The Centers for Medicare and Medicaid Services (CMS) posted the Optional State Assessment (OSA) Item Set, OSA Manual and OSA Change History table in the Downloads section on the
Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page.
The OSA is not a federally required assessment; rather, it may be required in some states for payment purposes such as for RUG-based Medicaid payment models. For example, the 20-page OSA, which will be effective October 1, 2023, contains legacy MDS Section G Activities of Daily Living (ADL) functional items and other MDS items that will be removed from federal OBRA assessments that will be occurring at the same time. Each state determines whether the OSA is required, and if so, when the assessment must be completed. For questions regarding completion of the OSA, please contact your State Survey Agency.
Background:
The 20-page OSA item set, Version 1.0, effective October 1, 2023, may be required by a State Medicaid Agency to calculate the Resource Utilization Group (RUG)-III or RUG-IV case mix group Health Insurance Prospective Payment System (HIPPS) code for state payment purposes. Several items—A0300, D0200, D0300, G0110, K0510, O0100, O0450, O0600, O0700, and X0570—that have been removed from all federally required item sets remain on the OSA for the purpose of calculating RUG-III/RUG-IV HIPPS codes. Instructions for completing these items are included in the 46-page OSA Manual. Instructions for completing other items on the OSA including newly required Race, Ethnicity and Language items can be found in the respective sections of Chapter 3 of the MDS Resident Assessment Instrument (RAI) 3.0 User’s Manual.
The guidance in the OSA Manual should only be applied when completing an OSA for payment purposes. Providers should use the guidance in the MDS RAI 3.0 User’s Manual (version 1.18.11), also provided in the Downloads section on the
Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) Manual page, to guide their completion of federally required assessments.