National Rehabilitation Reporting System (NRS): Data ... · National Rehabilitation Reporting System (NRS): Data Submission 1 National Rehabilitation Reporting System (NRS): Data

National Rehabilitation Reporting System (NRS): Data Submission

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For permission or information, please contact CIHI:

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© 2013 Canadian Institute for Health Information

Table of contents About CIHI ................................................................................................................................... iii

Privacy and Confidentiality of Health Information at CIHI ............................................................ iii

National Rehabilitation Reporting System (NRS): Data Submission ............................................ 1

Section 1: Introduction ............................................................................................................... 1

Section 2: Overview of the Data Submission Process .............................................................. 3

Section 3: Data Submission Contact ......................................................................................... 4

Section 4: File-Naming Conventions ......................................................................................... 5

Section 5: Data Record Types .................................................................................................. 7

Section 6: Facility Profile ........................................................................................................... 9

Section 7: Assessment Types ................................................................................................. 10

Section 8: Submission Timelines ............................................................................................ 11

Section 9: Electronic Data Submission Service ...................................................................... 12

Section 10: Reviewing and Understanding Submission Reports ............................................ 16

Section 11: Facility Testing ..................................................................................................... 24

Section 12: Summary .............................................................................................................. 25

Appendix A: Submission Warning Messages ............................................................................. 27

About CIHI

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About CIHI The Canadian Institute for Health Information (CIHI) collects and analyzes information on

Canada’s health care system and the health of Canadians and makes it publicly available.

Canada’s federal, provincial and territorial governments created CIHI as a not-for-profit,

independent organization dedicated to forging a common approach to the collection, analysis

and dissemination of Canadian health information. CIHI’s goal: to provide timely, accurate and

comparable information. CIHI’s data and reports inform health policies, support the effective

delivery of health services and raise awareness among Canadians of the factors that contribute

to good health.

Privacy and Confidentiality of Health Information at CIHI The protection of individual privacy, the confidentiality of records and the security of information

are essential to CIHI operations. We have a comprehensive privacy program to protect the

confidentiality and security of our data holdings, including the NRS, which includes a set of strict

principles and policies that govern how CIHI collects, stores, analyzes and disseminates data.

More information about our privacy program, including the NRS Privacy Impact Assessment, is available at www.cihi.ca/privacy. Symbols


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National Rehabilitation Reporting System (NRS): Data Submission Section 1: Introduction The National Rehabilitation Reporting System (NRS) was developed by CIHI in 2001 to support

data collection by hospitals for inpatient rehabilitation clients who are mainly age 18 and older.

The rehabilitation services are usually provided in specialized rehabilitation hospitals and in

general hospitals within rehabilitation units, programs or groups of rehabilitation beds. Data is

submitted to the NRS by more than 100 hospitals in 9 provinces and pertains to clients with

a range of health conditions including strokes, orthopedic conditions and amputations. This

self-study product provides a detailed look at the process for submitting data to the NRS.

1.1 Objectives

After completing this self-study product, you will be able to

Understand the data submission process;

Explain the role of the Data Submission Contact;

Follow correct file-naming conventions for data submission;

Differentiate between the various assessment types;

Demonstrate how to make updates and deletions;

Illustrate the importance of up-to-date facility profile information;

Identify when you should submit each assessment and record type;

Identify the data elements that link an admission assessment to a discharge assessment;

Identify timelines for data submission;

Illustrate how to access the electronic Data Submission Service (eDSS);

Demonstrate how to submit data using eDSS;

Illustrate how to access the eData Submission History page;

Demonstrate how to access Submission Reports via a link in the NRS Operational Reports;

Interpret the NRS Submission Reports; and

Describe the facility-testing process and requirements.


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1.2 Who Should Complete This Self-Study Product?

This self-study product is intended primarily for NRS Data Submission Contacts, health records

staff and other people responsible for submitting data to the NRS. Facility Coordinators and

other people interested in data submission may also find this product helpful.

1.3 What Will You Need?

Data Submission Contacts may find it helpful to have a computer with internet access while

completing this self-study product in order to follow along with the electronic Data Submission

Service (eDSS) application and access NRS Submission Reports. If you do not have access to

eDSS or Submission Reports, have your Facility Coordinator send an access request to [email protected].


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Section 2: Overview of the Data Submission Process Introduction

Data submission refers to the process of submitting the data collected by front-line clinicians in

your facility to CIHI as part of participation in the NRS.

2.1 Lesson Objective

Provide an overview of the data submission process.

2.2 Data Submission Process

Data is collected by front-line clinicians using the NRS Recording Forms and entered into

a vendor software system. The client records are then compiled into submission files and

submitted to CIHI using the eDSS application. Transmission of data can occur 24 hours a day,

seven days a week through eDSS. After the data files have been submitted, CIHI processes the

data and produces Submission Reports for your facility to review. Processing of files submitted

to CIHI may take up to three business days. Your facility then reviews the Submission Reports

and resubmits any rejected records or necessary corrections. Records accepted by the error

correction deadline (see Section 8) are included in quarterly reports for your facility.

The figure below shows the process.


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Section 3: Data Submission Contact Introduction

Data submission personnel are fundamental to ensuring the accurate and timely submission

of data to the NRS. This section outlines the roles of the Data Submission Contact. Normally,

the Data Submission Contact listed in the facility profile (see Section 6) is responsible for data

submission activities.


Explain the roles and responsibilities of the Data Submission Contact.

3.2 Database Contact Roles and Responsibilities

The Data Submission Contact is an integral member of the NRS facility team. The roles and

responsibilities of this person may include the following:

Liaising closely with the Facility Coordinator and site experts to discuss data and coding

issues, with the goal of establishing consistent facility-level practices;

Receiving data collected by front-line clinicians and reviewing the records for

completeness and accuracy;

Coding the required administrative and diagnostic elements or, depending on the

facility’s practices, liaising with staff responsible for completing these elements;

Producing the submission data files using licensed vendor software and submitting

these files to the NRS through CIHI’s secure eDSS system;

Accessing and reviewing the NRS Submission Reports;

Reviewing the reasons for any rejected or flagged records and resubmitting them

as necessary;

Monitoring and examining data quality issues;

Liaising with CIHI regarding data submission issues; and

Submitting annual facility test data (see Section 11).


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Section 4: File-Naming Conventions Introduction

After the data has been entered into the vendor software system, the Data Submission Contact

must compile the data into submission files. Submission file names must be standardized to

facilitate the receipt and processing of NRS data. This section outlines the proper naming

conventions that submission files must adhere to in order to be accepted into and processed

by the NRS.


Illustrate correct file-naming conventions for data submission to the NRS.

4.2 Proper File Name Conventions

Data submitted to the NRS must be in a text file (.txt). The file name must be in the

following format:

NRSyyyypphhhhhss.txt

Where

NRS = National Rehabilitation Reporting System

This identifies the data holding to which the submission file corresponds.

yyyy = fiscal year

This is the fiscal year of the records contained in the file (not necessarily the current

fiscal year).

pp = quarter (01–04 or FI)

This is the quarter of the records that are contained in the file (not necessarily the current

fiscal year). FI would be selected if you are submitting a facility profile.

hhhhh = facility number

ss = submission sequence number (01, 02, etc.)

The sequence number must be unique within the quarter.

When submitting a new file to the NRS database, the submission sequence number must be

greater than the previously submitted file sequence number for that reporting fiscal year and

quarter. For example, if the last file sent to CIHI had a sequence number of 03 for the second

quarter of 2012–2013, the file name would be NRS2012025555503.txt. The next file sent to

the NRS must have a file sequence greater than 03; otherwise, the file will be rejected without

being processed.


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All files must be zipped in order to be submitted to CIHI through the eDSS application (see

Section 9). The zip file must use the same file name as the text file: NRSyyyypphhhhhss.zip.

4.3 Invalid File Names

If there are issues with the file name you are trying to submit via eDSS (see Section 9), the

applicable error messages will show above the Submission Description area in eDSS. For help

on resolving these errors, review Appendix B: Resolving eDSS Error Messages in the Electronic

Data Submission Services (eDSS)—External User Guide, Version 1.0, available within eDSS.

If there are any additional file name issues after submission, the facility will receive an email

from [email protected] providing instructions on how to resubmit the file.


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Section 5: Data Record Types Introduction

Three record submission types can be submitted to the NRS: initial records, update records and

deletion records. This section will describe the three submission types and the circumstances in

which each type should be submitted.

5.1 Lesson Objectives

Describe the three record submission types; and

Explore the processes for making updates and deletions to records.

5.2 Initial Records

Initial records are indicated by the Data Record Type = 2 on the Admission, Discharge or

Follow-Up Assessment.

If a record is rejected with errors, it is not stored at CIHI. The corrected assessment must be

resubmitted as an initial record. For example, if an admission assessment is rejected with the

error “Missing data element 55A—Comprehension FIM® Instrument Mode; invalid to partially

code FIM® Instrument items,” the data element 55A will need to be entered into the admission

assessment and the assessment resubmitted as initial.

A list of any rejected records and a description of their errors will appear in the Submission

Report, accessed via the NRS Submission Production link within Operational Reports

(see Section 10) for each submission file.

5.3 Update Records

Update records are indicated by the Data Record Type = 3 on the Admission, Discharge or

Follow-Up Assessment. An update can be submitted only for a record that was previously

accepted into the database. That is, if a record was rejected with errors, it is not part of the NRS

database and an update record cannot be submitted to correct the errors. As mentioned above,

rejected records must be resubmitted as initial records.

An update should be submitted when it is discovered that previously submitted information

was erroneous (for example, a wrong birthdate or incorrectly coded diagnosis). Update records

should also be used to correct records that were accepted but flagged with warning messages

(details on records flagged with warning messages are displayed in the Submission Report,

which is discussed in Section 10). For example, if a record receives the warning message

“Height (data element 40A) has been recorded as <120 cm (3’11”), please check your record

to ensure that this is correct,” it may be necessary to submit a correction with a revised height

value. If the value contained in a flagged record is correct, no correction needs to be submitted.


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You can submit corrections for all NRS data elements except the following:

4—Chart Number

5—Health Care Number

21—Admission Date

When submitting a correction, these three data elements must match the corresponding

assessment that already exists in the database or the correction record will be rejected.

5.4 Deletions

Deletion records are indicated by the Data Record Type =1. A delete record has its own

specific file record layout consisting of the following six data elements: Data Record Type;

1A—Facility Number; 2—Assessment Type; 4—Chart Number; 5—Health Care Number; and

21—Admission Date. Records must be deleted in the reverse order of submission to CIHI.

For example, a discharge record must be deleted prior to the deletion of its corresponding

admission record. For specific information regarding the file record layout of a deletion record,

please refer to the Rehabilitation Minimum Data Set Manual, Module 1: Technical Specifications

and Data Submission.

If changes need to be made to the following three data elements, a deletion record must be

submitted first.

4—Chart Number

5—Health Care Number

21—Admission Date

Then, after making the necessary changes to the data elements using your vendor software,

you can resubmit the assessment as initial.

When submitting a deletion record, the three data elements above must match the corresponding

assessment that already exists in the database or the deletion record will be rejected.


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Section 6: Facility Profile Introduction

The facility profile (sometimes referred to as the Facility Information File, or FIF) is a critical record

in the NRS database that contains the following administrative information about each facility:

Contact information for the facility;

The number of designated inpatient rehabilitation beds;

Contact information for the Facility Coordinator;

Contact information for the Data Submission Contact;

Contact information for the facility’s CEO; and

Facility type (general or specialty).

This section will discuss when to submit a facility profile and how information in the facility

profile is used.


Identify when to submit a facility profile; and

Explain the importance of up-to-date facility profile information.

6.2 When to Submit the Facility Profile

An updated facility profile must be sent at the beginning of each fiscal year, prior to submitting

patient records. The facility profile must be submitted separately from any patient data. Any

data submitted before the facility profile for that fiscal year will be rejected and will need to be

resubmitted once the facility profile has been accepted.

Facilities must also update the facility profile whenever there are any changes to information,

such as a change in Facility Coordinator or facility name.

6.3 How the Facility Profile Information Is Used

As the main identification record for each site, facility profiles must be up to date at all times for

the following reasons:

Submission Reports notifications are sent to the Data Submission Contact listed in the

facility profile.

Notifications that quarterly eReports have been updated are sent to the Facility

Coordinator and Data Submission Contact listed in the facility profile.

NRS communication distribution lists are based on contact information in the facility profile.

Peer groupings according to facility size (number of rehabilitation beds) and facility type

(general or specialty) in NRS eReports are based on the facility profile.


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Section 7: Assessment Types Introduction

This section provides information on submitting the three NRS assessment types: admission,

discharge and follow-up.


Identify when to submit each assessment type; and

Identify the data elements that link an admission assessment to a discharge assessment.

7.2 Assessment Records

Admission, discharge and follow-up assessments are completed by a participating facility

when a client is either admitted to or discharged from inpatient rehabilitation, or is receiving a

follow-up assessment after being discharged from inpatient rehabilitation. The recommended

time frame for completing each assessment is described below:

Admission Assessment (completed within 72 hours of admission to rehabilitation

facility/unit);

Discharge Assessment (completed within 72 hours prior to discharge from rehabilitation

facility/unit); and

Follow-Up Assessment (completed within 80 to 180 days following discharge from

rehabilitation facility/unit).

Admission and discharge assessments are mandatory in the NRS database while follow-up

assessments are optional. All three types must meet fixed record lengths to be accepted by

CIHI. For specific information regarding the contents of assessment records, please refer to

the Rehabilitation Minimum Data Set Manual, Module 1: Technical Specifications and

Data Submission.

Assessments in an episode of care are linked by the Chart Number, Health Care Number,

Admission Date and Discharge Date (for follow-up assessments only). This means that in

order to successfully submit a discharge assessment, the Chart Number, Health Care Number

and Admission Date on the discharge assessment must match that of the corresponding

admission assessment.

.


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Section 8: Submission Timelines Introduction

Data should be submitted to the NRS within fixed time periods in order to generate and publish

reports in a timely fashion. This section explains the NRS data submission deadlines that must

be met in order for data to be included in the quarterly comparative eReports.


Understand timelines for data submission.

8.2 Data Submission Timelines

NRS data must be submitted to CIHI each quarter by the error correction deadlines listed

below in order to be included in quarterly comparative eReports.

Quarter Reporting Period Submission Deadline

Error Correction Deadline

NRS eReports Data Updated*

Quarter 1 April 1–June 30 July 31 August 15 2 to 3 weeks after error correction

deadline Quarter 2 July 1–September 30 October 31 November 15

Quarter 3 October 1–December 31 January 31 February 14

Quarter 4 January 1–March 31 April 30 May 15

* This date may vary slightly according to CIHI’s internal production schedule.

It is recommended that all data for a quarter be submitted prior to the submission deadline to

allow two weeks for error correction. However, all initial and updated records can be submitted

up to the error correction deadline.


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Section 9: Electronic Data Submission Service Introduction

Submission files containing data are submitted to NRS through the electronic Data Submission

Service (eDSS). This online application provides secure data transmission though the internet

24 hours a day, seven days a week. This section describes how to access eDSS, how to submit

data using eDSS and where to review your submission history.


Explain how to access eDSS;

Explain how to submit data using eDSS; and

Illustrate how to access the eData Submission History page.

9.2 Accessing eDSS

To submit both test and live data to the NRS, you will need access to eDSS. If you are

submitting data and you do not already have access to eDSS, please have your Facility

Coordinator send an email request on your behalf to [email protected].

To access eDSS, click on the list of applications on CIHI’s website (www.cihi.ca) and then click

on eDSS.


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If you do not already have a Client Services account, you can create one. Start by clicking on

Create an account.


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Click on the eDSS link from the list of available services to open the eDSS application.

Note that you may have additional links listed under My Services.

9.3 Data Submission via eDSS

Below is a screenshot of the eDSS Data Submission page.

To submit NRS data, select

NRS from Data Holding;

The year that corresponds to the year in the file name;


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The period that corresponds to the file name (01 for quarter 1, 02 for quarter 2, 03 for

quarter 3, 04 for quarter 4 and FI for facility profile); and

Your facility number.

Once you have selected all of the required information, click Browse and search your computer

for the zipped data file, then click Next.

9.4 Submission History

To view the status of your submitted data files, click View History Log on the left-hand side

of the page. This History page allows you to search for file transactions according to date,

organization (if you submit on behalf of more than one organization) and file name.

Please note that the eDSS confirmation number displayed on the Submission Results screen

does not indicate that your data file has been processed and admitted into the NRS

database. It only confirms that the data file was successfully received by CIHI. Processing data

files and posting reports on CIHI’s website are not part of the eDSS application. Once the data

has been processed and reports have been posted, the identified Data Submission Contact for

your facility will be notified via email.

9.5 Questions Regarding eDSS

If you have any questions or problems related to eDSS, please send an email to [email protected].


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Section 10: Reviewing and Understanding Submission Reports Introduction

Submission Reports are available under the NRS Operational Reports link for all live and test

files submitted to the NRS database. These reports provide summaries of the assessment

types (facility profile, admission, discharge and follow-up), data record types (initial, update and

deletion) and submission status (accepted, rejected and flagged) of the records submitted in

each submission file. This section will demonstrate how to access the Submission Reports for

both live and test data and provide an overview of each of the Submission Reports available.


Illustrate how to access the NRS Operational Reports link;

Show how to access Submission Reports; and

Interpret the NRS Submission Reports.

10.2 Accessing Submission Reports

Submitted files are processed at CIHI within three business days. Once test or live submissions

are processed, your facility’s Data Submission Contact (as listed in the facility profile) will

receive an email indicating that the Submission Reports are available for review and download

via the NRS Operational Reports link. The Operational Reports secure application allows

participating NRS facilities to access Submission Reports, RPG Reports and NRS manuals.

To access the NRS Operational Reports link, log in to Client Services on CIHI’s website and

click the Operational Reports link from the list of products and services. Then click on the NRS

link and review the Terms and Conditions.


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If you do not have access to the NRS link after clicking on Operational Reports, please have

your Facility Coordinator send a request on your behalf to [email protected].

After you click on the NRS link and review the Terms and Conditions, you will be directed to the

NRS report selection page. If you have access to more than one NRS facility you may need to

select your facility from the drop-down menu to get to the report selection page. Depending on

your type of access, you may have all or just one or two of the following three links:


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The second and third links are for Submission Reports. To review reports for your live (production)

data, select NRS Submission—Production; to review reports for your test data, select NRS

Submission—Test. Submission files are listed starting with the most recent submission. For

each file that is submitted to the NRS, the following two submission reports will be available:

Submission Report (PDF); and

Submission Report (TXT).

Each report can be opened by clicking on the link. It can also be saved by right-clicking

on the link and selecting Save Target As. Submission reports are available on the CIHI

website for only 45 days after posting, so it is important to save a copy to a secure location

on your computer for your records.

10.3 Submission Scenarios

For each data submission file (test or live) that is successfully submitted to and processed at

CIHI, one of the following three scenarios will apply.

Scenario 1: The entire submission file is rejected due to a file-level integrity error, meaning

that no records were accepted into the NRS database. If the entire file was not accepted into

the database, the NRS team at CIHI will contact the data submitter via email to explain why

the file was rejected. The entire file will need to be corrected and resubmitted to the database.

A Submission Report will not be generated for a file-level error.


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Scenario 2: The submission file has been successfully processed but a record within the file

has been rejected due to a record-level error. A record-level error affects an entire record,

not just a portion of it. For example, submitting a discharge assessment for which there is no

corresponding admission assessment is a record-level error. Record-level errors result in the

rejection of that particular record; it will need to be corrected and resubmitted to the database.

Note that rejected records do not affect other records contained in the submission file. If some

of your records were rejected, you must review the second page of the Submission Report

entitled “Errors/warnings affecting Assessment Records” to identify the errors so that you can

fix them and resubmit the affected records.

You may also need to make corrections related to records flagged with warning messages

(by submitting an update record, if applicable).The difference between record-level warnings

and record-level errors is that warnings are accepted into the NRS database whereas errors

are rejected.

For example, submitting an admission assessment that contains the same Health Care

Number and Chart Number as an existing admission assessment that does not yet have a

corresponding discharge assessment will receive a warning message of “Potential Duplicate

Admission Assessment.” In this example, the record is not rejected outright as a duplicate

because its admission date is different from the existing record and so may be a legitimate

second admission for that client. If this is the case, the facility should look to submit the

discharge record that corresponds to the client’s first visit so that there are not two open/active

episodes in the database at the same time for the same person. Alternatively, if only one

admission record exists for the client, the facility should look to delete whichever of the two

records was submitted in error.

Scenario 3: The submission file has been successfully processed but a record within the file

has been rejected due to an element-level error. This type of error arises when the value

recorded for a particular data element does not comply with the coding specifications for that

data element. An example of this type of error would be recording a discharge date that is prior

to the client’s admission date. In the case of an element-level error, the entire record is rejected.

However, other records contained in the submission file are not affected. In this case, the record

should be corrected in a timely manner, saved and resubmitted to CIHI in a new submission file.

If the record then passes the edit checks, it will be accepted into the NRS database at CIHI.

You may also need to make corrections related to element-level warnings. This type of warning

might highlight, for instance, coding of the same comorbid health condition as both a pre-admit and

a post-admit condition. Because this coding can be legitimate in some circumstances, the record is

not rejected outright but rather is flagged for review by the facility. As with record-level warnings, it

is the responsibility of the facility to determine whether the element-level warning can be ignored or

an update needs to be submitted to correct what is actually a mistake.


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For ease of interpreting your Submission Reports, Appendix A has been provided to explain all

warnings that may be encountered in the reports. A record with only a warning will still be

accepted into the NRS database (assuming that no error messages exist for the same

record). Warning flags are meant to highlight potential data quality issues that should be

addressed by the facility; there is no need to contact CIHI to explain the outcome of this

internal review, though submission of updated records may be required.

10.4 Understanding the Submission Reports

Every NRS submission file processed at CIHI will have an associated Submission Report.

Please contact the NRS team at [email protected] if a Submission Report does not appear two to

three business days after you have submitted an NRS data file.

Submission Report Summary Page

The first page of a Submission Report contains summary information about the submission file.

The header contains information such as the facility number, file name, facility name and period

of submission.

The following is an explanation of the various lines contained on the first page of an NRS Submission Report:

Total records received indicates the total number of records that were contained in the

submission file.

Total records accepted indicates the number of records that were accepted into the NRS

database. Note that records with errors are not accepted into the NRS database at CIHI.

Total records flagged indicates the number of records that were flagged with warning messages.

Warning messages are for internal facility use only and were implemented to enhance the quality

of NRS data by flagging potential coding issues. These records are accepted into the NRS

database as long as the record is not also associated with an error message.

Total records rejected indicates the number of records that were rejected due to errors. If this

number is equal to zero, no record corrections need to be undertaken. More detailed information

about the rejected records is found in the subsequent pages of the Submission Report.

The next three lines in the report indicate the number of admission, discharge and follow-up

records accepted into the NRS database.


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The number of admission, discharge and follow-up records flagged with warning messages

follows in the next three lines.

Line number 11 indicates the number of new records that were accepted into the NRS

database. A new record can be an admission, discharge or follow-up record that is being

received at CIHI for the first time.

Line number 12 is for record updates accepted. A record update is a change or a correction

to a record previously accepted into the NRS database. NRS records can be corrected at any

time. A record update overwrites the existing record in the NRS database.

Line number 13 is for record deletions accepted. A record can be deleted from the NRS

database at any time. A record deletion is itself considered to be a record and will therefore

be included in the “total records received” line.

The last line reports the total errors and flags in the submission file. This number will usually

be greater than the number of total records rejected since records often contain more than one

error or flag.

The following is an example of page 1 of a Submission Report—Summary Page PDF.

It shows that a total of 14 records were submitted in the submission file, of which 8 admission

assessments and 4 discharge assessments were accepted with no errors; 2 records were

rejected with 3 corresponding errors/flags.


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Page 2 of the Submission Report lists the Errors/Warnings affecting assessment records. The

Type of Assessment, Chart Number, Admission Date, Error/Warning Number and Error/Warning

Message are listed for each rejected record.

The following is an example of a submission file with two new records rejected and shows that

both discharge records were rejected from the database because the corresponding admission

assessments could not be found.

Following the list of records with errors is a list of Errors/Warnings affecting Data Elements.

As with the list of rejected records, the Type of Assessment, Chart Number, Admission Date,

Element Number, Element Name, Submitted Value, Error/Warning Number and Error/Warning

Message are listed for each record with a corresponding error/warning. If a record is rejected

with multiple errors, it will be listed multiple times (once for each error).

The following is an example of a submission file with two element-level errors demonstrating

that both admission records were rejected from the database because the submitted codes for

the pre-admit comorbid health conditions were not valid.


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Section 11: Facility Testing Introduction

In order to facilitate data submissions and enhance data quality, all participating NRS facilities

are required to provide test data to CIHI on an annual basis before providing live data. Facility

testing is done after your licensed vendor has successfully submitted test data. If your facility uses

an in-house vendor system, successfully completed vendor testing will also meet the requirements

for facility testing.


Outline the facility testing process; and

Understand the facility testing requirements.

11.2 Facility Testing Process

1. Verify that your NRS vendor has completed the CIHI testing process. If you are not sure

whether your facility’s vendor has passed testing requirements, please inquire via email,

at [email protected].

2. Submit your updated test facility profile via eDSS. A facility profile must be submitted before

any test data can be accepted by the NRS database.

3. A confirmation email will be sent to the Data Submission Contact listed in your test facility

profile, indicating that the submitted test facility profile was processed and the test

Submission Report is available under the NRS Operational Reports link.

4. Review the Submission Report for your facility profile under the NRS Operational Reports

link. If your test facility profile was accepted, you can begin test data submissions.

5. Submit your test data via eDSS. You can submit actual or fabricated test data. The live

database is completely separate from the test database, so fabricated test data will not

appear in the live database and any actual data submitted to the test environment will

have to be resubmitted to the live environment once testing is complete.

6. Review your Submission Reports for your test submissions under the NRS Operational

Reports link. It is your facility’s responsibility to review the Submission Reports to ensure

that all test records were accepted and all requirements were met. For a complete list of

facility testing requirements, send us an email, at [email protected].

7. Once all test requirements have been met, the Data Submission Contact and Facility

Coordinator will receive an email notification from [email protected] indicating that testing is

complete and that live submissions may begin (starting with the live facility profile).

11.3 Questions Regarding Facility Testing

For any questions or problems related to facility testing, please send an email to [email protected].


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Section 12: Summary This self-study product provided a description of the role of the Data Submission Contact and

an explanation of the NRS data submission process, including data record types, updates,

deletions and Submission Reports. NRS timelines, naming conventions, submission timelines

and CIHI’s eDSS were also reviewed.

The purpose of this self-study product was to assist data submission personnel with accurate

and timely data submission to the NRS database. Timely and accurate submission assists CIHI

in producing accurate and helpful data for reports for use by stakeholders at the organizational,

regional and provincial levels.

If you have any questions regarding NRS data submission, please contact CIHI by sending an

email to [email protected].

Appendix A: Submission Warning Messages

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Appendix

Submission Warning Messages

Warning Number Warning Reason for Warning

How to Correct the Warning/What Next?

100001 Duplicate Comorbid Recorded on Admission and Discharge

The same comorbidity was coded on both admission and discharge. The only comorbidities that should be coded on discharge (data element 82) are those that arise after admission and during the rehabilitation stay that affect the person’s health/functional status and resource requirements during the rehabilitation stay. If a comorbidity recorded at admission (data element 81) still exists at discharge, it should not be re-coded in data element 82 unless the comorbidity resolved itself and then recurred during the rehabilitation stay. For example, if a client was admitted with the flu, recovered and then acquired the flu again during their rehabilitation stay, it would be appropriate to double-code comorbidities on 81 and 82, assuming the comorbidities affected the rehabilitation stay.

If the comorbidity did not arise after admission and during the rehabilitation stay, an update record should be submitted to remove the comorbidity from data element 82. If the comorbidity flagged and coded in data element 82 was present at admission, resolved itself during the rehabilitation stay and then was acquired again (the same comorbidity) during the client’s stay, no further action is required.

A


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100002 Duplicate Comorbid Recorded on the same Assessment (admission or discharge)

The same comorbidity was coded more than once within either the admission or discharge assessment. While it may be valid in some cases to duplicate diagnostic codes within an assessment, this warning is intended to assist identification of instances in which duplication is an error. Please verify internally that the duplicate entry is intentional and valid.

If the client did not actually have two of the same comorbidities at the time of assessment, then an update record should be submitted to remove the duplication. If the comorbidity was actually present more than once at the time of assessment and was correctly recorded, then no further action is required.

101000 Potential Duplicate Admission Assessment, please check your records to ensure that this is not a duplicate

This warning occurs when an admission is submitted to the NRS with the same Health Card Number (HCN) and chart number as an open assessment (that is, an admission assessment with no corresponding discharge assessment) that already exists within the NRS. It is meant to have you confirm internally at your facility that this is in fact a new assessment.

If this is a new additional admission for this client, ensure that the discharge for the first admission is submitted and accepted. No further action would be subsequently required. If this is not a new admission (that is, it is a duplicate of one already residing in the NRS database), please submit a delete record to remove the desired duplicate admission from the NRS database. If the discharge record for this client’s first (open) admission is included in this same file (that is, in the same file as the second admission record) and is accepted into the database, then this warning can be ignored. It occurs because the admission records within a

Appendix A: Submission Warning Messages

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file are processed before the discharge records in that file.

102000 Consider coding a more specific RCG subgroup if possible

This warning occurs when a general RCG is coded where a more specific option is available. For example, if an RCG is coded as 08.1 (Status Post Hip Fracture), your record will be flagged, as there are more specific sub-codes available, for example 08.11 (Status Post Unilateral Hip Fracture) or 08.12 (Status Post Bilateral Hip Fracture).

We strongly recommend that you update the record with a more specific RCG code. For example, if you know the client was admitted post–unilateral hip fracture, you should submit an update record in order to change the RCG code to 08.11 instead of 08.1, since a more specific RCG code is known for this client. If you do not have any further specificity available for the client, then no further action is required.

103000 Height has been recorded as <120 cm (3’11”), please check your record to ensure that this is correct

This warning is meant to flag outlier height values as potential data quality issues, (for example, coding of height in feet rather than in centimetres).

If the client’s actual height is less than 120 cm and was correctly recorded, then no action is required. If the height was entered incorrectly, please submit an update record containing the accurate height.

103001 Height has been recorded as >200 cm (6’6”), please check your record to ensure that this is correct

This warning is meant to flag outlier height values as potential data quality issues, (for example, coding of height in millimetres rather than in centimetres).

If the client’s actual height is greater than 200 cm and was correctly recorded, then no action is required. If the height was entered incorrectly, please submit an update record containing the accurate height.


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104000 Weight has been recorded as <35 kg (77 Ibs), please check your record to ensure that this is correct

This warning is meant to flag outlier weight values as potential data quality issues.

If the client’s actual weight is less than 35 kg and was correctly recorded, then no action is required. If the weight was entered incorrectly, please submit an update record containing the accurate weight.

104001 Weight has been recorded as >150 kg (331 Ibs), please check your record to ensure that this is correct

This warning is meant to flag outlier weight values as potential data quality issues, (for example, coding of weight in pounds rather than in kilograms).

If the client’s actual weight is greater than 150 kg and was correctly recorded, then no action is required. If the weight was entered incorrectly, please submit an update record containing the accurate weight.

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