D/C Assessment

[glm777, BSN, RN]

Section J1800 asks "has the resient had any falls since admission/entry or reentry or the prior assessment (OBRA or scheduled PPS), whichever is more recent". The definition of a "Prior Assessment" per the RAI manual is the "most recent MDS that reported on falls".

Can you consider a D/C assessment as a prior assessment? I haven't in the past because I didn't think a d/c assessment was considered an OBRA assessment (it is more a tracking record) and it isn't a scheduled PPS assessment so I haven't been including it when looking at a "prior assessment" . But now reading the definition of a prior assessment, I'm thinking I should be looking at the D/C as a prior assessment if it was indeed the last MDS, since it does report on falls. What do you all do?

[andy3k]

The D/C is an OBRA assessment. However, a D/C can never be a "prior assessment" because the only MDS record that can follow a D/C is an entry tracking record. You can no longer set an ARD and complete an assessment for a date after the date of discharge. If the resident admits or returns to the facility after discharge then the entry tracking record is your starting point.

The resident admits, or reenters, the facility and falls. On the 5-day, you set J1800 as yes for a fall.

If the resident does not fall after the ARD of the 5-day then J1800 on the 14-day would be no since the resident did not fall since the 5-day (the most recent assessment).

If the resident then discharges, you mark whether the resident fell after the ARD of the 14-day.

If the resident is readmitted, you complete the entry tracking record and start watching for a fall again as of the new entry date.