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Previous FAQ's are currently under review. This page will only show FAQ's posted since Aug. 2003
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(MPAF) MDS Medicare PPS Assessment Form
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Section A - ID/Background Information
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ABN's
A resident on rehab therapy is exhausting Part A benefits and will be continuing on Part B as the family wants to continue. We gave the generic notice and an ABN today, and we expect family will contact the QIO for an expedited determination. Is this correct?
4/14/2009
Admission Assessment
A resident was in our facility for rehab, went home, went back into the hospital and then back to us. In AB5, Residential History, would I mark “a,” Prior stay at this nursing home?
1/26/2009
I have a question concerning Admission assessments (AA8a=1). My understanding is that an Admission assessment must be completed on or before day 14. A question came up asking if a person is discharged prior to midnight on day 14, would an Admission assessment need to be done? I would think it should be done, since your Assessment Reference Date (ARD) (MDS item A3a) should be no later than day 13 in order to complete the assessment on day 14. What is correct?
10/21/2008
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
Annual Assessments
Please explain what the penalty is for assessments completed late - that is with the R2b completion date beyond what is acceptable. Will we be paid at the default rate? What about assessments not scheduled on time?
7/29/2008
ARD-Assessment Reference Date
Regarding the OMRA, the ARD has to be set on day 8, 9, or 10 after therapy ends. Is the therapy discharge day counted as day 1?
4/14/2009
Can the look back periods of the 5-day and 14-day assessments overlap? That would mean that some of the minutes captured on the 5-day will also be captured on the 14-day. Is that okay?
6/3/2008
An assessment coordinator at another facility called me yesterday (May 2), and in the course of the conversation, I discovered she had never done an Other Medicare Required Assessment (OMRA) on a resident who came off of therapy April 11 but remained skilled for nursing services. I know the OMRA is supposed to have an assessment reference date (ARD) of day 8, 9, or 10 after the end of therapy, but she wants to go back and make it April 20, since there are 14 days to complete the OMRA after setting the ARD. I think the ARD should be May 2, since that is when it was discovered that the OMRA was never done. Then they would bill the default rate from last therapy day until May 2. What is correct?
5/6/2008
A resident was admitted, and therapy did not pick him up right away (either the order was missed or therapy just didn’t pick up right away), so the resident is on skilled nursing now x 8 days. The 5-day PPS assessment is already scheduled. Rehab now wants to pick up starting the 9th day. What's the best thing to do as far as assessment switching from nursing RUG to rehab RUG?
4/22/2008
Looking back 14 days from my 30-day assessment ARD, I did not see any documentation from the physician or nurse practioner in the physician's progress notes. However, the nurse practitioner did come in within the 14-day observation window for physician visits and wrote orders on the physician's orders form but not in the progress notes. Can this be counted as physician's visit in Section P8?
2/12/2008
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 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 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 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
Attestation
A resident with a new CVA has expressive aphasia. Should this also be considered under B5c, episodes of disorganized speech, if the speech is incoherent/irrelevant?
7/29/2008
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
