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Test Your Knowledge Answers:

1) Rules for stopping the interview:

The BIMS should be attempted with all residents to determine if they are sometimes understood. If so, record the BIMS on the OASIS. The first four questions on the BIMS are not yes/no questions so if the resident gives no answer or answers that are unrelated or nonsensical, the interview is stopped, the rest of the items are dashed, a 99 is entered for the summary score, and staff is interviewed to complete the assessment. The staff assessment gives more latitude for assessing memory/recall than is allowed with the structured BIMS. For staff completing the assessment, it should be documented that the BIMS was attempted with the resident, the resident's actual response along with additional approaches to communication that did work. Even if the BIMS is stopped, this is would be useful assessment information.

2) The SOC is the date of the first reimbursable service and is maintained as the SOC until the patient is discharged. It should correspond to the SOC used for other documentation, including billing or physician orders.

3) Death at home is completed when the patient dies at home or anywhere other than after being admitted for a qualifying inpatient stay. This includes a patient who expires during outpatient surgery or in the care of the recovery room after outpatient surgery.

4) Yes. Even though the opening was created percutaneously, it is considered a surgical wound because a drain was inserted.

5) If the bedfast patient needs assistance to get on/off the bedpan, the appropriate Response for M1840 would be 4 - is totally dependent in toileting even if they can place and remove the urinal.

6) Because no nursing orders exist, the PT or ST could perform the comprehensive assessment at the SOC and all subsequent assessments.