ENTRY DATE

[marjo1]

Hello everyone. My question relates to date of entry A1600. Example: A resident was admitted on the medicare unit under medicare A then after a few months the payer source was changed and she was moved to the long term area (medicaid) and was placed under hospice service in the same facility. Each time the resident has a room change or change in payor source or status etc then billing adds that date as the most recent date unto the entry date section in MDI and a nurse is choosing the most recent date from billing as the entry date

If the resident was never discharged from the facility in the above example what dates should A1600 and A2400 A/B/C be on the significant change assessment or future quarterly assessment?. Thanks for your response.

[Talino]

What you do with the date changes in your system is but a facility practice. It has nothing to do with MDS's Entry Date.

Entry Date defined, Appendix A-6...

The initial date of admission/entry to the nursing home, or the date on which the resident most recently re-entered the nursing home after being discharged (whether or not the return was anticipated).

Suffice it to say, if there is no discharge tracking in a resident's MDS profile, the entry date remains the same for all upcoming MDS OBRA assm'ts.

[marjo1]

Thanks for the response to my entry date question. So since the resident was on medicare A during the first few months of admission do we need to keep putting those start and end date A2400 a/b/c on the subsequent assessments if the resident was never discharged?

[Talino]

... do we need to keep putting those start and end date A2400 a/b/c on the subsequent assessments if the resident was never discharged?

If you're completing MDS in hardcopy, yes. If you're completing the MDS electronically, most paid softwares auto-fill these fields in default on subsequent assm'ts.

Even if resident was not discharged there is an instance when the A2400 can change.

Example:

1/01/12 - Adm due to gen. weakness s/p fall/syncope related to Afib.

A1600 - 1/01/12

A2400A - Yes (PT 5x/week)

A2400B - 1/01/12

A2400C - 1/30/12 (PT d/c'd, reached max potential, no other skilled need)

2/28/12 - PT eval s/p fall due to near-syncope, unsready gait. PT started. You start w/ a 5-day PPS assm't again:

A1600 - 1/01/12 (same as above)

A2400A - Yes (PT 5X/week)

A2400B - 2/28/12

A2400C - 3/12/12 (PT d/c'd, no other skilled need)

Hence, in subsequent assm'ts, the answers to A2400 will be the most recent:

A2400A - Yes

A2400B - 2/28/12

A2400C - 3/12/12

[marjo1]

Thank you very much , your response was very helpful.