āThe updated MDS California Section S form, effective October 1, 2017, reflects the changes on the California Physician Orders for Life Sustaining Treatment (CA POLST) form dated January 1, 2016. The CA POLST remains an option for residents to designate end-of-life choices with their health care provider. The current CA POLST form (effective January 1, 2016) is available at http://capolst.org/
The updated Section S form is available on the California Department of Public Health website at: https://www.cdph.ca.gov/Programs/CHCQ/LCP/Pages/Minimum-Data-Set.aspx
Nursing facilities submitting MDS 3.0 need to obtain the updated software specification for California Section S from Quality Improvement and Evaluation System Technical Support Office (QTSO) website at: www.qtso.com
The changes in S9040A and S9040E are underlined on the table below:
| āS9040A | āDoes resident have a California POLST form in chart? | ā0. No
1. Yes
2. In Process |
| āS9040E | āCA-POLST Section D- signature of Physician, Nurse Practitioner or Physician Assistant | ā0. No
1. Yes |
MDS Section S completion is required on MDS comprehensive assessments, quarterly assessments, discharge assessments, and tracking records. Facilities are not required to complete section S on Medicare Part A Prospective Payment System (PPS) assessments.
If you have additional questions, please contact the MDS/OASIS Help Desk by email at mdsoaosis@cdph.ca.gov or by phone at (916) 324-2362.
Please distribute copies to MDS Coordinators, Directors of Nursing, and Facility Administrators.
Sincerely,
Original signed by Jean Iacino
Jean Iacino
Deputy Director