MDS Flashcards
(15 cards)
What is the MDS Admission process for MEDICAID?
When a Pt. Comes in under MEDICAID, Must do PRE-SCREENING then Determine if there is a MEDICAL NECESSITY.
PASARR = to screen for Mental Health LTCMI = The "MDS" info transmit for MEDICAL NECESSITY
PASARR is Mandated by?
The Federal government
**Even though is screens for Mental illness and is for MEDICAID Pt. Only
What is an OBRA ASSESSMENT?
An Assessment for MEDICAID (Normal assessment Plan)
14- Day Assessment
7- Day Care-plan
Quarterly Assessment
Yearly Assessment
What is LTCMI?
(FED) (Medicaid)
The System used for transmission for Medical Necessity
What is PASARR?
(FED) (Medicaid)
Pre-Admission Screening System used to screen for mental illness. Is mandated by FED is only for Medicaid Recipients.
What is the MDS Schedule for Medicare Pt.?
(Small MDS) or (Quarterly for medicaid) 5 Day MDS 14 Day MDS 30 Day MDS 60 Day MDS 90 Day MDS
** Because MEDICARE Pt. come in under SNF they are coming to the SNF for REHAB. They want to see progress. Hence why so often.
What is a RACK REVIEW?
When CMS comes in to look and see if WE OWE them MONEY.
** They come in to TAKE $$ Back
When must you give a DISCHARGE letter for when a Pt. comes off of MEDICARE
5 days before Pt. comes off.
What is a CERT?
(FED) (MEDICARE) (SNF)
Cert is a letter of certification from the Dr. that signed off on Pt. coming to facility.
Must have within 14 days of the Pt. being at the facility
If a Pt. Comes in UNDER for Therapy ONLY what is the payer Source? IS PASARR Required?
Medicare or Private Pay
and PASARR is not required, as it is for MEDICAID Pt.s Only.
What is PL1?
PL1 is the SYSTEM used for PASARR
How many levels are there for PASSAR?
3 Different Levels
Lev1- Evaluation and Determination
Lev2-Evaluation and Determination
Lev3-Mental and Functional Status
Under Medicare, how many RUG Groups are there? What qualifies you for being skilled?
53 Rug groups
If you are in the top 35 of the 53 you qualify as being a skilled Pt.
What is a RAP or a CAT?
It is a trigger in the MDS to notify of changes.
CAT= Care Area Triggers
RAP= Resident assessment Protocols
*Both do the same thing.
What is the tool to screen for MR MI? What type of services are required? who is required to provide them?
1-PASSAR (Mental Retardation, Mental Illness)
2-Specialized services are required , above that of REHAB, that is provided by the facility.
3-The State is required to provide and arrange these special services.
