MDS Alert

Reader Questions:

Know Which Assessments Should Be Submitted in ‘Expected’ Order

Question: I accidentally submitted a resident’s discharge assessment but hadn’t yet submitted their admission assessment. Do I need to recall the discharge somehow?

Minnesota Subscriber

Answer: According to the RAI Manual, yes, CMS expects a resident’s assessments to be submitted in a particular order, but the system will probably notify you. The RAI Manual says, on pages 2-52 to -53:

“The MDS records for a nursing home resident are expected to occur in a specific order. For example, the first record for a resident is expected to be an Entry record with entry type (item A1700) indicating admission, and the next record is expected to be an Admission assessment, a 5-Day assessment, a Discharge assessment, or Death in Facility tracking record. The QIES ASAP system will issue a warning when an unexpected record is submitted. Examples include an assessment record after a discharge (an entry is expected) or any record after a Death in Facility tracking record.

“The target date, rather than the submission date, is used to determine the order of records. The target date is the Assessment Reference Date (item A2300) for assessment records, the Entry Date (item A1600) for entry records, and the Discharge Date (item A2000) for discharge or Death in facility records.”

Note: No indicates that the record sequence is not expected, record order warnings will be issued for these combinations. Yes indicates expected record sequences; no record order warning will be issued for these combinations, per CMS RAI Manual Version 3.0