What is a Change Request Form and how does this apply to you?
Chapter 5 of the RAI Manual v1.18.11 outlines the correction policy for the MDS. For MDS assessments that have been completed, submitted, and accepted in iQIES, facilities should correct any errors necessary to ensure that the information in iQIES accurately reflects the resident’s identification, location, overall clinical status, or payment status.
The type of correction depends on the type of error:
- A modification request is completed when an MDS has clinical or demographic errors coded on the assessment.
- An inactivation request is completed when an event did not occur (e.g. a Discharge MDS was submitted for a resident who was not actually discharged from the facility).
- A Manual Assessment Correction/Deletion Request is required to correct:
- Unit Certification or Licensure Designation (Item A0410)
- State-assigned facility submission ID (FAC_ID) or State Code (STATE_CD)
- Test record submitted as a production record
- Record submitted was not for OBRA or Medicare Part A purposes (e.g., a 5-day PPS MDS is submitted for a managed care resident)
It is this last type of correction request that utilizes the forms noted in this writing. Please note that facilities must submit completed and signed forms to their State RAI Coordinator/State Automation Coordinator by Certified Mail through the US Postal Service Center.