MDS Alert

What Do You Think?

Question 1: I am still confused about when to do a Change in Therapy (COT). I was under the impression that I could do a COT to increase from a clinical to a rehab RUG, but I am now told that this is not true.

Answer 1: The Centers for Medicare & Medicaid Services (CMS) recently clarified the requirements for doing a COT OMRA, but they are confusing to many MDS Coordinators. Under the October 2013 clarification on 2-51 of the RAI manual, a COT cannot be completed for a resident that is not currently in a therapy RUG.

This will alter the completion of COTs as we used to do them. Therefore, communication between nursing and therapy is even more critical than ever.

Question 2: Does it matter if we do our OBRA admission assessment with the five-day or 14-day MDS for PPS?

Answer 2: You may complete the OBRA admission assessment in combination with any other assessment, as long as you totally complete it by the 14th day of admission. There is no penalty for doing the assessment on the five-day or 14-day MDS for PPS.

Q&A provided by Marilyn Mines, RN, BC, RAC-CT, of FR&R Healthcare Consulting in Deerfield, IL.