Long-Term Care Survey Alert

A: The December 2002 Resident Assessment Instrument user's manual outlines the process for the interdisciplinary team to make the determination that the resident has had a significant change in status.

Once the facility has made that determination, follow these completion dates:

Assessment Reference Date: The ARD for the SCSA can be no more than 14 days from the date that you determined a significant change occurred in the resident's condition.The  ARD is the last day in the observation period . So all observations made on that date are included on the SCSA.

Completion date of the assessment (MDSfield VB2): The VB2 date can be up to 14 days from the ARD; however, the ARD must be no more than 14 days from the date that a significant change in status was determined to have occurred. A common practice is to make that determination and immediately begin the SCSA, so the ARD is only one or two days different from the date of determination of a significant change in the resident's status.

Per the RAI manual, the care plan completion date must be dated by the 7th calendar day following the  completion of the RAPsno more than 21days follow-ing the ARDand is noted at VB4.

Keep in mind that the care plan is a snapshot of the resident at any given point in time and it should be updated as the changes in resident care needs are identified. Facilities will be cited if the care plan does not reflect the resident  needs whether the significant change in assessment has been completed.

Cheryl Field, with LTCQ Inc. in Lexington, MA, and Marilyn Mines, with FR&R Healthcare Consulting in Deerfield, IL.