Off Cycle Quarterly

Nov 02, 2008 01:30 PM

by miccay

In my facility, our MDS consultant insists there is something called an off cycle quarterly that can be done to increase your RUG or get something off the Quality Indicator Report that is flagging. She says this does not take the place of a quarterly assessment and does not reset the clock for the next assessment due. I am totally confused about this. It doesn't seem right and there is nothing in the RAI manual about it that I can find. Does anyone know if this is kosher? I am thinking an off cycle quarterly is possibly a significant change assessment or a correction because those are done off cycle usually. Please help.

Talino · Nov 03, 2008, 07:47 AM

Re: Off Cycle Quarterly

There is no specific CMS mandate that precludes a facility from conducting more frequent assessments than is actually required. States may have a more stringent policy. In which case, when a facility chose to perform an early quarterly assm't to capture a higher RUG or remove a flag, you can't be unequivocably cited of "manipulation" or unscrupulous practices.

There is no need to designate another term as "off cycle quarterly". The MDS assm't to support your claim has to be transmitted and stored in the database. It is what you code it is. So if an early quarterly is done now, the next quarterly is 92 days of this new R2B.

After several quarterlies (more than the usual 3), just make sure, you don't lose track of the Annual assmt's due date.

miccay · Nov 03, 2008, 05:18 PM

Re: Off Cycle Quarterly

Originally Posted by Talino

There is no specific CMS mandate that precludes a facility from conducting more frequent assessments than is actually required. States may have a more stringent policy. In which case, when a facility chose to perform an early quarterly assm't to capture a higher RUG or remove a flag, you can't be unequivocably cited of "manipulation" or unscrupulous practices.

There is no need to designate another term as "off cycle quarterly". The MDS assm't to support your claim has to be transmitted and stored in the database. It is what you code it is. So if an early quarterly is done now, the next quarterly is 92 days of this new R2B.

After several quarterlies (more than the usual 3), just make sure, you don't lose track of the Annual assmt's due date.

I understand that assessments can be moved around - done early or whatever to capture a better RUG, but I am being told that an "off cycle quarterly" does not restart the clock for the 92 days for the next assessment due. It is completed and transmitted to the state, but it is an extra assessment that is thrown in there between real assessments. This is the part that doesn't make any sense to me. Why would the state allow this and why would an MDS coordinator waste time completing an extra assessment just to keep the QI report from flagging? I am being told that it is something that is expected to be done from my management company. I do not want to do anything that would cause the facility to be cited. And I don't want to do anything fraudulant.

edhcinc · Nov 04, 2008, 11:42 AM

Re: Off Cycle Quarterly

Most software will not let you do more quarterlies than the MDS cycle allows--that is, a comprehensive followed by 3 quarterlies, comprehensive, etc. This sequencing is the basis for the software's MDS scheduler.

If your software DOES allow an "extra" quarterly, you will get an error message after submission (though the assessment will be accepted).

Check with your state RAI coordinator. S/he will know if there is some special rule in Georgia which allows this.
Good luck!

Rexie68 · Nov 05, 2008, 10:32 AM

Re: Off Cycle Quarterly

Instead of an "off cycle quarterly"-whatever that is-we do early annuals to capture higher RUG levels. This does restart the 92 day assessment clock. In PA, only annuals count toward RUG/CMI levels, so we have to do a full assessment to capture therapy minutes, etc. Sometimes it turns out to be a significant change, other times not. But either way, it's perfectly acceptable to do a full assessment at any time...it's just more work for us!! I've done 2 annuals in a row before (taking the place of a quarterly). It works for us, and has helped our CMI increase about 20 points in the past few years.....ergo more Medicaid dollars. Again, it will all change with 3.0 Hope this helps!!

gonenutz · Nov 05, 2008, 07:50 PM

Re: Off Cycle Quarterly

In my experiences and references from the RAI, you can do a quarterly assessment at any time during your 92 day cycle to capture what ever it may be that is going to increase your rug score and it does reset the 92 cycle from that r2b date. This also pertains to annuals, they can be done early also. Just remember the MDS must reflect the current residents condition and becareful that what ever you are using to increase the rug does not trigger a Sig Change if it does you need to do the sig change assessment instead of a quarterly.

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Off Cycle Quarterly

Off Cycle Quarterly

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