MDS Alert
Test Yourself
How would your facility handle this scenario?
The SNF sets the assessment reference date (ARD) for a Significant Change in Status Assessment (SCSA) on day 22 of the resident's Part A-covered stay. The beneficiary "grouped" into a rehabilitation RUG. Therapy ends on day 24 and the SNF performs an OMRA with an ARD of day 33.
Which assessment would the SNF use to replace the 30-day Medicare-required assessment?
Answer: The SNF must use the SCSA with the ARD of day 22 to replace the Medicare required assessment. That's because the ARD falls within the assessment window for the Medicare-required assessment and is before the date on which the Medicare-required assessment is due.
The OMRA with an ARD that fell on day 33 of the stay cannot replace the Medicare-required assessment because it already has been replaced by the SCSA. Payment to the SNF will change on day 22 (the ARD of the SCSA), since the SCSA must be used to replace the Medicare-required assessment, and then again on day 33 of the covered stay, based on the OMRA. The payment associated with the RUG code derived from the OMRA will continue until the next Medicare required assessment or off-cycle assessment, whichever occurs first.
Source: CMS Transmittal A-01-56
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