<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".24" citation="COMAR 10.09.10.24" title_num="10" subtitle_num="09" chapter_num="10" heading="MDS Validation and Ventilator Care Validation.">
  <paragraph num="A.">
    <text>MDS Validation.</text>
    <paragraph num="(1)">
      <text>In order to validate that the Nursing Service rate is supported by medical record documentation, accurately coded and submitted, the Department shall conduct periodic MDS validation reviews, which shall:</text>
      <paragraph num="(a)">
        <text>Compare the MDS assessment coding with the corresponding medical record documentation to determine unsupported MDS assessments;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Determine the completeness, timeliness, and accuracy of resident MDS assessments identified on the resident roster; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Determine the completeness and accuracy of the resident payment source listed on the resident roster.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Findings from the MDS validation may be used to adjust a nursing facility’s per diem payment rate to reflect the validated case mix index used in the rate setting process.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Ventilator Care Validation.</text>
    <paragraph num="(1)">
      <text>In order to validate that days paid for residents that meet the requirements for ventilator care are supported by medical record documentation of the need for ventilator care services, the Department shall conduct a periodic ventilator care validation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Findings from the ventilator care validation shall be used to recoup payments for days not supported by medical record documentation.</text>
    </paragraph>
  </paragraph>
</regulation>