Nathan, I thought that this had been clarified to mean (like the old days) if the resident had been newly coded to a 3,4,or 8 from a 0,1,2 ( reverse as in the significant improvement). Maybe I am mistaken, but this would not impact the plan of care with these changes? Am I wrong? Any other ideas out there?
Brenda W. Chance, RN, RAC-C MDS Coordinator CONFIDENTIALITY NOTICE: This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information. Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message. -----Original Message----- From: Nathan [mailto:[EMAIL PROTECTED] Sent: Wednesday, February 18, 2004 2:00 PM To: [EMAIL PROTECTED] Subject: Re: Significant Change The RAI Manual says that a SCSA will be done when there is a decline in two or more of the ten domains listed below. Dressing and Personal Hygeine both fall within domain # 4. However, the manual states on p2-8/para 4, "This may include two changes within a particular domain." It says on p2-8/para 2, "If there is only one change, however, staff may still decide that the resident would benefit from an SCSA. It is important to remember that each resident's situation is unique and the interdisciplinary treatment team must make the decision as to whether or not the resident will benefit from an RAI" BOTTOM LINE - When the survey walks in, would you rather defend your decision to do the SCSA or the decision not to do the SCSA? Your choice. I would do it if it was me. 1. Resident's decision-making changes from 0 or 1 to 2 or 3 for Item B4; 2. Emergence of sad or anxious mood pattern as a problem that is not easily altered (Item E2); 3. Increase in the number of areas where Behavioral Symptoms are coded as "not easily altered" (i.e., an increase in the number of code "1"s for Item E4B); 4. Any decline in an ADL physical functioning area where a resident is newly coded as 3, 4, or 8 (Extensive assistance, Total dependency, Activity did not occur) for Item G1A; 5. Resident's incontinence pattern changes from 0 or 1 to 2, 3 or 4 (Item H1a or b), or there was placement of an indwelling catheter (Item H3d); 6. Emergence of unplanned weight loss problem (5% change in 30 days or 10% change in 180 days) (Item K3a); 7. Emergence of a pressure ulcer at Stage II or higher, when no pressure ulcers were previously present at Stage II or higher (Item M2a); 8. Resident begins to use trunk restraint or a chair that prevents rising when it was not used before (Items P4c and e); 9. Overall deterioration of resident's condition; resident receives more support (e.g., in ADLs or decision-making) (Item Q2 = 2); 10. Emergence of a condition or disease in which a resident is judged to be unstable (Item J5a). Nathan ----- Original Message ----- From: "Kristen Tryba" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Tuesday, February 17, 2004 9:54 AM Subject: RE: Significant Change > I Wouldn't. > > -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of > Holly McGran > Sent: Wednesday, February 18, 2004 11:33 AM > To: AANAC List Serve (E-mail) > Subject: Significant Change > > > > > Would you do a Significant change if a resident went from a 3 to > a 4 in dressing and a 3 to a 4 in personal hygeine on an MDS with > absolutely no other change in any other areas on the MDS? Thank you in > advance. Holly McGran > /---------------------------------------------------------- > 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 -----------------------------------------------------------/ /---------------------------------------------------------- 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 -----------------------------------------------------------/
