Reporting Provider Bed Information in the T‐MSIS Provider File (Provider)

Technical Instructions History

Brief Issue Description

These technical instructions outline best practice for reporting Medicaid-certified bed information for a provider in the T‐MSIS Provider file when the provider is a facility with types of beds that are represented by the T-MSIS bed type values.

Background Discussion

Context

States report data about a facility-provider’s Medicaid-certified beds on the T‐MSIS Provider (PRV) file PROV‐BED‐TYPE‐INFO (PRV00010) record segment, reported via the segment’s data elements, including BED‐TYPE‐CODE (PRV173), BED‐COUNT (PRV135), PROV-LOCATION-ID (PRV129), BED‐ TYPE‐EFF‐DATE (PRV130), and BED‐TYPE‐END‐DATE (PRV131). Each PRV00010 record segment represents a Medicaid-certified bed type and the number of that type of bed at the given facility provider location. The PRV00010 record segment is not required for providers that are not facilities with types of beds that are represented by the T-MSIS bed type values.

Challenge

Some states have reported overlapping and redundant PRV00010 record segments. Sometimes this is because the state’s proprietary bed type classification system is more granular that the T-MSIS bed type categories. Sometimes this is the state is not properly maintaining historical changes in facility bed information.

States are also seeking guidance regarding which beds at a given facility they should report via the PRV00010 record segment.

CMS Technical Instructions

Each PRV00010 record segment represents a Medicaid-certified bed type and the number of that type of bed at the given facility-provider location. A provider that is a facility with types of beds that are represented by the T-MSIS bed type values must have a PRV00010 record segment for each unique combination of SUBMITTING‐STATE, SUBMITTING‐STATE‐PROV‐ID, PROV‐LOCATION‐ID, and BED‐TYPE-CODE. The number of beds for each bed type should be reported on its own separate segment. If the value in one or more of the data elements in the PRV00010 record segment changes, a new record segment must be created, ensuring the two segments’ effective dates and end dates do not overlap.

States that submit a PRV file using a non-claims submission method that includes historical records should continue to report historical record segments in their submissions with information that is accurate for the date range for each segment according to segment effective and end dates (that is, the values accurately reflect the truth as it is understood to be at the time the record is created or updated). This ensures a full historical account of the facility provider’s beds are recorded in T‐MSIS.

Please see below for additional information on how to report each of the data elements in the PRV00010 record segment.

BED‐TYPE‐CODE

BED‐TYPE‐CODE is a data element used in T-MSIS to classify Medicaid‐certified beds at facilities, including Inpatient hospitals, Nursing Facilities, Intermediate Care Facilities for the Intellectually Disabled (ICF‐ID), Skilled Nursing Facilities (SNFs), and Institutions for Mental Disease (IMDs). If the provider is a facility, the bed types for the facility should be categorized into the T‐MSIS BED-TYPE-CODE valid values.^[1]

In many cases, a facility will have only one bed type. If a facility has only one bed type, then it should have one PRV00010 record segment with segment effective and end dates that span the duration the facility is enrolled with the state’s Medicaid program, or that span the duration for which the facility has only one bed type. In the case of facilities with multiple bed types, states should create multiple record segments—one for each bed type. As a provider changes bed designations over time, new records will need to be created to record the correct number of beds by type within the effective date and end date range for which the values in the segment were in effect.

In the event where a provider’s bed types are ambiguous, such as swing beds, the BED‐TYPE‐CODE should be reported based on the provider’s facility type, using the BED‐TYPE‐CODE valid values as a basis. If a facility has beds with types they consider more granular than the valid values for BED‐TYPE‐CODE, then these should be consolidated into one of the relevant valid values for BED‐TYPE‐CODE. There should be no more than one PRV00010 segment per bed type within a record segment’s effective date and end date range. This may mean that states need to combine more granular bed types into the T‐MSIS bed type valid values. For example, a hospital might have 150 acute care beds, 20 intensive care beds, 10 rehabilitation beds and 15 nursery/bassinet beds. These more granular bed types would be consolidated into one of the relevant valid values for BED‐TYPE‐CODE. Therefore, this facility would have one record segment with a BED‐TYPE‐CODE of ‘2’ (Inpatient), with a BED‐COUNT of ‘195’.

If states know the number of Medicare SNF beds, they should report that under BED-TYPE-CODE of ‘4’ (Title 18 Skilled Nursing Facility). States should not double‐count beds under two different bed types. For example, a state should not count beds reported as Medicare SNF beds in the Nursing Facility bed type as well. When the provider is a facility with beds, and the bed type is unknown, states should choose the most appropriate bed type (for example, hospitals would be coded to Inpatient [BED‐TYPE‐CODE of ‘2’] and nursing facilities to Nursing facility [BED‐TYPE‐CODE of ‘3’]).

For BED‐TYPE‐CODE, the value ‘8’ (Not Applicable) should not be used and has been removed from the T‐MSIS Data Dictionary. If the provider is not a facility, states do not need to report a PRV00010 record segment, making BED‐TYPE‐CODE of ‘8’ (Not Applicable) obsolete.

BED‐COUNT

If the number of beds is unknown, states should space-fill BED‐COUNT, rather than report zero beds. If the provider is not a facility with types of beds that are represented by the T-MSIS bed type values and therefore the PRV00010 record segment is not applicable, states should not report this record segment for the provider and therefore should not report a zero value.

BED‐TYPE‐EFF‐DATE and BED‐TYPE‐END‐DATE

The BED‐TYPE‐EFF‐DATE and BED‐TYPE‐END‐DATE define the date spans for which the information for a unique PRV00010 record segment is applicable.

States should report the BED‐TYPE‐EFF‐DATE as the first day of the time span during which the values in all data elements in a unique PROV‐BED‐TYPE‐INFO record segment (defined as a unique combination of SUBMITTING-STATE, SUBMITTING-STATE-PROV-ID, PROV-LOCATION-ID, and BED-TYPE-CODE) are in effect (that is, the values accurately reflect reality as it is understood to be at the time the record is created).

States should report the BED‐TYPE‐END‐DATE as the last day of the time span during which the values in all data elements in a unique PROV‐BED‐TYPE‐INFO record segment are in effect (that is, the values accurately reflect the truth as it is understood to be at the time the record is created). If the BED‐TYPE‐END‐DATE is open ended (that is, the information in the segment is current with no known end date), it should be populated with 99991231 (December 31, 9999).

If the number of beds changes, then a new segment is reported. One segment includes the date range (effective date and end date) that applies to the previous number of beds, and the additional segment includes a date set that applies to the new number of beds. The only instance in which states need to change data on the record without starting a new date range is when the information is later determined to be inaccurate for the date range reported and the change represents a correction to the data.

Endnotes

[1] For the most up to date T-MSIS data element definitions, valid values, and other T-MSIS data dictionary artifacts, state T-MSIS teams should refer to the Data Guide available on the Operations Dashboard (OD) via the CMS.gov Enterprise Portal. Users without access to the OD should refer to the publicly available Data Dictionary artifacts published on Medicaid.gov: https://www.medicaid.gov/medicaid/data-systems/macbis/transformed-medicaid-statistical-information-system-t-msis/t-msis-data-dictionary/index.html. CMS publishes major version updates of the Data Dictionary and associated artifacts to Medicaid.gov. Minor version updates are published to the Data Guide on a more frequent basis.