15 What do you do if a private pay resident is discharged within 14 days of admission, and you’ve completed only a portion of the Admission assessment?
You must complete the assessment with the day of death or discharge as the ARD.
Completion of the assessment is not required, but you must file the incomplete assessment in the discharge record.
Completion of the OBRA discharge is not required.
You complete the assessment, including CAAs, to the best of your ability.
16 Mr. J.’s Annual assessment is in progress. The assessment reference date (ARD) is October 10. Which option represents an acceptable sequence of events?
Team members completed their sections, several attesting to their accuracy at Z0400 on October 11, others signed off on October 12. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 11 and V0200B2, (CAA completion), on October 14.
Team members completed the behavior items in section E and signed them off, attesting to their accuracy at Z0400 on October 9. All other sections were signed off by October 12 at Z0400. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 12 and at V0200B2, (CAA Completion), on October 13.
Several team members completed their sections and signed them off, attesting to their accuracy on October 11. All other sections were signed off at Z0400 by October 12. The registered nurse assessment coordinator signed at V0200B2, (CAA completion), on October 12 and at Z0500B, (MDS completion), on October 13.
Team members completed the sections with interview items signed on October 10. Other non-interview items were signed off on either October 11 or October 12. The registered nurse assessment coordinator signed at Z0500B, (MDS completion) on October 12 and V0200B2 (CAA completion)
17 June 5 was the assessment reference date (ARD) for Mrs. K’s Admission assessment. Her first Quarterly assessment had an ARD of September 3. In October, she had a significant change in status, and the significant change of status assessment (SCSA) had an ARD of October 15. When is the next Quarterly due at A2300 and her next Annual assessment due at A2300?
Quarterly due no later than December 1, Annual due no later than June 5
Quarterly due no later than December 1, Annual due no later than October 15
Quarterly due no later than January 15, Annual due no later than June 5
Quarterly due no later than January 15, Annual due no later than October 15
18 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step?
Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA).
Document that the resident has had significant change in status requiring an SCSA.
Complete a Significant Change in Status Assessment.
Schedule an Annual Assessment.
19 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step?
Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA).
Document that the resident has had significant change in status requiring an SCSA.
Complete a Significant Change in Status Assessment.
Schedule an Annual Assessment.
20 When is a comprehensive assessment not required?
The resident is admitted to the facility for the first time and remains beyond 14 days.
The resident has a significant change in status by MDS definition.
The resident returns after a five-week hospital admission.
A resident’s significant weight loss is her only change in health status.
21 Today is October 21. Mr. E., a private pay resident, was admitted on October 10. The assessment reference date (ARD) for his Admission assessment is October 20. It is clear today that he has suffered a significant change in status related to extension of his stroke. The physician does not want to admit him to the hospital because the nursing facility can provide the necessary care and services. From an MDS standpoint, what is the correct course of action?
Complete the Admission assessment as planned.
Complete a Significant Change in Status Assessment, because it will replace the Admission assessment.
Dually code the assessment as both the Admission and PPS 5 Day.
Dually code the assessment as both the Admission and SCSA.
22 On December 1, a long-term care resident was again readmitted from a six-day hospital stay. She is not Medicare eligible. The nurse assessment coordinator (NAC) completed a Significant Change assessment with an assessment reference date (ARD) of December 9. On December 30, the resident was readmitted to the hospital again and the NAC completed an OBRA Discharge return anticipated assessment. The resident returned to the skilled nursing facility on January 5. In this situation, which of the following is the most likely assessment to be completed next?
A significant change assessment
A quarterly assessment
A care area assessment
A care plan
23 After completing the Quarterly MDS, when must it be transmitted to the national QIES ASAP system?
Within 7 days
Within 14 days
Within 21 days
Within 31 days
24 While reviewing a resident’s medical record, it is discovered that the resident’s race was incorrectly coded at A1000 on the most recent comprehensive assessment. What is the correct course of action?
Complete an SCPA within 14 days of identifying the error
Complete a modification utilizing the section X Correction Request
Complete an SCSA within 14 days of identifying the error
Complete an inactivation utilizing the section X Correction Reque
25 When a significant, uncorrected error has been identified, what qualifies the error as significant requiring a significant correction of a prior comprehensive or quarterly assessment?
The resident had two uncorrected errors identified
The resident’s birthdate was coded as January 1, 1936, but the correct birthdate is January 19, 1936
The clinical status was misrepresented and a subsequent assessment with the correct information was not submitted
The resident was admitted to Hospice after the assessment’s ARD, but before the assessment was completed
The RNAC must ensure the error is correct in the seven-day editing period prior to transmitting. If this is done, no Significant Correction to prior comprehensive is required
The RNAC must attest to completion, lock and transmit the assessment and follow up within 14 days with a Significant Change in status assessment
26 The interdisciplinary team is in the process of completing a Quarterly assessment for a resident. The ARD was yesterday. The dietitian reports to the MDS coordinator that she just realized the resident’s weight on the quarterly three months ago was incorrect. The weight that was coded and care planned was 102 lbs. and the actual weight was 120 lbs. What is the correct course of action now?
Modify the previous Quarterly to correct the weight and continue to complete the regularly scheduled Quarterly that is already in progress when the error was found
Modify the previous Quarterly to correct the weight
Modify the previous Quarterly to correct the weight and follow up with a significant correction to prior Quarterly within 14 days
Modify the previous Quarterly to correct the weight. Change the reason for assessment on the current Quarterly to a significant correction of prior Quarterly
27 A long term resident fell, fractured her femur, had a three-day stay in the hospital, and returned on a Medicare A stay. In the initial evaluation of the resident after hospitalization, the interdisciplinary team noted that the fall with major injury was not coded on the OBRA Discharge assessment. What is the correct course of action now?
Modify the OBRA Discharge assessment to add the fall. Follow the PPS schedule of assessments. Code the first one as a combination Significant Correction of Prior Discharge/PPS 5-Day assessment
Modify the OBRA Discharge assessment to add the fall. Follow the PPS schedule of assessments, and continue the OBRA schedule where it left off, considering significant change in status, if appropriate
Inactivate the OBRA Discharge assessment and perform a Significant Change in Status Assessment to capture the fall prior to admission. Begin the PPS schedule of assessments
Begin the PPS schedule of assessments. Code the fall that happened prior to hospitalization in J1800 and J1900c on the current assessment
28 When the RNAC was reviewing an Annual assessment prior to attesting to completion in Z0500, he noticed that two pressure ulcers were not coded on the Annual assessment. What is the correct action now?
No action is required. The RNAC’s signature verifies completion only. The RNAC has no role in whether an accurate assessment is transmitted to the national repository. The RNAC should sign and lock the assessment
Expert Solution Preview
Introduction: As a medical professor in charge of creating college assignments and answers for medical college students, it is crucial to have a clear understanding of the rules and regulations regarding assessments in long-term care facilities. In this context, I will provide answers to several questions related to assessment protocols.
15. What do you do if a private pay resident is discharged within 14 days of admission, and you’ve completed only a portion of the Admission assessment?
Answer: You must file the incomplete assessment in the discharge record.
16. Mr. J.’s Annual assessment is in progress. The assessment reference date (ARD) is October 10. Which option represents an acceptable sequence of events?
Answer: Team members completed their sections, several attesting to their accuracy at Z0400 on October 11, others signed off on October 12. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 11 and V0200B2, (CAA completion), on October 14.
17. June 5 was the assessment reference date (ARD) for Mrs. K’s Admission assessment. Her first Quarterly assessment had an ARD of September 3. In October, she had a significant change in status, and the significant change of status assessment (SCSA) had an ARD of October 15. When is the next Quarterly due at A2300 and her next Annual assessment due at A2300?
Answer: Quarterly due no later than January 15, Annual due no later than June 5.
18. The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step?
Answer: Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA).
19. The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step?
Answer: Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA).
20. When is a comprehensive assessment not required?
Answer: The resident is admitted to the facility for the first time and remains beyond 14 days.
21. Today is October 21. Mr. E., a private pay resident, was admitted on October 10. The assessment reference date (ARD) for his Admission assessment is October 20. It is clear today that he has suffered a significant change in status related to extension of his stroke. The physician does not want to admit him to the hospital because the nursing facility can provide the necessary care and services. From an MDS standpoint, what is the correct course of action?
Answer: Complete a Significant Change in Status Assessment, because it will replace the Admission assessment.
22. On December 1, a long-term care resident was again readmitted from a six-day hospital stay. She is not Medicare eligible. The nurse assessment coordinator (NAC) completed a Significant Change assessment with an assessment reference date (ARD) of December 9. On December 30, the resident was readmitted to the hospital again and the NAC completed an OBRA Discharge return anticipated assessment. The resident returned to the skilled nursing facility on January 5. In this situation, which of the following is the most likely assessment to be completed next?
Answer: A significant change assessment.
23. After completing the Quarterly MDS, when must it be transmitted to the national QIES ASAP system?
Answer: Within 14 days.
24. While reviewing a resident’s medical record, it is discovered that the resident’s race was incorrectly coded at A1000 on the most recent comprehensive assessment. What is the correct course of action?
Answer: Complete a modification utilizing the section X Correction Request.
25. When a significant, uncorrected error has been identified, what qualifies the error as significant requiring a significant correction of a prior comprehensive or quarterly assessment?
Answer: The clinical status was misrepresented and a subsequent assessment with the correct information was not submitted.
26. The interdisciplinary team is in the process of completing a Quarterly assessment for a resident. The ARD was yesterday. The dietitian reports to the MDS coordinator that she just realized the resident’s weight on the quarterly three months ago was incorrect. The weight that was coded and care planned was 102 lbs. and the actual weight was 120 lbs. What is the correct course of action now?
Answer: Modify the previous Quarterly to correct the weight and continue to complete the regularly scheduled Quarterly that is already in progress when the error was found.
27. A long-term resident fell, fractured her femur, had a three-day stay in the hospital, and returned on a Medicare A stay. In the initial evaluation of the resident after hospitalization, the interdisciplinary team noted that the fall with major injury was not coded on the OBRA Discharge assessment. What is the correct course of action now?
Answer: Modify the OBRA Discharge assessment to add the fall. Follow the PPS schedule of assessments, and continue the OBRA schedule where it left off, considering significant change in status, if appropriate.
28. When the RNAC was reviewing an Annual assessment prior to attesting to completion in Z0500, he noticed that two pressure ulcers were not coded on the Annual assessment. What is the correct action now?
Answer: Modify the previous Annual to correct the pressure ulcer coding.
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