X0150. Type of Provider, Step-by-Step

Step-by-Step Coding Guide for Item Set X0150: Type of Provider

1. Review of Medical Records

• Objective: To determine the facility type providing care to the resident.
• Key Points:
  • Examine the resident's admission documentation and facility licensure information to ascertain the type of facility.
  • Look for any facility accreditation documents or state licensure categorizations that clarify the type of provider.

2. Understanding Definitions

• Objective: Clarify the different types of providers as defined in the MDS 3.0.
• Key Points:
  • Different types of providers include Skilled Nursing Facilities (SNFs), Nursing Facilities (NFs), Swing Bed facilities, and others, each with distinct functions and regulatory standards.

3. Coding Instructions

• Objective: Provide specific guidance for coding the type of provider in X0150.
• Key Points:
  • Code according to the facility type: For example, SNF, NF, or Swing Bed, based on the facility's operational definition and licensure.
  • Refer to official guidelines: If uncertain, refer to CMS or state-specific guidelines to correctly categorize the facility.

4. Coding Tips

• Ensure the facility's current licensure or certification status aligns with the coded provider type.
• Regularly update this item if there are changes in the facility’s licensure, certification, or function.

5. Documentation

• Objective: Maintain clear documentation supporting the coded type of provider.
• Key Points:
  • Document in the resident's file any official licensure or certification records that define the facility as a specific type of provider.
  • Include a note in the MDS assessment documentation referencing the basis for the coded provider type.

6. Common Errors to Avoid

• Misclassifying the facility due to misunderstanding or outdated information regarding facility licensure and functions.
• Failing to update the provider type in MDS assessments when there are changes in facility certification or function.

7. Practical Application

• Scenario: A facility recently transitioned from a Nursing Facility (NF) to a Skilled Nursing Facility (SNF) due to changes in the services offered and received new state licensure. This change is documented in the facility's licensure records, and the MDS coordinator ensures that X0150 is coded as "SNF" in all subsequent assessments, referencing the new licensure status.

The Step-by-Step Coding Guide for item X0150 in MDS 3.0 Section X is based on the Long-Term Care Facility Resident Assessment Instrument 3.0 User’s Manual, Version 1.18.11, dated October 2023. Healthcare guidelines, policies, and regulations can undergo frequent updates. Therefore, healthcare professionals must ensure they are referencing the most current version of the MDS 3.0 manual. This guide aims to assist with understanding and applying the coding procedures as outlined in the referenced manual version. However, in cases where there are updates or changes to the manual after the mentioned date, users should refer to the latest version of the manual for the most accurate and up-to-date information. The guide should not substitute for professional judgment and the consultation of the latest regulatory guidelines in the healthcare field.