CMS form 672 and survey readiness (long)

[glm777, BSN, RN]

Our program (Matrixcare) automatically populates the form each time we complete an MDS. However we have noticed that certain things didn't seem accurate. For instance, the program kept checking off "contractures" for all residents who have limited ROM. But often the cause of the limited ROM was injury (ie: hip fracture). So we have been unchecking that box on the 672 since the resident does not have a contracture. But now, after reading the actual instructions, it seems appropriate to code contracture on the 672 as the instructions say the limited ROM can be due to "deformity, disuse, pain etc". So I guess my question, after all of this, is: should we be following the directions explicitly, even if it doesn't seem accurate to us? This came up because during a recent survey of our sister home, the 672 had several residents checked off as being on a urinary toileting program but there was no documentation of that - because the resident was not actually on a toileting program. But according to the instructions for the 672, the way the MDS was coded did indeed warrant toileting program being checked off on the 672 (H0300 =1,2 or 3) since the instructions direct us to code everyone NOT totally continent, as on a toileting program.

I feel like if we follow the direction exactly the way they say, we do not get an accurate picture of the residents at all!

I would appreciate any input.

CMS672.pdf

[Talino]

You are correct to check the matrix manually and regularly and remove what flagged items do not apply.

MDS software programs conduct logic tests based on CMS specs.  The provider has to document why the flags do not apply.

• The 672 contracture definition refers to a more permanent or chronic limitation. Limitation in ROM due to a recent fracture is self-limiting or reversible.
• A frequently incontinent resident cannot be on individualized urinary toileting program because she’s incapable of making needs known, has a neurogenic bladder, or paraplegic.