Refer to page 2-7 of the December 2002 User Manual for the MDS.  It
indicates that you have up to a 14 day window to return the resident to
"baseline".  That is, the resident may have qualified for a significant
change in condition assessment but you have some time to develop and
implement a treatment plan designed to reverse the decline, unless it is
irreversible or an improvement.  I recommend the team re-evaluate the
resident's status every couple days to determine early if the plan is
working or not.  If not, you would still have time to make some changes to
the care plan (where the treatment plan has been detailed) with the hope of
demonstrating improvement before the 14th day.  If your treatment plan
demonstrates success but has not totally reversed the loss/es, make a note
in the clinical record indicating that the interdisciplinary team
anticipates the treatment plan is likely to continue to encourage resident
improvement given additional time and that the interdisciplinary team does
not believe a new assessment is needed.  So, the identification of the
decline should be outlined in the clinical record, entries made every couple
days during the (up to) 14 days discussing the resident's response to the
plan of care (the new treatment plan can be modifications of current care
plan problems or new care plan problems) and ultimately, the team's decision
regarding the need to proceed to the significant condition change
assessment.


Jane Craven, RN, C.
Sr. Consultant, Nursing Services
Tendercare (Michigan) Inc.

                -----Original Message-----
                From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
Behalf Of Bogda Habich
                Sent: Tuesday, December 16, 2003 10:17 PM
                To: [EMAIL PROTECTED]
                Subject: Sig.Change

                The last 60 day assessment was pone 12/04/03 and submitted.
t present the resident started to deteriorate. How should I code this.Please
help. Bogda.

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