Effective Nov. 1, nursing facility providers must complete section GG and related fields when they submit an Omnibus Reconciliation Act assessment.
On Nov 1., each provider or vendor will have to set the STATE_PDPM_OBRA_CD value to “1 (Yes, perform PDPM calculations for OBRAs)” in their Minimum Data Set software.
Once this feature is activated, data entered in the applicable MDS fields should not affect OBRA required assessments of resident well-being and will not affect the calculation of the MDS Resource Utilization Group III code used by Texas Medicaid for payment purposes.
The additional data contained in the applicable MDS fields is vital to compare current RUG III data with Patient Driven Payment Model Data in order to develop future Medicaid payment methodologies. These may include a PDPM type model adapted for use in Texas long-term care.
This advanced notice is intended to allow facilities time to develop their processes, ensure staff are appropriately trained and allow time to work with any software venders as needed.
HHSC will issue a provider letter in the future with more guidance.
Contact your specific MDS software vendor for support.