Re: Changing ARD's and documentation

[Holly Sox, RN, RAC-C]

Nancy, I think it has more to do with facility policy than documentation requirements for Medicare.  My facility does not require "assessment notes" from each discipline when completing the PPS assessments.  They are required for all OBRA assessments.  The information for most sections is often contained in other documentation, for example, wt records, vital sign records, nursing notes, activity participation logs, etc.  If your facility requires the notes, then it should be sufficient for a summary note to be written, even after the ARD, stating , "Over the past week (or whatever time frame you decide), resident has participated in such and such activities; or exhibited daily aggressive behaviors;" or whatever it is that your assessment note generally includes.   Again, I don't think that an assessment note is required to be written within the assessment window.    HS Holly F. Sox, RN, RAC-C Clinical Editor   www.careplans.com   [EMAIL PROTECTED] ----- Original Message ----- From: MDSNancy To: [EMAIL PROTECTED] Sent: Wednesday, December 17, 2003 8:01 AM Subject: Changing ARD's and documentation I have a question that I'd like to know how everyone is handling this?  This situation has come up a few times and unless I'm missing something, I don't see how to resolve it.   There are times when the ARD needs to be changed to capture a better RUG for a Medicare resident.  But what do we do when the ARD has been changed and one of the disciplines has not written their assessment note yet, and now with the new ARD it will be outside of the window?   Am I missing something?  How does everyone handle this?   I would appreciate any info here. Thanks, Nancy Do you Yahoo!? New Yahoo! Photos - easier uploading and sharing