Combining assessment types

RainRN1, ASN, RN · Jan 27, 2011

Move the quarterly ard to the 18th I can't imagine it will throw you out of compliance unless you are using the 92nd day already

Raine

rukiddingme · Jan 27, 2011

Yep, unfortunately it was using 92nd day. Usually we don't - but this was a special circumstance due to illness w/ hospitalization.

Ruas61, BSN, RN · Jan 28, 2011

I did an admit, 5day and discharge return not anticipated all in the same one.

rukiddingme · Jan 28, 2011

So am I right on the ARD thing? The ARD's for each 'assessment' you combine must be the same exact date, otherwise you can't combine.

katoline · Feb 1, 2011

that's my impression. sometimes i have had to do a seperate discharge because therapy didn't treat that day. so the last covered mcr day would be the last tx day (unless there was a nursing skill) and the ARD for discharge has to be the day of discharge, right? I guess that would only happen if there was a window that you couldn't go past, like day 8 ARD and the resident left on day 9.

Another question, I thought you could combine a sig change with a pps assessment, like a returning resident having a 5 day, sig change. but i thought i read somewhere, that you can't combine a sig change with a pps assessment, or was it an OBRA? which it would take the place of anyway. sometimes my rehab mgr rattles things off so fast, i really have to think about them and check them out later if i don't get interrupted and forget. lol.

RainRN1, ASN, RN · Feb 2, 2011

There are only 2 assessments you cannot combine with another assessment and those are the entry and death in the facility I believe. There is a chart in the RAI manual that tells you which assessments can be combined and which ones can't so double check me.

Raine

rukiddingme · Feb 2, 2011

Well, from what I've seen since Oct. 1st, there aren't too many places to use the 'combining assessments'.

Per the RAI: when combining PPS w/ OBRA assessment, they must have one 'common' ARD. And no medicare assessments may be combined, due to the date requirements.

iceprincess492 · Feb 2, 2011

The ones I seem to combine the most are a 5Day with a d/c assessment when someone is sent back to hosp or decides to leave by day 8

andy3k · Feb 3, 2011

"So, if I have a resident with a Quarterly on 1/17/2011 and their 5 day PPS is for 1/18/2011, I still have to do two seperate assessments, right?"

If the resident returned from the hospital within 30 days of discharge - return anticipated then you would be completing a readmission/return PPS (not a 5-day). You can complete the readmission as early as day 1, so the quarterly and readmission can be scheduled together if you want. If the quarterly was due while the resident was out of the facility, you may reset the ARD of the quarterly up to 14 days after return. The only time that the quarterly would be due before the readmission is if the quarterly ARD is set for day 92, the ARD is on or after the day of return from hospital, and you choose to set the readmission ARD later than the quarterly. Please let me know if there is another possible scenario other than this.

To answer other questions I saw:

Combined assessments MUST have the same ARD. You can always (re)schedule an OBRA early, which makes it easy to combine an OBRA with a PPS, but a PPS must always be scheduled in the appropriate window. A Sig Change cannot be combined with another OBRA, because you can only select one A0310A at a time, but you can combine a Sig Change with any PPS. A Sig Change is comprehensive MDS so it counts as if you completed an annual, resetting the quarterly/annual schedule. Combos that I see most often are admission/5-day, admission/14-day, 5-day/discharge, and Start of Therapy/5-day/discharge (short stay assessment).