Test Your Knowledge

Test Your Knowledge Questions:

1) A resident takes Tylenol PM nightly with an indication for sleep. During the pain interview, the resident reports that Tylenol PM helps with pain as well. Should Tylenol PM be coded as scheduled pain medication or not?

2) Scenario:

A resident was admitted on 11/28 under Medicare A. The resident was transferred and admitted back to the hospital on 11/29. The resident returned on 12/1 under Medicare A. A 5-day DCRA with an interrupted stay was completed on 11/29. The 5-day/admission was scheduled for 12/8, day 8 from the readmission.

Would this be correct, or should a 5-day DCRA with interrupted stay not have been done and then schedule the 5-day/admission for a different day, such as 12/7?

3) How is the primary diagnosis determined for a long-term resident residing in a facility under Medicaid for 3 years? The resident has diabetes and at times requires insulin changes and A1C every 3 months. The resident also has lower extremity weakness due to spinal stenosis and requires a Hoyer Lift for transfers. Would diabetes be the primary diagnosis and the reason for the long-term stay or would spinal stenosis due to poor mobility be considered the primary diagnosis?

4) A first recertification, due by day 14, was missed and the physician sign a delayed certification form. When would the next certification be due?

5) How is weight loss in the last six months assessed if the resident has only been in the facility for 14 days?

6) A question about Pace Medicare and the 5-day assessment. Would an assessment be submitted/transmitted to CMS or would an assessment just be completed and not transmitted to CMS as it is done for skilled HMO patients?

7) What would be the deadline to make a correction to an MDS assessment that triggered in Quarter 3 for Decline in Mobility (Long Stay Quality Measure (QM)) so that it does not impact Quarter 3 calculations?