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Contact Information

Wendy Castro

MDS Training Coordinator RAC-CT

 wendy.castro@state.co.us

cdphe_mds_colorado@state.co.us

303-692-2854

Test Your Knowledge Answers:

1) The resident's responses to the scripted interview items must be entered on the MDS despite what documentation in the medical record during the look-back shows.  In cases like this, I would document in the resident's medical record that the pain interview was completed.  Something to the effect: During the MDS scripted Pain interview conducted on ____,  the resident responded to the question asking whether he/she had any pain during the MDS 5-day look-back window as "No pain." The medical record shows that the resident did ask for and received PRN pain medication __ times during the look-back.  The MDS will be coded to reflect the resident's response that he/she had no pain during the look-back as instructed by the RAI User's Manual." 

2) Code 1 since it was 25% or less of the calories and 500 ccs or less of fluids through the IV.

3)  If the doctor does write the orders for discharge it could still be an unplanned discharge. If the resident was safe to discharge I wouldn't consider it resident-driven. The fact that therapy thinks they can treat them longer doesn't necessarily mean that the therapy was reasonable and necessary. You will have to determine whether the discharge was resident-driven (likely unsafe or safety concerns) or an appropriate discharge.

4) MDS item GG0110 reports device use before admission. The GG0120 Mobility device is looking at the 7-day window looking back from the ARD but does not include days prior to admission.  If this is a new admission and you set the ARD for the 5-day PPS MDS for day 5, you would only look at the device used in the 5 days since admission through 11:59 PM on the ARD of the 5-day PPS MDS or Admission MDS. This GG item has a different look-back from the GG assessment of function items. 

5) Blisters on heels due to friction would very likely be pressure ulcers. When you get a new pair of shoes and walk a lot that first day, a blister often develops on your heels. They are pressure ulcers.

6) If a resident is admitted and discharged on the same day before midnight an NT tracking form and Discharge MDS (DRNA unplanned combined with discharge from Med A) would be required.

-You may combine a 5-day (if already opened in the EHR) with the Discharge MDS

-If the 5-day was not opened, you may bill default (ZZZZZ) for the one-day

Same-day admit and discharge can only be billed if the resident was discharged to home, a non-Medicare participating facility, or expired. It cannot be billed to Medicare since they were not in the facility at/past midnight and if the resident went to another Medicare participating provider.