AANAC

Next Page
Notice: Previous FAQ's are currently under review. This page will only show FAQ's posted since Aug. 2003






Search:

Click on the question to view it's answer. Choose the list above to select another category.
Admission Assessment
Q. Patient was admitted to our subacute unit, because of deconditioning following a CVA. She was receiving OT/PT/ST with managed care insurance for 14 days. I did a 14-day/Admission assessment. On the 15th day, she became Medicare. Do I now wait and do a 30-day Medicare assessment, or use day 15 as day 1 of Medicare and begin the cycle over again with the 5-day, 14-day, 30-day, etc?  9/26/2005
Q. Our facility now has this bed hold policy of holding the bed for 10 days, and if the responsible party does not want to pay privately after the 10th day, the bed will be given to new residents. Does that mean that when the resident comes back I have to considered him as a brand new admission, meaning we will have to do an Admission assessment again even though the facility expected him to return?  5/17/2005
Q. Patient admitted in June. An Admission Assessment combined with the 5-day PPS Assessment was transmitted (01/1. She was discharged Return Not Anticipated (6). She was recently readmitted for rehab due to a new hip fracture. Should the first assessment be another 01/1? She will be discharged back to her home when therapy ends.  1/24/2005
Q. A resident was discharged home last year and then was later readmitted after another acute episode. Are we still expected to pull forward 15 months of MDSs for the new chart? I know that we do if they go to the hospital, but is it also required with a planned discharge home with no plans to readmit?  6/25/2004
Q. A resident went to the assisted living unit that is a part of the same building that the SNF is in for 3-4 weeks. Things didn't work out, and she's been readmitted to the skilled unit she left. I've got MDS's and her care plan in the chart from her old chart. She's coming back Medicaid. I don't know yet if she d/c'd with no return anticipated or not. Talking with staff they felt like she shouldn't have tried it and hasn't really changed since her discharge to the assisted living. Do I need to do her admission (OBRA) assessment again?  6/21/2004
Q. We have a patient that was discharged-return anticipated on 7/30/03. The patient lost bedhold status on 8/12 and the chart was closed. He returned to the facility on 9/22/03. Would you do another admission assessment or continue with the previous schedule and do the scheduled quarterly (if no significant change).   10/24/2003
Q. We have a patient that was discharged-return anticipated on 7/30/03. The patient lost bedhold status on 8/12 and the chart was closed. He returned to the facility on 9/22/03. Would you do another admission assessment or continue with the previous schedule and do the scheduled quarterly (if no significant change).   10/24/2003
ARD-Assessment Reference Date
Where can I find the regulations related to the ARD? Therapy wants to change the ARD after it’s already been set, but an RNAC in another building says this is not allowed. Which is correct?  3/14/2006
Q. When a resident leaves the facility and returns during the middle of an observation period for an MDS, how do you adjust the observation period so you’re not billing for days out of the facility? What happens to the assessment schedule?  6/16/2005
Q. When completing an assessment for a resident who goes to the hospital, I always use day prior to d/c for my "bill through" date, knowing that I can't bill for date of d/c (since the hospital is billing for this day). This usually means that my ARD is changed to date of discharge. In the past, I have always counted therapy minutes if they were actually given before the discharge since this helps to set RUG rate. Therapy is questioning me about this stating that they have been told that they just loose those minutes, that therapist does not get paid for them as they cannot bill for them. Is this correct?  6/16/2005
Q. When setting the ARD for the 14-day assessment, is it appropriate to set the ARD on day 14 and count day 8 in my look back for the 7-day observation period? That would mean that the observation periods for the 5-day and the 14-day assessments would be overlapping.  2/25/2005
Q. The observation period ends 12/25 for a resident’s Quarterly Assessment. She went to the hospital 12/21. I think I still need to do her quarterly, but my ADON said I shouldn't have to do one till she gets back because she left during her observation period. Should I do the quarterly on her? If so, do I change the observation period to end on the day she left for the hospital or leave it and do it with what info I have and leave the ARD the same?  1/24/2005
Q. The previous MDS person left, and I am dealing with some late skilled assessments. The ARDs have been set, but not all of the MDS sections have been completed. The documentation is in place and on the chart but just not data entered. Can the ARD remain the same and the MDS be completed and then the R2b signed for day actually entered into the computer even though it will be late?  11/16/2004
Q. I am new at MDS's and am confused. Please give me some advice. The first section of the new RAI clarifications and revisions states that the ARD is the last date of the assessment. We have therapies in the afternoon and the therapists do not always have time to put the minutes in or do their sections of the MDS on the last day of the ARD. Is it considered late if it is not finished until the next day? What about nursing, there are always doctors in late in the evening writing new orders? If the MDS is finished that afternoon, something could be missed.  6/25/2004
Automation/Submission
Q. Does a resident/responsible party needs to sign a separate form for electronic submission of information for MDS, or is the signature on the sheet they sign when admitted talking about releasing information to different places for payment, etc., good enough?   4/20/2007
I made a "fatal error" - I submitted an MDS that indicated on Section w that resident was not admitted during the flu season, but clearly he was. How can I fix this without a lot of chaos?   5/18/2006
I made a "fatal error" - I submitted an MDS that indicated on Section w that resident was not admitted during the flu season, but clearly he was. How can I fix this without a lot of chaos?   5/2/2006
49, 42I need some advice. My facility has morphed into a large continuing care retirement community (CCRC). If I do a discharge return anticipated when a resident returns to another area, such as assisted living, independent living, or the dementia unit, then if they again need skilled care, they reenter and I do a significant change assessment or a PPS assessment. When submitted to the state they come up 'late' because often it is greater than 92 days. The state presented us with a list of late assessments when they came in for survey. What can we do to avoid this situation?  4/25/2006
Q. Can I sign a computer-printed copy of MDS that is old? MDSs were done on time, signed, dated, sent, accepted, etc. Unfortunately, somewhere between RNAC and Medical Records, they did not end up in closed charts. Claims are being denied because there is no MDS in the chart. Can I print them up, sign them, put them in charts, and appeal? Or, am I out of luck?  2/25/2005
Q. How long do we have to keep the state final, initial and transmission log validation reports?  2/25/2005
Q. I transmitted MDSs to the state today and received a warning that the state calculated a rehab RUG score on one of the assessments. Our RUG level was SE3 on this particular one.Do Ineed to worry about this?   1/24/2005
Q. I am concerned. Our server was sent out for repairs, and I have been without a computer since last Wednesday. I have been handwriting my MDSs in the interim. My concern is that when the computer comes back up tomorrow and I go to enter all the data in our computer, the system automatically puts in the dates. All my dates will be wrong, plus I cannot do RAPs until the system is up, so all my RAPs will be late as well. How do I answer to state if they question this, and will my Med A be out of compliance? Will I get default rates on those Med As?  12/13/2004
Q. I accidentally entered the ARD as 11-21-04 instead of 11-22-04 and submitted it before I realized the mistake. Can I do a modification of the ARD or not?  12/13/2004
Q. I made a mistake and transmitted an OMRA with the ARD on day 11 instead of day 10. Can I inactivate assessment and transmit it again with the right ARD or we have to take a default payment?  6/25/2004
Q. A resident developed a stage 2 pressure ulcer the day before the MDS ARD. The nurse missed coding this on his MDS. Treatment orders were in place and being carried out the day the wound was found, and a wound care plan for risk for pressure ulcers was in place and was updated shortly after the ulcer treatment was started. Do you do a modification or a significant correction assessment in this case?  6/25/2004


Reproduction of material from AANAC.ORG without written permission is strictly prohibited
Trademark Policy - Privacy Policy - Copyright Policy- List Serve Policy
AANAC owns and also uses in commerce the mark RAC-CTTM, which is awarded to individuals who successfully complete Certification requirements.

Copyright © 2000-2008, American Association of Nurse Assessment Coordinators (AANAC)
AANAC is a program of Long-Term Care Nurse Net ™
400 South Colorado Boulevard, Suite 600 | Denver, CO 80246
Telephone 800.768.1880 | Fax 303.758.3588 | Email Us | Site Map