Test Your Knowledge

Test Your Knowledge Questions:

1) With Section G it was always taught 'hands-on' counted. So when doing a wheelchair follow, the 2nd person was never counted because they didn't have 'hands on the resident'. Now Section GG comes along and what is the status of the wheelchair follow under GG? Some of the aides who work at other centers are being told as soon as there are 2 helpers, code dependent. Should or should not the old theory of "hands-on" be considered? 

2) For a Medicare Part A discharge how are we supposed to answer Item A2121 medications list to another provider? It is only a PPS end of stay, should it even be coming up to answer? 

3) Once the ARD is set, can the assessment be opened before that date? The social services director is asking as they need to complete Section C before the ARD or it would have to be dashed. What is the point of the ARD date?

4) If a SCPA (Significant Correction of Prior Comprehensive Assessment) is transmitted, does it restart the OBRA cycle? 

5) A wound-certified physical therapist staged a sore as a Stage 3 pressure ulcer. This was verified with the physician and coded on the last MDS assessment. A new wound specialist stated this wound should not have been a Stage 3 pressure ulcer. Should a modification of the MDS be submitted to remove the Stage 3 pressure ulcer? 

6) What is the best practice for capturing the three days of discharge performance for Section GG for an unplanned or emergent transfer? 

7) For a long-term patient readmitted from the hospital, what are the clinical conditions that would require a Significant Change in Status Assessment on readmission? Also, can the SCSA be combined with a Medicare 5-Day on readmission? 

8) For the MDS items that are unable to be answered (e.g., ER hospital discharge) and interviews were not completed? Can the answer be copied from a previous answer? How about residents who are only at the facility for 2-3 days?

9) Item D0100 was coded as "Yes", interview should be conducted. Item D0150 A1 and B1 were both coded "9" - no response. Is it accurate that the PHQ interview would be considered completed and proceed to D0700 - Social Isolation? The RAI on page D-11 says "If only the PHQ-2© is completed because both Item D0150A1 and D0150B1 are coded 9, leave Items D0150A2 and D0150B2 blank, then end the PHQ-2© and leave Item D0160-Total Severity Score blank."

But then on the same page, it says "If symptom frequency in items D0150A2 through D0150I2 is blank for 3 or more items, the interview is deemed NOT complete. Total Severity Score should be coded as "99" and the Staff Assessment of Mood should be conducted."

10) If a resident goes to the hospital during the assessment period for outpatient administration of a medication via IV infusion, such as Venofer, would this be coded on the MDS? 

11) A resident who was scheduled for quarterly was diagnosed with COVID-19 on 12/11/23 of her 7-day look back. The lookback started on 12/07/23. The MDS was changed to SCSA related to the COVID diagnosis. The resident was placed in isolation with contact and droplet precautions. Staff used full PPE with all care. The resident has not left the room. All meals, restorative nursing, care, etc. brought to the room. Physician orders for isolation and diagnosis for COVID-19. Question: How many days does the resident have to be in isolation to code it on the current SCSA MDS? The resident was in isolation for a total of 3 days of her 7-day lookback period. 

12)  If a resident expires while on a leave of absence (LOA) at home for a few days, would a discharge assessment be required? 

13) For a resident not on Med A who was admitted on 12/8/23 and then admitted to Hospice on 12/19/23, which dates would be used for Section GG Admission assessment? The original ARD date was 12/15/23 but changed to 12/19/23 due to being admitted to Hospice. Would the Section GG dates be 12/8-12/10 or 12/13-12/16? 

14) Can you code IVF on the MDS if given to increase potassium due to Lasix use? The goal is to balance electrolytes. 

15) About the ARD, what would be the lookback period for completing the pain interview? Some say 5 days and others say 7 days. I know ideally it would be as close to the ARD as possible but wondering about the official "wiggle room". 

16) If a resident falls more than 3 times since the last quarterly assessment, how would this be coded in Section J? Would it be coded that it happened only one time or three times?