Texas NFs Must Not Submit MDS Optional State Assessment — Clarification

Texas nursing facilities (NFs) must not transmit Minimum Data Set (MDS) Optional State Assessments (OSAs) to the Centers for Medicare and Medicaid Services (CMS) Internet Quality Improvement and Evaluation System (iQIES).

Texas HHSC previously informed Texas NFs that use of OSA was optional and could be voluntarily transmitted to the CMS iQIES system. This was based on technical information Texas HHSC received from the iQIES Service Center. We have received additional clarification from CMS that Texas NFs must not submit the OSA because Texas does not use the OSA to calculate the Resource Utilization Group (RUG).

CMS’ only intent with the OSA was to provide state Medicaid agencies the ability to obtain a RUG calculation when they have no other means to do so. The OSA was not intended for other uses. Texas providers may use the OSA in their vendor software or electronic health records for their own purposes, however, they must not transmit those assessments to CMS.

Texas Medicaid has implemented data entry on the RUG section of the Long-term Care Medicaid Information (LTCMI) to collect any RUG III required items CMS removed from MDS Omnibus Budget Reconciliation Act (OBRA) assessments with reference dates on and after Oct. 1. The Long-term Care Online Portal will then calculate the RUG code used for Medicaid reimbursement.

Email LTCR Policy with questions about this alert.