Q&A: The RAI User’s Manual guidance for mechanically altered diet mentions “soft solids.” Would that include solids that are naturally soft or solids that we would “soften”?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: The RAI User’s Manual guidance for mechanically altered diet mentions “soft solids.” Would that include solids that are naturally soft or solids that we would “soften”? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: The diet needs to be mechanically altered to facilitate eating/swallowing in order to code …

Q&A: If the resident was in the emergency department (ED) and then admitted to the hospital before readmitting to the nursing home, can I capture IV fluids at the ED visit?  

MDS 3.0 and the RAI Process / NAC / Q&A

Question: If the resident was in the emergency department (ED) and then admitted to the hospital before readmitting to the nursing home, can I capture IV fluids at the ED visit?   Answer from Jessie McGill, RN, BSN, RAC-MTA, RAC-CTA: IV fluids from pre-admission are captured under K0520A2, while not …

Q&A: Can Z codes be used as the admitting diagnosis on the claim?

Billing and Reimbursement / NAC / Q&A

Question: Can Z codes be used as the admitting diagnosis on the claim? Answer from Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC: Admission Diagnosis codes (Field Locator 69 on the claim) should be the code that is the reason the resident is being admitted to the facility, versus a lower …

Q&A: A long-term care resident has a Quarterly assessment due on 6/19 and an Annual assessment due on 6/27. Can I do the Annual assessment early, before the Quarterly deadline?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: A long-term care resident has a Quarterly assessment due on 6/19 and an Annual assessment due on 6/27. Can I do the Annual assessment early, before the Quarterly deadline? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, you can absolutely do this. Set the ARD for the …

Q&A: When a resident returns from an interrupted stay, is an IPA required or any kind of readmission assessment if no change?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: When a resident returns from an interrupted stay, is an IPA required or any kind of readmission assessment if no change? Answer from Jeff Taylor: IPAs are always optional. In an interrupted stay, no new Medicare MDS is required. You would do the required OBRA Discharge assessment and an …

Q&A: A resident on a Medicare Part A stay discharged return not anticipated. His last covered day of Medicare was the day before. Can I combine the Part A PPS Discharge with the OBRA discharged return not anticipated?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: A resident on a Medicare Part A stay discharged return not anticipated. His last covered day of Medicare was the day before. Can I combine the Part A PPS Discharge with the OBRA discharged return not anticipated? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, when a …

Q&A: For section GG documentation, the direct care staff was given the wrong dates. It was supposed to be the ARD and the two days before, but they did the first 3 days of the look-back period. Am I able to use any of the GG documentation they completed?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: For section GG documentation, the direct care staff was given the wrong dates. It was supposed to be the ARD and the two days before, but they did the first 3 days of the look-back period. Am I able to use any of the GG documentation they completed? Answer …

Q&A: A resident came to our facility for a short stay with a Stage 4 pressure ulcer. The resident has since exhausted his 100 days of Medicare, became a long-term resident, and still has the Stage 4 pressure ulcer. Will this resident trigger the long-stay pressure ulcer measure?

NAC / Q&A / QAPI and Quality Initiatives

Question: A resident came to our facility for a short stay with a Stage 4 pressure ulcer. The resident has since exhausted his 100 days of Medicare, became a long-term resident, and still has the Stage 4 pressure ulcer. Will this resident trigger the long-stay pressure ulcer measure? Answer from Jessie …

Q&A: When a resident received IV fluids (K0520A) for hydration, but did not have any calories from the fluids, do we code K0710A (Proportion of total calories the resident received through parenteral or tube feeding) as 1. 25% or less?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: When a resident received IV fluids (K0520A) for hydration, but did not have any calories from the fluids, do we code K0710A (Proportion of total calories the resident received through parenteral or tube feeding) as 1. 25% or less? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Correct, …

Q&A: A resident was admitted to our facility on Medicare Part A and passed in facility after only a couple of hours. I had scheduled a 5-Day/Admission for the 7th day before she passed. How do I set up MDS assessments?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: A resident was admitted to our facility on Medicare Part A and passed in facility after only a couple of hours. I had scheduled a 5-Day/Admission for the 7th day before she passed. How do I set up MDS assessments? I know I can’t combine the death in facility …