Q&A: If the stay is only 15 days, how do I calculate the 30-day weight loss for section K?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: If the stay is only 15 days, how do I calculate the 30-day weight loss for section K?  Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: You use the weight that is closest to 30 days before the date the current weight was measured-—the weight coded on the …

Q&A: What ARD is used for a Death in Facility record if the resident expires before midnight, but the mortuary did not pick up until after midnight?  

MDS 3.0 and the RAI Process / NAC / Q&A

Question: What ARD is used for a Death in Facility record if the resident expires before midnight, but the mortuary did not pick up until after midnight?   Answer from Jeff Taylor: The actual time/date of death.   The death certificate should specify both when death was pronounced and either the …

Q&A: Can the physician certification be met through a detailed order versus a separate certification form?

Billing and Reimbursement / NAC / Q&A

Question: Can the physician certification be met through a detailed order versus a separate certification form?   Answer from Jessie McGill RN, BSN, RAC-MTA, RAC-MT: CMS does not mandate a specific form or format, but to meet the requirements, the certification must have all the required information. This is found …

Q&A: We have a resident that had a qualifying hospital stay (QHS), then went to an LTACH for more than 30 days. Can the resident utilize their Medicare benefits since the transfer from acute hospital to SNF is more than 30 days?

Billing and Reimbursement / NAC / Q&A

Question: We have a resident that had a qualifying hospital stay (QHS), then went to a long-term acute care hospital (LTACH) for more than 30 days. Can the resident still utilize their Medicare benefits in our skilled nursing facility (SNF) or not, since the transfer from acute hospital to SNF …

Q&A: What is the look-back period for K0100? The RAI User’s Manual does not mention the look-back period or if this can include days during the hospital stay?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: What is the look-back period for K0100? The RAI User’s Manual does not mention the look-back period or if this can include days during the hospital stay? Answer from Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC: When a look-back period is not specifically mentioned, the look-back is 7 days. …

Q&A: Is there a specific table that shows which items if dashed will count against us for the Skilled Nursing Facility Quality Reporting Program (SNF QRP)?

NAC / Q&A / QAPI and Quality Initiatives

Question: Is there a specific table that shows which items if dashed will count against us for the Skilled Nursing Facility Quality Reporting Program (SNF QRP)? Answer from Carol Maher, RN, GERO-BC, RAC-MTA, RAC-MT, CPC: Yes, CMS releases a document for each fiscal year (FY). The current document, Skilled Nursing …

Q&A: Is a Pure Wick catheter coded as an external catheter?  

MDS 3.0 and the RAI Process / NAC / Q&A

Question: Is a Pure Wick catheter coded as an external catheter?   Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Yes, this would meet the definition of an external catheter in the RAI User’s Manual.  EXTERNAL CATHETERDevice attached to the shaft of the penis like a condom, …

Q&A: When assessing a fall with an injury to the head, such as a laceration, bruise, or hematoma, would this automatically be considered a major injury?  

MDS 3.0 and the RAI Process / NAC / Q&A

Question: When assessing a fall with an injury to the head, such as a laceration, bruise, or hematoma, would this automatically be considered a major injury?   Answer from Jessie McGill RN, BSN, RAC-MTA, RAC-CTA and Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: The RAI User’s Manual definition for …

Q&A: How do you code walking if the resident only walks with therapy staff?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: How do you code walking if the resident only walks with therapy staff? Answer from Jennifer LaBay, RN, RAC-MT, RAC-MTA, QCP, CRC, and Jessie McGill, RN, BSN, RAC-MTA, RAC-CTA: If the resident only walked with therapy, then the assessment for usual performance is based on the resident’s usual performance …

Q&A: With the new definition of fall with major injury, would a bump on the head or a laceration be a head injury? With the new definition of fall with major injury, would a bump on the head or a laceration be a head injury?

MDS 3.0 and the RAI Process / NAC / Q&A

Question: With the new definition of fall with major injury, would a bump on the head or a laceration be a head injury? With the new definition of fall with major injury, would a bump on the head or a laceration be a head injury? Answer from Jennifer LaBay, RN, …