MDS Alert
Would You Code These Residents
The answer isn't always as straightforward as you might think.
1. Mrs. Jones, who receives warfarin therapy for deep-vein thrombosis, has had INR results in the therapeutic range since admission 50 days ago.
2. Mr. Smith who receives warfarin for atrial fibrillation had at least one INR that was out of the therapeutic range, prompting the physician to lower the blood thinner dosage within the last 60 days.
3. Mrs. Tonka who has a diagnosis of type 2 diabetes has had two abnormally high blood glucose readings in the past 30 days. The results were obtained via fingerstick samples and not reported by the facility's regular lab.
4. Ms. Andrews had abnormal electrolytes in the hospital seven days before admission to the SNF 30 days ago. Since admission, she has received one chemistry panel, the results of which were normal.
You'd code the first three examples as a "yes" or "1" at P9, but not the fourth.
According to the RAI user's manual, the intent of P9 (abnormal lab values) is "to document whether the resident had any abnormal laboratory values during the last 90 days or since admission to the nursing facility. This item refers only to laboratory tests performed after admission to the nursing facility. 'Abnormal' refers to laboratory values that are abnormal when compared to standard values, not abnormal for the particular resident ...
Abnormal blood glucose levels, including levels obtained via finger-sticks are included in this item."
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