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Calculation of RAP 17
Error -108 and 29
Error -306 & 307
Error -397
Fatal File Message-29
Medicare Assessment
Message - 70
Resident Level Quality Indicator Summary


Accessing NHQI Reports
CMS Memo Regarding Resident Level Report
Newspaper ads


As of Date
Discharged Residents on Summary Report
No Print Icon
Zeros on Quality Indicator Reports

MDS Frequently Asked Questions

07/02/2002 - Updated completed July 5, 2002 - error -108 and -29 should no longer occur with this situation.

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 this situation.

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 this correct?

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 rejected?

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 with RAPs.

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 with RAPs.


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 17?

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 3 conditions:

  1. 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.
  2. None of these 3 psychotropic medication items (O4a, O4b, and O4c) is recorded as having been received for 1 or more days.
  3. 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" (value '0').

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 recommended:

  1. 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.
  2. Record the revised items on the MDS form documenting that consideration was limited to days actually in the facility.
  3. Revise the RAP17 trigger based on the revised responses to O4a, O4b, and O4c.
  4. 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 Memo


Newspaper Ads

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.

QI Frequently Asked Questions


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 be utilized.





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