Re: COMBINING 5 DAY AND ADMISSION MDS

[carol maher]

Yes, time is an important factor for all of us.  That is why I would want to code the 5 day as the admission assessment if the resident was going to be in the facility for more than 14 days.  (If they were going to be discharged before day 14, I would only do a 5-day PPS and then a discharge AA8a=8, discharge prior to completing initial assessment, not return not anticipated)  When combining the admission assessment with the 5 day, I give myself enough time to observe the resident, collect the data from all disciplines and complete the assessment, work the RAPS and get all of the required signatures by day 14.  IF I waited to combine it with the 14 day, I would have to do the 5 day PPS assessment and then set the date for the admission/14 day day 11-14 and have to complete that comprehensive assessment very quickly to have it done, signed, RAPS completed by day 14.  That is a lot of pressure, especially when MDS coordinators have no control over whether they will be pulled to the floor to work clinically.  So, by using the 5 day window, it gives us more of that precious time commodity.  When I worked in PA, a case mix state, I would often use the grace days for the 5 day assessment to ensure that I had 5 days of therapy on that admission/5 day PPS assessment so that it would work dually well for the PA case mix system.  It more accurately reflected the resident on the admission assessment and I could also catch all of the info from the acute care stay on the assessment.  So, it was timely, it worked for case mix and it gave me the time I needed to complete my work.  Win win.


-----Original Message-----
From: [EMAIL PROTECTED]
Sent: Feb 22, 2004 11:59 PM
To: [EMAIL PROTECTED]
Subject: COMBINING 5 DAY AND ADMISSION MDS

I guess I am having a difficult time understanding why you would code the 5 day and admission together except in rare circumstances.  My clients did this when the software would not allow an Admission assessment if we did a 5day, sent the Res. to the Hospital and then tried to do the admission when they returned.

Most software has corrected this.  The Admission is a COMPREHENSIVE assessment.  Don't you want as much time as possible to observe the resident so you can adequately work the RAPS?  What am I missing

And, nurses complain about all of the 'paperwork'.  Fort short term residents not expected to stay 14 days why would you do all of the additional paperwork involved with the admission assessment?  This is an OBRA assessment usually coded "discharge not anticipated".
Delores

PS--if I thought the resident would be discharged before day 14, I would not do the initial with the 5 day--the only time I don't.

Correct!

Delores L. Galias, RN, RHIT

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