MDS for falls...


Our facility recently decided that their interpretation of falls does not include lowers. However, the RAI manual says that even if the resident is intercepted, it is still considered a fall and should be charted as such. I am kind of at a loss in how to chart this, because I was under the impression that the guidelines weren't open to interpretation. Any advice or comments is appreciated.


1,010 Posts

Specializes in ER CCU MICU SICU LTC/SNF.

The falls definition in the RAI is an authoritative statement. A surveyor will have a feast tagging a facility on their "own" interpretation. Even a scientific evidence is moot unless adapted by CMS.


9 Posts

That is exactly what I thought, but the COO thinks that if our facility interprets it a certain way that they can argue the case. Just makes me SMH.:banghead:


9 Posts

I just don't see how something the CMS states can be open to interpretation- change in planes or some such thing. It worries me because they want me to chart it in the MDS as no falls- even if they have lowers which should be considered falls according to CMS.

tyvin, BSN, RN

1,620 Posts

Specializes in Hospice / Psych / RNAC.

If you are the MDS coordinator, than you abide by what the RAI states. Your name goes on that MDS as signed and correct. You are certifying that it is correct. You are team leader because it's your responsibility to have the whole thing filled and done by all the other team members. The final signature is yours. Don't be bullied.

If you're the RN that signs off on the MDS than you tell them... Anytime a resident/patient goes to the floor (unless they're in activities on the floor doing exercises), it's a fall; period. You do realize the authority you have; don't you?

You create the care plans; how ever the fall happens; it must be part of the care plan and all interventions looked at. Do you have many falls? Are you discussing it during your morning team meetings? That's when it needs to be discussed, and present the definition to all team members. It's an either or situation; either the person went to the ground or they didn't...with or without assistance...simple.

You tell them to petition CMS to change the definition of a fall.