The LTCPro Clinical News provides you with the most recent information on your COWORKER Clinical Software including the availability of updates that can be downloaded now, information on upcoming product updates, as well as important notices from entities such as CMS.


October 1, 2020

ICD-10 LIBRARY UPDATE AVAILABLE TO DOWNLOAD

Each October CMS provides an updated set of ICD-10 codes that are effective October 1 of that year. Coworker Clinical includes a library of ICD-10 codes and you do have the ability to manually edit that library content if you prefer to go that route. However, we have provided a database utility (FY2021_ICD10_DB_Update) in your download folder that you can use to automatically update this Coworker library with the latest ICD-10 codes.

In order to use this utility the downloaded file must be placed in the same folder on your system that contains your live data (Clinicaldata.mdb) and all users must be out of Coworker Clinical at the time you run this utility (similar to any other database update process).

To run this utility, you must be on a workstation that contains Microsoft Access (either retail or the runtime). Simply double-click the utility file (FY_2021_ICD10_DB_Update.accde) to start the process. It will take several seconds to a few minutes to perform the update and will issue a message when it is done. After you click on that message it will ask if you want to compact and repair your database. It is not necessary to do this step but, if you would like to, be sure you made a copy of your live database (ClinicalData.mdb) before you started this utility. Compacting and repair rarely runs into a problem, but it is not impossible so having a backup of your data is your safety valve should a problem arise.

September 30, 2020

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6108) available to be downloaded. This update contains the changes for the MDS assessments that have an ARD of 10/01/2020 or later. Please review the September 23rd notice for details on the changes included in this update. The downloaded file also includes a database update process (Clinical_DB_Update_6108) that must be run as part of the installation process. This update also includes a revised version of the PDPM_Grouper.DLL from CMS that will need to be installed (see below) on any workstations that processes Section Z of the MDS assessment.

Like previous database updates, the database update process requires that all users be out of Coworker Clinical in order to run the process. This process must be run before any users attempt to launch Coworker You will need to copy the database update file (Clinical_DB_Update_6108.accde) from the folder you unzipped the download file and place it in the folder where your Coworker Clinical data resides. The database update process should not take very long and will indicate when it is completed.so watch for the Process Completed status as it may be almost simultaneous. As with all other Coworker clinical program updates, each user will be automatically updated to version 6108 when they next launch the application once the update is installed.

Critcal:

After the update has been installed and the database update process run, if your state is one of the states that will be collecting PDPM data on OBRA type assessments then you will need to select the Facility process from the Process list on the left side of the main menu. From there select Main Screen and click on the MDS3 Information tab. On that tab you will see a new option called State Collects PDPM Data. You will need to check that option. Checking this option then enables various fields in Sections GG-A, I and J that would otherwise not be enabled on an OBRA type assessment. It will also remove the note on Section Z stating that Z0100 is not required for this type of assessment. Finally, and this is very important, you must install this update before you create any OBRA type assessments with an ARD or 10/01/2020 or later. If you have already created such assessments, you will need to delete them and create them over again. If your state is not one of the states collecting PDPM data on OBRA type assessments then you do not need to perform this step as the defaulting for this new option is false (not checked). This update does include an updated version of the CMS supplied PDPM_Grouper.DLL. This DLL is required for assessments dated 10/01/2020 or later so that Z0100 of Section Z of the MDS will be properly calculated for OBRA type assessments if your state is collecting PDPM data. This DLL file will need to be copied and placed on each workstation that will have a need to calculate the RUGS-IV score in Section Z of the MDS assessment. Because different versions of Windows look for DLL files in different places we suggest the following placements:

• For all versions of Windows place this DLL file in the C:\Coworker\ccwprocs folder or whatever folder path you have established on drive C of the workstation from which the application is launched. This is the folder in which you will find Coworker90.accde.
• For workstations running a 32 bit version of Windows or a 64 bit version of Windows, place this DLL file also in the C:\Windows\System32 folder. Note: you may have to have admin rights on the workstation in order to do this.
• For workstations running the 64 bit version of Windows, place this DLL file also in the C:\Windows\SYSWOW64 folder. Note: you may have to have admin rights on the workstation in order to do this.

September 23, 2020

October 2020 MDS Changes Update

We are finishing up the changes in CoWorker Clinical regarding the MDS requirements effective October 1, 2020. The original changes slated for this date (specification level 1.18) were pushed back by CMS earlier this year. However, they did issue some minor changes (specification level 1.17.2) that will take effect. Basically, those changes have to do with non-PDPM assessments (e.g., OBRA assessments) that may be required by various states for Medicaid reimbursement purposes. Many states have been utilizing RUGS scores for determining the Medicaid reimbursement rates even though Medicare moved from RUGS to PDPM last October. The non-PDPM required assessments were not calculating a valid PDPM score for these types of assessments and the Section Z fields Z0200 and Z0300 need to still calculate a RUGS score. Some states want to see a valid PDPM score in Z0100 on these non-PDPM required assessments so that they can start to gauge the impact of using PDPM scores instead of RUGS scores. Therefore, effective 10/01/2020 all non-PDPM required MDS assessments with an ARD of 10/01/2020 or later that include Z0100 need to return a valid PDPM score. This means that various fields in Sections GG, I and J that were previously disabled for these non-PDPM required assessments will now need to be enabled and required, and that Section Z will return a valid PDPM score in Z0100. This requires some changes in the enable/disable logic for these MDS sections as well as a new PDPM DLL to calculate a valid PDPM score for these non-PDPM required assessments.

This change is only applicable for facilities in states that have indicated they will be collecting PDPM data on non-PDPM required assessments (e.g., annual and quarterly). There will be a new field under the Facility / MDS 3 Information screen to indicate whether your state is collecting PDPM data effective 10/01/2020 on these non-PDPM required assessments. You will need to determine whether your state is one of the states that will be collecting this information and set that field appropriately.

We will have the updated version of Coworker Clinical available to download and install no later than 10/01/2020. Because these changes fall under a new specification level you will need to not start any non-PDPM required assessment with an ARD of 10/01/2020 or later until you have installed this update so that the assessment will be at the correct specification level and will have these additional fields enabled. This means, if you pre-create assessments in advance and those assessments were created using your current version of CoWorker Clinical that you will need to delete those pre-created assessments and create them over again with this CoWorker Clinical update once it is available and you have installed it.

This update will continue to support the current MDS assessment requirements so you can download and install the update prior to 10/01/2020 (once we make it available) and still be able to create and processing MDS assessments with an ARD less than 10/01/2020.

February 3, 2020

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6107.6) available to be downloaded. This update contains some minor corrections to the MDS assessments so it is not critical that you install it immediately, but it is suggested you install it as soon as practical.

Here are the items included in this update.

• Corrected some logic in the PDPM Detail screen that was causing this screen to come up with a different PDPM Grouper value then what was calculated in Section Z when Section J question 2100 (recent surgeries) had a value of Yes.
• Corrected the MDS Section O0425 headings for A,B and C on the assessment printout (they were correct on the input screens).
• Corrected the edits on MDS Section O section O0425 to properly handle the case where the therapy minutes for questions 1,2 and 3 total 0 minutes therefore questions 4 and 5 should be skipped. Also, corrected the screen not retaining the answer to question 0430. Note: both 0425 and 0430 only apply when A0310H = 1.
• Changed the enable/disable logic for Section A question A2400 to be in accordance with the value of A0310G1. A2400 is only to be completed if A0310G1 = 0 (not a SNF Part A interrupted stay) or left blank (A0310G and A0310G1 are only enabled if the assessment includes a discharge (A0310F = 10 or 11)).
• Corrected the printout of MDS Section A on an NC assessment with an ARD of 10/01/2019 or later to drop the mental retardation wording in the instructions for A1500.

Note: this update does not include a database update so it can be installed without having to have all your users out of the software. However, each workstation will not be updated to 6107.6 until the user gets out of the application and goes back in. If you have not installed version 6017.2 (which did include a database update) then you will need to run the database update that came with that version.

November 30, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6107.5) available to be downloaded. This update contains some corrections to the MDS IPA type assessments as well as some other Important corrections so you will want to download and install the update as soon as possible.

Here are the items included in this update.

• Corrected the skip logic on an IPA assessment Section GG regarding the value entered into GG0170I5.
• Corrected the automatic setting of H0100Z = 0 or 1 based on the responses to the other questions in H0100 on an IPA assessment.
• Corrected the automatic setting of O0100Z =0 or 1 based on the responses to the other questions in O0100 on an IPA assessment.
• Added a new edit from CMS that was issued on 10/28/2019 regarding ND assessments and questions A0310G1 and A2400C.
• Corrected an issue where question X0660H is enabled when the assessment is an original assessment and it should be disabled.
• Changed the spec_vrsn_cd in the submission file from 3.00.1 to 3.00 to see if that gets rid of the waning on the validation report. There does not appear to be any documentation on the correct value.
• Modified the field for selecting a particular payer on the Payer History report screen to only show each unique payer once. In prior versions the same payer could show multiple times. While that did not affect the ability to select a particular payer, it did require a lot more scrolling to get to the desired payer.
• Modified the field for selecting a particular personal contact on the Personal Contact report screen to only show each unique contact once. In prior versions the same contact could show multiple times. While that did not affect the ability to select a particular contact, it did require a lot more scrolling to get to the desired contact.
• Modified the field for selecting a particular professional contact on the Professional Contact report screen to only show each unique contact once. In prior versions the same contact could show multiple times. While that did not affect the ability to select a particular contact, it did require a lot more scrolling to get to the desired contact.
• Corrected an issue where the Personal Contact report was only showing the first contact number for each contact.
• Corrected an issue where the Professional Contact report was only showing the first contact number for each contact.
• Enhanced several ADT reports that have a filter option to report only on one type of item (e.g., event type) such that, when you select a single resident from the resident field that the available types shown in the list are only types used by the selected resident. The list remains as before if you have not selected a specific resident.

Note: this update does not include a database update so it can be installed without having to have all your users out of the software. However, each workstation will not be updated to 6107.5 until the user gets out of the application and goes back in. If you have not installed version 6017.2 (which did include a database update) then you will need to run the database update that came with that version.

October 30, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6107.4) available to be downloaded. This update contains some additional corrections not available in prior versions so you will want to download and install the update as soon as possible. We realize that updates have been coming out somewhat frequently this month but we wanted to make available program corrections as quickly as possible in order to make your MDS entry as smooth as possible. We do anticipate that the frequency of updates will begin to slow down significant over the next month.

Here are the items included in this update.

• Corrected an issue where MDS Section A would not approve with question A0310 highlighted stating values cannot be blank. The issue was with A0310G1 being blank due to A0310G being blank because A0310F was not a 10 or 11.
• Corrected a runtime error when one or both of the selected assessments have an ARD of 10/01/2019 or later.
• Corrected the tab order in MDS Section O question O0400B after selecting Date for the ending date field.
• Corrected an issue where entering a response to A0300A for assessments with an ARD of 10/01/2019 or later (other than an NC assessment) was giving a runtime error.
• Corrected an issue where attempting to approve MDS Section Z on an assessment with an ARD of 10/01/2019 or later you may get an approval error stating that values cannot be blank when A0310C (which no longer exists) has a certain value.
• Corrected an issue when trying to change the reason for an assessment with an ARD of 10/01/2019 and you get a runtime error.

Note: this update does not include a database update so it can be installed without having to have all your users out of the software. However, each workstation will not be updated to 6107.4 until the user gets out of the application and goes back in. If you have not installed version 6017.2 (which did include a database update) then you will need to run the database update that came with that version.

October 23, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6107.3) available to be downloaded. This update contains several program corrections and a new MDS entry option so it should be installed as soon as possible. We are now just over 3 weeks into the new PDPM changes to the MDS and users have had the opportunity to create a good variety of MDS assessments at this point so we anticipate that the frequency of program updates will be slowing down going forward. We appreciate your patience as we all work through this initial MDS change scenario and truly appreciate you making us aware of any issues that you encounter so that we can get them corrected ASAP.

Here are the items included in this update.

• Changed the logic in the nursing section of the PDPM Detail screen to match how the CMS DLL is treating conditions where the word 'one' was bold. We took that to mean one and only one whereas CMS treats that as one or more.
• Changed the enable/disable logic on MDS Section A for question A0310G1 to follow the same logic as for question A0310G. Even though the input form does not have enable/disable logic instructions on this specific question, the MDS is being rejected if A0310G1 is answered and A0310F is not either a 10 or 11.
• Corrected the enabling/disabling of MDS section N0450 based on the answer provided in N0450A.
• Corrected an issue where attempting to approve MDS Section J where J2300-J5000 are disabled was indicating those questions need to be answered.
• Added a new button to the MDS entry form called OA. This button is to only be used in special situations where one or more fields are disabled in the MDS section but have values in those fields that need to be cleared. If you double-click this button on a section that is not approved it will enable all fields for edit in that section so that you can clear the response. To return the section to the normal enabled/disabled status for the various fields in that section move away from that section and then return to that section. Note: this action should only be taken if a field got incorrectly populated due to some sort of enable/disable logic for that section where that logic has been correct in the current program version.
• Changed Section A question A0310H so that it cannot be modified in Section A (similar to A0310A, A0310B and A0310F) as doing so makes the assessment data out of sync with the MDS header record. Similar to the above mentioned fields, if you need to change A0310H then you must do it using the change reason feature in Section A.
• Corrected an issue where the Unlock Temp Tables may not show a temp table in use if the staff member that was using that table is no longer in your staff table (e.g., the staff member was deleted).
• Corrected an issue where MDS Section O question O0100K2 on an ND assessment is disabled when it should not be.
• Corrected an issue where MDS Section I question I5600 on an NP or NQ assessment did not have the input field on the correct place on the input form.
• Changed the background color on the PDPM effective fields from light salmon color to a medium blue (Maya Blue) color because the original color was too close to the color used for the Section A question that cannot be changed in Section A without performing a change reason process or editing the resident's demographic data and similar colors were causing users to think they could not entered into these PDPM sensitive fields.

Note: this update does not include a database update so it can be installed without having to have all the users out of the software. However, each workstation will not be updated to 6107.3 until the user gets out of the application and goes back in. Note: there was a database update process (Clinical_DB_Update_6107.2.1) released last week that should be run if it has not already. This was just a database update and not a program update so even if this process has been run the program version number on your main menu will still be showing 9.0.6107.2. If you are uncertain if this database update has been run or not you can look in the folder that holds your clinicaldata.mdb file. If you see Clinical_DB_Update_6107.2.1.accde in that folder then it can be assumed that process was run. If you remain uncertain then send a support request to support@ltcpro.us and we will contact you to double-check this.

October 13, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

This a critical Coworker Clinical update (version 6107.2) available to be downloaded and installed. You should perform this task as soon as possible and before you attempt to submit any assessments with an ARD of 10/01/2019 or later. CMS has released newer versions of both the PDPM Grouper DLL and the RUGSIV DLL that are included with this update. These DLLs are used to calculate the PDPM and RUGIV scores on assessments and without them you may end up with the wrong PDPM Grouper. Additionally, some issues have been found with versions 6107 and 6107.1 of the Coworker Clinical product that have been resolved with this update.

This update includes the following changes:

• The most recent version of the CMS supplied PDPM Grouper DLL that is used to calculate PDPM scores in section Z of the assessment.
• The most recent version of the CMS supplied RUGIV DLL. This DLL affects all assessments (not just those with an ARD of 10/01/2019 or later) but will not likely affect the actual RUGS score but will reflect the latest version ID for RUGS. Assessments using RUGS calculated before this update will still be accepted but the version ID will result in a warning on your validation report. You do not need to recalculate those assessments but, if the assessment has not yet been transmitted, recalculating Section Z will eliminate that warning when the assessment is transmitted.
• Corrected an issue where attempting to change an NC (5-day) assessment to a NC (99-not a PPS: A0310B=99) will not let you make that change because it wants A0310G answered but A0310G is disabled). A0310G is not required for this type of assessment so the error logic was incorrect. Note: this is only a possible situation with ARDs of 9/30/2019 or earlier.
• Corrected an issue on the New Assessment form where A0310D was being enabled when the assessment date is 09/30/2019 or earlier even though A0200 is set to a 1 (nursing home).
• Corrected an issue where when trying to print out your CAA templates you received an error that the report could not be found.
• Corrected an issue where when selecting a new diagnosis the corresponding diagnosis description in the next field is not the correct description.
• Corrected an issue where Section A on a NT assessment with an ARD of 10/01/2019 or later was not properly enabling/disabling certain fields based on the content of other fields. Also corrected various other parts of business logic that were not being invoked properly resulting in missing edits.
• Corrected an issue for NT assessments with an ARD of 10/01/2019 or later where the resident stay list in A1600 was not showing the prior admit dates for the resident.
• Corrected an issue when submitting assessments with an ARD of 10/01/2019 or later and the submission file is rejected because of a missing field (X0570A). This rejection occurs even when not submitting a correction assessment.
• Corrected the warning on the validation report regarding the wrong SPEC_VRSN_CD. With this update the correct specification version code is now being placed in submission files.
• Corrected an issue where you got a fatal error on the validation report for the ICD-10 format of I0020B. Note, what you entered into A0020B was not the issue. The issue was when that was placed in the submission file.
• Corrected an issue where the submission of certain types of assessments with an ARD of 10/01/2019 or later were being rejected due to missing fields.
• Corrected screen tab order (how the cursor moves from field to field) for NC assessments with an ARD of 10/01/2019 or later.
• Added question A0300 to the NP assessment form where the ARD is 10/01/2019 or greater.
• Reviewed and refined some of the logic behind the forms needed for ARDs of 10/01/2019 or later including enabling/disabling fields and setting or clearing the error check logic. These changes are a bit too complex to detail out in this item but version 6107.2 will react more logically to user input than the prior versions 6107 or 6107.1.

The zip file you will be downloading contains 5 files. Those files are: Clinical90.accde, PDPM_Grouper.DLL, RUGSIV.DLL.Clinical_DB_Update_6107.2.accde and Version 6107.2 Installation Notes.pdf. The installation notes pdf document is also available separately in the Smart Vault site. Whoever does the update should read the installation notes on installing this update as it does require a database update process to be run and the copying of a DLL files to various workstations. Like previous database updates, this requires that all users be out of Coworker Clinical in order to run this database update process. You can download the zip file and place it in the folder where your Coworker Clinical data resides prior to getting all users out of the application but you must not unzip that file until all users are out of the application. The database update process will not take very much time (less than the prior database update so watch for the Process Completed status as it may be almost simultaneous. As with all other Coworker clinical updates, each user will be automatically updated to version 6107.2 when they next launch the application once the update is installed.

The PDPM_Grouper.DLL file and RUGSIV.DLL file will need to be copied and placed on each workstation that will have a need to calculate the PDPM or RUGS score in Section Z of the MDS assessment. They will be replacing files by the same name. Because different versions of Windows look for DLL files in different places we suggest the following placements:

• For all versions of Windows place these DLL files in the C:\Coworker\ccwprocs folder or whatever folder path you have established on drive C of the workstation from which the application is launched. This is the folder in which you will find Coworker90.accde.
• For workstations running a 32 bit version of Windows or a 64 bit version of Windows, place these DLL files also in the C:\Windows\System32 folder. Note: you may have to have admin rights on the workstation in order to do this.
• For workstations running the 64 bit version of Windows, place these DLL files also in the C:\Windows\SYSWOW64 folder. Note: you may have to have admin rights on the workstation in order to do this.

Because this update includes a newer version of the PDPM Grouper DLL, any NC or IPA assessment with an ARD of 10/01/2019 that has not been submitted but Section Z has been calculated should have section Z recalculated. The changes to the DLL file only affect certain MDS situations so it is more likely the recalculation will not change your PDPM Grouper score. However, since this score controls your reimbursement from Medicare for the entire resident’s Medicare stay you will want to take this step just in case the revised DLL results in a different PDPM Grouper value.

A few of the corrections in Coworker Clinical involve various sections of certain assessment types with an ARD of 10/01/2019 or later so you may want to go through those sections even if they have been approved already just to make sure you have a valid assessment.

As always, if you would like an overview of the changes from an LTCPro support person you can email support@ltcpro.us and we will be happy to set up a GoToAssist remote session with you and do that overview. We want you to feel as comfortable as possible with this transition over to PDPM.

October 7, 2019

PDPM Grouper Issue

Today CMS released a revised version of the PDPM Grouper DLL that corrects some issues discovered in previous versions of that DLL. Coworker Clinical utilizes this DLL to calculate the PDPM Grouper value(s) in Section Z of the MDS assessment for any assessment with an ARD of 10/01/2019 or later. Consequently, if you have assessments with an ARD of 10/01/2019 or later ready for submission and have calculate Section Z then it is possible that you will have an incorrect PDPM Grouper value. While the issues corrected do not affect most assessments, it is advised that you do not submit any such assessments until which time LTCPro makes this revised DLL available. We are currently testing the revised DLL against the PDPM Detail report and plan on publishing a new version of Coworker Clinical on 10/11/2019. This update will include some minor corrections to a few issues found in Coworker Clinical version 6107 and 6107.1 as well as this new PDPM Grouper DLL from CMS. Note: this revised DLL does not affect assessments with an ARD prior to 10/01/2019 so you can continue to submit those assessments.

If you do have any assessments with an ARD of 10/01/2019 or later that must be submitted prior to 10/11/2019 then please email this to support@ltcpro.us and we will contact you to supply the revised DLL from CMS ahead of the program update later this week.

September 30, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6107.1) available to be downloaded. This update contains a correction to an issue with the 6107 update regarding the resident personal contacts, professional contacts and payer screens so you will want to download and install the update as soon as possible. This update also includes a revised version of the RUGSIV.DLL from CMS and an enhancement to the PDPM Detail screen introduced in version 6107 as well as a few minor program corrections.

Here are the items included in this update:

• The PDPM Detail screen now includes an additional tab called Optimizer. Under this tab you will see two sub-forms. The first shows all the admit diagnoses assigned to the resident. MDS Section I question I0020B is where you enter the primary admission diagnosis for the resident. What you enter into that question has a significant effect on what PDPM Grouper the resident will fall under so you want to make sure you use the diagnoses that will result in the best PDPM Grouper classification. Further, the reimbursement amount associated with a particular PDPM Grouper classification changes (decreases) over the length of the stay so the variance between PDPM Groupers is also affected by the length of stay. So, this Optimizer screen has a field for entering the estimated length of stay so that, when you click the Calculate button on this tab, the percentage variance between various admit diagnoses will be more accurately reflected. If this calculation process reveals that a different admit diagnosis in I0020B would result in a better PDPM Grouper value then you have the option to go back to Section I and utilize that particular admit diagnosis. Additionally, the bottom sub-form will show any diagnoses assigned to the resident that are not included in MDS Section I question I8000 where such diagnoses may have an effect on the SLP and/or NTA portion of the assigned PDPM Grouper. Only diagnoses that are part of the comorbidity set are included in this sub-form. If any such diagnoses are shown in this sub-form you may want to return to Section I and enter those diagnoses in I8000 and recalculate the PDPM Grouper to see if that results in a better PDPM Grouper value.
• The resident personal contact, professional contact and payer screens were enhanced in version 6107 to help ensure that the city, state and zip code entries corresponded to a valid combination. That enhancement had an issue whereas opening these screens may result in a runtime error. This program update has corrected that issue.
• Version 6107 enhanced the various screens where you select an ICD-10 diagnosis to have the selection list include indicators as to whether that ICD-10 code was one affecting SLP or NTA portions of the PDPM Grouper. The Resident Diagnosis screen in version 6107 was not properly showing this indication and that has been corrected with this update.
• A correction has been included to MDS Section O question O0450 (for assessments with an ARD of 9/30/2019 or earlier) to properly activate or de-activate O0450 based on the values in A0310C and A0310F.
• A correction has been made to the Care Plan flowsheets screen to work properly when switching the resident selection list from name to ID. Prior to this correction that screen was not working properly when using the ID order option.

Note: this update does not include a database update so it can be installed without having to have all your users out of the software. However, each workstation will not be updated to 6107.1 until the user gets out of the application and goes back in. If you have not installed version 6017 (which did include a database update) then you will need to run the database update that came with that version.

This update does include an updated version of the CMS supplied RUGSIV.DLL. This DLL is still required for assessments dated 10/01/2019 or later if your state will continue to use RUGS-IV for the Z0200 and Z0250 calculations. This DLL file will need to be copied and placed on each workstation that will have a need to calculate the RUGS-IV score in Section Z of the MDS assessment. Because different versions of Windows look for DLL files in different places we suggest the following placements:

• For all versions of Windows place this DLL file in the C:\Coworker\ccwprocs folder or whatever folder path you have established on drive C of the workstation from which the application is launched. This is the folder in which you will find Coworker90.accde.
• For workstations running a 32 bit version of Windows or a 64 bit version of Windows, place this DLL file also in the C:\Windows\System32 folder. Note: you may have to have admin rights on the workstation in order to do this.
• For workstations running the 64 bit version of Windows, place this DLL file also in the C:\Windows\SYSWOW64 folder. Note: you may have to have admin rights on the workstation in order to do this.

September 9, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

October 1 is approaching and with it comes the MDS changes effective October 1. These are significant changes to support the switchover from RUGS IV to PDPM for Medicare so installing this update (version 6107) in a timely manner is critical. You must install this update before you attempt to create any MDS assessments with an ARD of 10/01/2019 or later but you can install it now. MDS assessments with an ARD of 9/30/2019 or earlier will continue to be created using the MDS specifications in effect prior to October 1. By installing this update now you will be able to create test assessments with an ARD of 10/01/2019 or later and have them created using the new MDS specifications that take effect on 10/01/2019. You can also start the creation of live assessments with an ARD of 10/01/2019 or later once this update is installed. One important note: if you have already created any assessments with an ARD of 10/01/2019 or later (e.g., an advance creation of an upcoming quarterly assessment) using any version of Coworker Clinical prior to this new version (6107) then those assessments will have been created with the wrong MDS specification level and will have to be deleted and recreated once version 6107 is installed.

As stated in the August 23rd posting, the Continuex FTP site is not available for downloading this update and you will have to be registered under Smart Vault in order to download this update. Please see the August 23rd post for more details on getting registered for Smart Vault.

The zip file you will be downloading contains 5 files. Those files are Clinical90.accde, PDPM_Grouper.DLL, Clinical_DB_Update_6107.accde, Version 6107 Installation Notes.pdf and Version 6107 Release Information.pdf. The installation notes pdf document is also available separately in the Smart Vault site. Whoever does the update should read the installation notes on installing this update as it does require a database update process to be run and the copying of a DLL file to various workstations. Like previous database updates, this requires that all users be out of Coworker Clinical in order to run this database update process. You can download the zip file and place it in the folder where your Coworker Clinical data resides prior to getting all users out of the application but you must not unzip that file until all users are out of the application. The database update process has a bit more work to do than several prior database updates so the process will take longer than it has in the past but should not take more than 10 minutes. As with all other Coworker clinical updates, each user will be automatically updated to version 6107 when they next launch the application once the update is installed.

The PDPM_Grouper.DLL file will need to be copied and placed on each workstation that will have a need to calculate the PDPM score in Section Z of the MDS assessment. Because of different versions of Windows look for DLL files in different places we suggest the following placements:

• For all versions of Windows place this DLL file in the C:\Coworker\ccwprocs folder or whatever folder path you have established on drive C of the workstation from which the application is launched. This is the folder in which you will find Coworker90.accde
• For workstations running a 32-bit version of Windows or a 64-bit version of Windows, place this DLL file also in the C:\Windows\System32 folder. Note: you may have to have admin rights on the workstation in order to do this.
• Besides the necessary MDS changes, this update also includes an enhancement to the address entry screens in Coworker Clinical. The release notice contains additional information on this enhancement but the primary goal is to ensure that you enter a valid combination of city, state, and zip when entering address information. While this enhancement will not correct existing entries unless you return to the appropriate data entry screen and edit the entry, it will ensure that new entries represent a valid combination of city, state, and zip. A valid combination is critical at the point that your data will be eventually migrated over to the LTCPro product from the Coworker product. More information on that migration will be forthcoming at a later date.

Any user that works on the MDS should read the Version 6107 Release Information document. Once the update is installed that document can be found in the folder that contains your clinical data (typically a mapped network drive). Steps are outlined in that document as to how to indicate the switch over of MDS from RUGS to PDPM. Please note that only one user needs to perform those steps as that information is contained in a common file shared by all users. If you have any questions after reading this document you can contact LTCPro via email to support@ltcpro.us and we will be happy to answer your questions.

This database update will also update your ICD-10 code library to the codes in effect as of October 1. The library update will also add the default clinical category and the SLP and NTA indicators for each code as required by the PDPM calculation process.

Besides the necessary MDS changes, this update also includes an enhancement to the address entry screens in Coworker Clinical. The release notice contains additional information on this enhancement but the primary goal is to ensure that you enter a valid combination of city, state, and zip when entering address information. While this enhancement will not correct existing entries unless you return to the appropriate data entry screen and edit the entry, it will ensure that new entries represent a valid combination of city, state, and zip. A valid combination is critical at the point that your data will be eventually migrated over to the LTCPro product from the Coworker product. More information on that migration will be forthcoming at a later date.

As always, if you would like an overview of the changes from an LTCPro support person you can email support@ltcpro.us and we will be happy to set up a GoToAssist remote session with you and do that overview. We want you to feel as comfortable as possible with this transition over to PDPM.


August 23, 2019

October 2019 MDS Changes Update

We have completed the PDPM changes to the Coworker Clinical software and we are currently in the final testing phase. We will be publishing the program update for downloading on September 9th. That update will include both the actual program and a database update process that you will need to run. Complete instructions for installing this updated version of Coworker Clinical and running the database update process will be including with the September 9th post to this webpage. This process will be basically the same as with prior program updates. As always, you are welcome to call the Helpline (800-453-2828) or email support@ltcpro.us if you would like assistance with installing this update.

Please be aware that the Continuex FTP site is no longer active. The program update will be posted on a Cloud file share site called Smart Vault. Smart Vault requires a set of credentials to gain access to it but does not cost you a fee for that access. If you, or another person, will be the one actually downloading the update and have not already requested and received a set of credentials for Smart Vault then please email support@ltcpro.us providing your full name and the facility you are connected with and you will receive back an email inviting you to Smart Vault where you can establish those credentials. Alternatively, when you are ready to install this update you can call the Helpline (800-453-2828) or email support@ltcpro.us and a support specialist can set up a remote session with you and upload the installation pieces to you. However, in order to do this, you must not be restricted from having a remote connection program (we use GoToAssist) establishing a connection with you. Some network security may be set to prevent such remote connections.

If you have not already, it is strongly advised that you gain some familiarity with PDPM through either available webinars or seminars. PDPM is replacing RUGS as the reimbursement model for Medicare and PDPM is significantly changing what determines the classification of a Medicare resident, and the resultant reimbursement rate, from being heavily based on therapy to being based and admitting diagnosis, other diagnoses, certain ancillary needs, and nursing care. The diagnoses you enter into the MDS assessment plays a critical role in this determination as to what PDPM level a resident falls into. Please be aware that this update will also continue to support RUGS IV and RUGS III classifications. If you have non-Medicare residents with coverage that will still be using RUGS (e.g., certain states will continue to use RUGS for Medicaid rate determination) you will still be able to specify that Section Z questions Z0200, Z0250 and Z0300 be set to use RUGS IV or RUGS III. This update will continue to support the current MDS assessment so you can download and install the update prior to 10/01/2019 and still, be able to create and processing MDS assessments with an ARD less than 10/01/2019 using RUGS. Once downloaded you will be able to create test assessments, if desired, to get a feel for the MDS changes effective 10/01/2019. These test assessments (with an ARD of 10/01/2019 or later) that you create using this update should be deleted when you are done trying them out. One important note: if you typically create MDS assessment records for the future (e.g., the next NQ assessment) and have already created such assessments with an ARD of 10/01/2019 or later using the current version of Coworker Clinical then you will have to delete those assessments and create them again once you have installed this update as those existing ones will have been create at the wrong MDS specification level.

July 10, 2019

October 2019 MDS Changes

• LTCPro is currently working on the Coworker Clinical product for the MDS changes that go into effect October 1. These changes are necessary for the new PDPM scoring that replaces the current RUGS IV scoring in section Z. We plan on having a Clinical update available for you to download with these changes in early September so that you can create some test MDS assessments ahead of needing to create production MDS assessments. This update will continue to support the current MDS assessment so you can download and install the update (once it is available) and still be able to create and processing MDS assessments with an ARD less than 10/01/2019. The test assessments with an ARD of 10/01/2019 or later that you create using this update should be deleted when you are done trying them out. One important note: if you typically create MDS assessment records for the future (e.g., the next NQ assessment) you will not want to do that with this update just in case CMS makes in last minute changes to the 10/01/2019 specifications. We will let you know in a future posting when this update is actually available and when you can begin to create production MDS assessments with an ARD of 10/01/2019 or later.

May 6, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.17) available to be downloaded. There are no regulatory changes included with this update but there is a correction to the Admit Wizard so you will want to install this update as soon as reasonably possible. This update also includes a fairly significant enhancement to the Frequency Code maintenance form that should help you with cleaning up older frequency codes that are no longer needed.

Here are the items included in this update.

• Added alpha sort to selection list of resident payers on the Resident Payer form making it easier to find existing payers.
• Corrected the text section on coding for MDS section GG0100 where it stated "3" instead of "1" for "Dependent. Note: the selection list for the input fields were correct, just the text information on the form was incorrect.
• Added the MBI field to the Resident Demographic form presented during the Admit Wizard so that you do not have to enter the MBI number after completing the admit.
• Corrected an issue when using the Admit Wizard for a new admit (not a re-admit) that it was not completing after step 7 and was presenting a blank section of the form when it should have been returning to the main resident maintenance form.
• Added the MBI field to the Resident Demographic form presented during the Admit Wizard so that you do not have to enter the MBI number after completing the admit wizard.
• Added several checks to the Frequency Code Maintenance form to help prevent deleting a frequency code still in use. Note: frequency codes are shared between physician orders and care plan interventions so users may have thought they could delete a frequency code not used with physician orders not knowing it was being used with care plan interventions. When attempting to delete an existing frequency the form now checks to see if the frequency code is attached to any active order, active interventions, DC'd orders, resolved interventions, library order or library interventions and prevents the delete of the frequency code if attached to active orders or active interventions. If the frequency code is attached to an inactive physician order or resolved care plan intervention or to only orders or interventions for a discharged resident a warning is issued stating such. If the frequency code is attached to an item in the physician order library or the care plan intervention library as similar warning is issued.
• Corrected an issue when using the Admit Wizard on a pre-admit status resident where steps 3-5 were activated when they should not have been.
• Enhanced the Frequency Code Maintenance form to add capabilities to better manage frequency codes. The select list now has filters to show only active codes, inactive codes or unused codes. Active frequency codes are those used by active physician orders or active care plan interventions Inactive frequency codes are those not used by active physician orders or active care plan interventions but used by either Dc'd physician orders or resolved care plan interventions or orders/interventions for a discharged resident. Unused frequency codes are those not used by any physician order or any care plan intervention. The form now has an option to show, when selection a frequency code, how many active physician orders, active care plan interventions, physician orders in the library and care plan interventions in the library use the selected frequency code. That option also has an indicator if the selected frequency code is unused by any physician order (entered or in the library), care plan intervention (entered or in the library). There is also a new button to delete all unused frequency codes (activated only when setting the list to Unused Only). You must be an admin user and enter your password in order to use this new delete button.
  Caution: if you do decide to use the new Delete Unused button it is strongly suggested that you first click the Print button to get a report of the unused frequency codes so that, if that process deletes something you might want to use in the future you will have the necessary information to add it back in again. If you have concerns about doing a blanket delete like this you can always delete individual frequency codes one at a time.
• The Frequency Code Maintenance screen also now has an option to show how many instances the selected frequency code is used with active physician orders, active care plan interventions, physician order library items and care plan intervention items as well as if the frequency code is unused. Note: this display is an option because it takes some additional time to gather that information and you may not need it all the time. Also, the usage for inactive physician orders or care plan interventions is not displayed. If a frequency code has 0 usage in the four category count fields and is not checked as unused then the frequency code is attached to only either DC’d orders or resolved care plan interventions.
• Changed the Frequency Code Report to only show the frequency codes in the selection list currently active on the Frequency Code maintenance form. Also added the usage counts for each code similar to what can be optional shown on the maintenance screen.

Note: this update does not include a database update so it can be installed without having to have all your users out of the software. However, each workstation will not be updated to 6106.17 until the user gets out of the application and goes back in. However, if you have not installed version 6016.16 (which did include a small database update) then you will need to run the database update that came with that version.

April 2, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.16) available to be downloaded. The last published update was 6106.14 so you might notice that the version number has jumped 2 values. If you are currently on version 6106.14 you need not worry that you have somehow missed some updates. A few clients may have received 6106.15 as early testers but version 6106.16 contains everything in version 6101.15 that was never officially published.

Here are the items included in this update. Please pay extra attention to the first item as it may require some action on your part once the update has been installed.

• Changed how resident alerts are treated. Prior versions were inconsistent in alert handling. Alerts will being treated as stay independent on the alert entry screen but treated as stay dependent on the resident alert report. With this version, alerts are now treated as stay dependent so alerts are added again with each new admit. The admit process now provides a way to copy alerts from a prior stay and the alert entry screen also has that copy ability.
  This change may affect alerts for a resident who has been readmitted. Since, in prior versions, an alert (on the Resident Alert form) would show even if that alert was entered under a prior stay you would not have entered that same alert for the readmitted stay as you would have seen it on that entry form. Since this update now displays resident alerts based on the resident stay, alerts from a prior stay will no longer show on this form. So, for a readmitted resident you will need to add the appropriate alerts for the selected stay. You can do this manually or utilize the new Copy From Prior Stay feature on the Resident Alert screen. To determine if a readmitted resident is missing any alerts from a prior stay you can select a prior admit date from the dropdown list at the top of the Resident Alert form to a prior stay and any alerts associated with the selected prior stay will be displayed. Note: all of this only applies if you use the Resident Alert form and the resident has been readmitted.
• Changed the report heading on the diagnosis section of the physician order report from ICD-9 to just ICD.
• Corrected an issue where deleting a resident stay was not deleting the CAA records associated with the MDS assessment for that stay. Note: this issue had no visible effect to the user. It simply left some orphaned records in the database.
• Corrected an issue where it was not adding an 802 record for a resident who does not have an 802 record and the user was using the Replace option on the extract process.
• Corrected the masking of the resident's SSN on the face sheet when using the mask SSN option. It was showing 4 characters starting at the fifth position (SSN is stored without the dashes) and it should have been starting at the sixth position.
• Added a sort to the Admitted From selection list so that it is sorted by name.

This update does include a small database update process (Clinical_DB_Update_6106.16.accde). Like other database updates, you must apply this database update prior to any users launching the new Clinical version from their workstations. All users will need to be out of Clinical in order to run the database update. As usual, the database update program must be placed in the same folder that holds the data database (ClinicalData.mdb) and executed from a server or workstation that either has retail Access 2010/2013 or the Access 2010/2013 runtime installed.

February 14, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

Click here to download the User documentation for the new 802 report

There is a new clinical update (version 6106.14) available to be downloaded. The last published update was 6106.12 so you might notice that the version number has jumped 2 values. If you are currently on version 6106.12 you need not worry that you have somehow missed some updates. A few clients may have received 6106.13 as early testers but version 6106.14 contains everything in version 6101.13 contained.

This update includes support for the new CMS Matrix For Providers (802) report that replaced the original Roster / Sample Matrix (802) report. For historical purposes, this update continues to provide the original 802 report in addition to this new 802 report. You can click on the following link to download a PDF that explains where to find this new 802 report and how to use it.

This update does include a small database update process (Clinical_DB_Update_6106.5.13.accde). Like other database updates, you must apply this database update prior to any users launching the new Clinical version from their workstations. All users will need to be out of Clinical in order to run the database update. As usual, the database update program must be placed in the same folder that holds the data database (ClinicalData.mdb) and executed from a server or workstation that either has retail Access 2010/2013 or the Access 2010/2013 runtime installed. Like all prior database updates, this latest database update will bring your database current regardless of what level it might currently be at. If you have any questions, would like installation assistance with this update or received a short demonstration of the new 802 report process simply call the LTCPro Helpline (800-453-2828) or email support@ltcpro.us and we will provide you with the assistance you are looking for. Note: if you simply want a demonstration of the new 802 process then install the update prior to requesting the demonstration so that we can perform the demonstration with your current data.



January 10, 2019

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.12) available to be downloaded.

This update includes two corrections related to the October 2018 MDS changes. One of the corrections involves using the copy forward feature when creating a new MDS assessment so you should look at installing this update as soon as reasonable.
The changes in this update include:

• Corrected an issue where question I0020A is not being disabled when question I0020 has a value less than 14 after you have populated I0020, left Section I and returned to Section I. Also corrected an issue where I0020A may contain a dash and returning to Section I is not clearing out that dash. Note: Section I was working correctly with the enable/disable of I0020A when you first go to Section I. It was only an issue when returning to Section I.
• Corrected and issue where, when creating a new assessment using the copy forward option and the source assessment had responses in Section GG (either A or D) and the new assessment should have a blank section GG, the answers for section GG were not all cleared from what was in the source assessment. Note: this was occurring only for the new Section GG questions added with the 10/01/2018 version of the MDS.

Note: while this update corrects the copy forward feature when creating new assessments, it does not correct (clearing out the answers that got into Section GG by the copy forward process) any assessment that includes Section GG that was created using version 6106.11 or earlier. If you have such assessments then you have one of two choices:

• 1. You can delete the assessment and create it again using copy forward under version 6106.12.
• 2. You can open Section GG-A and/or GG-D on the assessment even if it is marked as completed and not required and then clear out the field answers that incorrectly got copied forward into this assessment. Once you have done that, double-click the FA button to approve the section that you just blanked out. When you go to approve Section Z and it asks if you want to run edits on all the sections, respond with No.

This update does not have an associated database update. However, there was a database update (Clinical_DB_Update_6106.5.3) issued with the version 6106.9 / 6106.10). If you have not downloaded and executed that database update then you should do that with this program update. If you are not certain if that database update was executed then you can download this database update and execute it. If it had been executed then it will inform you that your database is already at the current version and you can respond that you do not want to rerun the process.



November 20, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.11) available to be downloaded.
This update includes some additional corrections related to the October 2018 MDS changes as well as one product enhancement. While the included corrects are likely not of a critical nature or involve somewhat of an uncommon situation it is advised that you download and install this update when you can.
The changes in this update include:

• Corrected an issue where MDS Section GG-A could give you a runtime error if question GG0170M1 was set to 07, 09, 10 or 88.
• Corrected an issue where in Section GG-A if you responded with 3 GG0110 question set to 1 then the screen incorrectly set GG0110Z to 1 and did not allow it to be changed to 0..
• Corrected an issue with Section I on an NP type assessment where it was setting I0020A to a dash when entering a value less than 14 in I0020. In such cases I0020A should be blank and not a dash.
• Corrected the description in the key area of Section GG printouts for assessments with an ARD of 10/01/2018 or later to reflect the proper description of the 88 value. Note: this was only an issue on the MDS printouts and not on the input forms.
• Corrected the description in Section N printouts for assessments with an ARD of 10/01/2018 or later to reflect the proper question number and description for question N2003. Note: this was only an issue on the MDS printouts and not on the input forms.
• Removed the format options Resident Only and Blank form from the MDS Print screen when you get to that screen from the specific assessment screen because those options will not work properly under that situation. Note: you can still print an MDS form with these options from the Assessment Printing screen.
• Added a new dashboard (graph) for showing the mix of primary diagnoses for a particular date. There is an option to filter the chart to a specific payer if desired. Note: in order for the graph to be accurate the resident must have a diagnosis marked as a primary diagnosis and the diagnosis must have a diagnosis date less than or equal to the specified date and the diagnosis' resolved date (if any) must be greater than or equal to the specified date.

Note: This update does not have an associated database update. However, there was a database update (Clinical_DB_Update_6106.5.3) issued with the version 6106.9 / 6106.10). If you have not downloaded and executed that database update then you should do that with this program update. If you are not certain if that database update was executed then you can download this database update and execute it. If it had been executed then it will inform you that your database is already at the current version and you can respond that you do not want to rerun the process.

October 29, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.9) available to be downloaded.
The reported issues with the October 1 version of MDS are appearing to calm down so we are hoping the frequency of updates will slow down with this update. However, because of the many types of MDS assessments and their schedules it is possible that we have not exercised every possible combination of assessment types and answers after just under a month of assessment creations. If you encounter any issues with MDS assessments after installing version 6106.9 be sure to let us know ASAP so that we can take care of those in a timely manner.
Here are the items included in this update (items corrected since version 6106.8):

• Corrected an issue when approving Section Z on a comatose resident (B0100 = 1) and you elect to loop back and check all the sections that Section C fails the edits on questions C0700, C0800, C0900 and C1000.MDS Section GG - Corrected an issue where your entry into Section GG-D for questions GG0170O3 and GG0170P3 were not being retained when you saved that section.
• Corrected an issue where Section N question N0410H was not showing on an NOD type assessment with an ARD of 10/01/2018 or later.

Note: this update does not include a database update so it can be installed without having to have all your users out of the software. However, each workstation will not be updated to 6106.9 until the user gets out of the application and goes back in. However, if you have not downloaded and installed version 6106.8 then you will need to download and install that version first as it does include a quick database update step (see the post dated October 22 for details).

October 22, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.8) available to be downloaded. The last published update was 6106.5 so you might notice that the version number has jumped 3 values. If you are currently on version 6106.5 you need not worry that you have somehow missed some updates. A few clients may have received 6106.6 or 6106.7 as early testers but version 6106.8 contains everything in those prior versions that were never fully published.
There have been quite a few issues with MDS assessments with ARDs of 10/01/2018 that were fixed with this update. We have had an early release of this version out at a few clients since 10/17 and they have reported that 6106.8 appears to have addressed their issues so were are going ahead and publishing this update availability to all our clients at this time.
Some of the issues discovered since version 6106.5 simply require re-submitting (creating a new submission file) rejected assessments once 6106.8 has been installed. However, a few of the issues, mostly those involving Section GG-D as well as Section I, Section J and Section N, may require that those assessment be re-opened to view and confirm those sections. In some cases, just viewing the section will correct the issue but in other cases you may have to confirm that the answers in those sections have retained all the initial answers you entered before approving that section. So, to be totally safe, you may want to take any rejected assessments and not yet submitted assessments and view Section GG-D (if data was entered), Section I (questions I0020 and I0020A), Section J (question J2000) and Section N (questions N2001, N2003 and N2005) before you place that assessment in a submission file. New assessments created using version 6106.8 should be fine.
As you know, the MDS has 11 different types with variations in some of the sections. Questions within a section can require or not require answers based on how you answered other questions in that section or even how you answered a question in another section so there is quite a bit of complex logic involved with MDS entry and approval and there is almost an unlimited amount of variations of answers. This makes for a period of fine-tune adjusting the program when a new MDS specification level is issued by CMS and we appreciate your patience as we find and fix all of this. In the past we have found that the number if issues with a new MDS specification level tend decline after about 3 weeks or some and, hence, the frequency of updates also slows down. We are about at that point but the possibility exists that other issues might be discovered in the next couple of weeks as the MDS activity for assessments with ARDs of 10/01/2018 or later are first being created. Please be sure to report anything that you might encounter that is not some sort of obvious user entry error so that we can look at the situation and determine if some sort of program update is needed for that issue. Your cooperation is greatly appreciated.
Here are the items included in this update (items corrected since version 6106.5):

• MDS submission file creation process - Corrected an issue where the changes made to this process to speed it up could sometimes result in a warning that a resident's next due date could not be calculated due to a missing admit date.
• MDS Section GG - Corrected an issue where your entry into Section GG-D for questions GG0170O3 and GG0170P3 were not being retained when you saved that section.
• MDS Section GG - Corrected an issue where your entry into Section GG-D for questions GG0170O3 and GG0170P3 were not being retained when you saved that section.
• MDS Section GG - Corrected some instruction language on Section GG-D in the GG0170 area where is was saying "admission" and should have said "discharge".
• MDS Section GG - Corrected some edit logic on Section GG (both GG-A and GG-D) that was not allowing you to approve the section due to some skipped GG0170 questions that can be skipped based on responses to other GG0170 questions.
• MDS submission file creation process - Corrected an issue where if Section I question I0020A is populated that the assessment is being rejected due to an invalid ICD10 format on that field.
• MDS Compare Report - Corrected an issue where the MDS Compare Report screen would issue a runtime error is one of the two assessments had an ARD of 10/01/2018 or later.

This update does include a small database update process (Clinical_DB_Update_6106.5.2.accde). Like other database updates, you must apply this database update prior to any users launching the new Clinical version from their workstations. All users will need to be out of Clinical in order to run the database update. As usual, the database update program must be placed in the same folder that holds the data database (ClinicalData.mdb) and executed from a server or workstation that either has retail Access 2010/2013 or the Access 2010/2013 runtime installed. This database update process also includes the database change that was done with version 6106.4 and for which that update indicated that you should call the Helpline in order to have us make that database change. So, If you have not yet installed 6106.4 or you have but have not called the Helpline, you no longer have to install version 6106.4 or call the Helpline for that database update that came with version 6106.4.

October 15, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.5) available to be downloaded. This update includes corrections for the items listed in the October 10 post as well as a program improvement that speeds up the creation process for MDS submission files.Here are the items included in this update:

• Corrected an issue where, in Section GG of the MDS, questions in the GG0170 section were not presenting response option 88 as a possible choice.
• Corrected an issue where if the MDS submission file included one or more NPE type assessments with an ARD of 10/01/2018 or later that the file creation process would issue an runtime error and not create the file. The problem was with the submission file creation process and not with the actual NPE assessment so there is no need to modify anything in the NPE assessments. They just need to be submitted again once version 6106.5 is installed.
• Corrected an issue where an MDS assessment of type NC was not disabling question J2000 in Section J when Section A question A0310B was not equal to 01. This was, therefore, not allowing you to approve Section J when leaving J2000 blank.
• Corrected the setting of questions I0020 and I0020A in MDS Section I for assessments with an ARD of 10/01/2018 or later when those questions were not to be answered. The system was setting those questions to dashes when they needed to be left blank thereby causing such assessments to be rejected with invalid answers to these 2 questions. Once version 6106.5 is installed you will have to go to section I on those assessments. This will replace the dashes with blanks and then you can transmit the assessment. Note: if you already transmitted the assessment and it was rejected you only need to do the above and transmit it again. You do not need to do a correction on the assessment as it was not accepted by CMS when you originally transmitted it.
• Changed the spec_vrsn_cd value in MDS assessments with an ARD of 10/01/2018 from 1.16.1 (which we thought was the correct value when we published version 6106.4) to 2.02 which is what CMS wants for assessments with an ARD of 10/01/2018 or later. Note: assessments transmitted using version 6106.4 or earlier were still being accepted as the incorrect spec_vrsn_cd was only a warning. So, there is no need to resend any such assessments that resulted in this warning (only this warning). Any assessments transmitted after version 6106.5 is installed should no longer get this warning on the validation report.
• Shortened the time it takes to create the MDS submission file by changing what residents have their next assessment due dates updated during the MDS submission file creation process. Prior versions ran through all active residents each time you created an MDS submission file. That was more work than normally necessary so this update limited which residents were updated to just those residents who had assessments in this submission file. However, this means that the next assessment due dates for residents with completed but not submitted assessments will no longer have their next assessment due dates updated during the MDS submission process until which time an assessment for that resident is transmitted. If you want the system to continue to process all active residents like it did before there is a new option on the MDS Submission screen (a checkbox just above the create button) that you can check to cause the process to include all active residents. Also, as part of this enhancement, a progress field was added to the screen showing what steps the file creation is working on and we eliminated both the pop-up forms (one for indicating it was about to update the next assessment due information and the other when the process was completed) that were presented during the process and you had to click OK to have the process continue. Now, when the process is completed, the process status will indicate such and you can close the form.

This update does include a small database update process (Clinical_DB_Update_6106.5.accde). Like other database updates, you must apply this database update prior to any users launching the new Clinical version from their workstations. All users will need to be out of Clinical in order to run the database update. As usual, the database update program must be placed in the same folder that holds the data database (ClinicalData.mdb) and executed from a server or workstation that either has retail Access 2010/2013 or the Access 2010/2013 runtime installed. This database update process also includes the database change that was done with version 6106.4 and for which that update indicated that you should call the Helpline in order to have us make that database change. So, If you have not yet installed 6106.4 or you have but have not called the Helpline, you no longer have to install version 6106.4 or call the Helpline for that database update that came with version 6106.4.

October 10, 2018
Now that our clients are starting to create MDS assessments with an ARD of 10/01/2018 or later the opportunity has presented itself for issues to be found with the new screens and code added to our Clinical product related to the MDS changes for October. Despite performing extensive testing of those changes it is always possible that something gets through the cracks and has to be addressed. We normally announce when a new update is available to be downloaded and in that announcement we list what was fixed/changed in that update. However, we feel that, during this period of early use of changes, it is beneficial to you to know we are aware of certain issues even before we have the correction so that you do not have to take the time to alert us of an issue you encounter. So, here is what we are aware of so far and for which there will be fixes in version 6106.5. If you encounter an issue that is not in this list then please make us aware of it so we can get a correction for that in the next update.

• If your MDS submission file includes one or more NPE type assessments with an ARD of 10/01/2018 or later then creation of the submission file will result in a runtime error and the submission file will not successfully be created. Until the next update you should exclude any NPE type assessments with an ARD of 10/01/2018 or greater so that the other assessments can be submitted. Once version 6106.5 is available and installed you will be able to submit those NPE type assessments. You will not have to re-open them; just wait to submit them.
• MDS Section GG added some additional possible responses for the 0170 question set. One of those possible responses (88) is not showing in the drop-down list for the various fields and you cannot just enter 88. There is no workaround for this issue in the current release.
• The new question in Section J (J2000) is only supposed to be answered if A0310B = 01. Version 6106.4 was supposed to disable this field unless A0310B = 01 but the coding change for that is not working as intended. Until version 6106.5 is available your only option is to leave this field blank in such cases and utilize the FA (force approve) button to approve the section. Remember, if you do use FA to force approve a section you have to bypass rechecking the complete MDS when you approve Section Z or it will un-approve the section that you force approved.
• The new section I questions (I0020 and I0020A) are only to be answered if A0310B = 01. The current version of the software sets these fields to a dash if A0310B not equal to a 01 but it turns out that the validation report will reject the assessment if these fields are set to a dash. Because the software disable these fields if A0310B is not equal to 01 you cannot just clear these fields and use the FA (force approve) button. So, you will have to wait until version 6106.5 is available and then reopen those assessments that auto-filled with a dash in these fields and re-approve Section I. Then you can submit these assessments. Note: because they were rejected because of the dash you do not do a correction assessment but merely edit the current assessment using the process described here and then submit them again.

October 9, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.4) available to be downloaded. There are some changes in this update that affect MDS assessments with an ARD or 10/01/2018 or later so this update should be downloaded and installed as soon as possible. Also, there is one small change needed to be done against your database that is related to the program changes. In order to avoid you having to go through a database update process with this update and having to get all users out of the program during that update we will address that database update through a call to the Helpline (800-453-2828). The process will take just a couple of minutes so, once version 6106.4 has been installed, call the Helpline and we will do a remote session with you to apply this database change. Note: this database change only needs to be done under one user at your facility and only involves NPE type assessments with an ARD or 10/01/2018 or later.Here are the items included in this update:

• CMS made a change to the MDS 1.16 specifications (ARD of 10/01/2018 or later) after the draft specifications were issued that we missed. This change involves when the new questions J2000, N2001, N2003 and N2005 are to be answered. These questions still appear on multiple assessment types but only need to be answered under certain conditions. Version 6106.4 now conforms to those conditions for those questions.
• NPE assessments with an ARD of 10/01/2018 or later should have included Section N (question N2005 only). This update now includes section N for NPE assessments with an ARD of 10/01/2018 once you call the Helpline (as noted above) and the proper database change has been made on your system.
• The spec-vrsn-cd value in the MDS submission file has been changed from 1.16 to 1.16.1 in order to eliminate the validation report warning on this field when submitting an assessment with an ARD or 10/01/2018 or later (see the October 4th post on this website for additional information on this issue).
• The drop-down list for frequency code field on the physician order library entry screen has been changed to sort the frequency codes by the code ID.
• The vendor information in the MDS submission file has been changed from Continuex Corporation to LTCPro.
• Changed the website that opens when the Clinical News is displayed from the Continuex website to the LTCPro website.

October 4, 2018
We have discovered that assessments with an ARD of 10/01/2018 or later are being accepted but the validation report is showing a warning that spec_vrsn_cd of 1.16 is invalid. It turns out that the last minute change to Section N regarding some skip wording is affecting the version code they are expecting. They advanced the version code from 1.16 to 1.16.1 on the form and even though that had no effect on the content of the submission file they are now expecting the version code in the submission file to reflect 1.16.1. This issue will be corrected in the next program update. However, the assessments with this warning have been accepted and there is no need to re-submit them or create corrections to them. Watch this webpage for the announcement when the next update is available.

September 19, 2018
October 1 is approaching and with it comes the MDS changes effective October 1. If you have already installed version 6106.2 when it was published back in August then you already had the necessary changes needed for October 1 assessments so you were already set. If you are running with version 6015.7 or earlier then you must download version 6106.2 and run the database update process in order to have the necessary MDS changes effective October 1. Further, if you have advance created any assessments with an ARD of 10/01/2018 and are still running with a version earlier than 6106 then those assessments will have to be deleted and created over again once you have installed version 6106 or later.

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.3) available to be downloaded. There is one minor change in this update that affects involves the MDS changes effective October 1 so you should download and install this update as soon as possible. This update also includes a program correction and a small product enhancement. Here are the items included with this update:

• CMS issued a small wording update in Section N question 0450 on the skip instructions for the October 1 MDS changes. While this change did not affect how the Coworker program actually processed Section N, this update changes the wording on the skip instructions to match what CMS released earlier this month. If you have already advance created assessments with an ARD of 10/01/2018 or later those assessments are fine. The only change you will see is in the wording of Section N on NC type assessments.
• Corrected a condition where the resident screen might incorrectly issue a pop-up that the resident stay information is out of sync with the resident information. Note: this issue would only occur if LTCPro had to hand build a missing stay record for a previous stay.
• Corrected the form display to only show, by default, logged on users but provide an option to show all logged on and out activity. Also, changed the sort order to sort by logged on date/time descending.

Note: this update does not include a database update so it can be installed without having to have all your users out of the software. However, each workstation will not be updated to 6106.3 until the user gets out of the application and goes back in.
August 17, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106.2) available to be downloaded. There are no regulatory changes in this update but it does contain some corrections to a few issues so you should plan on installing this update when you can. Here are the items included with this update:

• Added a way to force a table relink even if the linkages look good. A forced relink will occur if the process finds a file called CWWRelink.txt in the proc directory. This file only needs to exist. Its contents does not matter.
• Added a check on the resident select sub-form that, when changing the first or last name, it will ask for confirmation that you are trying to actually change the selected resident's name and not trying to select another resident.
• Version 6105.8 added a button on the main resident screen that you could click to print a facesheet from that screen. The changes for that feature passed that resident ID on to the facesheet screen. However, once it did that, it then remembered that resident ID even if you wanted to print facesheets from the reports side of the menu. Changed the logic so that it does not remember that resident ID when getting to the face sheet from the reports side of the menu.
• Added edits to MDS Section O to make sure O0400A1, O0400A2, O0400A3, O0400B1, O0400B2, O0400B3, O0400C1, O0400C2 and O0400C3 are not left blank.
• Corrected an issue where when attempting to print an assessment with an ARD of 10/01/2018 or later would issue a pop-up asking for the value of GG0170G1, G2 and G3 before printing. Note: the actual correction to this issue comes from running Cinical_DB_Update_6106.2.
• Corrected an issue where Section GG was not available for adding an MDS note.
• Corrected an issue where the MDS Specific Answers sub-form for Section N was issuing a pop up for a value related to N0450 questions instead of just using the question's answer.
• Corrected an issue where you click on the Edit button to open the resident screen while you have an MDS selected and, upon closing the resident screen, you were not returned to the MDS entry screen.
• Removed MDS Submission from the Multi-Resident menu as it is also on the MDS menu and the menu item on the Multi_Resdient menu item did did not take you to the MDS submission screen.
• Corrected an issue where, if you select Admit / Discharge / Transfer as a filter for the report list the resultant list is empty.

CMS published the final specifications for the October 1, 2018 MDS changes. The final specifications did not include any changes that were not already in Coworker version 6106 so that version and subsequent versions are all set for October 1.

This update does include a small database update process (Clinical_DB_Update_6106.2.accde). Like other database updates, you must apply this database update prior to any users launching the new Clinical version from their workstations. All users will need to be out of Clinical in order to run the database update. As usual, the database update program must be placed in the same folder that holds the data database (ClinicalData.mdb) and executed from a server or workstation that either has retail Access 2010/2013 or the Access 2010/2013 runtime installed.
June 20, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

It has been discovered that version 6106 has an issue with creating MDS submission files with ARD's between 10/01/2017 and 09/30/2018. The submission files are basically empty and CMS returns an error referencing field X0800. This issue has been corrected with update 6106.1.

If you have already downloaded version 6106 and installed it then download 6106.1 and install it. Version 6106.1 does not include a database update so this download and install can be done while other users are in the application.

If you have not already downloaded version 6106 then you will need to download both 6106 and 6106.1. You need the database update that is included in version 6106 but not in version 6106.1 so that is why you have to download both versions. If you are a network install you do not have to first install 6106 to the workstations and then version 6106.1 to the workstations as 6106.1 includes all changes in version 6106. However, you do have to run the database update included in the download file for version 6106 and that means all users will have to be out of the application while the database update process is run.

If you did install version 6106 and created one or more MDS submission files after that install, the assessments included in that file will have to be re-submitted (not re-opened or corrected but just re-submitted). If you do not know how to re-submit assessments you can call the LTCPro Helpline at 800-453-2828 and we will assist you with the re-submission process.
June 14, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6106) available to be downloaded. This update includes a set of changes originally targeted for version 6105.8 that was never published and some changes targeted for this verion. While there are no immediate regulatory changes in this update it would still be beneficial to install this update as soon as reasonable. Please review the list of changes below in determining when you will decide to install this update.

Here are the items included with this update:

• Corrects the heading title on Section GG - 0170.
• Corrects an issue in the MDS printout (not the screen) where Section GG - 0170B2 was not reflecting the exact answer entered in Section GG - 0710B2. What was showing was the first digit of what was entered in first digit of GG - 0130B2. Note: this was only an issue if GG0170B2 had been entered as 88.
• Corrects issue where the landscape version of the Quality Assurance report spilled over on the right causing a semi-blank second page when selecting more than one resident.
• Modified the Logged In Users screen to handle an open session record where the staff member has been deleted from the staff table but the log table contains an open session for that staff ID. This change allows the user to clear out such orphaned records from the log table.
• Added a check on the main Resident screen for a discrepancy between the most recent stay information and the resident's current status (resident stay shows discharged but current status shows admitted) and, if found, ask if you want to correct the resident's current status to match the stay information.
• Added a button to the main Resident screen to launch Print Facesheet without having to close that screen and go to the Reports to print their facesheet.
• .Corrects an issue where the resident's room does not print on the header portion of the MDS forms.
• Corrects an issue where, upon attemptingto open various reports such as the MDS 3 Specfic Answers report you would get an error indicating that focus could not be moved the the cbowing field.
• Adds the capability to print a single section of an MDS Assessment. Note: if the MDS page contains more than one section then selecting a specific section will include the other section information that normally comes on that page as the process works at a full page level.
• Corrects an issue with the MDS entry where states with a Section S were not presenting you with Section S for data entry. Note: this correction was only implemented for assessments with an ARD of 10/01/2016 or later. Also, any existing assessment created before this correction that has a status other than "incomplete" has set Section S as approved so the the Section S is not showing as not approved with the assessment has been approved should you pull back up one of these assessments.
• Adds sort by name to the 3 payer fields on the Admission screen so that the drop-down list is ordered by the payer name.
• Includes the MDS section changes going into effect 10/01/2018. Only assessments created with an ARD of 10/01/2018 will reflect these changes after installing this update. Note: the CMS specifications defining these changes are still in the draft mode so it is possible that further changes will be required btween now and 10/01/2018. If you want to take a look at these upcoming changes you can create a dummy assessment with an ARD of 10/01/2018 or later and then delete that assessment once you are done looking.
• Enhanced the MDS printing screen so that you can print (blank or with resident demographic data only) any assessment type for MDS versions 1.14 or later (including the upcoming version 1.16) from this screen.

This update does include a small database update process (Clinical_DB_Update_6106.accde). Like other database updates, you must apply this database update prior to any users launching the new Clinical version from their workstations. All users will need to be out of Clinical in order to run the database update. As usual, the database update program must be placed in the same folder that holds the data database (ClinicalData.mdb) and executed from a server or workstation that either has retail Access 2010/2013 or the Access 2010/2013 runtime installed.
April 3, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6105.7) available to be downloaded. This update does include a regulatory update as well as a few corrections to some reported issues with your current version of the software and one new optional feature. How soon you need to install this update depends on how quickly Medicare starts issuing the new Medicare Benefit Identification (MBI) numbers. While the original information indicated that these new MBI numbers were to become effective 10/01/2018, more recent publications have stated that, once a resident has the new number, it should be used in place of the old Medicare number in MDS submissions. Here are the items included with this update:

• For assessments with an ARD of 4/01/2018 or later and the resident has the new MBI number (and entered on the Resident Information screen), that MBI number will be placed in Section A question 0600B instead of the old Medicare number. For residents who do not yet have their new MBI number (e.g., that field is blank on the Resident Information screen), A0600B will continue to contain the old Medicare number.
• Added the ability to force a workstation to pull a fresh copy of the program file (Clinical90.accde) from the server drive even when the workstation already contains the same version. This capability provides a way to refresh the program file without having to perform a manual copy process on the workstation should the copy on the workstation be corrupt or is suspected of being corrupt. You force this update by holding down the shift key while you double-click the desktop shortcut for launching the Clinical application. You must continue to hold down the shift key until which time you see the application log on screen. Note: this option should only be used with a network install of the application (where your data exists on a network server) and not on a standalone installation of the application.
• Corrected some wording on both the Section GG screen and the MDS report to correctly match the offical form. Note: this change has no operational effect but was done for cosmetic reasons.
• Corrected an issue (asking for the value in a pop-up form) with the MDS Specific Answers screen when selecting something from Section GG.

Note: this update does not include a database update so it can be installed without having to have all your users out of the software. However, each workstation will not be updated to 6105.7 until the user gets out of the application and goes back in.
January 6, 2018

CLINICAL UPDATE AVAILABLE TO DOWNLOAD

There is a new clinical update (version 6105.5) available to be downloaded. There are no regulatory changes in this update but it does contain some corrections to a couple of issues so you should plan on installing this update when you can. Here are the items included with this update:

• Corrected an issue with physician order flow sheet printing introduced by the prior change to differentiate between upper case and lower case characters in the sort order code that was causing no lines to print when you utilized both upper and lower case letters in the sort order code.
• .Added a field to the resident screen for the new Medicare Beneficiary ID (MBI) that comes into effect 10/01/2018 but numbers will start to be issued 4/01/2018. You should continue to enter the resident's social security number even after you have their new MBI identification as the social security number will continue to be used at least through Septermber 30th. Note: the MDS assessment changes have not been defined as of yet.
• Corrected MDS Section O printout on NQ assessments. It was including ) O0100G, O0100L and O0100Z when these fields are not part of an NQ assessment. It was basically using the NC Section O printout.
• Changed the header on the discharge summary from a shaded format to a box format because the shading was causing issues when faxing.
• Corrected an issue when trying to approve MDS Section A and you got an invalid data type error when the prior assessment had D0300 set to a dash.

This update does include a small database update process (Clinical_DB_Update_6105.5.accde). Like other database updates, you must apply this database update prior to any users launching the new Clinical version from their workstations. All users will need to be out of Clinical in order to run the database update. As usual, the database update program must be placed in the same folder that holds the data database (ClinicalData.mdb) and executed from a server or workstation that either has retail Access 2010/2013 or the Access 2010/2013 runtime installed.