Test Your Knowledge

Test Your Knowledge Questions:

1) I'm not sure how to proceed with the pain assessment when the resident answers "No" for pain in the last 5 days, however, documentation shows the PRN pain medications were utilized in the past 5 days. (That does happen even with residents without Dx of dementia, or cognitive impairment!)

I think since the pain assessment should reflect the "resident voice", then "No" should be documented, as well as the PRN.

2) When coding Section K for IV fluids received in the hospital while not a resident in K0510B during the last 7 days, how do you code percent intake while a resident in the last 7 days in K0710A2 and K0710B2 if IV fluids were not given in facility? Do you dash these sections or code 1 for both since no fluids were received in the facility for 25% or less and 500 cc/day or less? 

3) If a resident wants to leave facility AMA and we are able to keep the resident long enough (maybe 1 day) to plan a safe discharge but prior to finishing therapy and/or nursing services, would this be considered planned or unplanned as a patient or family driven discharge?

4) I wanted to enlist your help with getting the correct look-back period for :

GG0120. Mobility Devices

Check all that was normally used in the last 7 days

In section GG it is typically a 3-day assessment time frame. However, this question states 7 days. In the RAI manual, it says:

Steps for Assessment 

1. Review the medical record for references to locomotion during the 7-day observation period. 

2. Talk with staff members who work with the resident as well as family/significant others about devices the resident used for mobility during the observation period. 

3. Observe the resident during locomotion. 

Am I correct in thinking that this is referring to the ARD backward to admission? OR is this taking into consideration the 3 days they are at the facility and 4 days prior? We don't typically go back before they admitted to us, but I'm confused since it says "7 days".

5) Resident has two blisters on heels that opened. The skin underneath is blanchable. No signs of DTI (discoloration). The resident was using her feet to pull herself by wheelchair during the week. She was more active than she usually is due to medication changes. IDT team determined they were friction blisters. How would these be coded in section M? 

6) If a resident is admitted and discharged on the same day before midnight, do we need to do entry and discharge MDSs?