Q&A: How do you set section GG discharge goals for a resident who is also receiving care for end of life? 

Question: How do you set section GG discharge goals for a resident who is also receiving care for end of life?  Answer from Jeff Taylor: Goals can include maintenance or even managed decline. This AAPACN resource is copyright protected. AAPACN individual members may download or print one copy for use …

Q&A: A resident enrolled in hospice revoked services for a skilled Medicare Part A stay during the month. What is required for beneficiary notices and assessments if the resident transitions to a Medicare Advantage plan at the beginning of the next month?

Question: A resident was on Hospice in community. He revoked hospice and had a qualifying hospital stay. He opted to receive rehab in the skilled nursing facility and then return to home. Medicare guidelines state traditional Medicare is responsible for his SNF stay through the end of the month of …

Q&A: What is the consequence of a late MDS submission?

Question: What is the consequence of a late MDS submission? Answer from Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC: There is no impact on Medicare payment if an MDS is submitted late. The facility could receive a survey citation, F-tag 640 (Encoding/Transmitting Resident Assessment), if late MDS submission is noted …

Q&A: An audit found a missed Significant Change in Status Assessment (SCSA) after a hospice election. The resident is still in the facility. Is an SCSA still needed?

Question: An audit found a missed Significant Change in Status Assessment (SCSA) after a hospice election. The resident is still in the facility. Is an SCSA still needed? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Yes, you would need to open the SCSA. The ARD can …

Q&A: If a resident is dependent on staff for functional items in section GG and they also had a decline in their bowel or bladder status, will they trigger for the New or Worsened Bowel and Bladder measure?

Question: If a resident is dependent on staff for functional items in section GG and they also had a decline in their bowel or bladder status, will they trigger for the New or Worsened Bowel and Bladder measure? Answer from Jessie McGill, RN, BSN, RAC-CTA, RAC-MTA:The QM 3.0 User’s Manual …

Q&A: When a resident is admitted to the nursing facility for hospice services, do we have to use the admitting hospice diagnosis as the primary diagnosis?

Question: When a resident is admitted to the nursing facility for hospice services, do we have to use the admitting hospice diagnosis as the primary diagnosis? Answer from Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC:Your team should determine the diagnosis that best reports the main reason the resident is …

Q&A: If a resident on a Medicare Part A stay leaves the facility on a leave of absence (LOA) with the family and is back in the facility after two midnights, are any assessments required?

Question: If a resident on a Medicare Part A stay leaves the facility on a leave of absence (LOA) with the family and is back in the facility after two midnights, are any assessments required? Answer from Jennifer LaBay RN, RAC-MT, RAC-MTA, QCP, CRC:A temporary home visit does not require …

Q&A: Are we required to complete physician certifications and recertifications for Medicare Advantage or just for Original Medicare? Where is the source guidance?

Question: Are we required to complete physician certifications and recertifications for Medicare Advantage or just for Original Medicare? Where is the source guidance? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: It is required for Original Medicare. As far as Medicare Advantage or replacement plans, it’s up to …

Q&A: For the “Admission Performance” in section GG, if therapy is started on day two and the resident’s performance improved on day two, do we still have to code their baseline usual functions from day one data?

Question: I have a question about coding Functional Abilities in section GG for self-care and mobility on admission for a Medicare A resident. When the RAI User’s Manual states this is to reflect the resident’s usual performance at baseline, does this mean that if therapy is started on day two …

Q&A: If a resident is discharged to the hospital on day 14, does an Admission MDS need to be completed?

Question: If a resident is discharged to the hospital on day 14, does an Admission MDS need to be completed? Answer from Scott Heichel RN, RAC-MT, RAC-CTA, DNS-CT, QCP, ICC, IPCO: Per the Federal rules in the RAI User’s Manual, no. If the resident is not in the facility through …