1. The MDS, like any other documentation prepared as a part of the medical record, is a legal document. It is inappropriate to discard it - see the last line on page 2-4 of the RAI User's Manual.
2. Once the observation window has closed, it is inappropriate to set the ARD back into the window. For example, for the Medicare 5-day assessment, the ARD must be set for day 1 -8. On day 9, the ARD can no longer be set back within the window. Starting the assessment over again with a new ARD is not possible, since the assessment window already closed. This is detailed on page 2-40 of the RAI User's Manual. In the scenario described in the original e-mail for this discussion thread, all of those assessments that were billed at a new RUG based on late assessments should have been billed at the default rate.
Rena
Rena R. Shephard, MHA, RN, FACDONA, RAC-C
Chair, American Association of Nurse Assessment Coordinators
[EMAIL PROTECTED]
Subj: Re: Changing PPS Assessments weeks after R2B before transmission
Date: 3/15/04 6:11:51 AM Pacific Standard Time
From: [EMAIL PROTECTED]
Reply-to: [EMAIL PROTECTED]
To: [EMAIL PROTECTED]
Sent from the Internet
RAI Manual 2-27 - last paragraph - asessments...must be completed within 14
days of ARD.
Date R2b is signed designates completion. If original is discarded then in
effect it wasn't done.
The new ARD is set and MDS completed, but what date is used for completion?
Is it within the 14
days after the ARD?
>From: [EMAIL PROTECTED]
>Reply-To: [EMAIL PROTECTED]
>To: [EMAIL PROTECTED]
>Subject: Re: Changing PPS Assessments weeks after R2B before transmission
>Date: Mon, 15 Mar 2004 13:09:52 +0000
>
>Just to clarify - the facility staff chooses the ORIGINAL ARD within the
>designated time frames. However, at times after the consultants' review the
>facility discards the ORIGINAL MDS and completes a new MDS based on the ARD
>recommended by the consultants. This is all done after the original R2b
>date but before transmission. The NEW ARD still falls with in the ARD
>guideline dates but technically was not chosen until well after. My group
>feels this is in violation of the manual but it is becoming a more common
>practice as facilities feel the money crunch. Facilities using this
>practice do not believe they are in violation. I was seeking clarification
>and opinions.
