Was the resident still on therapy when you did the quarterly assessment
and had not reached the stabilization point yet?  If so, then you would
not do the significant change until therapy had been completed.  If you
do a quarterly and recognize a significant change, then by all means, do
one unless this was expected and had been careplanned as such.

Brenda W. Chance, RN, RAC-C
MDS Coordinator
 
 
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-----Original Message-----
From: joelene galie [mailto:[EMAIL PROTECTED] 
Sent: Wednesday, May 07, 2003 9:10 AM
To: [EMAIL PROTECTED]
Subject: Re: SIG.CHANGES ONCE AGAIN

I disagree. Pg 2-7 RAI Manual - If Sig Change is identified in process
of 
completing a Quarterly assessment ... complete a comprehensive
assessment. 
The Quidelines list categories that are on both types of assessment and 
provide the basis for comparison from one assessment to the next
regardless 
of the type being completed.


>From: "carol  maher" <[EMAIL PROTECTED]>
>Reply-To: [EMAIL PROTECTED]
>To: <[EMAIL PROTECTED]>
>Subject: Re: SIG.CHANGES ONCE AGAIN
>Date: Wed, 7 May 2003 13:11:40 -0700
>
>The comprehensive assessment is to be an accurate reflection of the 
>resident.  You need to always look back to the last comprehensive 
>assessment in order to determine if their is a significant change.  
>Comprehensive assessments are admission, annual and significant change 
>assessments.  PPS assessments are not comprehensive assessments unless 
>combined with an admission, annual or significant change assessment.  
>Comprehensive assessment include RAPS and lead to care plans--so alway
look 
>back all the way to the last comprehensive assessment.
>   ----- Original Message -----
>   From: [EMAIL PROTECTED]
>   To: [EMAIL PROTECTED]
>   Sent: Tuesday, May 06, 2003 4:34 PM
>   Subject: SIG.CHANGES ONCE AGAIN
>
>
>   HI EVERYONE. I NEED SOME CLARIFICATION PLEASE.   I WAS ASKED TO DO A

>SIG. CHANGE ON A RES TODAY BECAUSE THEY HAD COMPLETED PT AND HAD AN 
>IMPROVEMENT IN ADL STATUS. HOWEVER WHEN I BEGAN TO COMPARE TO LAST MDS 
>ASSESSMENT WHICH WAS A QUATERLY. THERE WERE NO CHANGES  THAT I COULD
FIND. 
>THERE WAS A CHANGE IN ADL STATUS IN COMPARING THE ADMISSION ASSESSMENT
AND 
>THE QUATERLY ASSESSMENT. I WAS TOLD A SIG CHANGE COULD NOT BE DONE
INSTEAD 
>OF THE QUATERLY AS THIS RES. WAS STILL ON THERAPY. THE ADMIT WAS IN JAN
03, 
>QUATERLY MARCH 03 AND NOW THE SIG. CHANGE
>
>   2.SIG. CHANGES ARE ALSO BEING DONE ON OUR MED A RESIDENTS IN THIS
MANNER 
>ALSO.  WE HAVE RESIDENTS ON WHICH A 90DAY/ QUATERLY IS DONE AND THERAPY

>CARRY THEM FOR A EXTRA 4 WEEKS, WHEN THERAPY IS D/C ED AT THAT TIME A
SIG. 
>CHANGE IS COMPLETED ALTHOUGH LOOKING BACK TO THE 60 AND 90 DAY
ASSESSMENTS 
>THERE HAS BEEN NO CHANGE. I'M TOLD WE HAVE TO LOOK AT THE FIRST OMRA 
>ASSESS. WHICH WE DO WITH THE 14 DAY ASSESS.    I HAVE NEVER LOOKED THAT
FAR 
>BACK. IS IT NECESSARY. ARE WE MAKING WORK FOR OURSELVES. THE MDS ASKS
FOR A 
>90 DAY LOOK BACK OR SINCE LAST ASSESS FOR  CHANGES IN ADL FUNCTION .

>PLEASE HELP.     THANKS

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The Case Mix Discussion Group is a free service of the
 American Association of Nurse Assessment Coordinators
      "Committed to the Assessment Professional"
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    For more info visit us at http://www.aanac.org
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/----------------------------------------------------------
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
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