I follow pages 2-7 to 2-13 of the manual. If you make the determination while you are
doing a quarterly or an annual, code that assessment as a Significant Change in
Status. Even though the annual is a comprehensive, our instructions are to code the
assessment as a SCSA if it meets the criteria for significant change. Also, I read
the facility 24 hour report each day to try to catch Significant Changes when they
occur. I also have the dietitian bring anyone who has a Significant weight loss to
the IDT's attention so we can monitor to see if other changes are occurring. I take a
good look at any resident who has had a foley inserted or who has had a restraint
initiated also. I don't jump on the SCSA immediately, but discuss them at IDT , look
that their ADLs and then try to make a determination if the change will resolve within
a few weeks or if it looks more major. If I believe that the change will resolve, I
write a note about the decision and then put the resident back on the list to be
discussed at IDT in a week or 2 weeks depending. If the change is resolving, I write
a note to that affect and do not do the SCSA. If the change is not resolving as we
expected, I write a note to that affect and set a date for the SCSA. If the whole
team works together that way, you can catch more changes when they occur. The ADL
changes are usually picked up when the next assesssment is due unless a major event
has occurred that is noted on the 24 hour report. Hope this helps.
-----Original Message-----
From: Kathy Archibald <[EMAIL PROTECTED]>
Sent: Nov 5, 2003 8:37 AM
To: [EMAIL PROTECTED]
Subject: Re: Significant Change
I would also like some clearer guidance, we also were cited last year for
not doing a significant change (& I saw that we should have done it). One
of our problems, is that we may be doing a quarterly or an annual
assessment, and its not until we have gone through that whole data
collecting process and are dong our MDS when we see we potential 'signficant
changes'. What kind of system am I lacking that others have, and where are
the clearcut definitions so we can determine yes or no.
Kathy Archibald RN
Living Center Supervisor
Caribou Memorial Hospital
email: [EMAIL PROTECTED]
FAX 1-208-547-2790
Soda Springs ID 83246
----- Original Message -----
From: "Holly McGran" <[EMAIL PROTECTED]>
To: "AANAC List Serve (E-mail)" <[EMAIL PROTECTED]>
Sent: Wednesday, November 05, 2003 6:48 AM
Subject: Significant Change
I need some input from this fine group - we recently had our survey and
received a significant change deficiency. There were 4 residents that had a
significant change (they were clear "significant" changes and should have
been done). The problem now is the MDS Coordinator is afraid not to do a
significant change on residents for what I feel are minor changes. For
example Mood and behavior symptoms (a 2 to a 1) and a change in 2 to 3 in
section G in one area. The care plans are current and don't need to be
changed. The care plan team is going crazy because they are not
"significant" changes. She is reading the guidelines in the manual to the
letter and not looking at the whole picture. If anyone can give me any
guidance on how you determine significant change in residents, I would be so
appreciative. Thank you in advance.
Holly QI in CT
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
/----------------------------------------------------------
The Case Mix Discussion Group is a free service of the
American Association of Nurse Assessment Coordinators
"Committed to the Assessment Professional"
Be sure to visit the AANAC website. Accurate answers to your
questions posted to NAC News and FAQs.
For more info visit us at http://www.aanac.org
-----------------------------------------------------------/
