Test Your Knowledge

Test Your Knowledge Questions: 

1) Does dashing Shower/Bathing Self and Tub Transfer count towards the "dash threshold" and result in the 2% penalty?

2) If a resident receives a partial bed bath as part of routine am/pm care can the level of assistance for bathing be coded in the MDS? 

3) If a resident uses a specialty chair to wheel 50 or 150 feet like a Broda chair or recliner would we answer those 2 questions not applicable since they are not using a regular wheelchair?

4) When coding in section GG of the MDS, do you have to use all three days of the assessment period to code and sign Section GG or can you choose just day one and/or day two? 

5) Is both a 5-day assessment completed (but not submitted) plus an admission OBRA assessment completed (to submit) for Medicare Advantage residents? 

6) New Section N item, "antiplatelet", are all ASA coded or only extended releases? 

7) A Medicare Part A resident expired three days after admission. They received skilled nursing services only and did not complete any MDS interviews. Is a 5-day PPS assessment needed? 

8) Part of the new coding instructions for section O “while a resident,” states to include services performed or received since admission OR in the last 14 days. Does this mean it includes services from before entry into the facility and within the last 14 days?

9) Does the physician or physician extender have to acknowledge at risk for malnutrition prior to the assessment reference date (ARD) to code it in Section I? 

10) If anticoagulant was missed being counted in section N0410 (pre-Oct 1st) and the assessment has been accepted, should the assessment be modified or just corrected moving forward? If it is recommended to modify, how far back would you go to submit the modifications? 

11) Is it OK to dash Section GG items (e.g., car transfers, curbs, steps) for long-term care residents on quarterly/OBRA MDS or will it affect QRP?

12)  If a nurse attended and finished competency skills with a Respiratory therapist, can Respiratory therapy be coded in Section O if that nurse provided a nebulizer treatment for 15 minutes and the medical record was documented? 

13) Is Heparin given BID as part of an IV SASH Flush NOT coded as an IV Anticoagulant medication? 

14) Would it be appropriate to code an ostomy as a nonsurgical dressing in M1200G? Other than H0100C, is Ostomy coded anywhere else in the MDS? 

15)  If a resident is discharged home with skilled home health, how is the discharge status coded, and is the reconciled medication list provided to the home health provider or to the resident? 

16) If a resident is discharged from a Medicare Part A stay, but is remaining in the facility, how is A2121, provision of reconciled medication list to subsequent provider answered? 

17) Will either or both CMS Forms 802/672 still require updating? 

18) I have a resident who sleeps only in a lift chair due to SOB when lying in bed. According to the RAI manual, you're supposed to code roll left and right, sit to lying, and lying to sitting on side of bed on any surface the resident sleeps in, including a lift chair or recliner. My question is: how do you assess/code sit to/from supine transfers in a recliner and/or in a lift chair? 

19) Can active MRSA in the nares be coded as isolation?  

20) In Section GG0170E (Chair/bed to chair transfer), is Gerichair included? 

21) A resident decided to leave the facility without an MD order, which had been known for a few days (and the MD did not agree with the discharge.) Would it be reasonable to consider this discharge unplanned? 

22) Before October, a pain interview wasn't required for a PPS DC; however, I see it is now required. Was this an October change? 

23) If a resident was admitted with a prosthetic knee infection on IV antibiotic and the surgical site is CDI, can it be coded as " Wound infection" at I2500. Wound infection (other than foot)?

24) If a public health nurse came to administer flu vaccines, would this be considered "given in the facility" even if given by someone other than facility staff? 

25) How are A2121 and A2122 answered for a LTC resident who is staying and not being discharged to another provider?