MDS Alert

Published on Fri Mar 25, 2016 PDF

What happens when you’re combining more than two assessments?

Knowing when you can and cannot combine two assessments can be tricky. When should you combine assessments, and how should you set the Assessment Reference Date (ARD)?

If you have a Medicare unscheduled assessment that falls within a scheduled Medicare-required assessment window, you need to combine the two assessments with an ARD appropriate to the unscheduled assessment, according to the Centers for Medicare & Medicaid Services (CMS).

If you completed a scheduled assessment and an unscheduled assessment that falls in that window, the unscheduled assessment could supersede the scheduled one. This means that Medicare may modify your payment until you complete the next unscheduled or scheduled assessment used for payment.

The table below covers the most commonly occurring situations in which you may need to combine assessments. Note that the “Assessment Window” is the defined days when you may set the ARD, and this includes grace days as applicable. (Remember that unscheduled assessments do not have grace days and that the COT-OMRA is optional under certain circumstances.)

Acronyms:

SCSA — Significant Change in Status Assessment
SCPA — Significant Correction to Prior Comprehensive Assessment
OMRA — Other Medicare Required Assessment
SOT — Start of Therapy
EOT — End of Therapy
COT — Change of Therapy