quarterly

Transcription

quarterly

W H AT ’ S I N S I D E
2
Inside CMS
9
Q+A
10
Jacksonville Top 10 Reasons
11
Upcoming Workshops
12
New in AANAConnect
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New C-NEs and RAC-CT®s
SPRING 2012
LTC QUARTERLY
SPEC
IA
EDITI L
ON
April 1 MDS changes:
Are you ready?
Caralyn Davis, Staff Writer
Keeping up with changes has become an almost constant battle for MDS
coordinators and interdisciplinary teams (IDTs), and a new round of MDS changes
is days away. On April 1, Version 1.08 of the RAI User’s Manual for the MDS 3.0 and
Version 1.10.4 of the MDS 3.0 item sets will go into effect. (The updated RAI Manual,
the Changed Pages and Change Tables Document, and the accompanying Errata
Document can be found on the MDS 3.0 Training Materials webpage. Printable
item sets are available on the MDS 3.0 Technical Information webpage.) AANAC’s
master teachers offer the following last-minute suggestions for ensuring a smooth
transition on April 1 and with any subsequent updates:
Check the status of your software.
AANAC
400 S. Colorado Blvd., Suite 600
Denver, Colorado 80246
Phone 800.768.1880
Fax 303.758.3588
1
© 2012 AANAC. No part of this publication may
be reproduced without written permission
from AANAC. The information presented is
informative and does not constitute direct legal
or regulatory advice.
The new rules will be effective for MDSs with an assessment reference date (ARD)
of April 1 or later. However, the ARD represents the endpoint of the observation or
look-back period. “The typical look-back period is seven days or 14 days,” points out
Judy Wilhide Brandt, rn, rac-mt, c-ne, president of Judy Wilhide MDS Consulting in
Virginia Beach, VA. “So we need to start opening assessments and working on them
(for example, coding interviews) in the days leading up to April 1.”
Consequently, updated software needs to be ready to go now, says Brandt. “New software
should have been installed, beta-tested, and ready no later than two weeks into March.”
continued on page 3
INSIDE CMS
Caralyn Davis, Staff Writer
Key takeaways
From the
MDS National
Conference
While the 2012 MDS National
Conference that CMS held in early
March was packed to the rafters, many
long-term care professionals were unable
to attend for a variety of reasons, leaving
them feeling like they didn’t know the
secret handshake required to enter
the executive suite of “MDS World.”
However, AANAC is able to throw
open the doors of knowledge thanks
to Jennifer Pettis, rn, bs, wcc, rac-mt,
director of program development
at Harmony Healthcare International
in Topsfield, MA, and chair of the
AANAC Expert Advisory Panel. Pettis
attended the conference, gleaning five
key takeaways for MDS coordinators,
directors of nursing, and other
interdisciplinary team (IDT) members:
c-ne,
1. Care plans should be
built on resident voice.
Providers should take heart from the
“profound” message on the critical
importance of care planning delivered
by Karen Schoeneman, technical advisor
of the Division of Nursing Homes
at CMS, in the keynote, “Looking at
the Rules in Our Head: What is Care
Planning for?,” suggests Pettis.
As recently as 20 years ago, long-term
care practice “was really dictated by
the rules in your head,” says Pettis.
Schoeneman suggested those rules
care planning. We should be using the
MDS and Care Areas to identify resident
choices, and rather than our practice
being dictated by all of these rules in
our head, it should be dictated by what
that resident is telling us is important
to them. The RAI process is intended for
us to end up with this individualized,
person-centered care plan based on
the goals of the resident, what their
needs are, and what their strengths
or limitations or risk factors are—not
those institutional rules that sometimes
overshadow resident choices.”
From an MDS standpoint, Schoeneman’s
message boils down to “facilities should
take a look at the process of the MDS,”
asserts Pettis. “The focus of the MDS
process shouldn’t just be the completion
of this tool for reimbursement and
survey compliance. Strong assessments
are embedded into the MDS and the
Care Areas. Many times, if we do a good
As recently as 20 years ago, long-term care practice “was really dictated by
the rules in your head,” says Pettis.
revolved around institutional practices,
including practices such as ensuring
“every resident was up for breakfast” and
any resident who wanted to rest could
“only take naps at certain times during
the day, and they needed to lie on top
of the covers.”
“Back then I was a nurse’s aide, and it’s
not that I was a bad nurse’s aide,” reflects
Pettis. “The rules we followed were what
our practice at the time told us was right,
so that is what we did.”
Long-term care is now “heading toward
full circle,” Pettis points out. “Karen
really challenged us to think about
2
job of using these assessment tools
provided by CMS, we can get rid of other
layers of paperwork that are burdening
interdisciplinary team members because
we’ll already have the individualized
information we need to serve as the
building blocks for the plan of care.”
2. Discharge assessments
are getting shorter.
MDS coordinators will soon find the
workload a little lighter for all discharge
assessments, says Pettis. Currently,
discharge assessments come in at a
whopping 111 questions. However,
continued on page 6
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
April 1 MDS changes, continued from page 1
Printing out a hard copy of the discharge
assessment will help drive home the
changes—and give MDS coordinators
a reference to use when checking that
their software has the new item set,
suggests Brandt.
Hand out updated
manual sections.
Brandt was recently in a facility where
the dietitian was using Section K
coding instructions from a draft 2009
RAI Manual. “Nobody had given her
any updates in more than two years,”
she notes. “We tend to forget about
dietitians, social workers, and activities
staff. However, all team members who
code MDS items need to have a current
version of the coding instructions.”
Similarly, Deb Myhre, rn, c-ne,
a consultant with Ankeny, Iowabased Continuum Health Care Services,
recently visited a facility that didn’t
understand isolation coding because
they didn’t have a current Version
1.07 RAI Manual. “Keeping track of
the updates can be difficult given all
of the changes we’ve had, but MDS
coordinators have to be able to go online
and make sure team members have
current information,” she stresses.
rac-mt,
If software vendors have scheduled the
update to occur on April 1, it may be too
late to request earlier implementation
this time around. Nevertheless,
MDS coordinators should alert the
administrator or other appropriate facility
decision-maker to ensure the problem is
resolved prior to future updates, suggests
Brandt. “The software companies have to
be responsive to our needs.”
Prepare to work on paper.
Facilities won’t be able to electronically
open assessments with ARDs of April 1
or later until they have the new software.
CMS doesn’t offer any wiggle room
in setting ARDs timely, so providers
should prepare for potential software
issues by printing out a batch of blank
MDS assessments, says Brandt. “If MDS
coordinators need to get the ARDs
established and they cannot establish
them in the computer, they should be
ready to set the ARDs on paper.” Note:
Page 2-8 of the RAI Manual states: “The
facility is required to set the ARD on the MDS
Item Set or in the facility software within the
appropriate timeframe of the assessment type
being completed.”
Review the MDS item sets.
Read and discuss the update.
The ZIP file of MDS item sets for the
April 1 release includes a 12-page
document, MDS 3.0 Item Set Change
History (aka MDS30_Item_Changes_
v1.10.4.pdf). “This is a handy list of
changes to the forms that providers can
review,” says Brandt.
“This sounds really simple, but a
surprising number of people don’t read
the updates to the RAI Manual until
after a problem occurs,” says Myhre.
“When CMS publishes an update, the
MDS coordinator sometimes will
hand it out to the interdisciplinary
One positive change is “how much
team and then expect that those team
shorter the discharge assessment is going members will do what they want to do
to be,” she notes. “Regardless of whether
with it. Consequently, manual updates
a discharge is unplanned or planned,
sometimes sit on the back burner.
the discharge assessment is going to be
Unfortunately, I’ve seen that happen
noticeably shorter. For example, column
many times.”
2 in G0110 (ADL assistance) is not there,
So not only do IDT members need their
and the only item in O0100 (special
updated sections of the RAI Manual,
treatments, procedures, and programs) is
“they have to read it and understand
hospice care. CMS listened to providers
it, and if they don’t understand
about the burden of doing MDSs.”
something, they need to ask questions
continued on page 4
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A A N AC LT C L E A D E R 3 . 2 0 . 2 012
before implementation occurs,” says
Myhre. One way that MDS coordinators
can prompt team members to read
the manual updates is to schedule
a 15-minute segment during a care
conference to review section changes.
of meeting will keep everyone informed.”
(Have questions about the April 1 update?
AANAC members have access to help from
a wide array of MDS experts via the MDS
Connection and LTC Network discussion
groups on AANAConnect. )
When CMS issues an RAI Manual update, that might be a good time to find
ways to help the team, suggests Myhre. “One of the first things I look at to
reduce the MDS burden is the turnaround time—from when the ARD is set
to when the assessment is completed.”
“The team just needs to sit down and talk
about the changes for a few minutes,” she
explains. “This is an easy way for MDS
coordinators to fulfill their management
responsibility and ensure that each
person on the team knows what to do
with their particular section of the MDS.
I’m also a big believer that the whole
team should understand what each team
member is responsible for, and this type
Highlight Section M changes.
Section M (skin conditions) includes
several revisions. Two that stand out are
the re-introduction of skin tears in item
M1040G and the addition of moistureassociated skin damage (MASD) in item
M1040H, says Brandt.
MASD “has to be diagnosed correctly
and treated correctly in order to heal.
Pressure didn’t cause MASD, so relieving
pressure is not going to cure it,” she
points out. “With the inclusion of MASD
on the MDS, my hope is that MASD will
come to the forefront and that clinicians
will look with fresh eyes on correctly
diagnosing and treating the multifactorial skin issues that our frail elderly
typically have.”
Use updates as a catalyst
for improvement.
The burdens of the RAI process frustrate
a lot of IDT members. When CMS issues
an RAI Manual update, that might be a
good time to find ways to help the team,
suggests Myhre. “One of the first things
I look at to reduce the MDS burden is the
turnaround time—from when the ARD is
set to when the assessment is completed.”
With some exceptions, facilities have 14
days to complete the MDS. (Need details?
continued on page 5
A ANAC
prouDly
reCogNizes
Nurse Assessment
Coordination Day™
May 8th, 2012.
Held in conjunction with National Nursing
Home Week™ & National Nurses Week.™
Nurse Assessment Coordination Day is a special day we’ve
created to honor you—the picture-perfect champions of resident
care, accurate assessment and voice and choice.
We invite you to visit our NAC Day web page, coming in early April, to find a
variety of AANAC resources, sponsoring partner discounts and much more that
show just how much we appreciate the support and care you provide your
residents today and every day.
We’ll keep adding surprises throughout April—so check back often
and see what’s new.
COMING SOON!
www.aanac.org/NACDay2012
4
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
Review Chapter 2 of the RAI Manual.)
However, many providers arbitrarily
shorten the process. For example, Myhre
visited one facility that always set ARDs
on Mondays and gave the IDT members
two days—Tuesdays and Wednesdays—
to get the MDS done so the team could
have care conferences on Thursdays of
the same week.
“People are often resistant to change,
but in this type of situation, making
better use of the available days to
complete the MDS and changing the
care conference to a later day so that the
team members have adequate time to
review their assessments and make good
coding decisions can alleviate a lot of
frustration,” she points out.
Double-check Final
Validation Reports.
“For the first few transmissions, providers
should check their Final Validation
Reports with a fine-tooth comb,” advises
Brandt. Why? Sometimes software updates
result in unintended changes or problems.
For example, there always is at least one
facility whose software incorporates
the wrong RUG grouper—even when
an update isn’t supposed to include any
SNF PPS changes. “So make sure that you
have the right RUG grouper for federal
RUGs, and if you are in a state with case
mix, make sure that you’re not getting
those warnings that say, ‘The RUG we
calculated is different from the RUG that
you submitted,’” says Brandt. “These are
errors that always must be corrected
because we cannot bill the wrong RUG.”
(Section 5, “Error Messages,” of the MDS
3.0 Provider User’s Guide explains what
the error messages mean and offers
potential solutions.) ●
5
Tips to fight MDS change fatigue
Obtaining staff buy-in for the April 1 RAI Manual update should be relatively
simple because “this latest round of changes primarily is a direct result of
CMS listening to what we said was wrong,” says Judy Wilhide Brandt,
rn, rac-mt, c-ne, president of Judy Wilhide MDS Consulting in Virginia Beach,
VA. “As a general rule, these changes clarify the MDS and make it easier
and quicker. The major exception is the addition of moisture-associated skin
damage in Section M, which is still a very good improvement because it will
make our residents’ lives better if we more correctly identify that issue.”
Nevertheless, some IDT members likely will be resistant to any change—
whether it’s perceived as good or bad—since they’ve already gone through
so many updates, says Brandt. “I see MDS change fatigue all the time.”
The most important defense against change fatigue is a good attitude,
suggests Deb Myhre, rn, c-ne, rac-mt, a consultant with Ankeny, Iowa-based
Continuum Health Care Services. “The MDS coordinator must be really
positive any time CMS issues an update. That is difficult to do when we’ve
had so many changes—and then the changes are changed. However, it’s the
MDS coordinator’s responsibility as a manager to be the ‘good cheerleader’
for MDS changes. Everyone knows that when you have a grumpy leader,
everyone else is grumpy too. So like any manager, the MDS coordinator
needs to portray a positive attitude. The key is to be process-driven. Rather
than grumble about individual changes, keep the team focused on what the
whole RAI process is for—to have better care planning and improve quality
of care and the lives of our residents.”
Another good leadership technique is for MDS coordinators to prepare
IDT members for a cycle of changes every April and October, says
Brandt. “Everyone needs to accept the fact that we are likely to have
structural and other substantive changes involving either the MDS or SNF
PPS every six months for the foreseeable future.”
Also, with any future updates, MDS coordinators should let the IDT
members know as soon as they themselves learn about pending changes,
suggests Brandt. “Some MDS coordinators say, ‘I’m not going to bring it up
until right before the change because there is no sense in worrying about it.’
But forewarned is forearmed. It’s important that the team know what’s going
on, even if their particular section doesn’t have any changes. For example, if
the changes necessitate a software update, the team members have to plan
their work schedules to allow time for the new software to be installed.”
It’s also important that MDS coordinators provide IDT members with some
perspective. For example, with the April 1 update, a quick glance at the 300plus pages of RAI Manual changes might inspire panic. “However, there are
only a few substantive changes,” says Brandt.
For example, the changes include multiple instances of replacing “mental
retardation” with “intellectual disability” and replacing “entry or reentry”
and “admission or reentry” with “admission/entry or reentry.” In addition,
there are numerous capitalization changes, for example, replacing “state”
with “State.” So any time there is an update, MDS coordinators can calm a
lot of fears by looking at the change document and boiling down “what we
actually have to do differently,” says Brandt. ●
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
Inside CMS, continued from page 2
the April 1 update will cut planned
discharge assessments to 89 questions
and unplanned discharge assessments
to a maximum of 77 questions. Those
reductions—almost 20 percent for
planned discharges and 31 percent for
unplanned discharges—“should impact
the time spent on those assessments
positively,” she points out.
3. Interviews matter.
Nursing facilities that do not complete
resident interviews when residents
in fact could have participated in the
interviews are engaging in a practice
that places them at risk for citation
during survey, according to Tom Dudley,
technical advisor in the Division of
Chronic and Postacute Care in the Office
of Clinical Standards and Quality, who
reiterated comments he made during an
earlier Skilled Nursing Facility/Longterm Care Open Door Forum.
Why the crackdown? “The interviews
on the MDS are central to the whole
idea of the resident’s voice driving our
practice in long-term care,” says Pettis.
“In addition, the interviews are critical
for publicly reported data, and they have a
tremendous financial impact on facilities.”
So facility leadership (e.g., administrators,
DONs, or reimbursement directors)
should “vet the performance of all
staff members who are conducting
Chapter 3 of the RAI User’s Manual
for the MDS 3.0 provides the basic
instructions, interviewing techniques,
and suggested language (i.e., the script)
for conducting the interviews. In
addition, two RAI Manual appendices
offer detailed insights on interviewing
techniques, as well as cue cards, that
allow staff to make the most of resident
interviews: Appendix D, “Interviewing
To Increase Resident Voice in MDS
Assessments,” and Appendix E, “PHQ-9
Scoring Rules and Instruction For BIMS
(When Administered In Writing).”
(Note: Appendix E includes cue cards
for conducting the BIMS in writing.
Additional cue cards for other interviews
are included in MDS 3.0 Training Aids
in the ZIP file, “MDS 3.0 Training AidsSlides-Instructor Guides,” at the MDS 3.0
Training webpage.)
Importantly, Appendix D offers methods
and techniques to obtain better data
from residents who may have impaired
cognition. Providers can use the
techniques of unfolding or disentangling
that are described on pages D-2 – D-3 to
break down questions into “digestible
chunks,” notes Pettis. “I often liken it to
the way that we help residents who have
some impaired cognition pick out their
clothes. We don't open the closet and
say, ‘Here are 40 dresses. What would
you like to wear today?’ Instead, we start
with a general question: ‘Would you like
“No one would let a nurse administer medications before they were sure that
the nurse could do it safely and appropriately. Facilities should take a similar
approach to ensuring competence for those conducting resident interviews.”
resident interviews,” she recommends.
“No one would let a nurse administer
medications before they were sure
that the nurse could do it safely
and appropriately. Facilities should
take a similar approach to ensuring
competence for those conducting
resident interviews.”
CMS offers a number of resources to
help IDT members conduct effective
resident interviews, says Pettis.
6
a dress or pants?’ And then we move into
specifics: ‘You’d like a dress. I have pink
or blue. Which color would you like?’
And then we get even more detailed:
‘Here are two pink dresses. Which one
do you want to wear?’ So it’s the same
idea that in practice we’ve been doing for
years when we care for these residents
in day-to-day life. It should be natural
for us as clinicians to want to offer that
same technique when we are conducting
resident interviews.”
In addition, the cue cards are key to
keeping interviews efficient, says Pettis.
“Using the cue cards that CMS offers
makes interviews go so much faster, as
well as obtaining much better data in my
opinion. If you go to the grocery store
and are asked to sample and comment on
a new product, you will often be given a
list of options to choose an answer from.
That’s because the list of options speeds
the process along for the interviewer.
With resident interviews, using the cue
cards means you don’t have to repeat the
potential answers every single time. The
answers are right there in front of the
residents, and they are very easily able to
point to the response they want to give.
Residents aren’t pressured to remember
all of the options that the interviewer
just told them.”
4. Inactivation rules may force
changes in facility practices.
John Kane, a health insurance specialist
with the Division of Institutional
Postacute Care, confirmed that another
continued on page 7
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
skilled nursing facility prospective
payment system update document is
forthcoming, says Pettis. (Watch “Need
to Know” at AANAC. ) Additionally,
a key issue that Kane discussed at
the conference was the inactivation
of MDS assessments.
“The encoding period is an opportunity
for providers to take a look at the MDS
and say, ‘Is this right?,’” says Pettis.
“Providers should institute a solid audit
or checklist process to verify everything
that is unable to be corrected using the
standard modification process, including
“Once you have submitted that MDS, it is too late to change these items, so
you need to take the time to double-check that what is being submitted on the
MDS is what you think it should be.”
When an MDS assessment includes an
inaccurate event date (e.g., an assessment
reference date or a discharge date) or
an inaccurate reason for assessment,
“providers cannot inactivate that
assessment, and then take the same
assessment and just correct it and
resubmit it,” says Pettis. “When you
inactivate an assessment, for all practical
purposes that assessment doesn’t exist
anymore. You can’t simply fix the
problem and re-upload that MDS. You
have to create a brand-new assessment,
including setting a current ARD. The
day that you begin that process of
inactivation is the earliest day that you
could set the ARD.”
ARDs and reasons for assessment. Once
you have submitted that MDS, it is too
late to change these items, so you need to
take the time to double-check that what
is being submitted on the MDS is what
you think it should be.”
5. Q
uality measures will include
four survey-only measures.
The quality measures (QMs) are coming
back to the traditional survey process.
Since October 2010, surveyors have been
following the instructions in surveyand-certification letter S&C-10-27-NH to
replace Tasks 1 – 5C in the traditional
survey process as defined in Appendix
P, “Survey Protocols for Long-term Care
Facilities,” in the State Operations Manual.
CMS’ Karen Schoeneman advised
conference attendees to “rip up that
survey-and-certification letter and go back
to Appendix P for the traditional survey
process,” says Pettis. (Note: The Quality
Indictor Survey, or QIS, process will continue
to use Quality of Care and Life Indicators, or
QCLIs, to drive the survey process.)
The survey QMs will include many
of the same QMs that will be publicly
reported on Nursing Home Compare.
However, CMS deemed some of the
publicly reported measures unnecessary
to the survey process, particularly the
pneumococcal vaccine and influenza
vaccine measures. In addition, CMS has
This policy has “very serious potential
payment implications,” she points out.
“There is no question that CMS heard
providers at the conference express
concerns about that, and they definitely
are considering suggestions as to how
that could be better handled.”
But what can providers do in the
meantime? “Make the best possible use
of the encoding period,” suggests Pettis.
Providers have seven days following
the completion of a resident’s MDS
assessment to encode the MDS data.
(To learn more, see Chapter 5 of the RAI
Manual.) At most facilities, IDT members
now enter assessment data directly into
facility software rather than on a paper
MDS, so few providers take advantage
of—or even remember—the available
seven-day encoding period.
continued on page 8
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A A N AC LT C L E A D E R 3 . 2 0 . 2 012
developed four survey-only QMs that
have been “recreated from the old QIs
[quality indicators],” says Pettis. The four
survey measures that won’t be made
available to the public are long-stay
measures that address these issues:
•Falls. The publicly reported QMs
include a “fall with major injury”
measure. However, the survey
measures will include a falls measure
that identifies any long-stay resident
who has had a fall in the look-back
scan, regardless of whether a major
injury occurred, says Pettis.
•Behavior symptoms affecting others.
“Several behaviors will go into this
measure and potentially could flag that
as an area to be investigated during
survey,” notes Pettis. “Providers should
make sure everyone is on the same
page about how they code behaviors
affecting other people. Ask, ‘Are we
consistently following the rules?’”
•Psychoactive medications,
in the absence of psychotic or
related conditions.
•Anti-anxiety/hypnotic medications.
With both of the medication-focused
survey QMs “a resident is going to flag
when you use these medications, and
there is not an appropriate associated
condition,” says Pettis. “When an
appropriate associated condition is
present, the resident will be excluded
from that reporting.”
Many appropriate associated conditions
are diagnosis-based and come from
MDS Section I. However, two of these
excluding conditions are in Item E0100
(potential indicators of psychosis),
specifically E0100A (hallucinations) and
E0100B (delusions), notes Pettis. “In most
nursing facilities, staff do a good job of
capturing hallucinations, which are a
sensory perception of something that
continued on page 13
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A A N AC LT C L E A D E R 3 . 2 0 . 2 012
Q+A
Regarding coding respiratory therapy
on the MDS, do competencies for
lung sounds have to be done by a
respiratory therapist or can they be
done by a nurse?
To capture respiratory therapy on the
MDS, treatments must be provided
by a respiratory therapist or a trained
respiratory nurse, according to Appendix
A of the RAI User's Manual. It says that
respiratory therapy services are for
assessment, treatment, and monitoring
of patients with deficiencies or
abnormalities of pulmonary function,
and that respiratory therapy services
include "coughing, deep breathing,
heated nebulizers, aerosol treatments,
assessing breath sounds and mechanical
ventilation, etc."
It goes on to say, "A respiratory nurse
must be proficient in the modalities
listed above either through formal
nursing or specific training and may
deliver these modalities as allowed
that nurse previously was competency
tested as a part of his or her nursing
program or by a respiratory therapist.)
Rena R. Shephard, mha, rn, rac-mt, c-ne
([email protected])
A resident returned from the hospital
after having a qualifying stay for
Medicare Part A. The readmission
date was Feb. 17. We did a Significant
Change/5-day assessment with an
ARD of Feb. 29 (Day 8). The RUG was
Rehab High. The 14-day assessment
ARD was March 2 (Day 15), which also
was day 7 of COT observation. The
RUG score went to Rehab Very High. I
told therapy that we would need to do
a COT OMRA, because the RUG score
increased. Therapy disagrees with
me. Which is right?
You don’t have to complete a COT OMRA
when day 7 of COT observation falls on
the ARD of a scheduled assessment, but
you have the option and would want to
As a former DON, my preference is to have a respiratory therapist provide
training, validate return demonstrations, and check key competencies
annually. But a nurse with demonstrated competency and experience in
these areas can provide the training.
under the state Nurse Practice Act
and under applicable state laws." Who
provides the training is not specified
by the regulation. As a former DON,
my preference is to have a respiratory
therapist provide training, validate
return demonstrations, and check key
competencies annually. But a nurse
with demonstrated competency and
experience in these areas can provide the
training. (When I've had a nurse do it,
when the RUG increases. If you combine
the 14-day with the COT then the RV
RUG would be retroactive to day 9. So it
is in your benefit do complete a COT.
Ronald A. Orth, rn, nha, cpc, rac-mt
([email protected])
A resident was admitted Feb. 10.
PT started Feb. 15 (day 6), and the
resident was seen by PT on Feb. 15
and 16 for a combination of 95
minutes. Next day of service for PT
was Feb. 22 (day 13). The resident
was seen on consecutive days from
Feb. 24 to 27 (days 16 – 18). Without
a SOT OMRA, the resident does not
classified into a rehab RUG. If I do
the SOT with day one being Feb. 15,
how would this resident classify into
a rehab RUB if only seen twice in
that seven day window. Any help is
much appreciated.
You will not be able to do a SOT OMRA
for this resident, because there was not
enough therapy provided by the 7th day
after the start of therapy to correctly
place this resident into a Rehab RUG. The
next scheduled assessment will be when
you will be able to realize the rehab RUG.
Carol Maher, rn-bc, rac- ct
([email protected])
Our Quality Assurance Committee
is lacking in focus. I am the
chairperson, so I feel responsible
to give it meaning. Can you give
me suggestions?
F520 Quality Assessment and Assurance
contains excellence guidance in order
to have a successful QAA effort. Give
particular attention to the definition of
“Quality Deficiencies” that differ from
deficiencies cited by the survey team.
Quality deficiencies can be related to
facility operations and practices that
cause negative outcomes, or to enhancing
quality of care and improving quality
of life. The QAA Committee should
decide which areas to investigate based
on issues that are meaningful in your
setting. The decision on how to proceed
can be both corrective and preventive
in nature. The regulation requires that
the DON, a physician, and at least three
9
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
BETTER TOGETHER—THE 2012 AANAC ANNUAL CONFERENCE
You’ve probably noticed
that there are all sorts of
new and exciting reasons
why the 2012 AANAC
Annual Conference in
Jacksonville, Florida is
going to be our best yet.
As the deadline for
online registration
gets closer, we wanted
to give you at least 10
additional reasons why
you simply can’t afford
to miss this event. Read
1
2
3
PRECONFERENCE
the information and skills that you need most.
PRODUCT THEATERS Get in-person demonstrations of the
products and services that have been designed to ease your workload and
make your job simpler.
5
THE 2012 AANAC AWARDS Join us as we celebrate our celebrities
6
INCREASED EXHIBIT HOURS You’ll have more time than ever to
assessment capabilities to manage and support residents who suffer from
skin wounds, chronic pain or dementia.
in long-term care with a fantastic evening event complete with food,
beverage and an entertaining reception to follow.
interact and learn about the newest trends and products right from the source.
And maybe even win a prize during our “Exhibit Hall Scavenger Hunt.”
7
NETWORKING WITH THE BEST Join forces with hundreds
8
A VIBRANT CITY With a growing population, a strong economy, and
9
CONNECTED COMMUNITY Meet other attendees before you
CONFERENCE
April 18 – 20
LEARNING TRACKS New education tracks will help you focus on
CLINICAL SESSIONS Learn how to utilize your physical
JACKSONVILLE, FL
Hyatt Regency
Riverfront
you more opportunities, choices and chances to get the vital updates and
information you need.
4
on for our “Top Ten”
reasons to attend.
A LONGER CONFERENCE We expanded our conference to offer
April 16 – 18
10
of other long-term care leaders, experts and enthusiasts by being a part
of this conference. Spend time sharing success stories, and challenges
and get insider information from others who have been through similar
situations as yourself.
diverse cultural and recreational opportunities, Jacksonville distinguishes
itself as one of the nation’s most dynamic and progressive cities.
even arrive on-site and start putting faces to all the friends you’re going to
make, through the AANAConnect online conference community.
ONLY ONE CHANCE Since we’ll only have one conference this year,
this is your best opportunity to join colleagues to ensure you’re up-todate on the most current regulatory updates, survey preparedness skills,
quality control tactics and resident voice and choice issues.
SHARE THE FUN, THE KNOWLEDGE
AND THE EXPERIENCE WITH OTHER LTC PROS.
REGISTER TODAY AT WWW.AANAC.ORG/2012CONFERENCE
AANAC 2012
UPCOMING WORKSHOPS
TRAINING PARTNER
MASTER TEACHER
DATES
CITY/STATE
AANAC RAC-CT Certification
Robin L. Hillier
Apr 16 – 18
Jacksonville, FL
AANAC Medicare University
Judy Wilhide Brandt
Apr 16 – 18
Jacksonville, FL
AANAC C-NE Certification
Jennifer Pettis
Apr 16 – 18
Jacksonville, FL
AANAC RAC-CT Recertification
Rena R. Shephard
Apr 18
Jacksonville, FL
Harmony Healthcare International
Jennifer Pettis
Mar 27 – 29
Seattle, WA
LeadingAge TX
Ronald Orth
Mar 27 – 29
Austin, TX
LeaderStat
Lisa Hohlbein
Apr 10 – 12
Dallas, TX
Pathway Health Services, Inc.
Cynthia Perrault
Apr 10 – 12
Westmont, IL
LeadingAge Iowa
Deb Myhre
Apr 10 – 12
Des Moines, IA
Jennifer Pettis
Apr 10 – 12
New York, NY
LeadingAge NY (formerly NYAHSA)
Sandy Biggi
May 1 – 3
Rochester, NY
Jennifer Pettis
May 1 – 3
Windsor, VT
LeadingAge New York (formerly NYAHSA)
Sandy Biggi
May 1 – 3
Rochester, NY
Cynthia Perrault
May 8 – 10
Green Bay, WI
LeaderStat
Lisa Hohlbein
May 8 – 10
Detroit, MI
LeaderStat
Lisa Hohlbein
May 15 – 17
Silver Spring, MD
Judy Wilhide MDS Consulting
Judy Wilhide Brandt
May 15 – 17
King of Prussia, PA
KHCA—Kansas Health Care Association
Becky LaBarge
May 16 – 18
Topeka, KS
Hill Educational Services, Inc.
Carol Hill
May 21 – 23
Mobile, AL
Cynthia Perrault
May 22 – 24
Spokane, WA
Judy Wilhide Brandt
May 22 – 24
Boston, MA
Duran Consulting Services
Sandy Biggi
June 4 – 6
Portsmouth, NH
Jennifer Pettis
June 4 – 6
Charleston, SC
Judy Wilhide Brandt
June 5 – 7
Virginia Beach, VA
2012 AANAC ANNUAL CONFERENCE
RAC-CT CERTIFICATION WORKSHOPS
MEDICARE UNIVERSITY WORKSHOPS
The workshop schedule is subject to change and is updated regularly. To see a full AANAC Training Partner workshop schedule, visit aanac.org/workshops
11
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
What’s new in
Feeling overwhelmed with the
fast-approaching April 1 CMS
revisions to the MDS and RAI
User’s Manual? So are your peers.
Join other AANAC members and the experts in
discussing these updates on AANAConnect,
your online discussion forum. AANAConnect
is the perfect place for you to ask questions,
receive clarification, and begin to understand
the many updates that will be implemented in
just over a week. In case you missed our recent
webinar on these April 1 changes hosted by
Jennifer Pettis, or Rena Shephard’s email with
the detailed highlights, here are a few things
you might be interested in discussing on
AANAConnect:
• Assessment inactivations
• Interviews and unplanned discharges
• Carrying forward prior interview responses under
limited circumstances
• Future item set changes/updates
• Assessment combinations
Active Discussions this
week on AANAConnect:
LTC Network:
Thread Subject: C
larify
on COT and on
Admit/PPS
Posted by: Tammy Sp
ears
. . . After meeting in St.
Louis I have become co
nfused
on COT.
I want to know that if
I do a 5 day PPS on da
y 8 and
then I do a COT review
on day 15 but also have
my 14
day scheduled for tha
t day. I am okay so far
.
Bu
t
now if
therapy tells me they
are ramping up the RU
G
on
day 11
or 12 and I still plan to
use day 15 but I set ass
ess
me
nt
into the computer on
day 14 with a 14 day an
d a COT
because the level is go
ing up (and same if I kn
ew it was
going down). HERE’s
where I am confused
.
.
.
If I set
this assessment with
the COT is this conside
red
EARLY
cause it is day 6 of the
COT review that I actua
lly
put the
COT for day 7 along wit
h the 14 day, and so do
I
ha
ve to
take a default for that
one day?
This is just one part of
Tammy’s question. To
read the full
post, just click on the
thread subject above.
• Deciding on the ARD for unscheduled assessment
after the ARD window closes
• Effect of early and late COT ARD on COT observation
The April 1 changes will most certainly affect you and/or
your team. Make sure you are in-the-know and ready to
implement these amendments to ensure you’re proving
the best care possible according to the most current rules
and regulations.
Change is never easy, but going
through it with a network of
support makes it a whole lot easier.
Login to AANAConnect today:
connect.aanac.org.
12
n:
MDS Connectio
ion C and J
: Inter views sect
ct
je
ub
S
d
ea
hr
T
Greenwood
Posted by: Kathy
12 and I
T done 3/8/
ent who had a CO
Hi— I have a resid
day. This morning
interviews yester
e
th
d
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e
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ed (3/9/12). For th
l and was admitt
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em as he
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intervie
ate NO and inte
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iated.
would be apprec
staf f? Any help
Thanks!!
the
of conversation in
n generated a lot
Carol
d
an
rd
ha
This conversatio
ep
rts Rena Sh
pe
ex
r
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w
ho
e
Se
read
community.
clicking on the th
this question by
news
od
go
tle
Maher answered
lit
a
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r,
tte
be
en
Ev
e.
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tes to the RAI Us
m the April upda
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re
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ot
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swered fast!
Manual. Just
3.0 questions an
DS
M
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yo
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best place to
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
What You
Need to Know
Check out these latest updates from the
“Need to Know” section of the AANAC
homepage and find the information you
need to get the job done right.
CASPER Reporting User’s Guide for MDS
Providers UPDATED, Including Section
on QM Reports
MDS 3.0 Provider User’s Guide UPDATED,
Including Section 5, Error Messages, for
Interpreting Validation Reports
Five Star State-Level Cut Point Tables and
Staff Time Values Data Set UPDATED
doesn’t really exist. However, I’ve found delusions to be one of the most undercoded items on the MDS. Residents who have a delusion, or false, fixed belief, due
to memory loss or dementia should still be coded as having a delusion. Take the
example of a resident who says, ‘I have to get home. My child is two years old, and
she’s home alone.’ Staff members try to reassure that resident, but she remains
fixed on that idea that she has a child at home. According to the MDS, that is a
delusion and should be captured as such, but many facilities fail to do so.”
From a process standpoint, the message for the new QMs is that facilities need
to “understand the data underneath each measure,” she suggests. “Look at what
sits underneath the exclusions and any other risk adjustments, and understand
that the coding for those items is just as important as the coding that actually
makes the measure itself flag. And then if you do have residents, for example
on psychoactive medications, who flag, it will be worth your time to take that
medical record and determine, ‘Are we missing something that would in fact
exclude this resident from flagging in that measure?’” (Note: The QMs will be a
significant focus in upcoming RAC-CT recertification classes.)
Editor’s note: For coding/technical details from the conference, see the article,
“CMS National Conference Provides Updates, Clarifications” by AANAC Executive
Editor Rena Shephard. ●
Reimbursement Tip
Ancillary services (e.g. therapy,
labs) provided, to a Medicare
Part A beneficiary, on the day of
discharge are not separately billable
to Medicare Part B. These charges
should appear on the Part A claim.
Ron Orth
Treatment of
Members Policy
AANAC has posted the
Treatment of Members Policy
on the website. If you need to
access it, please click here.
FAQ referral
Do you have a question you need
answered NOW? Members of AANAC
can go directly to the experts! Go to
the FAQ section of the website. The
answer may be right in front of you!
13
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
AANAC
Board of Directors
Carol Siem msn, rn, bc, gnp
Chair
Ruth Minnema rn, ma, c-ne, rac-ct
Vice Chair
Carol Maher rn-bc, rac- ct
Secretary
Peter Arbuthnot aa, ba, rac- ct
Treasurer
Susan Duong, rn, bsn, nha, rac- ct, c-ne
Patrice E Macken, mba, rhia, lnha, rac- ct
Gail Harris, rn, bsn, rac- ct, c-ne
Joanne Powell nha, rhia
Diana Sturdevant ms, gcns-bc
AANAC
Expert Panel
All articles published in LTC Leader are
reviewed by a National Editorial Advisory
Board to ensure the accuracy of the
information we provide. AANAC is pleased
to introduce you to our panel of volunteer
reviewers who represent the best and
the brightest in our field:
Jennifer Pettis rn, wcc, rac-mt, c-ne
Chair, Harmony Healthcare International
Topsfield, MA
Betty Frandsen rn, nha, mha, c-ne
Nichols, NY
Robin L. Hillier cpa, stna, lnha, rac-mt
President, RLH Consulting
Becky LaBarge rn, rac-mt
Vice President, Clinical Reimbursement
The Tutera Group
other members of the facility staff serve on the committee. You will give added
value to your efforts by including representation from nurses’ aides, therapists,
staff nurses, social workers, and activities staff, as well as the administrator
and the medical director. Assess processes and outcomes, conduct root cause
analysis, assure compliance with standards of quality, and use an ongoing
interdisciplinary approach to improve delivery of care and resident outcomes.
Take copies of F520 to your next meeting to share at the beginning of your
discussion so that the committee members understand just how important their
roles are. Obtain F520 from the State Operations Manual Appendix PP by visiting
http://www.cms.gov/manuals/Downloads/som107ap_pp_guidelines_ltcf.pdf.
The regulation is located near the very end of the manual.
Betty Frandsen, rn, nha, mha, c-ne ([email protected])
What can we expect from a QIS survey med pass inspection?
Survey team nurses or pharmacists conduct this task using the Medication
Administration Observation/Drug Storage worksheet, Form CMS-20056.
One surveyor is assigned to organize and ensure completion of this task, and
also review drug-storage areas. A combined total of at least 50 medication
administrations to at least 10 randomly observed residents from different units
is included. Surveyors attempt to observe medications by multiple routes, and
ask about the routes of administration. Adjustments are made to observations
in order to include as many routes of administration as possible. Observations
may not all be done in one day. Multiple medication-administration times may
be observed for each resident. Refused medications are counted as observable
medications, and the surveyor watches to see how the nurse addresses this
issue. If any medications are not administered properly, the significance of each
error is determined by considering the following elements: resident’s condition,
medication category, and frequency of the error. The surveyors assigned the
Medication Administration Observation task confer and calculate the error rate
as follows:
•Combine all surveyor observations into one overall calculation for the facility
•Calculate the Medication Administration Error Rate (%)
using the following formula:
Medication Administration Error Rate (%) = Number of Errors observed
divided by Opportunities for Errors (doses given plus doses ordered but not
given) multiplied by 100.
Deb Myhre rn, c-ne, rac-mt
Nurse Consultant, Continuum Health
Care Services
Ron Orth rn, nha, rac-mt
Clinical Reimbursement
Solutions, LLC, Milwaukee, WI
Andrea Otis-Higgins
rn, mlnha , cdona , clnc, rac-mt
CEO, Administrator, St. Andre Healthcare
Biddeford, ME
Rena R. Shephard mha, rn, rac-mt, c-ne
AANAC Executive Editor
President, RRS Healthcare,
Consulting Services, San Diego, CA
Judy Wilhide Brandt rn, rac-mt, c-ne
Regional MDS/Medicare
Consultant President, Judy Wilhide
MDS Consulting, Inc.
14
After the overall error rate is determined, the team decides if a citation is
appropriate. If the error rate is 5% or greater, they cite F332, Free of Medication
Error Rates of 5% or Greater. If any medication error is considered significant,
they cite F333, Residents Are Free of Any Significant Medication Errors. You can
obtain Form CMS-20056 which is utilized by the surveyors for the medication
administration observation from https://www.qtso.com/qisforms.html under the
category Mandatory Facility Task Pathway Forms. You can use this form as part of
your QAA activities all year long.
Betty Frandsen, rn, nha, mha, c-ne ([email protected])
●
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
LOOK AT WHAT YOUR COLLEAGUES
HAVE BEEN UP TO!
C-NE Recipients
January 1 – March 15, 2012
Nancy Adams
Cristy Castleberry
Sharon Arnold
Esther Field
Jessica Boe
Elaine Brown
Edie Galeener
Lynn Hild
January 1 – March 15, 2012
Jennifer Abela
Evelyn Abreu
Rochelle Adams
Leonilla Addeh
Marie
Apostol-Andes
Joy Aquino
Robin Arnicar
Candice Arnold
Anuradha
Adhikari
Rhonda Arnold
Phebe-Ann Agarin
Lacy Axtell
Caroline Agbaje
Irma Bacchus
Benedicta Agbi
Kathleen Backer
Anne Ahern
Ramonietta Bagnol
Adam Airington
Denise Bailey
Nicole Alexander
Patricia Bailey
Cathy Allen
Amy Baker
Janene Allen
Deanna Baker
Julia Alvarez
Heather Baker
Rhea Amponin
Levon Baker
Adele Anderson
Rochelle Baker
Allison Anderson
Myrna Baleria
Elizabeth Anderson
Nancy
Banfield Johnson
Jane Anderson
Susan Anderson
Mark Andres
Tiffanie Andrews
Rhonda Antoine
Tanya Banks
Susan Bardo
Zilphia Barney
Marget Barringer
Gay Barth
Staccey Bascue
Pamela Baumann
Kimberley Beals
Kandice Beard
Stacey Beard
Neva Bennett
Kathleen Bentley
Maricel Bernadas
Mary Berry
LaWanda Bradley
Barbara Carstens
Tammy Bradley
Guenivere
Caslangen
Ava Braithwaite
Ruth Bratton
Nancy Briarton
Hope Bridges
Lydia Britschgi
Andrea Brown
Gary Brown
Jeana Brown
Deborah Brumble
Cathy Brunetti
Marina
Bukhrashvili
Marianne Bunge
Mary Berryman
Cherri Burchard
Janice Bey
Susan Burish
Leah Biby
Jodie Burroughs
Patience Bigbee
Pamlia Blackmer
Evangeline
Cabanban
Deborah Blake
Beth Cagle
Jill Blanchard
Evanthe Rockwood
Holly Styles
Thomas McVay
Laura Windle
Malissa Nelson
Linda Winston
Kathleen Rivers
John Brown
MDS 3.0 RAC-CT®
Recipients
Christopher
Johnson
Lacy Castleton
Maria
Rosario Casuat
Blake Cavanagh
Ursula Cedeno
Danita Chambers
Patricia Charlot
Ruth Chaza
Cheri Childress
Youngsuk Cho
Rashi Choudhary
Carmela Christie
Victoria Cisse
Jessica Claudio
Alecia Clayboin
Ann Cockerill
Jennifer Young
Jana
Creamer-Shatkosky
Angeline Cuevas
Erica Dodd
Gail Doetzl
Tiffany
Cunningham
Judith Dogbe
Diana Dai
Jonette Domingo
Riza Damania
Judith Donahue
Randy Danan
Barbara
Dornenburg
Amanda Danberry
Beminda
Datuin-Pal
Gloria Daughtry
Amy Earnest
Christina Davis
Joan Eastman
Stanley Davis
Melvina Echols
Heather Day
Shanna Eckberg
Dee Deckard
Lori Eckman
Patricia Decker
Rachael
Edmundson
Carol Ann Coker
Loreta Del Rosario
Patricia Call
Jacqueline Collins
Becky DeLaFuente
Craig Blevins
Jennifer Cambron
Linda Comfort
Amelia Deluna
Sarah Blevins
Lizbeth Caminita
Julie Cook
Charina DeMille
Janet Blough-Black
Carolyn
Campanella
Laura Cook
Gloria Dennis
Lilibeth Corpuz
Rose-Marie Desir
David Corriveau
Susan DiFate
Melinda Cotton
Linda Diforte
Heidi Courtright
Amanda Dillard
Rhonda Craig
Elizabeth Disch
Jessica Boe
Ousman Bojang
Christine Bowen
Frances Bradley
Karen Campbell
Julie Carlone
Diana Carlson
Jeffrey Carson
Patricia Duffy
Emma Duquette
Klarisse Chantlle
Del Rosario
Janet Campbell
Nancy Dixon
Gail Doan
Maria Teresa
Cuevas
Ann Cohen
Karen Boatright
Seema Diwan
Diane Ehmann
Leslie
Elliott-Manning
Houn Elllis
Heidi Engeman
Chonna
Jossette Enriquez
Dee Erickson
Jessica Esguerra
Lualhati Espina
Annette Fairrow
Douglas Farley
15
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
First Quarter 2012 RAC-CT Certifications, continued from page 15
Jessica Faulkner
Patrice Grindstaff
Kathy Inman
Beverlyn Larry
Tammy McAdam
Dawn Ocon
Iwona Regula
Leonila Fernandez
Kathi Grom
Cynthia Isenberg
Mary Larson
Glenda McAuliffe
William Odom
Kristi Reinberger
Genalyn Ferrer
Marie Gruber
Susan Iwaniuk
Patricia Larson
Susan McCauley
Davnet Okeke
Letisia Rendon
Linda Fischer
Cathy Grundy
Karen Jackson
Kathy Lashomb
Vicki McCullough
Miranda Oliphant
Susan Revella
Kay Flanagan
Susan Guzman
Tara James
Denise Latina
Jennifer McCullum
Nadine Olness
Marquita Reynolds
Kimberly Fleming
Geraldine Habal
Marie Jean-Louis
Maureen Lawlor
Kristi McDonald
Heather Orback
Carlos
Rhashaun Davis
Viven
Flores Monterde
Patricia Floyd
Barbara Folmar
Samantha
Fortenberry
Theresa Forthman
Elaine Fox
Holly Francis
Donna Frank
Tammy Franks
Jennifer Friddle
Rita Frieder
Dolores Fritz
Sharon Fuller
Fran Fullerton
Emmanuel Galega
Sara Gardner
Adoracion Garrote
Celeste Garza
Ethel Garzon
Diane Gayle
Rita Gelovani
Caryl Gere
Jenna Giandalia
Christine Gilliland
Irene Ginczek
Stephanie Giroir
Amber Glass
Suzanne Glisan
Laveta Glover
Elaine Gorman
Jana Graeber
Bernice Graham
Stephanie Haines
Brandie Jenkins
Lindsay Lay
Gail McGatlin
Kandra Ortez
Rachel Halili
Carolyn Jessee
Alicia LeGrand
Tabitha McGill
Elizabeth Oryall
Carrie Hall
Myrlande Jocelyn
Evelyne Lemy
Lisa McHale
Mary Ouellette
Robin Hall
Nancy Johnson
Joyce Lewandowski
Kimberly McIver
Yvonne Paguio
Sonya Hall
Tamekia Johnson
Kristi Lewis
Leona Palmieri
Deborah Hamernik
Tiffany Johnson
Rachel Lewis
Dawn
McNally-Harris
Shanna
Hammontree
Jesselyn
Johnson-James
Cherryl
Lewis-Berry
Ursula Hander
Carol Johnston
Jayne Lewis-Pitter
Jill Hannagan
Deanna Jones
Shannon Lien
Dhanjit Harakh
Rachel Jones
Tabitha Lindback
Theresa Harnage
Rashonna Jones
Malou Llenos
Michelle Harris
Stephanie Jones
Theodore Llenos
Marissa Harrison
Trennese Jones
Renee Loenen
Amy Harrold
Marie-Claire
Joseph
Vicki Lohrman
Kathy Hartline
Karyn Hartline
Kim Hartness
Robin Havens
Tish Hays
Trina Heady
Taffy Hembree
Robin Hendrix
Patty Herndon
Lisa Hettich
Maryann Hickey
Renee Higgins
Kitty Hofman
Janella Hogan
Jill Hogrefe
Faye Holbert
Christy Howe
Joy Hudson
Beth Gray
Katherine
Lynne Hurtt
Velda Green
Evelyne Huydic
Jeri Gregory
Onyeka Ibeh
Angela Griffin
Kathy Ingalls
Natalie Griffin
Angela Ingle
Dorene Judd
Shelly Justice
Kelley Kalenchuk
Deborah Kaplan
Felicia Kelley
Naomi Kelley
Traci Kellum
Angela Kemp
Amy Kerr
Crystal King
Katrina King
Lyudmila Kletsko
Elizabeth Lorenzo
KellyAnn Lunghi
Jocbee Lusan
Karen Lynch
Susan Maak
Emelinda Macleod
Daria Macy
Tracie Magee
Cheri Magelky
Joan Maire
JoAnn Malohn
Maria
Felma Manaig
Deborah
McSparrin
Jean Medina
Rebecca Medina
Douglas Merow
Deborah Merten
Cameron Meyer
Teresa Middleton
Carol Miller
Brenda
Miller-Huber
Patricia Milord
Marilyn Mines
Debra Minton
Marcella Minucci
Monica Miranda
Tereta Mitchell
Venus Molina
Amanda Monsivais
Robin
Moore-McElroy
Judy Richards
Angela Richmond
Jeanette Rios
Julie Ritchie
Elisa Rivera
Adolfo Peter Paras
Brenda Rivers
Karen Parker
Judy
Roberts-Velapoldi
Lynn Parker
Malissa Parks
Sarah Robinson
Eleanor Parnell
Idalina Rocha
Anita Patterson
Veronica Patterson
Barbara
Patterson-Paul
Cynthia Payne
Dean Pearce
Remedios Peloton
Rosalina Perez
Tanesha Perry
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Susan Lade
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16
A A N AC LT C L E A D E R 3 . 2 0 . 2 012
First
2012 RAC-CT
Certifications,
FinalQuarter
Rule Changes,
continued
from page 2 continued from page 16
Janet Sekelsky
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AANACad_030512 3/6/12 11:04 AM Pagechange
1
MDS Interview Forms
RESIDENT
INTERVIEWS
Assessment Reference
Date:
Directions: Conduct interview in private setting. Be sure the resident can hear you. A resident with
a hearing impairment should be interviewed with their usual communication device/technique.
____/____/_____
A1100.
Language
Identification Information
A. Does the resident need or want an interpreter to
communicate with a doctor or health care staff?
0.
No
1.
Yes
Specify in A1100B, Preferred Language
9.
Unable to determine
B.
Preferred language:
Hearing, Speech, and Vision
SECTION B
B0700.
Makes Self Understood
Enter Code
Ability to express ideas and wants, consider both verbal and non-verbal expression
0.
Understood
1.
Usually understood – difficulty communicating some words or finishing thoughts but is able if prompted or given time
2.
Sometimes understood – ability is limited to making concrete requests
3.
Rarely/never understood
SECTION C
C0100.
No (resident is rarely/never understood)
Yes
Continue to C0200, Repetition of Three Words
C0200.
(06/10)
Form # CP3001-C
2.
3.
Mood
Missed by 1 year
Correct
Should Resident Mood
Interview
be Conducted?
to conduct interview with all residents
month are we–inAttempt
right now?”
Ask
resident: “What
Enter Code
0.
1.
D0200.
(06/10)
(06/10)
Enter Code is rarely/never
B. Able to
report correctComplete
month Staff Assessment of Resident Mood (PHQ-9-OV)
No (resident
understood)
Missed
by >1
month
or no answer
Yes
Continue to0.
D0200,
Resident
Mood
Interview
(PHQ-9©)
1. Missed by 6 days to 1 month
2. Accurate within 5 days
Resident Mood Interview (PHQ-9©)
Ask resident: “What day of the week is today?”
Say to resident: “Over the
havetoyou
beencorrect
bothered
of the following problems?”
Enterlast
Code2 weeks,
C. Able
report
dayby
of any
the week
0. 1,Incorrect
no answer
If symptom is present, enter 1 (yes) in column
SymptomorPresence.
1. Correct
If yes in column 1, then ask the resident: “About how often have you been bothered by this?”
C0400.
Recall
Read and show the resident
a card with
the symptom frequency choices. Indicate response in column 2, Symptom Frequency.
Enter Code
that
Enter Score
slowly
lot more than
Reorder From:
speaking so
a
H. Moving orSCORE
moving around
SUMMARY
you have been
C0500.
usual
or of hurting
yourself in some
way
dead,
be better off
Add scores forthat
questions
and fill in total score (00 - 15)
you wouldC0200–C0400
Thoughts
I. 99
Enter
if the resident was unable to complete the interview
Total score must
be between 00
and 27.
SCORE
2, Symptom Frequency.3 or more items).
TOTAL SEVERITY
in Column
D0300.
for
Refer to RAI Version 3.0frequency
Manualresponses
pages C-1
through
C-15 for
coding
guidelines and time frame for interview completion.
is blank
Frequency
all
Interview Enter
Conducted
By to complete
99 if unable
$
Inc. All rights
reserved. Reproduced
Resident Name
SECTION F
Form # CP3001-D
Enter Code
C. Able
to Activities
recall
“bed”or sleeping too much
Code
C. Enter
Trouble
falling
or staying
asleep,
Preferences for Customary
Routine
and
0. No – could not recall
D.interview
Feelingwith
tiredfamily
or having
little energy
If resident is unable to complete, attempt to complete
significant
2. member
Yes, no or
cue
requiredother
0. No (resident is rarely/never understood andE.family/significant
other
not available)
Complete Staff Assessment
Poor appetite
or overeating
C0500.
SUMMARY
SCORE
Continue to F0400, Interview for Daily
Preferences
1. Yes
Enter
Score
Add scores for questions C0200–C0400 and fill in total score (00 - 15)
F. Feeling bad about yourself – or that you are a failure or have let yourself or your family down
Enter 99 if the resident was unable to complete the interview
Should Interview for Daily and Activity Preferences be Conducted?
– Attempt
to interview
allofresidents
able to communicate.
1. Yes,
after cueing
(“a piece
furniture”)
F0400.
Interview for Daily Preferences
LEARN THE STEPS TO SUCCESS!
interview (i.e.,
with permission.
pages D-1 through
800-438-8884
Add scores for
Enter Score
Copyright© Pfizer
SECTION F
F0300.
© 2010 MED-PASS, Inc.
Enter Code
Ask resident: “Let’s go back to an earlier question. What were those three words that I asked you to repeat?”
1. Symptom
Presence
2. Symptom Frequency
Directions: Conduct interview in private setting.
the resident
can
1. Be sure 2.
FOR toCUSTOMARY
If unable to rememberPREFERENCES
a word, give cue (something
wear; a color; a piece of furniture) for that word.
0. No (enter 0 in column 2)
0. Never or 1 Day
Symptom
Symptom
hear you. A resident with a hearing impairment
should be
interviewed Enter
with
A. Able to ROUTINE
recall “sock” AND ACTIVITIES FOR MDS 3.0
Code
1. 2 - 6 Days (several days)
1. Yes (enter0.
0 - 3No
in column
their usual communication device/technique.Presence Frequency
– could2)
not recall
2. 7 - 11 Days (half or more of the days)
9. No Response
column
2 blank)
1. (leave
Yes, after
cueing
(“something toAssessment
wear”) Reference Date:
3. 12 - 14 Days (nearly every day)
Enter Scores in Boxes
Does resident need or want an interpreter
to communicate with the doctor or health
careno
staff?
2. Yes,
cue required
_____/_____/_______
□ No □ Yes □ Unable to determine Preferred language: ________________________________________
A. Enter
Little
or pleasure
in“blue”
doing things
B. Able
to recall
Code interest
0. Noexpressions)?
– could not recall
Is the resident able to express ideas and wants (consider both verbal and non-verbal
1.depressed,
Yes, after
(“a color”) understood
Feeling down,
or cueing
hopeless
□ Understood
□ Usually understood
□B.Sometimes
understood
□ Rarely/Never
2. Yes, no cue required
800-438-8884
Form # CP3000
Reorder From:
D0100.
Interviews include:
Section C - BIMS
Section D - PHQ-9©
Section F - Daily/Activity Preferences
Section J - Pain
Ask resident: “Let’s go back to an earlier question. What were those three words that I asked you to repeat?”
things
If unable to remember
a word,
give
cue (something to wear; a color; a piece of furniture) for that word.
in doing
interest or pleasure
A. Little
A.
Able
to recall “sock”
or hopeless
0. No
down, depressed,
B. Feeling
1. Yes,
after cueing (“something totoo
wear”)
much
asleep, or sleeping
2. Yes, noorcue
required
staying
falling
C. Trouble
B.
Able to recall “blue”
energy
or having
tired
No
– could
notlittle
recall
Feeling
D. 0.
1. Yes, after cueing (“a color”)
down
overeating
2. Yes, noorcue
required
or your family
E. Poor appetite
have let yourself
are a failure or
C. Able to recall “bed”
– or that you
about yourself
watching television
Feeling
F. 0.
restless
Nobad
newspaper or
so fidgety or
as reading the
suchof
opposite – being
1. Yes, after cueing
(“a piece
furniture”)
on things,
noticed. Or the
concentrating
G. 2.Trouble
Yes, no cue requiredthat other people could have
(06/10)
A.and
Able
to report
correct
Enter Code ideas
Is the resident able to express
wants
(consider
bothyear
verbal and non-verbal expressions)?
0. Missed by > 5 years or no answer
□ Understood
Sometimes understood
□ Rarely/Never understood
1. Missed by 2 - 5 □
years
SECTION D
INNOVATION:
Boxes
Enter Code
INH 042010
C0300.
Temporal
Orientation with
(orientation
to year,
month,
and
day)
Does resident need or want
an interpreter
to communicate
the doctor
or health
care
staff?
□ No
□ Yes
□ Unable to determine
Preferred
_____________________________________________________________
Ask resident: “Please
telllanguage:
me what year
it is right now.”
t other
and family/significan
rarely/never understood
No (resident is
Preferences
Activity Preferences
Interview for Daily
Continue to F0400,
Yes
800-438-8884
1.
Form # CP3000
Enter Scores in
0.
Daily Preferences
in this facility…”
Interview for
“While you are
options and say:
the response
at all
Show resident
4. Not important can’t do or no choice
but
Coding:
5. Important, or non-responsive
1. Very important
important
9. No response
Enter
2. Somewhat
important
Codes in
3. Not very
clothes to wear?
Boxes
choose what
is it to you to
or things?
A. how important
personal belongings
take care of your
sponge bath?
is it to you to
bed bath, or
B. how important
a tub bath, shower,
choose between
is it to you to
meals?
C. how important
available between
have snacks
is it to you to
D. how important
own bedtime?
about your care?
choose your
is it to you to
involved in discussions
friend
E. how important
close
a
or
have your family
is it to you to
private?
F. how important
the phone in
be able to use
is it to you to
keep them safe?
G. how important
your things to
lock
to
have a place
is it to you to
H. how important
facility…”
Interview for
you are in this
F0500.
and say: “While
options
the response
at all
Show resident
4. Not important can’t do or no choice
but
Coding:
5. Important, or non-responsive
1. Very important
Enter
important
9. No response
2. Somewhat
Codes in
important
to read?
3. Not very
Boxes
and magazines
newspapers,
have books,
is it to you to
A. how important
you like?
listen to music
is it to you to
B. how important
such as pets?
be around animals
is it to you to
C. how important
the news?
keep up with
is it to you to
D. how important
groups of people?
do things with
is it to you to
E. how important
activities?
your favorite
good?
is it to you to do
the weather is
F. how important
fresh air when
outside to get
is it to you to go
or practices?
G. how important
religious services
participate in
is it to you to
important
of
4
how
H.
F0400.
problems?”
2 weeks,
Missed by 6 days
to 1 month
“Over the last1.
Presence.
Say to resident:
1, Symptom
bothered by this?”
2.
Accurate
within 5 days
2, Symptom Frequency.
1 (yes) in column how often have you been
response in column
present, enter
If symptom is
resident: “About
“What day
of the choices.
week isIndicate
today?”
Ask resident:
frequency
1, then ask the
with the symptom
If yes in column
Enter Code
C. a card
Able
to report correct day of the week2. Symptom Frequency
the resident
1 Day
Read and show
0. Never or
0. Presence
Incorrect or no answer
(several days)
1. Symptom
1. 2 - 6 Days (half or more of the days)
1.
Correct
0 in column 2)
2.
2. 7 - 11 Days (nearly every day)
0. No (enter
1.
2)
0 - 3 in column
Symptom
3. 12 - 14 Days
2 blank)
Recall
1. Yes (enter
Symptom C0400.
(leave column
Frequency
Presence
9. No Response
MOOD INTERVIEW FOR MDS 3.0
Symptom
Title
D-9 for coding
guidelines and
time frame for
interview completion.
ID #
Room #
Date
Physician
G. facility…”
Trouble concentrating on things, such as reading the newspaper or watching television
Show resident the response options and say: “While you are in this
Refer to RAI Version 3.0 Manual pages C-1 through D-9 for coding guidelines and time frame for interview completion.
H. Moving or speaking so slowly that other people could have noticed. Or the opposite – being so fidgety or restless
Enter
Coding:
Conducted
By
Title
that
you
have been
moving around5.a lot
more than
usual
Codes in
1. Very important
3. Interview
Not
very
important
Important,
but
can’t do or no choice
Boxes
2. Somewhat important
4. Not important at all
9. No response or non-responsive
I. Thoughts that you would be better off dead, or of hurting yourself in some way
A. how important is it to you to choose what clothes
to wear?
Resident
Name
ID #
Room #
Physician
INH 042010R
800-438-8884
resident: “What month are we in right now?”
Ask
If resident
Enter Code
No (resident3.
Correct Resident Mood Interview
Continue to D0200,
Yes
0.
1.
B. Interview
Able to (PHQ-9©)
report correct monthby any of the following
Resident Mood 0.
bothered
been
Missed
by >1
month
or no answer
have you
Preferenc
be
or significant
with family member
Daily and
for Daily and
complete interview
Assessment of
Complete Staff
Should Interview to complete, attempt to
not available) is unable
F0300.
(PHQ-9-OV)
Resident Mood
be2Conducted?
1.
Missed
- 5 years
Interviewby
Assessment of
Mood
Complete Staff
Should Resident 2.
Missedunderstood)
by 1 year
(PHQ-9©)
is rarely/never
Enter Code
Repetition of Three Words
SECTION D
SECTION F
Temporal Orientation (orientation to year, month, and day)
Ask resident: “Please tell me what year it is right now.”
A. Able to report correct year
with all residents
to conduct interview
Mood
Attempt
0.
Missed by > 5 years or –no
answer
Enter Code
D0200.
Ask resident: “I am going to say three words for you to remember. Please repeat the words after I have said all three.
The words are: sock, blue, and bed. Now tell me the three words.”
Number of words repeated after first attempt
Enter Code
0. None
1. One
2. Two
Directions: Conduct interview in private setting.
Be sure the resident can hear
3. Three
you. A resident with a hearing impairment should
be interviewed with their usual
Assessment Reference Date:
communication device/technique.
After the resident’s first attempt, repeat the words using cues (“sock, something to wear; blue, a color; bed, a piece of furniture”). You may
_____/_____/_______
repeat the words up to two more times.
Reorder From:
(06/10)
Form # CP3000
C0300.
Enter Code
No (resident is rarely/never understood)
Continue to C0200, Repetition of Three Words
Yes
Brief Interview for Mental Status (BIMS)
Repetition of Three Words
SECTION D
D0100.
0.
1.
Should Brief Interview for Mental Status (C0200-C0500) be Conducted? – Attempt to conduct interview with all residents
0.
1.
Cognitive Patterns
Should Brief Interview for Mental Status (C0200-C0500) be Conducted? – Attempt to conduct interview with all residents
Enter Code
Ask resident: “I am going to say three words for you to remember. Please repeat the words after I have said all three.
The words are: sock, blue, and bed. Now tell me the three words.”
RESIDENT
Assessment Reference
Number of words repeated after first attempt
Date:
INTERVIEWS
____/____/_____
0.
None
with
hear you. A resident
N TOOL
1.
One
the resident can device/technique.
COLLECTIO
setting. Be sure
communication
MDS 3.0 DATA
interview in private
2.
Two
with their usual
Directions: Conduct should be interviewed
3.
Three
a hearing impairment
Activities
to communicate.
After the resident’s first attempt, repeat the words using cues (“sock, something to wear; blue, a color; bed, a piece of furniture”). You may
y Routine and
all residents able
repeat the words up to two more times.
– Attempt to interview
es for Customar
other
Conducted?
Enter Code
_____/_____/_______
Is the resident able to express ideas and wants (consider both verbal and non-verbal expressions)?
□ Understood
□ Sometimes understood
Brief Interview for Mental Status (BIMS)
C0200.
Does resident need or want an interpreter to communicate with the doctor or health care staff?
□ No
□ Yes
□ Unable to determine
Preferred language: _____________________________________________________________
Reorder From:
C0100.
Enter Code
Improving care through knowledge
SECTION C
BIMS INTERVIEW FOR MDS 3.0
Directions: Conduct interview in private setting. Be sure the resident can
hear you. A resident with a hearing impairment should be interviewed with
their usual communication device/technique.
Cognitive Patterns
SECTION C
Date
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D.
Room #
ID #
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of 4
Physician
800-438-8884
F0500.
G.
□ Understood
how important is it to you to be able to use the phone in private?
H.
SECTION
how important is it to you to have a place
to lock yourJthings toHealth
keep themConditions
safe?
Interview for Activity Preferences
Reorder From:
C.
D.
F.
MDS 3.0 Observation Tool
_____/_____/_______
DAY 2
DAY 3
DAY 4
DAY 5
DAY 6
__________
__________
__________
__________
__________
DAY 7
C0700. Short-Term Memory OK
Seems/appears to recall after 5 minutes
0. Memory OK
1. Memory problem
C0800. Long-Term Memory OK
Seems or appears to recall
long past
1. Identify the dates in the 14-day observation period.
2. At the end of each shift, record appropriate response for
Symptom Presence using the codes provided.
3. Initial after each shift and enter verifying signature.
4. Summarize findings for MDS.
SYMPTOM PRESENCE
Check ()all that resident was able to recall.
DAY 4
DAY 5
DAY 6
DAY 7
DAY 8
DAY 9
DAY 10
DAY 11
DAY 12
DAY 13
DAY 14
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
__________
B. Feeling or appearing down,
depressed, or hopeless
Made decisions regarding tasks
of daily life
C. Trouble falling or staying asleep,
or sleeping too much
C1000. Cognitive Skills for
Daily Decision Making
D. Feeling tired or having little
energy
0. Independent – decisions
consistent /reasonable
1. Modified independence –
some difficulty in new situations only
2. Moderately impaired –
decisions poor; cues/supervision
required
3. Severely impaired –
never/rarely made decisions
Form # CP3003
800-438-8884
SIGNATURE
SIGNATURE
SIGNATURE
SIGNATURE
INH 060410
17
7
E. Poor appetite or overeating
F. Indicating that s/he feels bad
about self, is a failure, or has
let self or family down
concentrating on things,
G. Trouble
INITIALS SIGNATURE
such as reading the newspaper
or watching television
INITIALS
Reorder From:
INITIALS
INITIALS
INITIALS
INITIALS
Resident Name
INH 060410
Reorder From:
(06/10)
800-438-8884
D. That he/she is in nursing home
SIGNATURE
H. Moving or speaking so slowly that
INITIALS
SIGNATURE
other
people have
noticed, or the
opposite being so fidgety or restless
thatINITIALS
s/he has been
moving around
SIGNATURE
a lot more than usual
I. States that life isn’t worth living,
wishes for death, or attempts to
harm self
INITIALS
INITIALS
SIGNATURE
SIGNATURE
SIGNATURE
Room #
Physician
Improve resident outcomes. Start reducing ADL decline,
incontinence, hospitalizations, pain and restraint use in
your facility.
Physician
Title (00–10)
Date
Numeric Rating Scale
Ask resident: “Please rate your worst pain over the last 5 days on a zero to ten scale, with zero being no pain and ten as the worst
pain you can imagine.”
(Show resident
00–10 pain scale)
Room #
Physician
Enter two-digit response. Enter 99 if unable to answer.
Verbal Descriptor Scale
Ask resident: “Please rate the intensity of your worst pain over the last 5 days.” (Show resident verbal scale)
1. Mild
2. Moderate
3. Severe
4. Very severe, horrible
9. Unable to answer
Why look for certification?
Provide care you would want. Your residents will be
getting the kind of care that we will all want for ourselves,
and shows your commitment to positive outcomes.
Refer to RAI Version 3.0 Manual pages J-4 through J-14 for coding guidelines and time frame for interview completion.
Interview Conducted By
Resident Name
Title
ID #
Room #
Date
Physician
INITIALS
SIGNATURE
INITIALS
INITIALS
ID #
INH 042010R
DAY 3
__________
Z. NONE OF ABOVE are recalled
ID #
MDS 3.0 Observation Tool
_____/_____/_______
C0900. Memory/Recall
ABILITY
DAY 2
__________
INITIALS
A.
B.
Enter Code
0. No
1. Yes
DAY 1
D0500. Staff Assessment of
Resident Mood (PHQ-9-OV©)
A. Little interest or pleasure in
doing things
Why become certified?
Date
Room #
Pain Intensity – Administer ONLY ONE of the following pain intensity questions (A or B)
Enter Rating
Resident Name
SECTION D
MOOD
0. Memory OK
1. Memory problem
CHARTING CODES
MOOD
C. Staff names/faces
B. Location of own room
Interview Conducted By
Seems/appears to recall after 5 minutes
Directions:
SHIFT KEY
= ___________
= ___________
= ___________
A. Current season
A. Ask resident: “Over the past 5 days, has pain made it hard for you to sleep at night?”
Enter Code
F0600.
Daily and Activity Preferences Primary
Respondent
0. No
Enter Code
1. (F0400
Yes
Indicate primary respondent for Daily and Activity Preferences
and F0500).
9. Unable to answer
1. Resident
2. Family or significant other (close friend or other
representative)
B. Ask
resident: “Over the past 5 days, have you limited your day-to-day activities because of pain?”
Enter Code
9. Interview could not be completed
by resident or family/significant other (”No Response” to 3 or more items)
0. No
1. Yes
Refer to RAI Version 3.0 Manual pages F-1 through F-13 for coding guidelines
and
frame for interview completion.
9. Unable
totime
answer
Form # CP3002
(06/10)
Seems or appears to recall after
5 minutes
H.
how important is it to you to keep up with
the news?
J0400.
Pain Frequency
Ask resident: “How much of the time have you experienced pain or hurting over the last 5 days?”
Code
how important is it to you to do thingsEnter
with
groups
of people?
1. Almost constantly
2. Frequently
how important is it to you to do your favorite activities?
3. Occasionally
4.when
Rarely
how important is it to you to go outside to get fresh air
the weather is good?
9. Unable to answer
how important is it to you to participate
in religious
services
J0500.
Pain
Effect or
onpractices?
Function
J0600.
CHARTING CODES
__________
AANAC’s Resident Assessment Coordinator Certified
designation is the gold standard in LTC professional
development. No matter your position or goals, our
certification is guaranteed to give the advantage you need
for successful assessments and superior resident care.
Enter Code
800-438-8884
SECTION C
COGNITIVE PATTERNS
DAY 1
__________
INH 042010R
1. Identify the dates in the 7-day observation period.
2. At the end of each shift, record the resident’s status using
the charting codes provided for each section.
3. Initial after each shift and enter verifying signature.
Directions:
Pain Presence
Interview
Conducted
By
Title
how important is it to you
to have
books, newspapers,
and magazines to read?
Ask resident: “Have you had pain or hurting at any time in the last 5 days?”
how important is it to you to listen to music you like? 0. No
Continue to J0400, Pain Frequency
1. Yes
Resident Name
ID #
how important is it to you to be around animals such as
9. pets?
Unable to answer
G.
SHIFT KEY
□ Sometimes understood
Should Pain Assessment Interview be Conducted?
Enter Code
J0300.
A.
B.
E.
COGNITIVE PATTERNS
J0200.
0. No (resident is rarely/never understood)
Show resident the response options and say: “While you are in this facility…”
Continue to J0300, Pain Presence
1. Yes
Coding:
Enter
1. Very important
3. Not very important
5. Important, but can’t do or no choice
Codes in
Pain Assessment
Interview
2. Somewhat important
4. Not important
at all
9. No response or non-responsive
Boxes
of 4
= _____________
= _____________
= _____________
By
Resident Name
Does resident need or want an interpreter to communicate with the doctor or health care staff?
how important is it to you to choose your own bedtime?
Refer to RAI Version
pages
D-1 through
D-9 for coding
guidelines
and_____________________________________________________________
time frame for interview completion.
□ No 3.0
□ Manual
Yes
□ Unable
to determine
Preferred
language:
how important is it to you to have yourIsfamily
or a close
involved
in discussions
about your
care?
the resident
ablefriend
to express
ideas
and wants (consider
both
verbal and non-verbal expressions)?
INH 042010R
Interview Conducted
Physician
Room #
ID #
_____/_____/_______
how important is it to you to have snacks available between meals?
Reorder From:
Inc.
Date
Title
By
Resident Name
SECTION J
TOTAL SEVERITY SCORE
Copyright© Pfizer Inc. All rights reserved. Reproduced with permission.
E.
F.
Title
2
D0300.
how important is it to you to take care
of your personal
belongings
things?
Directions:
Conduct
interview inor
private
setting. Be sure the resident can hear
PAIN INTERVIEW FOR MDS 3.0
Enter Score
AddAscores
all afrequency
responses
in Column
2, Symptom
you.
residentfor
with
hearing impairment
should
be interviewed
with Frequency.
their usual Total score must be between 00 and 27.
how important is it to you to choose communication
between a tub device/technique.
bath, shower, bed bath, or sponge bath?
Enter 99 if unable to complete interview (i.e., Symptom Frequency is blank for 3 or more items).
(06/10)
Daily and Activity
Form # CP3001-F
F0600.
Form # CP3001-J
(06/10)
Respondent
Primary
and F0500).
Preferences
Preferences (F0400
Daily and Activity
respondent for
to 3 or more items)
Indicate primary
other representative) t other (”No Response”
Enter Code
(close friend or
1. Resident
significant other
resident or family/significan
completed by
2. Family or
could not be
interview completion.
9. Interview
time frame for
guidelines and
F-13 for coding
pages F-1 through
Version 3.0 Manual
Date
Refer to RAI
Inc.
© 2010 MED-PASS,
Interview Conducted
1
© 2010 MED-PASS,
Version 3.0 Manual
INH 042010
Refer to RAI
Williamson
RAC-CT® Certification
Stand-Alone Forms
4-Page
Data Collection
Form
MDS 3.0 DATA COLLECTION TOOL
SECTION A
Enter Code
Jamie Vistrand
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
J. Being short-tempered, easily
annoyed
INITIALS
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
INITIALS
SIGNATURE
Create your future.
Visit aanac.org and start your certification today.
800-438-8884
www.med-pass.com (keyword: MDS)
Resident Name
ID #
Room #
Physician
A
AA
AN
N AC
AC LT
LT C
C L
LE
EA
AD
DE
ER
R 38 .. 2
00
2 .. 22 012
011
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WE’RE WITH YOU EVERY
STEP OF THE WAY.
GROW
Find out more
at aanac.org
LEARN
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JOIN
At every step in your
long-term care journey, AANAC
has the resources you need to succeed.
AANAC | 400 S. Colorado Blvd., Suite 600 | Denver, Colorado 80246 | Phone 800.768.1880 | Fax 303.758.3588
| 400 S.No
Colorado
Blvd.,
Suite 600 |may
Denver,
Colorado 80246
| Phone
800.768.1880
| Faxfrom
303.758.3588
© AANAC
2012 AANAC.
part of this
publication
be reproduced
without
written
permission
AANAC.
18
13
The information
presented
is informative
does not constitute
direct permission
legal or regulatory
advice.
© 2011 AANAC.
No part of
this publication
may beand
reproduced
without written
from AANAC.
The information presented is informative and does not constitute direct legal or regulatory advice.

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