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Selecting ARDs: Bubble Gum, Bubble Gum…

By Jessie McGill RN, RAC-MT, RAC-MTA - March 04, 2020

As a child, I can recall sitting in a circle, with legs crisscrossed, singing, “Bubble gum, bubble gum, in a dish, how many pieces do you wish?” to figure out who would be “It” in our next game of tag. Sometimes, scheduling the Assessment Reference Date (ARD) can seem like a game of random selection, just like the bubble gum game. But I’ll let you in on a little secret—the bubble gum game was never random for me. I would count in my head and figure out what number I would need to pick so that I knew exactly who would be “It.” ARD selection is a lot like that: although it may seem random to someone looking in from the outside, it requires strategic skills and intimate knowledge of the payment methodology. Let’s look at a few key strategies nurse assessment coordinators (NACs) should be using with every ARD selection.


1. Understand key terms and documentation requirements.

Completing the MDS is an interdisciplinary team (IDT) process, and nearly every team member is involved, whether it is providing the supporting documentation or writing the care plans. It is important that the IDT members involved in the MDS process are familiar with terms such as ARD, look-back period, and assessment window (see definition box), as these key terms drive both the documentation timeframes and completion of the MDS.