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Contact Information

Wendy Castro

MDS Training Coordinator RAC-CT

wendy.castro@state.co.us

cdphe_mds_colorado@state.co.us

720-443-2486

Test Your Knowledge Answers:

1) If the indication is sleep and not for pain relief, it would not be coded as a pain relief medication.

2) There is the option to do the 5-day either before or after the hospitalization in this case...BUT ---> not in both places, as the scenario indicates, because this is an interrupted stay. In this case, an IPA would be done instead of a second 5-day.

3) Is it because of diabetes, or is the lower extremity weakness and need for Hoyer lift the reason the resident needs to be in a nursing home? The resident should be assessed as to the kind/level of assistance the resident needs, and whichever one is the 'neediest' usually provides an indication of why the resident needs to be in a long-term bed. In the brief description provided, it appears that spinal stenosis requires a greater need.

4) The delayed recertification should note the time frame it is covering for what was missed. Like other recertifications, the next one would be due no later than 30 days from the signature date of the delayed certification form.

5) The RAI User’s Manual, page K-5 outline the steps for new admissions and coding K0300: the RAI User’s Manual:

1. Ask the resident, family, or significant other about weight loss over the past 30 and 180 days.

2. Consult the resident’s physician, review transfer documentation, and compare with admission weight.

3. If the admission weight is less than the previous weight, calculate the percentage of weight loss.

4. Complete the same process to determine and calculate weight loss by comparing the admission weight to the weight

30 and 180 days ago.

If the steps for assessment were not followed and were unable to obtain information about the resident’s prior weight, K0300 would be coded “no or unknown.” If the required information was obtained, the K0300 would be coded either yes or no depending on whether there was weight loss and a prescribed weight loss regimen.

6) We do not transmit any MDS coded as a PPS MDS for any payer other than the original Medicare.

7) Following the end of a quarter, CMS allows 85 to 90 days for submission of MDS assessments before the data are uploaded to be used in the Quality Measure (QM) rating calculation. This means that after the last day of the quarter, you have up to 85 days or so to submit MDSs with ARDs in the quarter and/or modify MDSs for that quarter before they are uploaded to the QM calculation. Once in that QM calculation, the QM will not change even when a modification is completed.