Validation and Editing Process

4146.3 - Validation and Editing Process (Rev. 1, 05-21-04) Each time a facility accesses the State MDS system and transmits an assessment file, the State system performs a series of three levels of validations: 1. Fatal File Errors - The first check examines the basic structure and integrity of the submission file. If there are fatal flaws in the file (batch of records), the entire file is rejected and the facility is notified of the reason for rejection in the “Initial Feedback Report.” In the event that a batch is rejected due to Fatal File Errors, the facility will not receive a “Final Validation Report.” Rejected files must be corrected and retransmitted. Fatal File Errors are described in a document named spdoc110.pdf, that is posted at the CMS website, http://www.cms.hhs.gov/medicaid/mds20/ under “MDS Software and Data Specifications” and then under “Version 1.10 Files Available for Downloading.” The spdoc.pdf document is in a “zip” file names MDS 110.zip. 2. Fatal Record Errors - If the file structure is acceptable, then each MDS record in the file is examined individually for Fatal Record Errors. These errors include out of range responses (this edit applies to most, but not all fields), selected inconsistent relationships between fields, or errors which made identifying a resident or record type difficult. Fatal Record Errors result in rejection of individual records by the State MDS database. The facility is informed of Fatal Record Errors on both the “Initial Feedback Report” and the “Final Validation Report.” An overview of Fatal Record Errors is provided in a document called spdoc110.pdf, available in a “zip” file names mds 110.zip at http://www.cms.hhs.gov/medicaid/mds20 under “MDS Software and Data Specification” and then under “Version 1.10 Files Available for Downloading.” A detailed listing of Fatal Record Errors is provided in the item-by-item MDS record specifications, Document names d_dt120.pdf, available in a “zip” file names mds 120.zip at http://www.cms.hhs.gov/medicaid/mds20 under “MDS Software and Data Specifications” and then under “Data Specifications Version 1.20 for the QIES MDS July 2002 Release.” One additional Fatal Record Error is based on the submission requirement under which the MDS record is submitted by the facility. There is a data field called SUB_REQ that deals with this issue. Fatal Record Errors based upon the SUB_REQ field are described in a special document named subreqspecs.pdf at http://www.cms.hhs.gov/medicaid/mds20 under “MDS Software and Data Specifications” and then under Data Specifications and Instructions for the QIES MDS November 26, 2001 Release.” At this level of validation, the MDS standard system at the State is designed to reject individual records with Fatal Record Errors and to accept records with no Fatal Record Errors. An electronic “final validation report” is made available to the facility and includes error messages for individual records found to have errors, and a statement of record status (accepted or rejected), with associated error statements for any rejected records. Rejected records must be corrected and retransmitted. 3. Non-Fatal Errors - If there are no Fatal Record Errors, the record is loaded into the State database and the record is further examined for Non-Fatal Errors. Any Non-Fatal Errors are reported to the facility in the “Final Validation Report.” Non-Fatal Errors include missing or questionable data of a non-critical nature, field consistency errors of a non-critical nature, and record sequencing and timing errors. The Initial Feedback Report is available for the facility to download immediately following the submission of a file. Since the Final Validation Report will not be available as quickly as the Initial Feedback Report, the facility may, based on experience, choose to obtain this report on a subsequent logon. The validations and edits described above fulfill all of CMS’ editing requirements under 42 CFR 483.315(h)(1)(iv). Also, as specified at 42 CFR 483.315(h)(2)(ii), States or other data/system users may not modify any aspect of the CMS MDS standard system, including these validations and edits, the Standard Record Layout, and the software code and specifications on which the system is based. States that use MDS data for Medicaid payment may require additional assessment information not required by CMS’ MDS system. Section S (the State-specific section) of the MDS system was designed for this purpose. Moreover, some States may impose additional edits on Medicaid assessments. However, a State or other data system users may not interfere with, modify, or delay the transmission of records, meeting CMS edit standards, from a Medicare and/or Medicaid certified facility to the CMS MDS standard system. Furthermore, the State or other data system users may not impose any requirements that modify the clinical accuracy of CMS prescribed MDS records, reports, or calculations.