Long-Term Care Survey Alert

The following Q&As have been provided courtesy of Marilyn Mines, RN, BSN, RAC-CT, BC, senior manager of clinical services for FR&R Healthcare Consulting in Deerfield, Ill.

Question 1: Do interviews have to be completed on every discharge assessment?

Answer 1: No. Since April 2012, interviews are not required for unplanned discharge assessments. 

Question 2: What is required to code turning and positioning program in section M1200C?

Answer 2: This is a specific, individualized program that has been developed for a particular resident based on an assessment.  This is not the routine turn/position q2hours. 

Usually, a tissue tolerance evaluation determines the specific times a resident should be turned and repositioned. The information gleaned from this type of assessment will alert staff how long a resident may maintain a particular position before the skin is in jeopardy. It may also identify a particular position that should be avoided based on the resident’s compromised skin.

Question 3: Is every weight loss for residents on a diuretic considered to be a physician prescribe weight loss program?

Answer 3: No. It is important to know why the resident has lost weight. Many residents are on maintenance diuretics that will have no impact on weight loss. However if the physician has ordered diuretics for the express purpose of diuresis, that would be considered a physician prescribed weight loss program.

Question 4:  My staff completes their CAAs as they complete the MDS. Someone told me this is not a good idea.  Since it works out so well for us, why isn’t a good idea?

Answer 4: The MDS RAI manual in chapter 4, explains that the RAI completion is a process. That process starts with the MDS. Only once the MDS is completed, and the CATs are identified, can the CAAs be completed.  

If you think about it, most CAAs draw information from other items on the MDS than those coded by the discipline responsible for completing specified items.  Until the entire MDS is completed, you may not be able to accurately complete and analyze a CAA.