Look in the RAI Manual at 5-6 where it describes "Errors Identified after
the Encoding Period" and also read Chapter 2 starting on page 39.  What you
are describing sounds like inappropriate manipulation of information and I
wouldn't want to be a part of it.
Winona

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Sent: Monday, March 08, 2004 5:35 PM
To: [EMAIL PROTECTED]
Subject: Changing PPS Assessments weeks after R2B before transmission


I am looking for documentation from CMS related to changing PPS assessments
after the 7 day edit/encoding period.  There is a PPS consulting group in
our area that requests that the facility not transmit until they {the
consultants}review. When the consulting group determines that additional
money could have been made by modification of the MDS and/or changing the
ARD, the facility is directed to complete a new MDS. This is done after the
R2b date and before transmission.
 
My group has concerns with this process:
1) Modifications to the MDS are done beyond the 7 day edit/encoding period. 
2) Changing the ARD, sometimes weeks later, does not seem appropriate as it
conflicts with the missed assessment MDS policy. {Example: If you can't set
the ARD date weeks after the fact then you can't re-set the ARD either.}
Second, the MDSs are then technically completed (R2b) beyond 14 days from
the ARD.
3) Temptation-they list your loss financially and the temptation to change
the MDS is strong (especially when the Administrator asks you to do it).
 
We are surprised that some major nursing home chains make a practice of this
and that a some experienced MDS coordinators have now adopted this practice.
The rebuttal includes "there is no financial penalty for completing
assessments beyond 14 days from the ARD". The RAI manual does not directly
tell you that you can not to do this but it seems implied by all the rules.
We do not recommend this practice. Can anyone help me to find CMS
documentation related to the support or non-compliance of this practice? 

Thanks very much. 
 


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/----------------------------------------------------------
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
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