MDS submissions must be made to the Internet Quality Improvement and Evaluation System (iQIES) beginning April 17, 2023. The CMS iQIES system is an internet cloud based program for MDS data submission, survey and certification, and data storage, tracking, and analysis.

Each skilled nursing facility must designate at least two Provider Security Officials available to meet iQIES access requests. CMS has provided articles and videos to make getting started easier:

Create an Account in HARP (HCQIS Access Roles and Profile system, the CMS secure identity management portal)

Register for iQIES Access

New User Checklist and Training Videos

With the ongoing goal to reduce the use of unnecessary antipsychotics, CMS will be conducting audits of schizophrenia coding in MDS data. They will adjust the Nursing Home Care Compare star ratings for facilities whose audits reveal inaccurate coding.

Inappropriate use of antipsychotic medications has been a wide-spread problem in facilities for a very long time, and became worse during and since the pandemic. Past surveys noted in many facilities an absence of comprehensive psychiatric evaluations and behavior documentation. Also, many residents had only sporadic behaviors noted in their medical records, and these behaviors were related to dementia, rather than schizophrenia.

When residents are given erroneous schizophrenia diagnoses, they are subject to poor care and unnecessary antipsychotic medications, both of which can be very dangerous, a recent CMS memorandum stated.

CMS Memorandum Antipsychotic Medications and Schizophrenia

Long term care facilities must develop and implement a baseline care plan for each resident within 48 hours of admission.

The guidelines state the 48 hour baseline care plan must include “the instructions needed to provide effective and person-centered care of the resident that meet professional standards of quality care,” including, but not limited to: initial goals based on admission orders, physician orders, dietary orders, therapy services, social services, and PASARR recommendation, if applicable.

According to the regulations, facilities may develop a comprehensive care plan in place of the baseline care plan if the comprehensive care plan meets all of the requirements for the baseline care plan outlined in the surveyor guidelines.

In order to assure all of the requirements of the guidelines are met, LTCS Books recommends that the facility develops and implements a comprehensive care plan within 48 hours of admission.

Baseline Care Plan Regulations