CMS 802

**I am not a director or assistant director, just a unit manager on the rehab floor.

Perhaps we could work this out together because I'm having some serious issues with my matrix.

1. Mental Illness (MI) (Non-Dementia) or IntellectualDisability (ID) or Developmental Disability (DD)(Mental retardation as defined at 42 CFR 483.45(a)):Resident has a diagnosis of MI or ID/DD. Enter MI formental illness not classified as dementia, ID for intellectualdisability or DD for developmental disability. A1500 =1and A1510A = checked, enter MI. A1510B = checked,enter ID. A1550A, B, C, D, or E = checked, manually enterID and/or DD as appropriate. I5700, I5800, I5900, I5950,I6000, I16100 = checked, enter MI. I8000 psychiatric/mood disorder diagnosis listed, enter MI
   
   
   
   
   So I've been going according to what the MDS states, and if I go deep enough into the rabbit hole...
   
   
   Psychiatric/Mood Disorder
   • I5700, anxiety disorderOctober 2015
   
   Page I-6
   
   
   
   CMS's RAI Version 3.0 Manual CH 3: MDS Items
   
   
   I: Active Diagnoses in the Last 7 Days (cont.)
   
   • I5800, depression (other than bipolar)
     
   • I5900, manic depression (bipolar disease)
     
   • I5950, psychotic disorder (other than schizophrenia)
     
   • I6000, schizophrenia (e.g., schizoaffective and schizophreniform disorders)
     
   • I6100, post-traumatic stress disorder (PTSD)
     
     So according to the RAI manual yes, it does.
     
     
     
     The real question here...do I know what I'm doing or am I completely getting this wrong?
     
     
     I'm having issues with the Moderate/Severe pain because any pain reported triggers the resident on the matrix, and our administrator screams at us for having so many triggered. We're all at a loss here.
     

Thanks...I found that too. I just have a hard time calling depression a mental illness. Why are we still doing these stupid forms? It takes hours and hours. I could be spending that time doing something useful like chart reviews or sitting with a resident who is going to die.

My administrator screams about everything. If you ask the resident during the ARD assessment time and they had pain, it's going to come out on the QMs and the 802. All we can do is make sure they have a pain management program.

That is what my administrator is yelling at us about. If they report 0 pain but get pain meds anyways... they show up! So she makes us manually check it off. In our opinion, the state will yes of course see terrible percentages. But as long as they investigate that the resident is not reporting pain and pain is manged and addressed in a timely and appropriate manner, it shouldn't matter. But apparently the raw percentages affects the 5 stars we don't get. I feel like she's making us lie and I feel like the DOH will question why no one is in any pain.

Now the person that agrees with me about the pain said depression wasn't a mental illness. I think it is, but then again there's ANOTHER area for depression. So ugh. Damned if we do and damned if we don't, I guess!

I want to code an EMR that updates this stuff live instead of just with every MDS assessment. You know, in my spare time.

For the 802 mental illness is depression, bipolar, schizoid... or other mental illness (anxiety) and you write MI. The intellectual disability/developmental disability portion is easier because you should know exactly who these patients are. The coding on the 802 has little to do with your QM per se. You can check items on the form that are relevant one the day of entry only.

As an aside the ID/DD patients must be marked on the 672 on line 108. The patients marked there better have a PASSAR level 2 on file.

The surveyors are only going to drill down on your 802 if they start seriously hen pecking. They have an 802. They know what is going on for your QM. The reason you do an 802 is you can show them you know your building. It doesn't have to be perfect, if after survey starts you see a problem you just tell them and fix it within the first 24 hours.. The 672 is where is counts to be correct. That is where the rubber meets the road for survey.