Section O changes will impact how you code treatments, procedures, and programs residents received or performed during assessment periods.
On October 1, 2023, the new MDS 3.0 will become effective and present major changes to many sections and revised coding procedures. Facilities will need to prepare now for the changes occurring in various sections. This blog is part of Polaris Group's Decoding the MDS 3.0 series which will explore the changes occurring in specific MDS sections.
What’s new in Section O?
Major changes to Section O include new assessment period columns and expanded choices for coding of data elements.
Section O identifies any special treatments, procedures, and programs received or performed during the assessment period. The language “or performed” is a new addition in MDS 3.0. Facilities can now code treatments, programs, and procedures the resident performed themselves independently or after set-up by facility staff.
In O0110, columns have been revised. The column for “while NOT a resident” has been eliminated while “on admission” and “at discharge” have been added. On admission refers to the time period on days 1-3 of the SNF PPS stay. While a resident refers to the time period after admissions/entry or reentry to the facility and within the last 14 days. At discharge refers to the time period in the last 3 days of the SNF PPS stay.
Other changes in Section O include:
- A change to O0250 (Influenza Vaccine) to include a reference for when facilities must offer residents the influenza vaccine.
- Clarifications for coding O0400 for an interrupted stay.
What to Expect
With Section O changes, facilities will need to review the resident’s medical record to determine if they received or performed any of the treatments, procedures, or programs within the assessment period defined for each column. Poor documentation will lead to poor coding and poor reimbursement. The MDS coordinator will look closely into nursing documentation to code these treatments, so documentation must be detailed, accurate, and timely to facilitate MDS completion.
Recommendations from Polaris
To implement Section O changes, facilities need to update their admission team on what new information is needed for this section and provide training. Facilities should also consider creating a standard request for information form and procedure that can be used to get information from the hospital to complete admission documentation. The UDAs will also need updating to include specific language on treatments provided and completed. Finally, facilities need to make sure that they educate nurses on how to make their charting very specific and detailed to assist with coding.
- For O0110C4, check if oxygen therapy was provided via a high-concentration delivery system. A high-concentration oxygen delivery system is one that delivers oxygen at a concentration that exceeds a fraction of inspired oxygen FiO2 of 40% (i.e., exceeding that of simple low-flow nasal cannula at a flow rate of 4 liters per minute).
- More information about when facilities must offer residents the influenza vaccine is available n 42 CFR 483.80(d), Influenza and pneumococcal immunizations, which can be found in Appendix PP of the State Operations Manual
- In the case of an interrupted stay, the therapy start date entered in O0400A5, O0400B5, and/or O0400C5 must reflect a date on or after the date in A2400B. Although the therapy start date occurred prior to the interrupted stay, the data specifications only accept a therapy start date that is on or after the date entered in A2400B.
Polaris Group Consultants can help you and your facility prepare for Section O changes. Polaris consultants can help you determine what staff departments are best positioned to collect new information and how best to document. Through Polaris’s rigorous training and recommendations guided from over 30 years in nursing home consulting, your facility can be ready and prepared for MDS 3.0 changes beginning October 1st.
- Learn about Polaris's Outsourced MDS solutions
- Read our Decoding the MDS 3.0 blog series