FAQs & Test Your Knowledge

Test Your Knowledge Questions:

1) Scenario: Section GG, determining usual performance

Per CMS: "Do not record the resident's best performance and do not record the resident's worst performance, but rather record the resident's usual performance."

Based on this guidance what would be the usual performance for data entered in the 3-day assessment window for eating where there is Independent (6x), Supervision (4x), Partial (2x), Dependent (1x)? (Since we no longer use the Rule of 3).

• Does this mean that it can never be Independent because that is the best performance? If yes, would the usual performance then be Supervision?

Data entered in the 3-day assessment window for Transfer

9. Not applicable (6x), Partial (4x), Substantial (3x), Supervision (1)

• Are the ‘Not Attempted Codes’ (07, 09, 10, 88) not considered when determining usual performance if there is at least 1 level of assistance documented during the observation window? In the example, would only Partial (4x), Substantial (3x), and Supervision (1) be looked at to determine the usual performance?

2) For Section N, since we code to medication classification, Insulin is classified as a Hormone, do we still code it under Hypoglycemic? 

3) The following question was received on 7/11/2024: A resident returned to the facility with orders to start skilled services on 7/03/24. Since they were a previous resident, a DCRA was completed when the resident was discharged to the hospital. When the resident returned, I initiated a 5-day stand-alone assessment as the resident returned with skilled orders. The resident level of function didn't warrant a significant change and no quarterly assessment was needed at the time of return. On 7/08/24 a notice was received that the last day of skilled services will be 7/10/24. Can the ARD be changed on the 5-day PPS assessment and combined with the DC skilled assessment? Or do they both need to be stand-alone assessments? 

4) I have a resident who declined to disclose their race and ethnicity. I am documenting that the resident declined to answer both of these. The rest of the responses are required to be answered. Is "no" marked for each item so that the MDS can be completed?

5) Residents who receive Avastin injections to the eyes during the reference period, would this count as an injection? 

6) Is it acceptable to correct an MDS for a resident who expired approximately a month ago? 

7) When is the appropriate timeframe to code question B0100 on the MDS? Do you all code it prior to the ARD or after? 

8) Is there a report in IQIES that can be run monthly to show short-stay claim measures (e.g., successful return to community, rehospitalization, or ER visits)? 

9) Clarification on accurate coding in Section GG for sit-to-stand transfers, toilet transfers, and chair-to-bed/bed-to-chair transfers with the use of a stand lift with the assistance of one. With the assist of 2 this would be coded as dependent but if the resident can hold on and place their feet on the platform for the transfer what would be the accurate coding?