October 1, 2018, saw the addition of Section GG to the MDS. Section GG is being touted as a new method of measuring functional gains over the course of a SNF stay. I recently had the opportunity to attend an excellent educational session about the changes to the MDS which presented a great forum to learn the differences between our old friend, Section G, and the new Section GG. Section G has been measuring the patient’s ADL needs by way of self-performance & support provided, while Section GG will measure changes in function from the first assessment to the last. This seems to be a logical way to measure outcomes and progress during the patient’s Part A stay.
While there are probably a million little nuances that the MDS gurus will be teaching and training SNFs in the coming years, I will instead provide you with my top 4 eye-openers from a regular person, who definitely does not consider himself an MDS guru:
1. Section GG introduces the concept of prior function. That’s awesome because it ties in with the whole idea of setting goals in order to measure progress. Long overdue! This section (GG0100) measures the patient’s functional abilities in self-care, indoor mobility, stairs, and functional cognition. When measuring functional cognition, don’t forget to get insight from Speech Therapy!
2. In Section G, a lower score means the patient is more independent when completing ADL tasks. Well, Section GG is just the opposite. A more independent patient will have a higher score in GG. That’s going to require MDS Coordinators to help their colleagues stay focused and organized in understanding & documenting these key concepts. Those in Case Mix states will have to work even harder!
3. in Section GG, SNFs are now being asked to report the patient’s “usual performance,” instead of their most dependent or most independent. Patient usual performance for each activity is rated using a 6-point scale:
- Independent =6
- Setup or clean-up assistance = 5
- Supervision or touching assistance = 4
- Partial/moderate assistance = 3
- Substantial/maximal assistance = 2
- Dependent = 1
4. Section GG is to be completed on the Evaluation, as well as the planned Discharge.
This little “starter kit” of 4 eye-openers are just the tip of the iceberg. Either way, Section GG’s arrival is making it very clear that achieving and measuring outcomes is important to CMS. Now that we have the conversation started, I recommend consulting a real MDS guru to help your SNF through the transition.
In the meantime, I’d love to hear your thoughts in the comment box below.