Resident Assessment

Question 1

When are comprehensive Assessments required?

Answer 1

Both-483.20 / 19.801-2
1-On Admission
2-Once a Year
3-When there is a SIGNIFICNAT CHANGE

Question 2

What are the different types of Assessments? When are Each Due?

Answer 2

Both- 483.20 / 19.801-2
(Medicaid/Private pay)
1-Comprehensive
-14 Days after admission
-AT least Once a YEAR (within 366 days after the ARD of the most recent comprehensive resident assessment)
-When there is a Significant Change (Timely Manor / 14 days after Should have noticed)

2-Quartely Review
-Once every Three Months (A Quarterly review assessment must be completed within 92 days of the ARD of the most recent, clinical assessment)

Medicare
5 / 14 / 30 / 60 / 90 day MDS assessments due.
Care plans still due day 21- (14+7 = 21)

Question 3

If a Resident is transferred to the Hospital and then later re-admitted, dose the facility need to do another Comprehensive Assessment?

Answer 3

Both - 483.20 / 19.801-2

No, Only if there is a SIGNIFICANT CHANGE.

Question 4

What are the Tool(s) by witch a Comprehensive Assessment is done?

Answer 4

Both - 483.20 / 19.801-
1-RAI- Resident Assessment Instrument - Both
2-MDS - Minimum Data Set - Texas

Question 5

What is the Tool that is used for Quarterly Assessments?

Answer 5

Both - 483.20/19.801-3

1-QRI - Quarterly Review Instrument — ( a smaller version of the MDS/RAI)

Question 6

How long must the facility store all OLD Residents Assessments for?

Answer 6

Both - 483.20 / 19.801-4

1- 15 months from when started the active record ( Admit Date)

Question 7

What are OLD Assessments to be used for?

Answer 7

Both - 483.20 / 19.801-4

1-develop, review, and revise the resident’s comprehensive plan of care

Question 8

Under what Payment system is PASSAR?

Answer 8

Texas/Both19.801-5
1-Medicaid

*Boyh but remember, passar is mandated by fed. At the state level under Medicaid

Question 9

In a Medicaid Facility what system must be coordinated with the RAI, and MDS assessments?

Answer 9

Texas/Both - 19.801-5
PASSAR- On Admission Only
(Preadmission Screening and Resident Review)

**PASSAR is mandated by Feds at and run through the state Medicaid program.

Question 10

When must DATA be ENCODED ready for transmitting Data?

Answer 10

Both- 483.20 / 19.801-6-b
1- 7 Days after the facility completes a resident assessment.

** Encoding means ENTERING MDS information into a COMPUTER.

Question 11

How many days must:
A care plan happen?
Encode MDS info?
Be ABLE to transmit encoded MDS info? 
Submit MDS info?

Answer 11

Both F287/19.18(6)
Care plan- 7 days after assessment = day 21
Encode-7 days after assessment = day 21
Able to transmit-7 days after assessment = day 21
Fed only:
Submit data - 14 days after assessment = day 28 Texas Only:
Submit data- must submit at least once a month.

Question 12

Who must conduct or coordinate the Assessments?

Answer 12

Both 483.20 / 19.801-8

A RN - Registered Nurse

Question 13

Who must SIGN OFF on Assessments?

Answer 13

Both 483.20 / 19.801-9

a RN - Registered Nurse

Question 14

What is the Penalty for Falsifying an ASSESSMENT?

Answer 14

Both 483.20 / 19.801-10-a
1- $1000 for each Assessment.
2- OR $5000 for each assessment if person that is falsifying ALSO causes another person to LIE

Question 15

What might DADS do is there has been willful false statements of the MDS?

Answer 15

Texas Only - 19.801-11

Possible that DADS might come in and TAKE OVER MDS and Assessments.

Question 16

PASSAR screens for what?

Answer 16

Texas Only - 19.801-13

Mental illness, & Mental Retardation ,

Question 17

When is the Comprehensive Care Plan Due?

Answer 17

-Both 483.20 / 19.802-
1- 21st Day after Admission, or 7 Days AFTER the Comprehensive Assessment – (14-7 = 21)

14 Assessment + 7 Care Plan = 21 Days

Question 18

Who is required to be on the Comprehensive Care Plan Team?

Answer 18

-Both - 483.20 / 19.802-b
1-Attending Physician
2-Regestered Nurse
** Physician does not need to be "physically present"
** all other Staff that need to be a part of the meeting (depending on the residents needs)
*** With HELP from the FAMILY
*** and participation of the RESIDENT
Quality Assurance team is
MD / DON / 3 other staff

Question 19

How often , and by who must a CARE PLAN be reviewed after CARE PLAN is in PLACE?

Answer 19

-Both - 483.20 / 19.802 -b -
1-Periodicaly
2-Qualifiyed Persons

Question 20

The Comprehensive Care Plan must be available to whom?

Answer 20

-Both - 483.20 / 19.802-g

All direct Care Staff.

Question 21

What type of Goals need to be in the Comprehensive Careplan?

Answer 21

Fed/State
Measurable Goals
Have Objectives 
Have time Tables
-Texas only- 19.802(a)
Short and Long Term Goals

Question 22

What are the 20 Categories of the MDS?

Answer 22

Both 483.20 / 19.801-2-b
A-ID Information
B-Hearing, Speech, Vision
C-Cognitive Patterns -- Paid
D-Mood
E-Behavior
F-Preferences for Customary Routines and Activities
G-Functional Status (ADL)--Paid
H-Bladder and Bowel--Paid
I-Active Diagnoses
J-Health Conditions
K-Swallowing--Paid
L-Oral/Dental Status
M-Skin Conditions--Paid
N-Medications
O-Special Treatments, Procedures and Programs
P-Restraints
Q-Participation in Assessment and Goal Setting
V-Care Area Assessment (CAA)
X-Correction Request
Z-Assessment Administration

Question 23

What must be included in the DISCHARGE SUMMARY? and when it be made available?

Answer 23

Both 483.20 / 19.803-
1-Re-cap of the entire stay of the facility
2-Final Summary of Resident Status–MDS CATAGORIES
3-Post Discharge Plan of Care.– How to do things in a different AREA.

Must be made available at the time of Discharge–Texas Only 19.803

Question 24

What is considered a “SIGNIFICANT CHANGE”?

Answer 24

F-274
Any TWO areas of INCLINE or DECLINE on the MDS is a SIGNIFICANT change OR any ONE of the following:
*NEW placement of an INDWELLING CATHADAR
*Weight loss of: 5% change in 30 days or 10% change in 180 days
*Pressure Ulcer of II or higher where, where there was NO pressure soars before.
*Emergence of a NEW condition or Disease that makes resident unstable
*an Overall deterioration

Question 25

What are RUGS?
1-Case mix index
2-grouping of revenue sources
3-Resident classification system
4-method of grouping income from MEDICAID and MEDICARE

Answer 25

3-Resident classification system

Question 26

Who has the final say in on the evaluation if a resident can self administer drugs?

Answer 26

The interdisiplinary team

**1994 final rules