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OBRA Timing and Scheduling for MDFS 3 1What is the assessment reference date (ARD)? The beginning of the observation period for items on the MDS. The endpoint of the observation period for items on the MDS. Not related to the observation period for items on the MDS. The endpoint of a Medicare Part A stay, known as the last covered day. 2 What is the minimum number of assessments due in one year? One, as long as it is a comprehensive assessment. Two, a comprehensive and a Quarterly. Three, a comprehensive and two Quarterlies. Four, a comprehensive and three Quarterlies. 3 After completing the MDS, when must it be encoded? 7 days 14 days 21 days 31 days 4 The assessment reference date (ARD) for a Significant Change of Status Assessment (SCSA) is set for March 20.  What is the date range for the 7-day “look-back” observation window? March 14 through March 20 March 14 through March 21 March 20 through March 27 March 27 through April 5 When signing at V0200B1 and entering the date at V0200B2, the registered nurse assessment coordinator is indicating which one of the following items?  Verifying that the CAAs are complete. Attesting to the accuracy of the MDS. Certifying that the care planning is complete. Verifying that the MDS is complete. 6 The Activities Director completed the items assigned to her for a resident’s Admission assessment on February 25. She was off the next day when the assessment was printed and ready for signatures verifying accuracy at Z0400. When she returned to work on February 27, what was the appropriate course of action for her? Sign Z0400A and enter February 27 at Z0400B. Ask a staff member who was present the previous day to verify the accuracy of her work and sign and date Z0400 for her items. Sign Z0400A and enter February 25 at Z0400B. Review the work she did on February 25 and attest to the accuracy on February 27. 7 The Activities Director completed the items assigned to her for a resident’s Admission assessment on February 25. She was off the next day when the assessment was printed and ready for signatures verifying accuracy at Z0400. When she returned to work on February 27, what was the appropriate course of action for her? Sign Z0400A and enter February 27 at Z0400B. Ask a staff member who was present the previous day to verify the accuracy of her work and sign and date Z0400 for her items. Sign Z0400A and enter February 25 at Z0400B. Review the work she did on February 25 and attest to the accuracy on February 27. 8 The regulation indicates which of the following for when the look-back period extends into the preadmission period? Permits capturing the information for coding on the MDS as long as the preadmission period captured does not exceed 7 days. Permits capturing the information for coding on the MDS as long as the preadmission period captured does not exceed 14 days. Does not permit capturing the information for MDS coding. Does not permit capturing the information for MDS coding unless the RAI User’s Manual instructions state otherwise. 9 If you complete the MDS and CAAs for an Admission assessment on day 7 of the stay, by what day must the care plan be completed? Day 7 Day 12 Day 14 Day 21 10 According to the OBRA regulations, the Admission assessment must be completed (CAA completion, V0200B2) by the end of what day? Day 7 Day 12 Day 14 Day 21 11 Which of the following is true about scheduling an Annual assessment? There should be no more than 366 days from the assessment reference date of the previous comprehensive assessment to the assessment reference date of the Annual. There should be no more than 366 days from the completion date of the previous comprehensive assessment to the completion date of the Annual. The number of days since the ARD of the previous quarterly is irrelevant. If the resident meets criteria for a Significant Change in Status Assessment, it is acceptable to just complete the Annual instead since it is exactly the same assessment. 12 If the resident discharges return anticipated prior to completion of the initial Admission assessment, and the nurse assessment coordinator elected not to complete the Admission assessment that was in progress, what is the appropriate choice upon return? Schedule a Significant Change in Status Assessment, because this is required upon readmission following any hospitalization. Schedule a start of therapy OMRA. Schedule an Admission assessment that must be completed by day 7 of the current stay. Schedule an Admission assessment that must be completed by day 14 of the current stay. 13 Comprehensive assessment is distinguished from an assessment that is not comprehensive by what characteristics? A comprehensive assessment does not include section V. A comprehensive assessment requires care planning; all other assessment types do not. A comprehensive assessment always requires CAAs. A comprehensive assessment must be supported by chart documentation. 14 If the assessment reference date for an Admission assessment is September 12, when must the registered nurse assessment coordinator sign off that the assessment is complete at V0200B2? By September 12. No later than the 14th day after admission. No later than the 14th day after the assessment reference date (ARD). No later than the 21st day after Admission. 15 What do you do if a private pay resident is discharged within 14 days of admission, and you’ve completed only a portion of the Admission assessment? You must complete the assessment with the day of death or discharge as the ARD. Completion of the assessment is not required, but you must file the incomplete assessment in the discharge record. Completion of the OBRA discharge is not required. You complete the assessment, including CAAs, to the best of your ability. 16 Mr. J.’s Annual assessment is in progress. The assessment reference date (ARD) is October 10. Which option represents an acceptable sequence of events? Team members completed their sections, several attesting to their accuracy at Z0400 on October 11, others signed off on October 12. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 11 and V0200B2, (CAA completion), on October 14. Team members completed the behavior items in section E and signed them off, attesting to their accuracy at Z0400 on October 9. All other sections were signed off by October 12 at Z0400. The registered nurse assessment coordinator signed at Z0500B, verifying MDS completion on October 12 and at V0200B2, (CAA Completion), on October 13. Several team members completed their sections and signed them off, attesting to their accuracy on October 11. All other sections were signed off at Z0400 by October 12. The registered nurse assessment coordinator signed at V0200B2, (CAA completion), on October 12 and at Z0500B, (MDS completion), on October 13. Team members completed the sections with interview items signed on October 10. Other non-interview items were signed off on either October 11 or October 12. The registered nurse assessment coordinator signed at Z0500B, (MDS completion) on October 12 and V0200B2 (CAA completion) 17 June 5 was the assessment reference date (ARD) for Mrs. K’s Admission assessment. Her first Quarterly assessment had an ARD of September 3. In October, she had a significant change in status, and the significant change of status assessment (SCSA) had an ARD of October 15. When is the next Quarterly due at A2300 and her next Annual assessment due at A2300? Quarterly due no later than December 1, Annual due no later than June 5 Quarterly due no later than December 1, Annual due no later than October 15 Quarterly due no later than January 15, Annual due no later than June 5 Quarterly due no later than January 15, Annual due no later than October 15 18 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step? Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA). Document that the resident has had significant change in status requiring an SCSA. Complete a Significant Change in Status Assessment. Schedule an Annual Assessment.   19 The interdisciplinary team has identified a change in a resident’s status. After assessing the resident and ensuring that follow-up care is provided, what is the nurse assessment coordinator’s next step? Determine if this change meets criteria listed in Chapter 2 of the RAI Manual for a Significant Change in Status Assessment (SCSA). Document that the resident has had significant change in status requiring an SCSA. Complete a Significant Change in Status Assessment. Schedule an Annual Assessment. 20 When is a comprehensive assessment not required? The resident is admitted to the facility for the first time and remains beyond 14 days. The resident has a significant change in status by MDS definition. The resident returns after a five-week hospital admission. A resident’s significant weight loss is her only change in health status. 21 Today is October 21. Mr. E., a private pay resident, was admitted on October 10. The assessment reference date (ARD) for his Admission assessment is October 20. It is clear today that he has suffered a significant change in status related to extension of his stroke. The physician does not want to admit him to the hospital because the nursing facility can provide the necessary care and services. From an MDS standpoint, what is the correct course of action? Complete the Admission assessment as planned. Complete a Significant Change in Status Assessment, because it will replace the Admission assessment. Dually code the assessment as both the Admission and PPS 5 Day. Dually code the assessment as both the Admission and SCSA. 22 On December 1, a long-term care resident was again readmitted from a six-day hospital stay. She is not Medicare eligible. The nurse assessment coordinator (NAC) completed a Significant Change assessment with an assessment reference date (ARD) of December 9. On December 30, the resident was readmitted to the hospital again and the NAC completed an OBRA Discharge return anticipated assessment. The resident returned to the skilled nursing facility on January 5. In this situation, which of the following is the most likely assessment to be completed next? A significant change assessment A quarterly assessment A care area assessment A care plan 23 After completing the Quarterly MDS, when must it be transmitted to the national QIES ASAP system? Within 7 days Within 14 days Within 21 days Within 31 days   24 While reviewing a resident’s medical record, it is discovered that the resident’s race was incorrectly coded at A1000 on the most recent comprehensive assessment. What is the correct course of action? Complete an SCPA within 14 days of identifying the error Complete a modification utilizing the section X Correction Request Complete an SCSA within 14 days of identifying the error Complete an inactivation utilizing the section X Correction Reque 25 When a significant, uncorrected error has been identified, what qualifies the error as significant requiring a significant correction of a prior comprehensive or quarterly assessment? The resident had two uncorrected errors identified The resident’s birthdate was coded as January 1, 1936, but the correct birthdate is January 19, 1936 The clinical status was misrepresented and a subsequent assessment with the correct information was not submitted The resident was admitted to Hospice after the assessment’s ARD, but before the assessment was completed The RNAC must ensure the error is correct in the seven-day editing period prior to transmitting.  If this is done, no Significant Correction to prior comprehensive is required The RNAC must attest to completion, lock and transmit the assessment and follow up within 14 days with a Significant Change in status assessment 26 The interdisciplinary team is in the process of completing a Quarterly assessment for a resident.  The ARD was yesterday.  The dietitian reports to the MDS coordinator that she just realized the resident’s weight on the quarterly three months ago was incorrect. The weight that was coded and care planned was 102 lbs. and the actual weight was 120 lbs.  What is the correct course of action now? Modify the previous Quarterly to correct the weight and continue to complete the regularly scheduled Quarterly that is already in progress when the error was found Modify the previous Quarterly to correct the weight Modify the previous Quarterly to correct the weight and follow up with a significant correction to prior Quarterly within 14 days Modify the previous Quarterly to correct the weight.  Change the reason for assessment on the current Quarterly to a significant correction of prior Quarterly 27 A long term resident fell, fractured her femur, had a three-day stay in the hospital, and returned on a Medicare A stay.  In the initial evaluation of the resident after hospitalization, the interdisciplinary team noted that the fall with major injury was not coded on the OBRA Discharge assessment.  What is the correct course of action now? Modify the OBRA Discharge assessment to add the fall.  Follow the PPS schedule of assessments.  Code the first one as a combination Significant Correction of Prior Discharge/PPS 5-Day assessment Modify the OBRA Discharge assessment to add the fall.  Follow the PPS schedule of assessments, and continue the OBRA schedule where it left off, considering significant change in status, if appropriate Inactivate the OBRA Discharge assessment and perform a Significant Change in Status Assessment to capture the fall prior to admission.  Begin the PPS schedule of assessments Begin the PPS schedule of assessments.  Code the fall that happened prior to hospitalization in J1800 and J1900c on the current assessment 28 When the RNAC was reviewing an Annual assessment prior to attesting to completion in Z0500, he noticed that two pressure ulcers were not coded on the Annual assessment.  What is the correct action now? No action is required.  The RNAC’s signature verifies completion only.  The RNAC has no role in whether an accurate assessment is transmitted to the national repository.  The RNAC should sign and lock the assessment The RNAC must ensure the error is corrected in the seven-day editing period prior to transmitting the assessment and follow up with a Significant Correction to prior annual within 14 days The RNAC must ensure the error is correct in the seven-day editing period prior to transmitting.  If this is done, no Significant Correction to prior comprehensive is required The RNAC must attest to completion, lock and transmit the assessment and follow up within 14 days with a Significant Change in status assessment 29 For which situation is an OBRA Discharge assessment not required? Transfer to acute hospital for admission. Discharge to the assisted living facility on the same campus as the nursing home. Discharge to another long-term care facility. Leave of absence to emergency room less than 24 hours. 30 Which of the following usually describes when an OBRA Discharge assessment-return anticipated form is used? Is admitted to the hospital. Goes with family home on a leave of absence. Is discharged to Assisted Living. Is discharged home. 31 Which of the following describes when an OBRA Discharge assessment is required for a resident? The resident leaves the facility for a temporary home visit. The resident goes out for a temporary therapeutic leave. The resident goes to the hospital for an observational stay of less than 24 hours when the hospital does not admit the resident to an inpatient bed. The resident goes to the hospital for an observational stay of more than 24 hours when the hospital does not admit the resident to an inpatient bed. 32 When should a Death in Facility tracking record be completed for a resident in a skilled nursing facility? When the resident dies within two hours of being admitted to the hospital When the resident dies while in the ambulance on the way to the ER from the SNF When the resident dies 26 hours after being sent to the hospital for observation When the resident dies one hour after discharge from facility 33 Which of the following does not require a Death in Facility tracking record to be completed for a resident in a skilled nursing facility? When the resident discharges to home and dies the next day When the resident dies 23 hours after being sent to the hospital for observation When the resident dies after three hours in the emergency room 34 When the resident dies while on a Leave of Absence to home for a holiday of Which of the following is true regarding the Entry Tracking Record? The transmission date must no later than the entry date plus seven days The completion date must be no later than the entry date plus 14 calendar days The transmission date must be no later than the completion date plus 14 days The completion date must be no later than the entry date plus seven calendar days it 35 When must an OBRA Discharge assessment be completed? When the resident left the facility by ambulance and is admitted to acute care When the resident dies in the ER less than 24 hours from leaving the facility When the resident leaves the facility for an overnight temporary home visit When the resident dies during a leave of absence from the facility

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