andy3k

Some states have a nursing act that requires comprehensive assessments to be done by RNs. In those states, the RN must perform the comprehensive assessment and sign complete. Quarterly and PPS/OMRA assessments obviously don't require an RN to perform. This rule is sometimes disregarded but it exists in some states, never-the-less.

Correct.

The RAI Manual says early assessments are allowed and does not define how early. Therefore, one day after an admission assessment, you could perform a quarterly or annual. The next day you could do yet another quarterly or annual, if you so chose. There is no 14 day requirement as mentioned in the previous post.

Now I'm curious. If there is a PPS tracking form different from the MDS 3.0 PPS Assessment Calculator that is helpful to people then I would certainly like to see it. If someone has a copy then please email to [email protected]. Equally important, I'd like to know what people, facilities, or companies created any forms that are emailed to me. Thanks.

For clarification, The care plan must be completed no later than 7 days after the CAA Process completion date at V0200B2. The MDS completion date at Z0500B and the CAA Process completion date at V0200B2 must meet the MDS requirements for that type of assessment. The only time a care plan can be completed on day 21 of a new admission is if the MDS is completed (Z0500B and V200B2 signed) on day 14. There is no 21 day rule that applies only to Admission assessments. If the admission is completed and on day 10 then the Care Plan must be completed by, and V200C2 signed by, day 17, no later than 7 days after MDS completion.

Hello croppyRN, I'm sorry to hear about your situation. I can't help with the workload management issue but I can recommend resources for MDS help when your regional coordinator is busy. First and foremost, I recommend contacting your state MDS RAI Coordinator with questions regarding anything in the RAI Manual or performing assessments in general. Their email address can be found on the CMS website and you should also be able to find their contact information on your state's MDS website. Many state RAI coordinators used to work in facilities and might have suggestions for workload. Another resource I recommend is the Texas DADS MDS website - some of the information is Texas-specific but it has a lot of information, links to other website, and its own resources that you might find useful.

I recommend you contact your state RAI Coordinator, Cheryl Shiffer, at 210.619.8010 to discuss MN requirements.

MDS 3.0 RAI Manual, page V-6: V0200C2, Date The date on which a staff member completes the Care Planning Decision column (V0200A, Column B), which is done after the care plan is completed. Hope that helps.

I know that at least one software product DOES allow you to distinguish non-Part A PPS-like assessments, but I'm afraid I don't remember which one. If you happen to be on the market for software, ask about this.

ibtootie, you are correct. MDS completed for residents in certified beds require A0410=3. In Texas, residents in non-certified beds require A0410=2.

I found out from a colleague that CMS no longer endorses the following, "marking A0310B something other than 99 for a non-Part A record is incorrect, as well, since A0310B is for Medicare Part A PPS records." They got in trouble with the provider organizations and took it back.

I confirm cwrnracct's post. Two weeks ago, CMS said exactly that on a conference call. CMS also has said in the past that marking A0310B something other than 99 for a non-Part A record is incorrect, as well, since A0310B is for Medicare Part A PPS records. I know that CMS would prefer that Medicare replacement, etc. records be labeled and recorded separately. I have heard of at least one software vendor (don't remember which one) that allows you to mark a record as non-Part A, using a non-MDS field, so that the record never gets submitted to CMS and meets CMS's desire for non-Part A Medicare records to be maintained separately.

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.

And you only have 2 days after death/discharge in which to set the discharge/scheduled assessment ARD for the date of death/discharge (SNF PPS Clarifications Memo, March 2012).

I got ninja'ed by Talino.