MDS Alert

Question 1: I am still confused about when to do a Change in Therapy (COT). I was under the impression that I could do a COT to increase from a clinical to a rehab RUG, but I am now told that this is not true.

Answer 1: The Centers for Medicare & Medicaid Services (CMS) recently clarified the requirements for doing a COT OMRA, but they are confusing to many MDS Coordinators. Under the October 2013 clarification on 2-51 of the RAI manual, a COT cannot be completed for a resident that is not currently in a therapy RUG.

This will alter the completion of COTs as we used to do them. Therefore, communication between nursing and therapy is even more critical than ever.

Question 2: Does it matter if we do our OBRA admission assessment with the five-day or 14-day MDS for PPS?

Answer 2: You may complete the OBRA admission assessment in combination with any other assessment, as long as you totally complete it by the 14^th day of admission. There is no penalty for doing the assessment on the five-day or 14-day MDS for PPS.

Q&A provided by Marilyn Mines, RN, BC, RAC-CT, of FR&R Healthcare Consulting in Deerfield, IL.