Need date help, and more..

[SitcomNurse, BSN, MSN, EdD, RN]

OK, Im helping a friend who dosent even know AllNurses, but will be a convert when I am done.. Im sure!

She forgot to put in an MDS that should have been done in October.

Should she:

Send out the e-mail request with the ARD as it should have been, and signature 7 days from that? She thinks it is legal, becuase the info is collected is from that timeframe. I say its not, because you are esentially back dating. I think you cant do a pain or cognitive interview at this point and call it that point....

OR

Do the MDS with the ARD, but a signature date of now/today, and a late submission?

She told a few people that the first option I mentioined is not illegal.

I cant see how it isnt. Im having a problem with the whole thing.

She is waiting on my responsee, and we are both scouring the manual.. help!!

[Talino]

Do the MDS with the ARD, but a signature date of now/today, and a late submission?

If this is not a PPS assm't, this is a viable approach ('tho opened to interpretation). Use the actual ARD it was due but complete and sign today's date (attesting all info entered was derived from that actual ARD). Since the interview did not take place, you can dash fill all the interview sections. Expect a warning - "completion date more than 14 days from ARD". You have up to 14 days to submit from today's completion date so there is no warning regarding late submission.

Unless there's a sig. change, the most appropriate recourse - do the interviews and set the Quarterly ARD today. You have up to 14 days to complete it. Submit and expect a warning "late assm't, ARD more than 92 days from previous ARD". Update care plans accordingly. Go back on track of the original assm't schedule.

Either way, document the oversight.

[andy3k]

"Assessment Reference Date (ARD) refers to the last day of the observation (or “look back”) period that the assessment covers for the resident. Since a day begins at 12:00 a.m. and ends at 11:59 p.m., the ARD must also cover this time period. The facility is required to set the ARD on the MDS Item Set or in the facility software within the appropriate timeframe of the assessment type being completed. This concept of setting the ARD is used for all assessment types (OBRA and Medicare-required PPS) and varies by assessment type and facility determination." RAI Manual pg 2-8

It is extremely important to ensure that the ARD is set according to CMS rules, not only to avoid inaccurate assessments but also to avoid potential payment consequences. Facility staff must open up an item set for a resident in the facility MDS software and set

the ARD in Item A2300 OR create a hard copy of Section A of the MDS Item Set, entering the resident’s name in A0500 and the ARD in Item A2300.

ARDs that are only noted in meeting minutes, PPS calculating tools, therapy logs, nurse’s notes, facility forms, memos, or by any other method not specifically mentioned on page 2-8 of the RAIM3 as quoted above, may NOT use that notation as the ARD in Item A2300. The reason is because the ARD was noted but not set per CMS policy.

If the ARD was not officially and correctly documented until now, it cannot be set for an earlier date.

[SitcomNurse, BSN, MSN, EdD, RN]

Do you mean to say that she cannot put the ARD as 10/12/12 for a look back of that period, and signature today? OR she should have the ARD as 10/12/12 and signature 10/18/12? By putting the signatures 10/18/12, the document will lock normally, and making any later date for signature (as in today) it wont lock normally. I said.. there has to be a late submission then, but I dont work the system so I dont know if something like that even exists in sumissions.