Prevent delays in processing payments

Minnesota Department of Health sent this bulletin at 05/02/2024 01:48 PM CDT
minnesota department of health

Prevent delays in processing payments by correctly entering therapy and isolation dates

Tips and clarifications

To prevent delays in processing payments, staff must ensure that the therapy and isolation start and end dates are correctly entered on all Prospective Payment System (PPS), Omnibus Budget Reconciliation Act (OBRA) comprehensive, OBRA noncomprehensive assessments, and Optional State Assessment (OSA) when appropriate. When the end of therapy dates, and/or start and end dates for isolation are not on the assessment, this assessment will not be immediately processed requiring a call from the Case Mix Review staff for further information.

Discrepancies in the Resource Utilization Group (RUG) classification between the OSA and the classification letter

If the RUG classification on the OSA does not match the classification letter received on the CMR Portal, review the documentation entered on both the OBRA and OSA to make sure the data matches. If the data does not match in the OBRA and OSA contact Case Mix Review at health.fpc-cmr@state.mn.us.

Short stay facilities

If you have elected to be a short stay facility, neither an OSA and/or admission assessment is required to be completed until the resident is in the facility for more than 14 days.

When to complete an OSA

The OSA is required for most admissions to nursing facilities that are Medicare and Medicaid certified regardless of who the payer is. The OSA is not required with PPS, discharge or entry tracking. The OSA is required:

  • Each time an OBRA comprehensive, quarterly, or Significant Correction to prior Quarterly Assessment (SCQA) assessment is completed, and
  • When all therapy and isolation services end, if the most recent assessment (either an OBRA assessment with an ARD on or before 9/30/2023 or an OSA with an ARD on or after 10/1/2023) resulted in a rehabilitation or isolation RUG-IV classification in Z0200A.

Contact information

Case Mix Review
625 Robert Street N P.O. Box 64975
St. Paul, MN 55164-0938
651-201-4200
health.fpc-cmr@state.mn.us
www.health.state.mn.us