addressed in RAP17 (E1n, G3b, I1i, J1f,
J1m, J1n, J4a, J4b, J4c, K1b, B5a through B5f, B6, C7, E3,
E5, I1ee, J1i, H2b, H2d, and J1k).
Only when all 3 of the above conditions are met will the
RAP17 problem occur. When these 3 conditions all occur, then
the RAP value should be "unable to determine" (value '-'),
but the MDS system determines that the RAP is "not triggered"
Frequency of Occurrence: This problem will be exceedingly
rare. The problem was first reported in October 2000. It is
easy to understand why the problem must be rare, since it
will only occur when the assessor is completing a comprehensive
assessment including RAPs but does not know whether psychotropic
medications were given to the resident in the last 7 days.
This should only happen on comprehensive assessments soon
after admission or reentry (within 7 days of admission or
reentry to the facility), when there is no documentation available
concerning whether psychotropic medications were received
immediately prior to admission or reentry.
Work-Around: If a facility has an MDS assessment rejected
because of this problem, then the following work-around is
- Reassess each of the 3 psychotropic medication items (O4a,
O4b, and O4c) that had a response of "unable to determine"
(value '-') but limit consideration to those days that the
person actually resided in the facility. If the resident
is a new admission, then only consider the days since admission.
If the resident is reentering after a prior discharge, then
only consider those days in the 7 day assessment reference
window that the resident was actually in the facility. Limiting
consideration to days in the facility will allow assessment
based upon the clinical record in the facility and should
eliminate any "unable to determine" responses.
- Record the revised items on the MDS form documenting that
consideration was limited to days actually in the facility.
- Revise the RAP17 trigger based on the revised responses
to O4a, O4b, and O4c.
- Submit the revised assessment record to the State.
This work-around is only permitted in the rare cases described
in this document, and only until the problem is corrected
in the standard MDS system.
Question: I submitted a Medicare assessment and left T1aA
and T1aB blank. The 1.10 data specifications list 'sp' as
a valid value. Why is the record rejecting with error -29,
Invalid data value?
Answer: With the 1.10 data specifications, 'sp' (space)
became a valid response for those fields, but the State edits
were not changed. A 'sp' response in T1aA and/or T1aB on Medicare
(AA8b = 1, 2, 3, 4, 5, 7 ,8) assessments currently results
in a -29 fatal record message, 'Invalid data value'. After
contacting HCFA for clarification, a space will be valid and
edits in the State systems will be changed to allow this.
Until that change, facilities can enter zero '0' in those
fields for Medicare assessments when the resident had not
received recreational therapy.
CMS Memo Regarding Resident Level Report
Download the CMS
Question: How does this affect the newspaper ads?
Answer: The revised measures will be in the newspaper ads.
However, no new facilities have been added to the ads. So,
those facilities that were told during the preview that they
would not appear in the ads will still be suppressed.
Accessing NHQI Reports
Question: I want to review the NHQI reports that are posted
October 14 - 22. How do I access those?
Answer: The NHQI reports are accessed by connecting to
your state server as if you were going to submit a file of
MDS assessments. Select the "Casper Reports (Online Reports)"
link. You do not need the plug-in.
Select "Connect to MDS Online Reports". When you
are prompted for a User ID and Password, they are the same
as the ones used to submit MDS assessments. Once these are
entered correctly, you will be able to view the reports.
Question: I can't change the "as of date" when requesting
a QI report using custom settings and I previously had been
able to. Why?
Answer: With the May 22, 2000 release, this date is now
defaulted to the day prior to the day you are requesting a
QI report to be created. The ability to change this "as of
date" has been removed. This is because of the implementation
of the Correction Policy.
Question: Why are the numerators and denominators in my Facility
Quality Indicator Profile Report all zeros (0)?
Answer: The Quality Indicator Reports provides the facility
status for each of the MDS-based QI's as compared to a peer
group of the facilities in the State.
The numerator is the number of residents in the facility who
have the QI condition.
The denominator is the number of residents in the facility
who could have the condition.
Prevalence indicator QI's are based on the status of a resident
at a point in time (the most current assessment).
Incidence indicator QI's are based on the change in status
of a resident over a period of time (from the previous assessment
to the most current assessment).
When a facility specializes in short-term stays, most of the
assessments that the facility submits are admission assessments.
Admission assessments reflect the status of a resident on
admission, therefore QI's are not reported for an admission
assessment. However, if another assessment is submitted for
the resident (i.e., Quarterly), the assessment will now be
used in calculating the Quality Indicators.
Question: I have discharged residents listed on the QI Resident
Level Summary Report. Is this a mistake in the calculations?
Answer: No, this is not a mistake. A Resident Level Summary
Report is not a roster report. You will notice that some of
the residents you have discharged will be listed on the Resident
Level Summary. This is not an error. If a resident
has had an assessment during the time frame selected for the
QI report, they will be calculated into the QI's, even if
there is a discharge in the system. For example, on 7/5/1999,
QI reports are requested with the time frame selected 1/1/1999
- 6/30/1999. A specific resident has an assessment (coded
AA8a = 01, 02, 03, 04, 05, or 10) with a target date of 2/3/1999
and then is discharged on 3/20/1999. That resident will appear
on the QI Resident Level Summary with the target date of 2/3/1999.
To the far right under the colmn heading "Discharged in Report
Period", there will be a check mark indicating the resident
has been discharged.
Question: If my Adobe report screen does not have a print
icon, how do I print out the report?
Answer: Select File -> Print from the Adobe Reader menu.
It is recommended that Adobe Acrobat Version 3.02 or higher