Significant change in status assessment required when therapy (and isolation) ends 2021, 1st Special Session HF33/SF37 Chapter 7, Article 13, Section 1 HHS omnibus bill Effective: August 1, 2021, and applies to all assessments with an assessment reference date of August 1, 2021, or later (Note bill language uses July 1, 2021, but the state agencies determined that a July 1, 2021 implementation was not possible) Short description Effective for all MDS’ with therapy and isolation end dates on or after August 1, 2021, a significant change in status assessment (SCSA) is required when all speech, occupational, and physical therapies have ended. The assessment reference date (ARD) of this assessment must be set on day eight after all therapy services have ended. The last day therapy was provided is considered day 0 when determining the ARD of the SCSA. A significant change in status assessment (SCSA) is also required when isolation for an infectious disease has ended. The ARD of this assessment must be set on day 15 after isolation has ended. The last day of isolation precautions is considered day 0 when determining the ARD of the SCSA. Summary The proposal to require a significant change in status assessment (SCSA) when therapy (and isolation) ends was not new. For the previous 4-5 years, legislators had received complaints from constituents who believed the nursing facility was charging a higher case mix classification rate, even though the associated services ended earlier during the stay. Bill language was introduced in previous years. However, the recent HHH Blue Ribbon Commission reviewed and recommended the strategy as one way to reduce Medicaid expenditures. Governor Walz included the policy change in his recent budget, and the Minnesota Senate and House of Representatives adopted without modifying. MDH hosted a 2021 CMR Program Statute Changes webinar on July 22, 2021 (https://bit.ly/3f2yuPY), where the following clarifications were provided to the following statement (from page 2): •
All Medicaid participating facilities are required to complete a significant change in status assessment (SCSA) when all skilled therapy or strict isolation services end regardless of the resident’s payer source or RUG classification.
Is the SCSA necessary if no rehab or ES1 classification (page 6)? According to MDH, If the resident does not have a rehab or isolation classification, a SCSA would not be required at the end of skilled therapy or isolation.
CARE PROVIDERS OF MINNESOTA
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2021 LEGISLATIVE UPDATE BOOK
