Deanna, The manual doesn't say that there is a change if the ADLS go from a 0 ,1 or 2 to a 3, 4 or 8. The manual actually says that "Any decline in an ADL physical functioning area where a resident is newly coded as 3,4, or8 for Item G1a. This is interpreted by the state of PA as any time a resident is a 3 (Extensive) when previously coded at a lesser level, or newly coded as a 4 (total dependence) when previously coded at a lesser level, or newly coded as 8 when previously coded at a lesser level. So, changing from a 3 to a 4 in 2 areas would qualify for a significant change. I know I was originally taught the way that you stated it, but the surveyors have been interpreting it the way that I just described. I called the state RAI coordinator and she agreed with how the surveyors are interpreting it. ----- Original Message ----- From: "Deanna J. Ogle" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Tuesday, February 03, 2004 5:05 PM Subject: RE: raps for scsa
> In this case, I would make a brief statement about why the each RAP > triggered, that the resident has not changed since the last RAP note, > reference that note and state that the plan of care remains current. The > only ones that I would go into much detail on and actually "work the RAP" on > are the areas that actually changed. BTW, changing from a 3 to 4 in one area > is not considered a significant change - see page 2-9 of the RAI manual. > Going from a 0, 1 or 2 to a 3, 4 or 8 is a change but not going from a 3 to > a 4. If the only other area that they changed was an increase in behavioral > symptoms, then the surveyors were mistaken in asking you to do a significant > change, especially if the person has not stabilized or meds are still being > adjusted. Is this person one that has expected declines r/t diagnosis or a > condition, if so, then that is another reason not to do a sig change yet. > See page 2-10. I don't know if you want to fight this one or just do it to > get it done but I would not knock myself out rewriting RAPs that were just > done and remain current. > > Deanna J. Ogle, RN > Care Manager > St. Francis Extended Health Care > (360)734-6760, ext. 322 > [EMAIL PROTECTED] > > > > > -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] > Sent: Tuesday, February 03, 2004 3:52 PM > To: [EMAIL PROTECTED] > Subject: raps for scsa > > > > Hello, all: > > I know I've seen this subject discussed before, but I can't clearly remember > the answer. > > We are doing a change of condition on a resident who has had only minor > changes, but the surveyers wanted it done. (We did ok, but not the perfect > survey of the past 2 years. Plus, they had the feds shadowing them so they > were in worse shape than we were.) > > Anyhow, my question is concerning the RAPS that we do with a scsa. This > resident really didn't change all that much; 3 to 4 in eating, more > inappropriate behaviors than before. It seems I remember that we don't have > to do all the RAPS all over again, just the ones with the changes. He had an > Annual Assessment done in December, so the RAPS were pretty much up to date. > > Is my memory correct? I hope!! > > Thanks for all the good information I get on this listserve. > > June Bradford RN, MDS CORDINATOR > > > /---------------------------------------------------------- > 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 -----------------------------------------------------------/
