Section N0450B - GDR

[glm777, BSN, RN]

How do you all interpret this question? Since there is no time frame associated with the question - how far back are you going? I have residents on Antipsychotics who have been here 10 years. Thanks for your input.

[Golden_RN, MSN]

I looked at the RAI manual and I interpreted the question to mean any time during this admission. Hopefully your facility is attempting annually or has documentation that it is contraindicated. Below is a clip from the manual:

Quote

Coding Tips and Special Populations (N0450B and N0450C) • Within the first year in which a resident is admitted on an antipsychotic medication or after the facility has initiated an antipsychotic medication, the facility must attempt a GDR in two separate quarters (with at least one month between the attempts), unless physician documentation is present in the medical record indicating that a GDR is clinically contraindicated. After the first year, a GDR must be attempted at least annually, unless clinically contraindicated (see F758 in Appendix PP of the State Operations Manual). • In N0450B and N0450C, include GDR attempts conducted since the resident was admitted to the facility, if the resident was receiving an antipsychotic medication at the time of admission, OR since the resident was started on the antipsychotic medication, if the medication was started after the resident was admitted.

[MDSNurse88, LPN]

A GDR has to be attempted at least once a year. If one has been attempted on a resident in the past I typically go back to that date and look forward from there.