Penalties for late Assessments?

[crazyforthis]

Hello. So glad I have found this forum! I am an Extreme newbie to anything related to MDS. Still wondering what I have gotten myself into. I am scheduled to take an MDS Bootcamp in May 2011 but in the meantime have many questions. So far I understand the ards but am confused by the completion date on the assessments. At the SNF I work at there are several patients records that are quite late as far as all MDS goes. I worked on a couple this past week where the admit assessment was due in February but had not been done along with all the following assessments! What are the penalties for having such late assessments? Do I still put the competion date as say March 7th if the ard is March 1st? Am I hurting myself (license/reputation) by even working on these late records? The current MDS person is leaving in a couple months and then it will be just myself. We are licensed for 46 beds with 3 of those being Hospice beds and we are not Medicaid certified. On average we run about 40 beds occupied at any given time with some patients being there for months (long after their Medicare days have run out) and some going back and forth the the hospital a couple times and again being readmitted to the SNF. It is overwhelming how much paperwork their is! The DON is new also about 4 or 5 months ago and is also taking the MDS bootcamp. The MDS people are the only ones who enter anything into our MDS app and it is not integrated with the electronic charting the nurses and CNAs use. I am still getting a handle on all of it, as I am new also to the electronic charting we use. I know I am in over my head but am quite determined to learn and figure it all out and becoming proficient with it

[andy3k]

What are the penalties for having such late assessments?

• For state surveys, you might get a tag. Greater chance of a tag if the offense is frequently repeated.
  
• Federal audits may have an issue with frequent late assessments but I am not familiar with how they might respond.
  
• Medicare doesn't really care WHEN the MDS is submitted as long as it is submitted when you request payment (as of April 2011).
  
• Medicaid policies differ by state but there is a chance that late MDS might have to collect default or no payment from Medicaid.
  

Do I still put the completion date as say March 7th if the ard is March 1st?

When you have confirmed that all required sections of the MDS are complete, AND when you sign and date Z0500, the date of confirmation and signature is your completion date. You can not and should not set your completion date any earlier or later than the date that all sections are completed and your signature is on record. MDS 3.0 RAI Manual pg Z-8.

Am I hurting myself (license/reputation) by even working on these late records?

Better late than never. Signing Z0500 does not confirm the correctness of each section, just the completion thereof. Surveyors and auditors will get more upset at missing MDS than late MDS. Your facility would rather get paid full amount, or even default, than nothing at all. Even though you don't get paid for discharges, for example, the surveyor can still tag you for not completing them and your MDS reports (roster, QM/QI) can still be affected by not completing them. In summary, better late than never.