This Solicitation opportunity from Ohio was posted on January 28, 2025. The submission period has ended. Browse the details below for market research, or find similar active opportunities.
Minimum Data Set (MDS) Exception Reviews RFP
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The Ohio Department of Medicaid (ODM) is implementing a contract aimed at enhancing the accuracy of Minimum Data Set (MDS) assessments for nursing facility residents through comprehensive Exception Reviews. This initiative seeks to provide a detailed analysis of MDS assessments to ensure benefits for the residents, ODM, and the facilities involved. The contractor selected for this endeavor will utilize specialized MDS analytical software provided by ODM to identify any discrepancies in the data submitted by nursing facilities. Additionally, the contractor will be responsible for developing risk models that consider a variety of clinical and operational factors. The work scope includes performing detailed statewide Exception Reviews of Nursing Facility MDS assessments. Key areas of focus will include the identification of clinical inconsistencies, analyzing Resource Utilization Group (RUG) distribution outliers, tracking significant changes in the Case Mix Index (CMI), and addressing software issues reported by both the state and nursing facility providers. The reviews will also cover RUG data fields, adherence to CMS Quality Measures, as well as statewide data comparisons across rehabilitation levels and leverage insights from prior reviews. Specific tasks encompass conducting entrance and exit meetings with facility representatives, generating reports that outline findings, providing recommendations on CMI adjustments, and assisting ODM in integrating these findings into their rate-setting processes. The contract necessitates the completion of 80 to 100 exception reviews each State Fiscal Year, spanning from SFY25 through SFY31, and covers facilities across the entire state of Ohio.
General Info
Place of Performance
OH, USASet-Aside
Documents
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Timeline
Submission Closed
Organization & Contact Information
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