uses of the MDS- Expanded-Payment

Detailed Question

Medicare and Medicaid Payment Systems. The MDS contains items that reflect the acuity level of the resident, including diagnoses, treatments, and an evaluation of the resident’s functional status. The MDS is used as a data collection tool to classify Medicare residents into PDPM components. The PDPM classification system is used in SNF PPS for skilled nursing facilities and non-critical access hospital swing bed programs. States may use PDPM, a Resource Utilization Group-based system, or an alternate system to group residents into similar resource usage categories for the purposes of Medicaid reimbursement. More detailed information on the SNF PPS is provided in Chapters 2 and 6. Please refer to the Medicare Internet-Only Manuals, including the Medicare Benefit Policy Manual, located at https://www.cms.gov/Regulations-and Guidance/Guidance/Manuals/index.html for comprehensive information on SNF PPS, including, but not limited to, SNF coverage, SNF policies, and claims processing.

Manual Version Used